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Home My WebLink AboutPR20190001209PERMIT #: CITY OF DIAMOND BAR COMMUNITY DEVELOPMENT DEPARTMENT 21810 Copley Drive, Diamond Bar, CA 91765 1909) 839-7020 Fax: (909) 861-3117 Building inspection Hotline (909) 839-7027 DIAIMONO BAR BUILDING PERMIT APPLICATION www.cKwfdiamondbar.com building@diamondbarca.gov JOB SITE ADDRESS 1653 CYPRESS GROVE LN, DIAMOND BAR, CA 91765 APN 8293016025 LOT# TRACT# OWNER NAME SMITH GORDON G & MARCIA L ADDRESS 1653 CYPRESS GROVE LN CITY DIAMOND BAR ZIP 9176S TEL <NO PRIMARY PHONE> APPLICANT NAME TEL CONTRACTOR NAME MIKE DIAMOND PLUMBING ADDRESS 3801 Lenawee CITY Culver City STATE CA ZIP 96232 TEL (310)838.0408 ARCHfENG/DES NAME ADDRESS CITY STATE CA ZIP TEL PJC DATE PJC# ISSUE DATE 12Jul 2019 PR# PR20190001209 TYPE CONSTRUCTION OCC GROUP SCOPE OF WORK CLEAN OUT INSTALLATION IN GARAGE/ DRIVEWAY #DWELL UNITS #STORIES #BEDROOMS BUILDING FEES DESCRIPTION SOFT FACTOR PSF ADJ AREAIVALUATION SFRJADD/REM GARAGE/CARPORT PATIO/DECK POOL/SPA RE -ROOF COMMERCIAL TOTAL VALUATION• TOTAL. Plumbing TYPE IQUANTITY AMOUNT TOTAL Disconnection, Abandonment, Alteration, or Repair of any House Sewer 1 $4109 1$4109 PLAN CHECK FEES PERMIT FEES CONSTRUCTION PLAN REVIEW ELECTRICAL PLUMBING $57 24 MECHANICAL INSPECTION FEE ISSUANCE $46 23 SMIP ENERGY RETENTION FEE $2 86 PRE)ALT FEE BASF PLOT PLAN ZONING CLEARANCE RECYCLING AND WASTE DEPOSIT PERMIT SYSTEM REPLACMENT FEE $2 29 TOTAL FEES: $108 62 COMMENTS PIC RECEIPT # PAY METHOD VALIDATION PERMIT RECEIPT # '"45546 PAY METHOD CK. #34134 VALIDATION RC PERMIT #: PR20190001209 ,c INSPECTION SETBACK / LETTER B= t tINSPECTOR: TRACK AND LEDGER FOOTINGS FORMS T-BAR SLAB POOL DEMOLITION UG PLUMBING ROOF DRAINS UG ELECTRICAL PDOLjSPA LIFER 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 I WALLS SHEAR WALLS INTERIOR WALL FOOTING/STEEL FRAMINGNENTING WALL STEEL SSTI I2NDI j LIFT RO MECHANICAL WALL DRAIN/SEAL RO ELECTRICAL W () C () WALL FINAL RO PLUMBING RO FRAMING PLANNING APPROVAL INSULATION WALL ROUGH FIREAPPROVAL INSULATION CEILING FINAL FIRE DEPARTMENT HOT MOP/SHOWERPAN FINAL PLANNING DRYWALL FINAL PW ENGINEERING LATH EXTERIOR FINALPW MAINTENANCE LATH INTERIOR '�., FLNAL HEALTH DEPT GAS TEST FINAL INDUSTRIAL WASTE SCRATCH COAT FINAL BUILDING ELECTRIC METER RELEASE FINAL MECHANICAL GAS METER RELEASE ',' FINAL ELECTRICAL SPECIAL INSPECTION FINAL PLUMBING t 1GF �� SMOKE&CARBON MONOXIDE DETECTORS TC OF OCCUPANCY CERT, OF OCCUPANCY COMMENTS PERMIT M PR20190001209 OWNER -BUILDER 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 checkmark(s) I have placed next to the applicable nem(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 hcensure 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) ) U I as owner of the property, or my employees with wages as their sole compensation, will do (J all of or (J 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.) {� 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 hcensure 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 owner -builder if it has not been constructed in as 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 sit ttp/www legmfo ca govjcalaw html 0T (Z SIGNATU 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 (commencmgwith Section 7000) of Division 3 of the Business and Professions Code, and my license is in full farce and effect LICENSE CLASS C36 LICENSE NUMBER, 765436 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 CYPRESS INSURANCE POLICY # EXPIRATION DATE COMPANY NAME OF AGENT MIWCO22336 PHONE # 1 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 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 re to building construction I authorize representatives of the City of Diamond Bar to enter the above-ide ie property for inspection purposes SIGNATURE OF PROPERTY OWNER OR AUTHORIZED AGENT DATE U