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Home My WebLink AboutPR20190000500CITY OF DIAMOND BAR COMMUNITY DEVELOPMENT DEPARTMENT 21910 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 bulldingIDdiamondbama.gov 30B SITE ADDRESS* 22317 BROKEN TWIG RD, DIAMOND BAR, CA 92765 APN 8713006012 LOT# OWNER NAME LEROY FRANCIS & KATHERINE TRACT# ADDRESS 22317 BROKEN TWIG RD CITY DIAMOND BAR ZIP 91765 APPLICANT NAME TEL <NO PRIMARY PHONE> TEL CONTRACTOR NAME Levi Builders ADDRESS 369 S Doheny # 174 CITY Beverly HMIs STATE CA ZIP 90211 TEL (747) 24&0742 ARCH/ENG/DES NAME ADDRESS CITY STATE CA ZIP TEL P/C DATE P/C# ISSUE DATE 10 Apr 2019 PR# PA20190000500 TYPE CONSTRUCTION OCCGROUP SCOPE OF WORK INSTALLATION OF (16) ROOF MOUNTED P V SOLAR MODULES 498 KW DC SOLAR EDGE INVERTER ON SFD #DWELL UNITS #STORIES #!BEDROOMS BUILDING FEES DESCRIPTION SO FT FACTOR PSF AD#AREA/VALUATION SFR/ADD/REM GARAGE/CARPORT PATIO/DECK P001/SPA RE -ROOF COMMERCIAL TOTAL VALUATION: TOTAL $12,000 0000 Electrical TYPE QUANTITY AMOUNT TOTAL Photovoltaic Systems 1 $7199 $7199 PLAN CHECK FEES PERMIT FEES CONSTRUCTION $90 55 PLAN REVIEW $SO 00 ELECTRICAL $7199 PLUMBING MECHANICAL INSPECTION FEE ISSUANCE $78 69 SMIP $2 60 ENERGY rENT10N FEE $12 00 PRE/ALT FEE BASF $100 PLOT PLAN ZONING CLEARANCE :YCLiNG AND WASTE DEPOSIT PERMIT SYSTEM REPLACMENT FEE $1000 TOTAL FEES. $316 83 COMMENTS P/C RECEIPT # PAY METHOD VALIDATION PERMTr RECEIPT# 44145 PAY METHOD Check # 3152 VALIDATION tM PERMIT #: PR20190000500 • , • r : , , J*["9141011 • r INSPECTION. SETBACK 1 LETTER TRACK AND LEDGER O. FOOTINGS FORMS T-BAR SLAB POOL DEMOLITION UG PLUMBING ROOF DRAINS UG ELECTRICAL POOVSPA UFER GROUND GAS TEST, EL, PL, ME SEWER LATERAL PRE GUNITE SEWER CLEANOUT POOL PRE DECK BONDING MAIN WATER LINE P•TRAP ROOF SHEATHING FENCE / GATE / ALARM FLOOR SHEATHING FINAL POOL SHEAR WALLS EXTERIOR WALLS SHEAR WALLS INTERIOR WALL FOOT NG/STEEL FRAMING/VENTING WALL STEEL IST()2ND((LIFT !........... .J RO MECHANICAL WALL DRAIN/SEAL RO ELECTRICAL W { } C () WALL FINAL RO PLUMBING''. NO FRAMING PLANNING APPROVAL INSULATION WALL ROUGH FIREAPPRLOVAL INSULATION CEILING FINALFIREDEPARTMENT HOT MOP/SHOWERPAN FINAL PLANNING DRYWALL FINAL PW ENGINEERING LATH EXTERIOR FINAL PW MAINTENANCE LATH INTERIOR FINAL HEALTH DEPT GAS TEST FINAL INDUSTRIAL WASTE SCRATCH COAT FINAL BUILDING f,F �1 ELECTRIC METER RELEASE FINAL MECHAN= GAS METER RELEASE FINAL ELECTRICAL SPECIAL INSPECTION 5WLPLUMBW6 SMOKE & CARBON MONOXIDE DETECTORS TC OF OCCUPANCY CERT OF OCCUPANCY COMMENTS PERMIT #: PR201900005M OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that 1 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 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 lice nsure 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 ($S00) ) (J I as owner of the property, or my employees with wages as their sole compensation, will do (_) 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 -Budder will have the burden of proving that it was not built or improved for the purpose of sale) U 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 forthe projects with a licensed Contractor pursuant to the Contractors' State License Law ) L) I am exempt from licensure underthe Contractor's State License law forthe 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 -budder 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- 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-10 LICENSE NUMBER 992181 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 ATTORNEY'S 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 STATE COMPENSATION POLICY # EXPIRATION DATE. INSURANCE FUND NAME OF AGENT 9142845 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 herebyaffirm rm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permitis 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 owner's behalf I 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 Barto enter the above -identified grope ns r es SIGNATURE OF PROP RTY OWNER OR AUTHORIZED AGENT Joshua Ogle GATE L / 7! 9