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Home My WebLink AboutPR20190000154/ ` I PERMIT #: PR20190000154 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 DIAMCtNI? BAR BUILDING PERMIT APPLICATION www.citvofdiamondbar.com budding@diamondbarca.gov JOB SITE ADDRESS 2117 DUBLIN LN, Unrtd, DIAMOND BAR, CA 91765 APN 8713007093 LOT# TRACT# OWNER NAME CHEN LI LIN ADDRESS 2117 DUBLIN LN #1 CITY DIAMOND BAR ZIP 9176S TEL <NO PRIMARY PHONE> APPLICANT NAME TEL CONTRACTOR NAME Safe -Way Electric Co ADDRESS 4091 Riverside Or Unit 211 CITY Chino STATE CA ZIP 91710 TEL (909) 464-9983 ARCH/ENG/DES NAME ADDRESS CITY STATE CA ZIP TEL P/C DATE P/C# ISSUE DATE PR# TYPE CONSTRUCTION OCCGROUP SCOPE OF WORK REPAIR EXISTING SERVICE PANEL - REPLACING EXISTING BUSS BAR FROM METER BASE TO 100 AMP MAIN BREAKER #DWELL UNITS #STORIES #BEDROOMS BUILDING FEES DESCRIPTION SO FT FACTOR PSF ADJ AREA/VALUATION SFR/ADD/REM GARAGE/CARPORT PATIO/DECK POOL/SPA RE -ROOF COMMERCIAL TOTAL VALUATION' TOTAL Electrical TYPE QUANTITY AMOUNT TOTAL Electrical Apparatus, Conduits and Conductors 1 $78 16 $78 16 PLAN CHECK FEES PERMIT FEES CONSTRUCTION PLAN REVIEW ELECTRICAL $78 16 PLUMBING MECHANICAL INSPECTION FEE ISSUANCE $45 02 SMIP ENERGY RETENTION FEE $3 91 PRE/ALT FEE BASF PLOT PLAN ZONING CLEARANCE RECYCLING AND WASTE DEPOSIT TOTAL FEES $127 09 COMMENTS P/C RECEIPT # PAY METHOD VALIDATION PERMIT RECEIPT # PAY METHOD VALIDATION ov PERMIT #; PR20190000154 All v ■1MJtMIG7►I*K67cTI7 INSPECTION SETBACK / LETTER D• TRACK AND LEDGER D•INSPECTOR: FOOTINGS FORMS T-BAR SLAB POOL DEMOLITION UG PLUMBING ROOF DRAINS UG ELECTRICAL POWSPA 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 WALLS SHEAR WALLS INTERIOR WALL FOOTING/STEEL FRAMING/VENTING WALL STEEL 1ST{ } 2ND(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 PWENGINEERING LATH EXTERIOR FINAL PW MAINTENANCE LATH INTERIOR FINAL HEALTH DEPT GAS TEST FINAL INDUSTRIAL WASTE ..........____ SCRATCH COAT .... FINAL BUILDING ELECTRIC METER RELEASE / (, FINAL MECHANICAL GAS METER RELEASE FINAL ELECTRICAL �} i- 4 G SPECIAL INSPECTION FINAL PLUMBING SMOKE I CARBON MONOXIDE DETECTORS -____-- TC OF OCCUPANCY CERT OF OCCUPANCY COMMENTS - � •i,i,i,t 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) indica 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 licensure and the basis for the alleged exemption Any violation of Section 7031 S by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500)1 (_) I as owner of the property, or my employees with wages as their sole compensation, will do (_) 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 -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 for the projects with a licensed Contractor pursuant to the Contractors' State License Law ) (J 1 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 -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 httplwww 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 809692 EXPIRATION DATE CONTRACTOR SIGNATURE WORKERS' COMPENSATION DECLARATION: WARNING FAILURE TO SECU RE WORKERS' COMPENSATION COVERAGE IS U N LAWF U L, AND SHALL SU BJ ECT 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 TRUCK INSURANCE EXCHANGE POLICY # EXPIRATION DATE NAME OF AGENT A01095233 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 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