The URL can be used to link to this page

Home My WebLink AboutPR18-13605 LU C" LLQ .n.r.l C) co r � CD LL 0 UJ CD Q z LU LLJ CL CD LU 0 0 LLJ GO 0 CD cu nc a.q �4F LU JOB SITE ADDRESS CITY OF DIAMONDBAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline 839-7027 ]BUILDING PERMIT APPLICATION www# ityoffliamondbar. o ' building@diamondbareatElov 35 AIN LOT OWNERS�r r r IDI CITY APPLICANT TEL. TFT CONTRACTOR t— '- PA _i lei �, ADDRESS L.�l CITES P f TEL #r f ARCH/ENG/ DESIGNER ADDRESS FF ... R )P TEL* OWNER -BUILDER DECLARATION # hereby affirm under penalty of peCjuiy that f ars exempt from the antractor,s State License Law for the mason(s) Indicated below by the chac mark(s), I have placed next to the appi Icable Item(s) [Section 7o3f .s, R usfness and Pratosslons Cade: Any city at county that requires a permit to construct, 81t8r, tMproVe, demolish, or repair, any structure, prior to Its issuance, also requires the applicant for the permit to fife a signed statement that he or she to ttcertsed pursuant to the provisfarrs of the ConlraetGrls State License Law (Chapter 9) Cammenclog with Section 700 of 01v fun 3 of the Buslness and Professtens Gude] or that he or she Is exempt from licensure and the basIs for the alleged exe rnptfon. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a ciwi I penalty of not more than five hundred do41a ($500). 1, as owner of th a property, or my em ployees with gages as their sole co m peri satin#, will do U all of or U porffans of the work, and the structum Is not Intended or offered for sale (Section 7044, Bustness and Professions Code; The Gontra ` State License law does not apply to an owner of proper} who, through employees' or personal effort, builds or Impmves the pmperty, provided that the Irnprovemants are not Intended or off ored for sale If however, the bufldIng U Improvement Is sold Wthin one year of completion, the mer -Builder will have the burden of proving that It was riot built or Impmved for the purpose of sale.)b i, as owner of the propel, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Prafessfons Cole: The Contractors' Mate LIcense Law doss not apply tG an owner of pmparty who builds or I mprowes thereon} and who contracts for the pt eGts with a licensed Contractor pursuant to the Contractors' State Lfeense Law.). am exempt from licensure under the Contractor's State License law fol the following reaso-n(s): Date: g -n - By my signature below I acknowledge that, except for my personal residence In which I must have res lad for at feast one year prior to completion of the improvements covered by this permit,l cannot legally sell a structure that I I we bold as an owner builder if It has rpt been constructed in Its e€ firety by licensed contractors. I understand that a copy of the applicable law, SeMon 7044 of the Business and Professions Code Is awailabte upon request win thfe application is sub i ed or at the following web site: httpAvww. ginfo,ca,gov/cafaw.html. LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perlutr that t aro Ilcensed under prowl Ions of Chapter 9 (co menctng with Secdon 70M) of Division 3 of the Business and Protes-slons Code, and my key a Is in full few and effect. LICENSE CLAS S: �+ .:. T LIC, M: r , P. DAVE. rrrr k .-CONTRACTOR- WORKER'S ONTRAC 1 OR+ WOR #' I RA I N DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLA ATION& I have and will maintain a Certificate of Consent to self -Insure for worker's CbmpensatiGn, as pro ed by Section 3700 of iia Labor Code, for the performance of the work for which this permit is Issued, I have and will mafntaln Worker's Compensation Insurance, as required by Section 3700 of the Labor Code, for thD perfor ance of tie work for which this permit is Issued, fly worker's Compensation Insurance Gamier and Policy Number are: CARRIER . + . POLICY NUMBER (WIS SECTION NEED NOT 8E COMPLETED IF THE PER IT IS FOR ONE HUNDRED DOLLARS $100 OR LESS). certify that fn Vie performance of Me work for which M permit is issued, I shat not empto+} any w on in an er so asto becom subject to the Worker's Compensation Laws of California. And agree #heat If � ect to the Workers mpen tion proms os of 3700 of ft Labor fie, I shag Mhw' a sic ,r r.rL DATE: { I..ICANT: fry. WARNING: Fallure to secure worker's Compensation coverageis' Unlawful, and shall subject an employer to odmfnaf penalties and civil fly a up to one hundred thousand dollars ($100,000), in addition to the cost of the compensatlon, damages as p vile -d for In s�dlon 3708 of the labor Code, interest, -am attorney's fees. CONSTRUCTION LENDING AGENCY hereby affirm under penalty of poijury that there is a Construction Lending Agericy for the performance of the work for which this permit ts Issued (Sec, 3097E G . C�)- -ENDER'S NAME: t-ENDER'S ADDRESS 0- 1 certify that I have read this application and state that the above Inforr"ation Is carnet. I agree to campy with all city and CD count} ordinances and state laws relating to building construction, aid hereby au rl�e representatluas of this county to ester upas the a�ue-mentioned prcpe for Inspection purposes, PERMITTEE NAME (PRINT . SIGNATURE OF PERI tO DATE PRESS FIRMLY APPLICATION � � TI1 BATE.: P SSUE DATE.-_1L02L_[ k .1--PERMIU: [TYPE FIR - X CONST. OCC GROUP: Scope of Work # D1llifL.T# TFIE #E0IB DESCRIPTION SQ, FT. FACTOR P F ADJ, ,AREA/VALUATION SFR/ADD/REM Garage/Carport co Patfo/Deck Poops Nie-Ftcof __j Commercial Z> Adj. Area: _ QUANTITY DESCRIPTION FEE LU CIO ra? CL PLAN REVIEW: ELECTRIC: PLUMBING: t4?('60 MECHANICAL: INSPECTION FEE: ISSUANCE: *a A. SMTP. ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: BASF: PLOT PLAN: ZONINGLE N E; TOTAL FEES C� COMMENTS., P/C: PAID BY: VALIDATION: REGEIPi`PAID BY: VALlUAT#4N; WHITE ---L- Department Copy, YELLOW — Finance Copy, PIN ---•- ase sc-r Ciopy SETBACK/ LETTER FOOTINGS FORMS SLAB UG..PLUMBING UG. ELECTRICAL UFER GROUND SEWER LATERAL MAIN WATER LINE SEWER CLEANOUT ROOF SHEATHING FLOOR SHEATHING SHEAR FALLS EXTERIOR HEAR FALLS INTERIOR FRAMINGNENTING ROUGH MECHANICAL ROUGH ELECTRICAL W( ROUGH PLUMBING INSULATION FALL INSULATION CEILING DRYWALL LATH (PRE) LATH EXTERIOR LATH INTERIOR GAS TEST KBATCH COAT ELECTRIC METER RELEASE GAS NIE T E,1 tEt-EA � SPECIAL INSPECTION FINAL BUILDING FINAL MECHANICAL FINAL ELECTRICAL FINAL PLUMBING T.C. of OCCUPANCY CERT, Of OCCUPANCY COMMENTS: KFIX :.LlI' CITY OF DIAMOND BAR INSPECTION 711 TRACT AND LED EFS SWITCH GEAR COMMERCIAL HOOD T- RA R INTERCEPTER HOT O P/FIFER PAN SEPTIMESSPOOL. HERS REPORT RECEIVED DEMOLITION ROOF DRAINS ROUGH CONDUIT POOUSPA ROUGH PLUMBING ROUGH H ELECTRICAL BOUGH MECHANICAL GAS TEST PRE GUNITE BOOL PRE DECK BONDING -TRAP FENGE / GATE/ ALAI FINAL POOL FALLS: WALL FOOTING/STEEL MALL STEEL ( )2111( LIFT FALL BOND BEAM T� FALL DRAIN/ / 0Q`kL FALL FINAL RO, F REFI I ISI U PLANNING APPROVAL ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT FINAL. PLANNING FINAL ENGINEERING/ F FINAL COMMUNITY SERVICES FINAL HEALTH DEPTA FINAL INDUSTRIAL FASTS -I,,-A 9 X r