HomeMy WebLinkAboutPR20180034799PERMIT #: PR20180034799
CITY OF DIAMOND BAR
COMMUNITY DEVELOPMENT DEPARTMENT
r�u 21810 Copley Drive, Diamond Bar, CA 91765
1!1 (909) 839.7020 Fax: (909) 861-3117 Building inspection Hotline (909) 839-7027
D'Ii41Nt7ND BAR BUILDING PERMIT APPLICATION www.citvofdiamondbar.com builduiggediamondbarca.gov
JOB SITE ADDRESS, 620 DIAMOND BAR BLVD N, Diamond Bar, CA 91765
APN 8706002032 LOT# TRACT#
OWNER NAME WXINVESTMENTLLC
ADDRESS 12346 VALLEY BLVD #E
CITY EL MONTE ZIP 91732 TEL <NO PRIMARY PHONE>
APPLICANT NAME TEL
CONTRACTOR NAME Professional Electrical Construction
ADDRESS 9112 Santa Anita Ave
CITY Rancho Cucamonga STATE CA ZIP 91730 TEL (909) 373-4100
ARCHJENGIDES NAME
ADDRESS
CITY STATE CA ZIP TEL
PJC DATE P/C#
ISSUE DATE 18Jan 2019 PR# PR20180034799
TYPE CONSTRUCTION OCC GROU P
SCOPE OF WORK (1) Patio Roof 12) Mansard Patio Roofs
#DWELL UNITS #STORIES #BEDROOMS
BUILDING FEES
DESCRIPTION
SO, FT
FACTOR PSF
ADJ AREAIVALUATION
SFRJADDJREM
GARAGE/CARPORT
PATIO/DECK
POOL/SPA
RE -ROOF
COMMERCIAL
TOTAL VALUATION.
TOTAL -
PLAN CHECK FEES
PERMIT FEES
CONSTRUCTION
$88148
$1,037 04
PLAN REVIEW
ELECTRICAL
PLUMBING
MECHANICAL
INSPECTION FEE
ISSUANCE
$45 02
SMIP
$14 00
ENERGY
RETENTION FEE
$5200
PREJALT FEE
BASF
PLOT PLAN
$493 21
ZONING CLEARANCE
RECYCLING AND WASTE DEPOSIT
TOTAL FEES.
$2,522 75
COMMENTS
PJC RECEIPT # PAY METHOD VALIDATION
PERMIT RECEIPT # PAY METHOD VALIDATION
PERMIT #: PR2018M 999 ,
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INSPECTION RECORD
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SETBACK f LETTER
D+
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TRACK AND LEDGER
DATE�
INSPECTOR:
FOOTINGS FORMS
T-BAR
SLAB
POOL DEMOUTION
UG PLUMBING
ROOF DRAINS
UG ELECTRICAL
'...,
POOL/SPA
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 I GATE i ALARM
FLOOR SHEATHING
FINAL POOL
SHEAR WALLS EXTERIOR
WALLS
SHEAR WALLS INTERIOR
WALL FOOTING/STEEL
FRAMINGIVENTING
WALL STEEL 1ST(} LND(] LIFT
RO MECHANICAL
WALLDRAIN%SEAL
RO ELECTRICAL W() C]]
WALL PI NAL
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
FINAL PW MAINTENANCE
LATH INTERIOR
FINAL HEALTH OEPT
GAS TEST
FINAL INDUSTRIAL WASTE
SCRATCH COAT
FINAL BUILDING
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ELECTRIC METER RELEASE
FINALMECHANICAL
.9- 5;w J 9
pre
GAS METER RELEASE
FINAL ELECTRICAL
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(f,{�._.. y'"
SPECIAL INSPECTION
FINAL PLUMBING
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SMOKE & CARBON
MONOXIDE DETECTORS
T C OF OCCUPANCY
CERT OF OCCUPANCY
COMMENTS
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)
orthat 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)
(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 budding 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 I, 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 )
U I am exempt from hcensure under the Contractor's State License law far 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/wwwleginfocagov/calawhtmi
SIGNATURE OF PROPERTY OWNER OR AUTHORIZED AGENT DATE
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjurythat 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 C10, C8, BA LICENSE NUMBER 9248SS
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 STATE COMPENSATION POLICY# EXPIRATION DATE
INSURANCE FUND
NAME OF AGENT 9058916 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, Gvil 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 Bar to enter the above -identified property for inspection purposes
SIGNATURE OF PROPERTY OWNER OR AUTHORIZED AGENT
DATE