The URL can be used to link to this page

Home My WebLink AboutPR17-14217. ;;'T' CITY OF DIAMOND BAR, I DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES ' 21810 Copley Drive, Diamond Bar, CA 91765 �� PRESS ye (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 FIRMLY BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@diamondbarea.gov A JOB SITE ADDRESS ta, 4 e APN LOT TRACT OWNER Et � ADDRESS i ,' r SFJ . CITY af FCr ZIP TEL. 62,L, < APPLICANT TEL. CONTRACTOR ADDRE S 6citO 41 z- - CITY Qi?M f , ® ZIP TEL- 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 reasons) indicated below by the checkmark(s), I have placed next to the applicable Item(s) [Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair, any structure, prior to Its Issuance, also requires the applicant for the permitto 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 Corte] or that he or she is exempt from licensure and the basis for the alleged exemption Any violation of Section 7031.5 by any applicant fora permit subjects the applicant to a civil penalty. of not more than five hundred dollars ($500). {_) I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Cade: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that It was not built or improved for the purpose of sale.). L) I, as owner of the property, am excluslvaly contracting with licensed Contractors to constructthe project (Section 7044, Business and Professlons Cade: 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 pursuantto the Contractors' State License Law,), Ll I am exempt tram Ilcensure under the Contractor's State License law for the following reeson(s): Date: Sign: By my signature below I acknowledge that, except for my personai residence in which I must hays resided for at least one year priorto completion of the improvements covered by this petmit,l cannot legally sell a structure that I have built as an owner -builder if it has not been constructed In Its entirety by Ilcensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professlons Code Is available upon request when this application is submitted or at the following Weh site. httplwwwieglnfo,ca,govlcaiaw.html. LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is In full force and effect. Ems. t LICENSE CLASS: LIC. NO.: ExP.DATE CONTR4crOR: WORKER'S COMPENSATION DECLARATION tFe I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: Jl I have and will maintain a Certificate of Consent to Self -Insure for Worker's Compensation, as provided by Section 3700 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 wodcfor which this permit is Issued My Worker's Compensation Insurance Carrier and Policy Number are: CARRIER ��'� e POLICY NUMBER (THIS SECTION NEED NOT BE COMPLETED IF THE PERMFF IS FOR ONE HUNDRED DOLLARS $100 OR LESS). I certify that In the performance of the work for which this permit is issued, l shall not employ any person In any manner so as to become subject to the Worker's Compensation Laws of California. And agree that If E should became subject to the Worker's Comp oyrovelD of Sectlon 3700 of the Lab o ode, I shall forthwith comply with those provisions. DATE:` APPLICANT: WARNING: Failure to secure Worker's CDmpensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,CW), 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 the work for which this permit Is issued (Sec. 3097, Clv, C.). LEN DER'S NAME: LENDER'S ADDRESS: I certify that I have read this application and staff that the above information is correct. I agree to comply withall city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon tXbIcned prerty for inspectionpurposes. ._ /ff PERMITTEE NRIN7) v E SIGNATURE OF PERMITTEE DATE 17— APPLICATION DATE:G�-p ISSUE DATE: I 't PERMIT# : TYPE CONST- R 1 11 - P/c,*P-2 PRI 1911 911 OCC GROUP: Scope Cf Work 16' Ip=`- $ # DWEL. UNITS # STORIES � 1 7< mos'y t # BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ. AREA/VALUATION BFR/AIDWREM Garago/Carport LOU Patio/peck w LL PocV5pa ZRe -Roof Commercial m Valuation: Adj. Area: QUANTITY DESCRIPTION FEE V F U w co z m J J Q U_ U CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE:- 7 SMIP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: 43i BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: ` P/C: PAID SY: $ VALIDATION'. RECEIPT A PAID BY: a �i VALIDATION: LC WHITE— Department Copy, YELLOW — Flnanoe Copy, PINK — Assessor Copy SET3ACKI LE I I'ER FOO IINGS FORMS SLAB UG, PLUMBING UG. ELECTRICAL UFFR GROUND SEWER LATERAL MAIN WATER LINE SEWER CLEANOUT ROOF SHEATHING FLOOR SHEATHING SHEAR WALLS EXTERIOR SHEAR WALLS INTERIOR FRAMING/VENTING ROUGH MECHANICAL ROUGH ELECTRICAL W( } C ( ) ROUGH PLUMBING INSULATION WALL INSULATION CEILING DRYWALL LATH (PRE) LATH EXTERIOR LATH INTFRIOH GAS TEST SCRAI (AI COA'I ELE. L FRIG N[L I E_R RELHASE GAS ME:ILR KI -EASE SPECIAL INSPE G IION FINAL BUILDING FINAL MECHANICAL FINAL ELECTRICAL FINAL PLUMBING T.C. of OCCUPANCY CERT. of OCCUPANCY TRACT ANLL 1.1.1)(141 SWITCI I GFAH COMMIIHC IAL HOOD T -BAH IN'I E #iCE:P l H3 - - HUT MOP/SHOWFRPAN SFPTIC/C F,9SPO01 Hr..RS REPORT RECEIVED DEMOLITION ROOF DRAINS ROUGH CONDUIT POOL/SPA ROUGH PLUMBING ... ROUGH - --- ROUGH ELECTRICAL ROUGH MECHANICAL GAS TEST - _. PRE GUNITE POOL PRE DECK BONDING P -TRAP FENCE / GATE/ ALARM FINAL POOL WALLS: WALL FOOTING/STEEL - WALL STEEL 1"( ) 2v°( } LIFT WALL BOND BEAM WALL DRAIN/ SEAL WALL FINAL -- RO. FRAMING PLANNING APPROVAL ROUGH FERE APPROVAL FINAL FIRE DEPARTMENT � FINAL PLAiVNIG