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Home My WebLink AboutPR17-23090CD DIANOND`BAR CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 PRESS (909) 839-7020 Fax: (909) S61-3117 Building Inspection Hotline (909) 839-7027 FIRMLY BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@diamondbarea.gov JOB SITE ADDRESS 4 d P :T L— C uu r APN LOT TRACT OWNER=Il Y W ADDRESS ca CITY I w. ZII�TEL. LZOI-2J 1'17.. APPLICANT SFi4i+l1J VSE 6A TEL.32i •5$`�'O 2�l CONTRACTOR E E SaIL-iAll ADDRESS 173 O 1 E 111 & r 0!4Ilii 001'4— CITY 511IIIIN TA 01' — CITYSANTA AN k-ZIP9t. (STEL.'IV-1 SC c7'Z5ZZ ARCH/ENG/ DESIGNER Al 2—O CITY v n a IP !"TEL. Q QI'° 7 - 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), i have placed next to the applicable items) [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 permit to file a signed statement that he or she is licensed pursuantto the provisions of the Contractor's State License Law (Chapter 9) Commencing with Section 7000 of Division 3 of the Business and Professions Code] or that he or she Is exemptfrom licensure and the basis for the all exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars ($500). (.) I, as owner of the property, or my employees with wages as theTsole compensation, will do U all of or (_) portlens of the work, and the structure Is not Intended or offered for sale (Section 7044, Business and Professions Code, 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 act intended or offered for sale. If however, the building or improvement is sold within one year of completion, the Owner-Bulider will have the burden of proving that it was not built or improved forthe 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 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 pursuant to the Contractors' Staie License Law), U I am exemptfrom licensure under the Contractor's State License law for the following reasen(s): 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 of the Improvements covered by this permit,l 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 Cade is available upon request when this application is submitted or at the fallowing Web site: hlp/wvvw.leglnfo,ca.gov/calow,html, LICENSED CONTRACTOR'S DECLARATION I hereby ai under penalty of perjury that I am licensed under provlslons of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions CCo�de, and my license Is in full force and effect LICENSE CLASS: LIC. NO.: 1 '; 9 I 1; 2— EXP. DATErI O 5 I` 'CONTRACTOR' WORKER'S COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: I have and will maintain a Gertificale of Consent to Self -Insure for Worker's Compensation, as provided by Section 3700 of the Labor Code, for the performance of the workfor which this permit Is Issued. i have and will maintain Worker's Compensation Insurance, as required by Section 5700 of the Labor Code, for the performance of the work for which this permit is issued. My Worker's Compensation Insurance Carrier and Policy Nu r are, r CARRIERA-I OortNf l 1 h C 7 I— V KA POLICY NUMRFR Gi (N -IIS SECTION NEED NOT BE CCMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS $100 OR LESS). I cernthat In the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation Laws of C I fomla� And agree that if I should become subject to the Worker's Compensation provisions of Section 3700 of the Labor C , I shall forthwith comply w' provisions. DATE APPLICANT: WARNING: Failure to secure Worker's Compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($I V0,000), in addition to the cast of the compensation, damages as provided for in section 3708 of the Tabor 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, Civ. C.). LENDER'S I LENDER'S ADDRESS: I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating t9 building construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes. S PAW rJ V F_ PERMITTEE NA {PRINT( I r r P 1 SIGNATURE OF PERIM TTIE DATE 1 APPLICATION DATE: 9 f ® P/C# ISSUE DATE: r `l y PERMIT#: E ' TYPE CONST. SO fi !r OCC GROUP: Scope of Work TZ rY10Vlrt D� SQr{ F # DWEL- UNITS # STORIES # BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport LQ Lu Patio/Deck Lu LL Pool/spa ZRe -Roof 01 JJ Commercial 5 D7 Valuation: Adj. Area: QUANTITY. FEE &¢ ry eDESCRIPTION V [7 z m CL CL J Q z a 2 U CONSTRUCTION: 1 PLAN REVIEW: ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: 71 S . —I _ SMTP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: r BASF:.- • . PLOT PLAN: ZONING CLEARANCE: TOTAL FEES50 v °. COMMENTS: PIC: PAID BY: VALIDATION: RECEIPT # ;7 0 S PAID 13Y: Q 0 VALIDATION: WHITE — Department Copy, YELLOW —Finance Copy, PINK --- Assessor Copy SETOACK/ LE: I I ER FOOTINGS FORMS SLAB UG. PLUMBING U.P. ELECTRICAL. UFFR GROUND SFWf-R 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 WAL..L. INSULATION CEILING DRYWALL LATH (PRE) LATH FXTFRIOR LATH IV PRIOR CAS TEST SCRATCIi COAI ELECTRIC: MLI FR RELEASE GAS MEI Ell RELEASE SPECIAL INSPECTION ....................... FINAL BUILDING FINAL MECHANICAL FINAL ELECTRICAL .................. FINAL PLUMBING T,C, of OCCUPANCY CERT. of OCCUPANCY I RAC I AND I_[ DGFH SWI II;t1 GLAII COMMERCIAL. HOOD I- 4AI I INiFRCEPIER HOT MOI-YSHOWFIWAN SEP t IG/C",ESSPOOL ................ HERS REPORT RECEIVED DEMOLITION ............ ROOF DRAINS ROUGH CONDUIT POOUSPA ROUGH PLUMBING ROUGH ELECTRICAL ROUGH MECHANICAL. GAS TEST - PRE GUNITE` POOL PRE DECK BONDING P -TRAP FENCE 1 GATE/ ALARM FINAL POOL WALLS: WALL. FOOTING/STEEL—_-- — -- WALL STEEL 1 6T( ) 2'"a( ) LIFT WALL BOND BEAM WALL DRAIN/ SEAL WALL FINAL, R0. FRAMING PLANNING APPROVAL_