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Home My WebLink AboutPR17-24055CITY OF DIAMOND BAR r i DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 PRESS (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 FIRMLY BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@diamondbarea.gov JOB SITE ADDRESS APN LOT TRAC OWNER.' a e :"�✓ra ADDRESS m APPLICANT TEL, CONTRACTORi ADDRES ? " -t CITY `'--' ZIP �� TEL.p 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, easiness 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 pursuant to the provisions of the Contractor's State License Law (Chapter 9) Commencing with Section 7000 of Division 3 ofthe Business and Professions Codej or that he Dr she is exempt from licensure and the basis for the alleged exemption, Any violation of Section 7031.5 by any applicantfor a permit subjects the applicantto a civil penalty of not more than five hundred dollars ($506), L11, as owner of the prop", or my employees with wages as their sale compensation, will do O all of or O portions 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 not Intended or offered for sale. If however, the building or Improvement Is sold within one year of completion, the Owner-Bullder will have the burden of proving that It was not built or improved for the purpose of sale.). Q 1, 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 Ccntractors' State License Law.). O I am exempt from licensure under the Contractor's State License law for the following reasan(s): Date; Sign: By my signature below I acknowledge that, except for my personal residence [n which I must have resided for at least ane year prior to completion of the improvements covered by this permit,l cannot legally sell a structure that I have built as an owner -builder 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 following Web site; htlp/wwwfeglnfo,ca.gov/calaw,html, LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under prevlslons 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. LICENSE CLASS: LIC. NO.:� �^ EXP. DATE - CONTRACTOR WORKER'S COMPENSATIGN DECLARATiOM1f i HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS; 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 workfor which this permit is issued. 1 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 are: CARRIER a "�- POLICY NUMBER , (f HIS SECTION NEED NOT RE COMPLETED IF7RFPFRMIT IS FDR ONF HUNDRED DOLLARS $100 OR LESS). I certify that in the performance of the work for which this permlt Is Issued, I shall not employ any person in any manner so- Este become subject to the Worker's Compensation Laws of California. And agree nat If ouldkece[iSe3ubJect to Worker`s Compensation provisions of Sectlon 3700 of the Labor Coda,1 shall forthwith c wi hesa vief DATE: °' '" APPLICANT, WARNING: Failure to 'Acura Worker's Compensation coverage isdhlaMul and employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,000), in addition to the cost of the compensatlon, 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, Civ. C.). LENDER'S NAME. LENDEH'S ADDRESS: I certify that I have read this apphcatlon and state that the above Information Is correct I agree to comply with all city and county ordinances and state laws relating to building Construction, and hereby authorize representatives of this county to enter upon the above-montloned properly for inspe ion purposes. PERMITTEE NAME (PRINfi SIGNATURE O�F PEflMIi EE -- ,:..,5"" ,,. , r .. DATE APPLICATION DATE: 111(4, 1 \-.I" P/C# ISSUE DATE: �E PERMIT#: S TYPE CONST. OCC GROUP: Scope of Work # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. ARLAIVALUATION SFFVADD/REM Garage/Carporl rn Lu Pedlo/Deck Lu w- Pool/Spa ZRe -Roof Commercial 03 m Valuation: Adj. Area: QUANTITY DESCRIPTION FEE a U cc r U W w m z m rL 4 v z �i- U CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: I MECHANICAL: INSPECTION FEE: ISSUANCE: SMTP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: PlC: PAID FLY: RECEIPT# PAID BY: VALIDATION: VALIDATIOM. WHITE— Department Copy, YELLOW —Finance Copy, PINK— Assessor Copy SEIBACKILEI LER FOOTINGS FORMS SLAB UG. PLUMBING UG.ELECTAIGAL UFER GROUND SEWER LATERAL ..................... MAIN WATER LINE SKIVER CLEANOUT ROOF SHEATHING FLOOR SHEATHING SHEAR WALLS EXTERIOR SHEAR WALLS INTERICR FRAMINGNENTING ROUGH MECHANICAL ROUGH ELECTRICAL W( ) G ( ) ROUGH PLUMBING INSULATION WALL INSULATION CEILING DRYWALL LATH (PREF IAIH rIXJRIOR ARI IN I F.RIOR GA91TS I SCHAI (.II GOA T LLK,TI;IC METER RELEASE GAS MI I Lit RELEASE SPECIAL. INSPECTION FINAL BUILDING FINAL MECHANICAL FINAL ELECTRICAL FINAL PLUMBING //171 T.C. of OCCUPANCY CERT. of OCCUPANCY COMMENTS - CITY OF DIAMOND BAR INSPECTION C TRACT AND LEDGLR SWITCH GEAR COMMERCIAL HOOD T -BAR INTERCEPTER HOT MOPISHOVVF[I['AN SEPTIC/CESSPOOL uE S REPORT RLCCIVED OFMW [TION ROW DRAINS ROUGH CONDUIT POOL/SPA ROUGH PLUMBING ROUGH ELECTRICAL ROUGH MEGHANIGAL GASTEST EST PRE GUNITE POOL PRE DECK BONDING P -TRAP FENCE I GATE/ ALARM ..... _.... .. FINAL POOL WALL& WALL FOOTING/STEEL WALL STEEL 1s{ ) 2N°( ) LIFT WALL BOND BEAM WALL DRAIN/ SEAL WALL FINAL RG, FRAMING PLANNING APPIIOVAL ROUGH EIRE APPROVAL FINAL FIRE DEPARTMENT FINAL PLANNING FINAL ENGINEERING/ PW FINAL COMMUNITY SERVICES FINAL. HEALTH DEPT. ffNAL INDI'STRIAL WASTE