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Home My WebLink AboutPR17-25785CITY OF DIAMOND BAR I I f r DEPARTMENT OF COMMUNITY &DEVELOPMENT SERVICES � 21810 Copley Drive, Diamond Ba~, CA 91765 PRESS (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 8394L� FIRMLY BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@diamondbarca:gov JOBSITEADDRESS '!CAC1�51 ,"e- APN LOT TRACT OWNER � irL? Lr ADDRESS CITY ZIP TEL. C u' APPLICANT � t U � xf r11 TEL. t d " ( ` p"� 7 `'1 CONTRACTOR i 6 TI -C ADDRESS 2k-3 �a OL"J r x (J CITY ZIP TLE.�`��cl'-�� ARCH/ENG/ DESIGNER ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the reason{s) indicated below by the checkmark(s), € have placed next to the applicable Items) [Section 7031.5, Business and Professions Code: Any city of county that requires a permit to construct, alter, improve, demolish, or repair, any structure, prior to Its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9) Commencing with Section 7000 of Division 3 of the Business and Professions Code] orthat he or she Is exempt from Ilcensurc and the hasis for the alleged exemption Any violation of Section 7031.5 by any applicantfor a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). (a 1, as owner of the property, or my employees with wages as their sole compensation, will do U all of or (-) portions of the work, and the structure is not Intended or offered for sale (Section 7044, Business and Professions Code: The Cantmaters' Stale License Law does not apply to an owner of property who, through employees' or personal effort, Indies or improves the property, provided that the improvements are not intended or offered for sale. If however, the bullding or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that It was not bullt or improved for the purpose of sale) U I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law.). U I am exempt from Ilcensure under the Contractor's State License law for the following reasons}: Date: Sign: By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion ofthe Improvements covered by this permit,) cannot legally sell a structure that I have built as an owner-bullder if it has not been constructed in Its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code is available upon request when this application Is submitted or of the following Web she: httplwww.logloto.ca.gDv/calaw.html, LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that i am Iloenscd under provisions of Chapter 0 (commencing with Section 7000) of Division 3 ofthe Business and Protesslons Code, and my license is in full force and effect. LICENSE CLASS: C 3�_ LIC. NO.: EXP, DATE: t- t V CONTRACTOR: WORKER'S COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: 4 have and will maintain a Certificate of Consent to Self -Insure for Worker's Compensation, as provided by Section 5700 of the Labor Code, for the performance of the work for which this permit is issued, I have and will maintain Worker's Compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My Worker's Compensation Insurance Carrier and Policy Number e: } CARRIERS POLICY NUMBER r, 3 l 5 ! (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS $100 OR FESS). I certify that In to performance of the work forwhich this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation Laws of Califamia. And agree that if I should become subject to the Worker's Compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. DATE: APPLICANT. WARNING: Failure to secure Worker's Compensation coverage is unEawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars {$100,000), in addition to the cost of the compensation, damages as provided for In section 3708 of the labor code, interest, and attorney's fees CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a Construction Lending Agency for the performance of Yoe work for which this permit Is issued (Sec. 3007, Civ. C.). LENDER'S NAME: LENDER'S ADDRESS: I certify, that I have read this application and state that the above mformaflon Is correct. I agree to comply with all city and county ordinances and state laws relating be bu' ding construction. and hereby authorize representatives of this county to enter upgn the above-mentioned pro ertyfor in pecllcn purposes. PER AMf ' �" SIGNA ' OF MITTEF CATElf z APPLICATION DATE: ( ISSUE DATE: TYPE CONST. PIC# PERMIT# : OCC GROUP: Scope of Work # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PST ADJ. ARLANALUATION SFR/ADD/REM Garage/Carport LU Patlo/Deck ut W_ Pool/Spa Re -Roof Commercial in in Valuatimn: Adj. Area: QUANTITY DESCRIPTION FEE J a U s r U W J z m rz a U qZ T U CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: 5 . SMTP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: P/G PAID BY:yg VALIDATION: RECEIPT# PAIDBY: Ft� VALIDATION: WHITE—Department Copy, YELLOW — Finance Copy, PINY—Assessor Copy SETBACK/ LETTER TRACT A711)CAIFOOTINGS FORMS SWITCH G COMMERCIAL HOOD SLAB _......_ .. ...... ......... UG. PLUMBING T-BAR UG. ELECTRICAL INTERCEPTER LIFER GROUND SEWER LATFRAI. MAIN WATFll LINE.HERS - - SLWLR Cl FANOUT ROUE SI{LA1111NG LI OOR til ILATIfINGROUGH - SHEAR WAILS EXTERIOR ,BEAR WALLS If 1TERIOR FRAMINGNENTING - HOT MOP/SHOWERPAN SEPTIC/CESSPOOL -... .. .................. _ .......... _ _......_ ..._ . ... _ .. REPORT RECEIVED _ DEMOLITION ROOF DRAINS CONDUIT - POOUSPA ROUGH PLUMBING . ROUGH ELECTRICAL ROUGH MECHANICAL ROUGH MECHANICAL ROUGH ELECTRICAL W( ) C ( ) GAS TEST _..._ ROUGH PLUMBING PRE GUNITE INSULATION WALL POOL PRE DECK BONDING INSULATION CEILING P-TRAP FENCE / GATE/ ALARM FINAL. POLI€. WALLS: WALL. FOOTING/5TE lel. WAI I. STLf 11'''x( ) 2"`(�) LIFT WALL BOND [it AM WALL DRAIN/ SLAL. DRYWALL LATH (PRE) LATH EXTERIOR LATH INTERIOR GAS TEST SCRATCH COAT Oq ELECTRIC METER RELEASE GAS METER RELEASE. WALL FINAL FRAMING PLANNING APPROVAI. - ROUGH FIRE APPROVAL..... FINAL FIRE DEPARTMENT SPECIAL INSPEC"i [ONRO. - -_ FINAL BUILDING FINAL. MECHANICAL FINAL ELECTRICAL FINAL PLU -8ING T.C. of OCCUPANCY C RTe of OCCUPANCY - -- FINAL PLANNING FINAL ENGINEERING/ PLII - - - - FINAL COMMUNITY SERVICES FINAL HEALTH DEPT. FIN3AL INDUSTRIAL WASTE COMMENTS: