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Home My WebLink AboutPR17-14949CITY OF DIAMOND BAR — DEPARTMENT OF COMNnINITY & DEVELOPMENT SERVICE 21810 Copley Drive, Diamond Bar, CA 91.763 PRESS / (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 FIRMLY BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@diamondbarca.gov ,JOB SITE ADDRLSS � / % �OAY.S/ APN LOT TRACT OWNER r— l V Z] ADD ESS � `1 WAi S f b� LA C -e CITY...I�if��^�� _ ZIP'?I'1(-5TEL. "r" APPLICANT TEL. CONTRACTOR �f�+ r.` vfit- z Rai ADDRESSor*��06C�- C ITY —rip— V I �J 6 ZIP 7.IEL.310 '7ig0 4-3`fp ARCH/ENG/ DESIGNER ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION hereby all 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] x that he or she Is exempt from licari and the basis for the alleged exemption. Any violaiien of Section 7031.5 by any appllcantfor a permit subjects the applicant to a civil panao of not more than live hundred dollars ($500), LJ 1, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not Intended or offered for sats (Section 7044, Business and Professions Code; The Contractors' State License Law does not apply to an owner of property who, through employees' or personal eflort, 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 I or improved for the purpose of sale.). (_) 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.). I am exef c/��undUthe Contractor's a is se 1a or the foil ngre on(s); Date: Sign:, By my signature below I acknowledge that, except fcV<y"par1 anal residence In which I m st have resided for at least one year prier to completion of the Improvements covered by this permlt,i cannot legally sell a structure that I have built as an owner-bullder if it has not bean constructed in Its entirety by licensed contracices. 1 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: httplwwwleg€nfo,ca,govlcaiavahtml, LICENSED CONTRACTOR'G 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 Coda,, and my license is in (full force and effect, LICENSECLASSJ9 F:� HID. NO / `� 1;) U EXP OATF; CONTRACTOR' (7 s4a".k WORKER'S COMPERSATIOK DECLARATION 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 fire worktor which this permit is issued. I have and will maintain Worker's Compensation Insurance, as required by Section 3700 ofttle Labor Code, for the performance ofthe work for which this permit is issued. My Worker's Compensation Insurance Carrier and RRNumber CAIa � � CARRER ^ R� POLICY NUMBER JHIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS $100 OR LESS). I certify that in the Performance Df the work for which this permit Is issued, I shall not employ any person IF any manner so as to become subject to the Workers Compensation Laws of California. And agree that if [ should become subject to the Worker's Compensation provisions of Section 3700 of the Labor Code, i shall fodhwith comply wifh those provisions. DATE: APPLICANT: WARNING Failure to secure Worker's Compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil tines up to one hundred thousand dollars ($tp0,000), in addition to the cost of the compensation, damages as provided for in section 3708 ofthe 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.I. LENDER'S NAME LENDER'S ADDRESS: I certify that I have read this appllcation and state that the ahovc information is correct. I agree to comply with all city and county ordinances and state laws relating to bullding construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for Inspection purposes. PER AME (PRIN d d i d r SIG D OF PERMITTEE DATE APPLICATION DATE: Fli -3 t e 7 PIC# ?yR `-Ie 1 ISSUE DATE: 491 QS 1\ PERI : k_1 " TYPE CONST. OCC GROUP: Scope of Work_4-?57—,44-L- # DWEL. UNITS # STORIES IO U FrZ # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport Patio eckL3Lc—,w LL Pool/spa ZRe -Roof d Commercial [0 Valuation - )C Area: Q USA DESCRIPTION FEE `NTITY CC r U Lv w m J rl U_ Z Q x v CONSTRUCTION:b� PLAN REVIEW: ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMTP: o c ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE ALT FEE: �1 BASF: L PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: P/C: PAID BY:B VALIDATION: RECEIPT q PAID BY: VALIDATION; WHITE Department Copy, YELLOW —Finance Copy, PINK— Assessor Copy CITE OF DIAMOND INSPECTION RECORD SETBACK/ LETTER TRACT AND Lk: [)GLH FOOTINGS FORMS SWITCH GEAR _............... SLAB I.ATII HKTFRi0R COMMERCIAL HOOD UG. PLUMBING WALLS: T -BAR UG. ELECTRICAL I ATI I INTERIOR INTERCEPTER UFER GROUND WAI I BOOTING/STEEL . HOT MOP/SHOWFHPAN SEWER LATERAL - SEPTIC/CESSPOOL MAIN WATER LINE HERS REPORT RECEIVED DEMOLITION ROOF DRAINS ROUGH CONDUIT PODUSPA SEWER CLEANOUT ROOF SHEATHING WALE. BOND BEAM FLOOR SHFATHING ELECTRIC METER RELEASE SHEAR WALLS EXTERIOR WALL DRAIN/ SEAL SHEAR WALLS INTERIOR ROUGH PLUMBING ROUGH ELECTRICAL FRAMING/VENTING -- ROUGH MECHANICAL ROUGH MECHANICAL HOUGH ELECTRICAL.. -W(--) C [ } GAS TEST RO FRAMING PLANNING APPROVAL ROUGH PLUMBING PRE GUNITE _.. INSULAT ION WALL._. INSUL&TION CHLING DRYWAI .I I ATHI'RI) POOL PRE DECK HONDING ....... ..... -- FINAL BUILDING . P -TRAP - BOUGIE MRL APPROVAL- FENCE / GATE/ ALARM FINAL POOL FINAL MECHANICAL { I.ATII HKTFRi0R WALLS: I ATI I INTERIOR WAI I BOOTING/STEEL . GAS Wk l WALL STEEL JS7( )2 ND( } LIFT SCRATCH COAT WALE. BOND BEAM ELECTRIC METER RELEASE WALL DRAIN/ SEAL GAS METER RELEASE -- WALL FINAL ....... _ SPECIAL INSPECTION RO FRAMING PLANNING APPROVAL _ ....... ..... -- FINAL BUILDING . - BOUGIE MRL APPROVAL- FINAL MECHANICAL FINAL FIRE DEPARTMENT FINAL ELECTRICAL ` FINALPLANNING FINAL PLUMBING FINAL ENGINEERING/ PW - T.C, of OCCUPANCY FINAL COMMUNITY SERVICES CERT, of OCCUPANCY FINAL HEALTH [DEPT, FINIAL INDUSTRIAL WASTE _ . COMMENTS: