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Home My WebLink AboutPR20190001042,A. AN PERMIT II: PR20190001042 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 DIAMOND BAR BUILDING PERMIT APPLICATION www.citvofdiamondbar.com building@diamondbarca.gov JOB SITE ADDRESS. 21246 GERNDAL ST, DIAMOND BAR, CA 91765 APN 8763002021 LOT# TRACT# OWNER NAME BROOKS MARK E & MARY M ADDRESS 21246 GERNDAL ST CITY WALNUT ZIP 91789 TEL <NO PRIMARY PHONE> APPLICANT NAME TEL CONTRACTOR NAME NEXGEN AIR CONDITIONING AND HEATING INC ADDRESS 2101 W Crescent Ave Unit B CITY Anaheim STATE CA ZIP 92801 TEL (657)208-1987 ARCH/ENG/DES NAME ADDRESS CITY STATE CA ZIP TEL P/C DATE P/OR ISSUE DATE PR# TYPE CONSTRUCTION OCC GROUP SCOPE OF WORK- Change out A/C 5-ton and Furnace BTU 80,000In same location #DWELLUNITS #STORIES #BEDROOMS BUILDING FEES DESCRIPTION SO, FT FACTOR PSF ADJ AREAfVALUATION SFR/ADD/REM GARAGE/CARPORT PATIO/DECK POOL/SPA RE -ROOF COMMERCIAL TOTAL VALUATION TOTAL Mecimnical TYPE QUANTITY AMOUNT TOTAL A/C Residential (< 100,001 BTU) 1 $32 4? $32 42 Furnace F A U , Floor (< 100,001 BTU) 1 $32 4? $32 42 PLAN CHECK FEES PERMIT FEES CONSTRUCTION PLAN REVIEW ELECTRICAL PLUMBING MECHANICAL $77 15 INSPECTION FEE ISSUANCE $45 02 SMIP ENERGY RETENTION FEE $3 86 PRE/ALT FEE BASF PLOT PLAN ZONING CLEARANCE RECYCLING AND WASTE DEPOSIT PERMIT SYSTEM REPLACMENT FEE $3 09 TOTAL FEES. $12912 COMMENTS P/C RECEIPT# PAY METHOD VALIDATION PERMIT RECEIPT # 45226 PAY METHOD Check # 4036 VALIDATION EM es t fl�iTTF A•iibT�hI�I�R/ZT� INSPECTION RECORD INSPECTION SETBACK / LETTER r= .• . TRACK AND LEDGER DATE: FOOTINGS FORMS T-BAR SLAB POOL DEMOLITION UG PLUMBING ROOF DRAINS UG ELECTRICAL POaVSPA LIFERGROUND 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 ISTI) 2ND) ) LIFT RO MECHANICAL WALL DRAIN/SEAL RO ELECTRICAL W () C [) WALL FINAL RO PLUMBING RO FRAMING PLANNING APPROVAL INSULATION WALL ROUGH FIRE APPROVAL INSULATION CEIUNG FINAL FIRE DEPARTMENT HOT MOP/5HOW ERPAN FINAL PLANNING DRYWALL FINAL PW ENGINEERING LATH EXTERIOR FINAL PLYMAINTENANCE LATH INTERIOR FINALHEALTNDEFT GAS TEST FINAL tAIDUSTRIAL WASTE SCRATCH COAT FINAL BUILDING ELECTRIC METER RELEASE FINAL MECHANICAL GAS METER RELEASE FINALELECTRICAL SPECIAL INSPECTION FINAL PLUMBING SMOKE & CARBON MONOXIDE DETECTORS TC OF OCCUPANCY £ERT OF OCCUPANCY COMMENTS -1/ 'i , OWNER -BUILDER DECLARATION I hereby affirm under penalty of penury 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 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 7031 S by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($SOO) I (_) I as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sate (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 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 licensure under the Contractor's State License law for the fallowing 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 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 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 1011173 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 permiCis 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 Old Republic General POLICY # EXPIRATION DATE, NAME OF AGENT AlCWA0001400 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 budding c is#ucuon I authorize representatives of the Gty of Diamond Bar to enter the above -identified property for inspe ion urpo f SIGNATURE OF PRO ERTY OWNER OR AUTHORIZED AGENT Adolfo Ibanez fir% DATE t