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Home My WebLink AboutPR20180034699d4 t r PE i #: PR20180()34699 CITY OF DIAMOND B COMMUNITY DEVELOPMENT DEPARTMENT 21810 Copley Drive, Diamond Bar, CA 91765 (909) 839-7020 Fax: (909) 861-3117 Building inspection Hotline (909) 839-7027 DIA5VIOND BAR BUILDING PERMIT APPLICATION www.citvofdiamondbar.com building@diamondbarca.gov JOB SITE ADDRESS 3531 CASTLE ROCK RD, DIAMOND BAR, CA 91765 APN 8714015 LOT# TRACT# OWNERNAME CHILI CHUN CHENG ADDRESS 3531 CASTLE ROCK RD CITY DIAMOND BAR ZIP 41765 TEL <NO PRIMARY PHONE> APPLICANT NAME TEL CONTRACTOR NAME Service Champions ADDRESS 3150 E Birch St CITY Brea STATE CA ZIP 92821 TEL 7144 777.7777 ARCH/ENG%DES NAME ADDRESS CITY STATE CA ZIP TEL PIC DATE P/C# ISSUE DATE 26 Nov 2018 PR# PR20180034699 ___-- TYPE CONSTRUCTION OCCGROUP SCOPE OF WORK Change out A/C and Furnace, Coll #DWELLUNITS #STORIES #BEDROOMS BUILDING FEES DESCRIPTION SO, FT FACTOR PSP ADJ ARWVALUATION SFR/ADD/REM GARAGE/CARPORT PATIO/DECK POOL/SPA RE -ROOF COMMERCIAL TOTAL VALUATION: TOTAL Mechanical TYPE QUANTITY AMOUNT TOTAL A/C Residential I< 100,001 BTU) 1 $32 42 $32 42 Fumace F A U , Floor j< 100,001 BTU) 1 $32 42 $32 42 Walk-in Box / Refrigerator Coil (<100,001 BTU) 1 $32 42 $32 42 PLAN CHECK FEES PERMIT FEES CONSTRUCTION PLAN REVIEW ELECTRICAL PLUMBING MECHANICAL $97 26 INSPECTION FEE ISSUANCE $45 02 SMIP ENERGY RETENTION FEE $8 75 PRE/ALTFEE BASF PLOT PLAN ZONING CLEARANCE RECYCLING AND WASTE DEPOSIT TOTAL FEES: $15103 COMMENTS P/C RECEIPT # PAY METHOD VALIDATION PERMIT RECEIPT# 42326 PAY METHOD Check # 7`171 VALDATION Em PERMIT #: PR20180034699 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 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 as 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 Iicensure 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 (_) all of or U 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 budding 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 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 ) (_) 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 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 govjcalaw 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 C20 LICENSE NUMBER 799170 EXPIRATION DATE. CONTRACTOR SIGNATURE WORKERS' COMPENSATION DECLARATION: WARNING' FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECTAN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COSTOF 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 Pacific Comp Insurance POLICY # EXPIRATION DATE NAME OF AGENT WA00060704 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 an 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 Bar to enter the above -identified property for sp ion purposes SIGNATUR OF P OPERTY OWNER OR AUTHORIZED AGENT AngelicaMartinez DATE. 1