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Home My WebLink AboutPR201800344774 PERMIT #: PR20180034477 CITY5MRMOND BAR COMMUNITY DEVELOPMENT DEPARTMENT 21810 Copley Drive, Diamond Bar, CA 91765 (9D9) 939.7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 DIAMOND BAR BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@dlamondbarci.gov JOB SITE ADDRESS:1729 FERN HOLLOW DR, DIAMOND BAR, CA 91765 APN $292023010 LOT# TRACT# OWNER NAME CHENG LILAC H ADDRESS 19216 CARRANZA LN _ CITY SANTA CLARITA ZIP 91350 TEL ENO PRIMARY PHONES APPLICANT NAME TEL CONTRACTORNAME Service Champions ADDRESS 1 3150 E Birch St CITY Brea STATE CA ZIP 92821 TEL (714) 777.7777 ARCH/ENG/OES NAME ADDRESS CITY I STATE CA ZIP TEL P/C DATE ( P/C# ISSUE DATE 22 Oct 2018 PR# PR20ISM34477 TYPE CONSTRUCTION OCC GROUP SCOPE OF,WORK (10) Ducts, Attic Insulation and Radian Barrier #DWELLUNITS 0 #STORIES #BEDROOMS BUILDING FEES DESCRIPTION so, FT FACTOR PSF ADJ AREA/VALUATION SFR/ADD/REM GARAGE/CARPORT I PATIO/DECK POOL/SPA j RE -ROOF ' COMMERCIAL j TOTAL VALUATION TOTAL: $43 6300 Mechanical TYPE QUANTITY AMOUNT TOTAL Aherauons of Duct System 10 $52 23 $52 23 PLAN CHECK FEES PERMIT FEES CONSTRUCTION $30573 PLAN REVIEW ELECTRICAL PLUMBING MECHANICAL $77 15 INSPECTION FEE .+ ISSUANCE $78 69 SMIP $140 ENERGY RETENTION FEE j $19 14 PRE/ALT FEE BASF '... $100 PLOT PLAN ZONING CLEARANCE RECYCLING AND WASTE DEPOSIT TOTAL FEES, $483 11 COMMENTS t i PJC RECEIPT # PAY METHOD VALIDATION PERMIT RECEIPT i+j PAY METHOD VALIDATION PERMIT#: 20384034477 OWPiER-BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the real n(s) indicated below by the checkmark(s) t have placed next to the applicable item(s) [Section 70315, Business and Professio is 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 prows ons 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 licensure 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) p (_} I as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) ortions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Cade TheContractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds c r 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 i proved for the purpose of sale ) U I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project ( ction 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property wh 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 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 or at least one year prior to completion of the Improvements covered by this permit, I cannot legally sell a structure that i ave built as an owner -budder if it has not been constructed in Its entirety by licensed contractors I understand that a copy the applicable law, Section 7044 of the Business and Professions Code is available upon request when this application is sub fitted 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 C20 LICENSE NUMBER 799170 EXPIRATION DATE- CONTRACTOR SIGNATURE* WORKERS' COMPENSATION DECLARATION: WARNING' FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT All EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION T THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTOR EY'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, issuey by the Director of industrial Relations as provided for by Section 3700 of the Labor Code, for the perfo mance of the work for which this permit is issued I have and will maintain workers' compensation insurance, as required by Section 3700 of the L bor Code, for the performance of the work for which this permit is issued My workers' compensation insura ce carrier and policy number are. CARRIER Pacific Camp Insurance POLICY # EXPIRATION DATE NAME OF AGENT WA00060704 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 o as to become subject to the workers' compensation laws of California, and agree that, if t should become subject to the workers' comp nsation 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 hich 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 msp c n purposes SIGNATURE OF PROPERER OR AUTHORIZED AGENT DATE U