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Home My WebLink AboutPR17-20299DIA 10ND'BAR: CITY OF DIAMOND BAR DEPART-mfNT OF CONL IUNITY & DE'VELOPNIENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 BUILDING PERMIT APPLICATION wwiv.cityofdiamondb ar. com building@diamondbarea.gov JOB SITE ADDRESS f lJ 15- e - : A V"1 bP W"N APN LOT TRACT OWNER ADDRESS CITY Ae- ZIP .-TEL. N11510 APPLICANT CONTRACTOR ADDRESS 7pfAl CITY Comom ZIP EQTEL. ARCH/ENG/ f� c DESIGNER ADDRESS 'D a"%r V36 �� yy cam�', ��.a CITY �s> :l gin ZIP Ar'2!Z ' TFL. 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 he€ow 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 far the permitto fife 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 exempt from Ilcensure 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 Itundred dollars ($5CO). U I, as owner of the property, or my employees with wages as their sole compensation, wh do U all of or U 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 empPoyees' 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 at completion, the Owner -Bulkier will have the burden of proving that it was not built 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 bulfds or Improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contraotors' State License Law.), U I am exempt from licensure under the Contractor's State License law for the following reason(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 prlorto cempletlotn of the improvements covered by this permif,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 Code is available upon request when this application is submitted or at the following Web site, httpAwww.leginfo.ca.govlcalaw.htm€. 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 IF nse is in full force and effect � r LICENSE CLASS: LIC. NO EXP. DATE:iIoNrRACTaR: WORKER'S COMPENSAIMON DECLARATION II HERE Y UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: I have and wIll malntaln 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. I have and wllI maintain Worker's Compensation Insurance, as required by Section 3700 ofthe Labor Code, for the performance cfthe work for which this permit Is issued. My Worker's Compensation Insurance Carrier and Policy Number are:j� �;� I ...-", CARRIER � d05040 yoviravvjz POLICY NUMBER tl, r.. gHIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 5100 OR LESS). I certify that 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 Workers Compensation Laws of California, And agree that If I should become subject to the Worker's Compensation provisions of Section 3700 of the Later Code, I shall forthwith comply with those provisions DATE: APPLICANT: WARNING: Failure to secure Worker's Compensation coverage is unlawful, and shall subject an empiayer 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 the work for which this permit is issued (Sec. 3097, Clv, C.). LENDER'S NAME: LENDER'S ADDRESS: I certify that I have read this application and stale that the above information Is correct. I agree to comply with all city and county ordlnances and state laws relating to building construction, and hereby authorize representatives of this county to enterupo the above-mentioned roperty for inspection purposes PERMITTEE E INT) 11ofio/_ ; .- SIGNAT E OF PER EE OATE PRESS FIRMLY APPLICATION DATE: ISSUE DATE: TYPE CONST. PIC# PERMIT# : OCC GROUP: Scope of Work C # DWEL. UNITS V V -=✓`?v -'d # STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADDi Garago/Carport Lj Patlo/Deck uj L- Pool/Spa ZRe -Roof OJ Commercial n a0 Valuation: QUANTITY !j Adj. Area: t _ DESCRIPTION FEE J U it r U w w ca z m a z a x U CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMTP: �3 ENERGY P/C: ENERGY PERMIT: RETENI FEE: PRE -ALT FEE: BASF:° PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: a� P/C: RECEIPT #PAIDB r??! PAID BY: VALIDATION: VALIDATIO WHITE— Department Copy, YELLOW — Finance Copy, PINK—Assessor Copy SETBACK/ LLITLR FOOTINGS FORMS .. . .---..___._.. SLAB UG. PLUMBING UG. FLECTRICAL - UFFR GROUND SFWFLI LATERAL MAIN WATER LINE SI-WER CLEANOUT ROOF SHEATHING FLOOR SHEATHING SHEAR WALLS EXTERIOR SHEAR WALLS INTERIOR FRAMING/VENTING ROUGH MECHANICAL ROUGH ELECTRICAL W( } C ( ) ROUGH PLUMBING ASULATION WALL INSULATION CEILING DRYWALL LATH (PRE) LATH EXTERIOR LATH INTERI0f,l - GAS TEST ._W �SCRATCW COAL ELECTRIC 11 MLILf1 RLLLAK GAS ME] I.R RPLEASE_ SPECIAI. INSPL(, I ION FINAL BUILDING FINAL MECHANICAL FINAL ELECTRICAL - f , - TRACT AND LEDGER SWITCH GEAR COMMERCIAL 11009 - T -BAR IN I FRCL.P LER - _ H01 MOWSHOWF.IWAN SFPTIC/CFSSPOOI_ HEMS REPORT RLL/ IVCD DEMOLITION RO(fl CIRAINS ROUGH CONDUIT POOL/SPA ROUGH PLUMBING BOUGH 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 ST( ) 2N°( ) LIFT WALL BOND BEAM WALL DRAIN/ SEAL WALL FINAL RO, FFIAWNG PLANNING APPROVAL ROUGH FIRE APPROVAL _..... .. FIRE DEPARTMENT FINAL PLANNING ...............__ ._ . ........ --- - FINAL PLUMBING FINAL ENGIEERIGI PW T.C. of OCCUPANCY FINAL COMMUMTY SERVICES CERTp of OCCUPANCY FINAL HEALTH DEPT.