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HomeMy WebLinkAboutPR20190001083,f 4 CARS CASE PERMIT If. PR20190001 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 buiidmg@diamondbarca.gov JOB SITE ADDRESS. 23938 GOLDEN SPRINGS DR, DIAMOND BAR, CA 9176S APN 8281013057 LOT# TRACT# OWNERNAME CHAMBERLAIN JOEL&MELINDA ADDRESS 23938 GOLDEN SPRINGS DR CITY DIAMOND BAR ZIP 91765 TEL <NO PRIMARY PHONE> APPLICANT NAME TEL CONTRACTOR NAME AVI - CON INC ADDRESS 981 IOWA AVE SUITE A CITY RIVERSIDE STATE CA ZIP 92507 TEL <NO PRIMARY PHONE> ARCH%ENGJDES NAME ADDRESS CITY STATE CA ZIP TEL P/C DATE PJC# ISSUE DATE 25 Jun 2019 PR# PR20190001083 TYPE CONSTRUCTION OCCGROUP SCOPE OF WORK. "CODE CASE" RE -ROOF 959 SOFT #DWELL UNITS 0 #STORIES #BEDROOMS BUILDING FEES DESCRIPTION SO FT FACTOR PSF ADJ AREAIVALUATION SFRJADD)REM GARAGE%CARPORT PATIO(DECK POOLJSPA RE -ROOF 95900 $9,200 00 COMMERCIAL TOTAL VALUATION TOTAL. $9,200 0000 PLAN CHECK FEES PERMIT FEES CONSTRUCTION $283 69 PLAN REVIEW ELECTRICAL PLUMBING MECHANICAL INSPECTION FEE ISSUANCE $45 02 SMIP $120 ENERGY RETENTION FEE $28 PREIALT FEE BASF $100 PLOT PLAN ZONING CLEARANCE RECYCLING AND WASTE DEPOSIT $250 00 PERMIT SYSTEM REPLACMENT FEE $22 69 TOTAL FEES, $631 COMMENTS P/C RECEIPT # PAY METHOD VALIDATION PERMIT RECEIPT # 45277 PAY METHOD CHECK 29162 VALIDATION CR I I } PERMIT #: PR20190001083 KILN�sl• r INSPECTION SETBACK/LETTER ''� TRACK AND LEDGER FOOTINGS FORMS TEAR SLAB POOL DEMOLITION UG PLUMBING ROOF DRAINS '.. UG ELECTRICAL '.. POOLAFA UFER 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 SSTOi 2NDi LIFT RO MECHANICAL WALLDRAIN/SEAL RO ELECTRICAL W OC I) WALL FINAL RO PLUMBING RO FRAMINGPLANNING APPROVAL INSULATION WALL ROUGH FIRE APPROVAL INSULATION CEILING FINAL FMEDFPARTMENT '... HOTMOP/SHOWERPAN FINAL PLANNING DRYWALL FtNA1PWENGINEERING I LATH EXTERIOR .. FINAL PIN MAFNTENANCE LATH INTERIOR FINAL NEALTN OEPT-T- GAS TEST FINAL INDUSTRIAL WASTE SCRATCH COAT FINAL BUILDING Yt - F 41 i ELECTRIC METER RELEASE FINAL MECHANICAL GAS METER RELEASE FINAL ELECTRICAL SPECIAL INSPECTION FINAL PLUMBING SMOKE & CARBON MONOXIDE DETECTORS T C OF OCCUPANCY CERT.¢FOCCUPANCV PERMIT #: PR20190001083 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 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 licensure and the basis for the alleged exemption Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500) ] (_) I as owner of the property, or my employees with wages as their sole compensation, will do (J 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 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) (_) I am exempt from Iicensure 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 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 http/www Iegmfo ca govjcalaw htm] 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 B LICENSE NUMBER 588602 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 MIDWEST EMPLOYERS POLICY # EXPIRATION DATE CASUALTY COMPANY NAME OF AGENT SNUWC0142937 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 1 should become subject to the workers' compensation provisions of Section 3700 of the Labor Code,1 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 1 agree to comply with all applicable city and county ordinances and state laws relating to b cons I authorize representatives of the City of Diamond Bar to enter the abov�dentdked for in purpo s SIGNATURE OF PROPERTY OWNER OR AUTHORIZED AGEN . DATE