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Home My WebLink AboutPR17-19276CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 PRESS y9, (909) 839-7024 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 FIRMLY BUILDING PERMIT APPLICATION fwww.cityofdiamondbar.com building@diamondbarea.gov JOB SITE ADDRESS Ai LOT TRACT OWNER � II ADDRESS < 1 -'T i e P,*f) t a " bi% 6 " k CITY`�'-Llba ? r t ZIP C TEL, fC-� f•�3d APPLICANT V l f TEL. -7/ - ,Ub f g f CONTRACTOR ADDRESS 9,-;� I CITYA/ii% h f I K -)F 1 ZIP TEL. Ci l � AFICH/ENC/ j;� DESIGNER I ADDRESS CITY ZIP TEL. OWNER-Bl11LDEfi 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 checkerark(s), I have placed next to the applicable item(s) [Section 7031,5, Business and Professions Gods: 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 Dlaislen 3 ofthe Business and Professions Code] or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Secllen 7031.5 by any applicant for a permit subjects the applicant to a civil penally of not more than five hundred dollars ($500). C-) 1, as owner of the property, or my employees with wages as their sole compensation, will do U all of or (_} portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professlons 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 tot 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.). (J 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 centractsfor the projects with a licensed Contractor pursuanttothe Contractors' State License Law,), U I am exemptlrom licensure under the Contractor's State License law for the following reason(s); Date: Slgm 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 permiLl 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: httphwww.Ieginfaca.govloalaw.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. LICENSE CLASS: C _ 1-15 LIC. NO.: g�F 2"� EXP. DATE) �[ • mel € CONTRACTOR: 3r�"4 : 11 WORKER'S &M0010hiEAWiON I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLGWING DECLARATIONS: have and will maintain a Cert[flcate of Consent to Self -Insure for Worker's Compensation, as provided by ectlon 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 3790 ofthe Labor Code, for the performance ofthe work for which this permit is Issued. My Worker's Compsnsatlon Insurance Carrier and Policy Number am CARRIER �" `• POLICY NUMBER t 2. [.`'-" (THIS SECTION NEED NOT BE COMPLETED IFTHE PERMIT IS FOR ONE HUNDRED DOLLARS S100 OR LESS). [ csrtitylhat In the performance of the workfor which this permit Is Issued, I shall not employ any person In any manner so asto become subject to the Worker's Compensation Laws of California. And agree that If I should become subject to the Worker's Compensation provisions of Section 3700 ofthe Labor Code, I shall forthwith comply with those provisions. DATE. APPLICANT; WARNING: Failure to secure Workers Compensation coverage is unlawful, and shall subject an employer 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 (Seo 3097, Dv, C.). LENDER'S NAME: LENDER'S ADDRESS: I codify 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 to building construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes. 61, 11-111 PERM I7T NA N X " t * �� i SI61, 1R DATE APPLICATION DATE: 1811 1 PIC# PRI-+- 1 `I2 -'(o ISSUE DATE: l~! `� �� PERMIT#: TYPE CONST. /D d $ Y) OCC GROUP: Scope of Work �6 2 Ll f 1 I ZI b'7 # DWEL. UNITS # STORIES I �� } # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport LO Patio/Deck w LL Pool/Spa ZRe -Roof 21 Commercial m Valuation: + Adj. Area: QUANTITY DESCRIPTION FEE c� x V J w z M J rs J Q U 4 x V 1E CONSTRUCTION: PLAN REVIEW: ELECTRIC: 53 1CI PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: r SMTP: ENERGY PIC: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: BASF: 1125 PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: �� a 30 %b if 141 P/C:3�By PAIDBY: L i RECEIPT# PAID BY: VALIDATION: VALIDATION:— WHITE Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy m7 ommsmomFOOTINGS SETBACIU LETTER 7AND FORMS SLAB UG. PLUMBING T -BAR UG. ELECTRICAL INTERCEPTER UFER GROUND HOT MOP/SHOWERPAN SEWER LATERAL SEPTIC/CESSPOOL MAIN WATER LINE HERS REPORT RECEIVED SEWER f LE,ANOUT DEMOLITION ROOT. 911FATHING ROOF DRAINS FLOOR YIFAI IIING ........ ROUGH CONDUIT -- W SHLAR WALLS EXTERIOR _.._ ., _..._.._..__.__ _ ... ..... __._ POOLISPA _ SHEAR WALLS INTERIORROUGH PLUMBING FRAMINGIVENTING ROUGH ELECTRICAL _______ ROUGII MECHANICAL -- ........ _... ROUGH MECHANICAL ROUGH ELEf IR CAL W( ) C ( ) GAS TEST ROUGH PLUMBING PRE GUNITE INSIJI ATION WAI I POOL PRE DECK BONDING INSIJI Al'ffl LFII ING P .I RAP D'HYWALL _ _ .._ .. ..... .... ...... -- _ FFNCF / GATE/ ALARM ...... Al 11 (PRE:) ... FINAL. POOL. LATH EXTERIOR WALLS: _.._..-. LATH INTERIOR WALL FOOTING/STEEL _2ri°( GAS TEST WALL S7E L Pl(.. j LIFT SCRATCH COAT WALL BOND 13FAM ELECTRIC METER RELEASE WALL DRAIN/ SLAL GAS METER RELEASE WALL FINAL, SPECIAL INSPECTION RO. FRAMING PLANNING APPROVAL FINAL BUILDING j .� » ROUGH EIRE APPROVAL...._ FINAL MECHANICAL FINAL FIRE DEPARTMENT FINAL ELECTRICAL ; FINAL PLANNING FINAL PLUMBING FINAL ENGINEERING/ PW T.C. of OCCUPANCY FINAL COMMUNITY SERVICES CERT, Of UCCUPANCY FINAL HEALTH DEFT. _._....._.._ FINAL INDUSTRIAL WASTE COMMENTS: