The URL can be used to link to this page

Home My WebLink AboutPR20190000658PERMIT M PR20190000658 CITY OF DIAMOND BAR COMMUNITY DEVELOPMENT DEPARTMENT 21810 Copley Drive, Diamond Bar, CA 91765 (909) 839-7020 Fax: (909) 861.3117 Building Inspection Hotline (909) 839-7027 DIAMOND BAR BUILDING PERMIT APPLICATION www.citvofdiamondbar.com building@dlamondbarca.gov JOB SITE ADDRESS, 632 BLENFIELD PL, DIAMOND BAR, CA 91765 APN 8281037099 LOT# TRACT# OWNER NAME CHODZKO MARK C & KATHLEEN ADDRESS 632 BLENFIELD PL CITY DIAMOND BAR ZIP 91765 TEL <NO PRIMARY PHONE> APPLICANT NAME TEL CONTRACTOR NAME Re i e 1 ADDRESS 19326 Ventura Blvd Ste 201 CITY Tanana STATE CA ZIP 91356 TEL 818)342-2927 ARCHJENGJDES NAME ADDRESS CITY STATE CA ZIP TEL P/C DATE PIC# ISSUE DATE 23 Apr 2019 PR# PR20190000658 TYPE CONSTRUCTION OCC GROUP SCOPE OF WORK PEX RE -PIPE TO (10) EXISTING FIXTURES #DWELL UNITS #STORIES #BEDROOMS BUILDING FEES DESCRIPTION SO, FT FACTOR PSF ADJ AREA/VALUATION SFRJADDJREM GARAGE/CARPORT PATIO/DECK POOLISPA RE -ROOF COMMERCIAL TOTAL VALUATION TOTAL, Plumbing TYPE QUANTITY AMOUNT TOTAL Plumbing FlAure f Trap or Set of Fixtures 10 $19 82 $198 20 + PLAN CHECK FEES PERMIT FEES CONSTRUCTION PLAN REVIEW ELECTRICAL PLUMBING $198 20 MECHANICAL INSPECTION FEE ISSUANCE $45 02 SMIP ENERGY RETENTION FEE $9 91 PREJALT FEE BASF PLOT PLAN ZONING CLEARANCE RECYCLING AND WASTE DEPOSIT PERMIT SYSTEM REPLACMENT FEE $7 93 TOTAL FEES. $26106 COMMENTS P/C RECEIPT # PAY METHOD VALIDATION PERMIT RECEIPT 0 PAY METHOD VALIDATION PERMIT #: PR2019000063' 1 s D • SETBACK/LETTER I TRACK AND LEDGER FOOTI NOS FORMS I I I T-BAR SHEAR WALLS INTERIOR WALL FOOTINGISTEEL FRAMINGIVENTING WALL STEEL IST( j 2ND() LIFT RO MECHANICAL I WALLDRAIN/SEAL ',. RO ELECTRICAL W () C I) ( ( ( WALL FINAL ( ' �[�,� RO FRAMING PLANNING RO PLUMBING ' APPROVAL ' INSULATION WALL ROUGH FIRE APPROVAL INSULATION CEILING FINAL FIRE DEPARTMENT ' HOT MOP/SHO W ERPAN FINAL PLANNING DRYWALL FINAL PW ENGINEERING (LATH EXTERIOR ' I FINALPWMAINTENANCE LATH INTERIOR '', FINAL HEALTH DEPT FINAL INDUSTRIAL MONOXIDE DETECTORS T COMMENTS ill PERMIT If, OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law forthe reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s) [Section 70315, 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 pursuant to the provisions of the Contractors' 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 licensure and the basis for the alleged exemption Any violation of Section 70315 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500) ] L) I as owner of the property, or my employees with wages as their sole compensation, will do (J all of or(_) 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 -Builder will have the burden of proving that it was not built or improved for the purpose of sale ) (-,) 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 Contractors' State License Law ) (_) I am exempt from licensure under the Contractor's State License law for the following reason(s) 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 permit, I cannot legally sell a structure that I have built as an owner -builder rf 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 http/www leginfo ca gov/calaw html SIGNATURE Of PROPERTY OWNER OR AUTHORIZED AGENT DATE 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-36 LICENSE NUMBER 9 78 2 EXPIRATION DATE CONTRACTOR SIGNATURE WORKERS' COMPENSATION DECLARATION: 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 COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS fEES 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 workers' compensation, issued by the Director of industrial Relations as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued My workers' compensation insurance carrier and policy number are CARRIER BENCHMARK INSURANCE POLICY # EXPIRATION DATE COMPANY NAME OF AGENT CST5013781 PHONE # 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 workers' compensation provisions of Section 3700 of the Labor Code, i shall forthwith comply with those provisions SIGNATURE Of APPLICANT DATE DECLARATION REGARDING 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 (Section 8172, Civil Code) LENDER'S NAME LENDER'S ADDRESS By my signature below, I certify to each of the following I am the property owner or authorized to act on the property owners behalf 1 have read this application and the information I have provided is correct I agree to comply with all applicable city and county ordinances and state laws relating to building construction I authorize representatives of the City of Diamond Bar to enter the above -identified property for inspection purposes SIGNATURE OF PROPERTY OWNER OR AUTHORIZED AGENT DATE