HomeMy WebLinkAboutPR20190000695UTITUrNT-ITTIR-711TOTOr.
PW 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.citvofdramondbar.com buildmg@diamondbarca.gov
JOB SITE ADDRESS* 20956 GLENBROOK DR, DIAMOND BAR, CA 91765
APN 8763011017 LOT# TRACT#
OWNER NAME KOO CHARLES
ADDRESS 20956 GLENBROOK DR
CITY WALNUT ZIP 91789 TEL <NO PRIMARY PHONE>
APPLICANT NAME TEL
CONTRACTOR NAME NEW QUEST ELECTRIC INC
ADDRESS 1891 SOUTH RESERVOIR ST
CITY POMONA STATE CA ZIP 91766 TEL (909) 670-5199
ARCHIENG%DES NAME
ADDRESS
CITY STATE CA ZIP TEL
P/C DATE P/C#
ISSUE DATE 30 Apr 2019 PR# PR20190000695
TYPE CONSTRUCTION OCC GROUP
SCOPE OF WORK INSTAILATION OF 1 RENIA 14-SO PLUG AND 1 QUAD OUTLET BOX
#DWELLUNITS #STORIES #BEDROOMS
BUILDING FEES
DESCRIPTION
SQ FT
FACTOR PSF
ADJ AREAIVALUATION
SFR/ADDJREM
GARAGE/CARPORT
PATIO/DECK
POO11SPA
'
r
RE -ROOF
COMMERCIAL
TOTAL VALUATION
TOTAL'
Electrical
TYPE
QUANTITY
AMOUNT
TOTAL
Lighting fixtures, Sockets, or Other Lamp Holding Devices
1
$2 35
$55 76
PLAN CHECK FEES
PERMIT FEES
CONSTRUCTION
PLAN REVIEW
ELECTRICAL
$55 76
PLUMBING
MECHANICAL
INSPECTION FEE
ISSUANCE
$45 02
SMIP
ENERGY
RETENTION FEE
$2 78
PREJALTFEE
BASF
PLOT PLAN
ZONING CLEARANCE
RECYCLING AND WASTE DEPOSIT
PERMIT SYSTEM REPLACMENT FEE
$2 23
TOTAL FEES.
$105 79
COMMENTS
P/C RECEIPT # PAY METHOD VALIDATION
It
PERMITRECEIPT# 44348 PAY METHOD CASH VALIDATION CR
I
PERMIT #: PR201800
141MOTS• r
INSPECTION RECORD
SETBACK I LETTER
DATE:
INSPECTOR:
INSPECTION
TRACK AND LEDGER
DATE:INSPECTION
FOOTINGS FORMS
T-BAR
SLAB
POOL DEMOLITION
UG PLUMBING
ROOF DRAINS
UG ELECTRICAL
PDOI/SPA
LIFER GROUND
GAS TEST, EL, PL, ME
SEWER LATERAL
PRE GUNTTE
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
FRAMINGNENTING
WALL STEEL DST() 2ND( I LIFT
RO MECHANICAL
WALL DRAIN/SEAL
RO ELECTRICAL W () C (}
[
7
WALL FINAL
RO PLUMBING
RO FRAMING PLANNING
APPROVAL
INSULATION WALL
ROUGH FIREAPPROVAL
INSULATION CEILING
FINAL FIRE DEPARTMENT
HOT MOP/SHO WERPAN
FINAL PLANNING
DRYWALL
FINAL PWENGIIEERING
LATH EXTERIOR
FINAL PIN MAINTENANCE
LATH INTERIOR
'.,,
FINALHEALTHLTEPT
GAS TEST
FINAL INDUSTRIAL WASTE
SCRATCH COAT
FINAL BUILDING
i
ELECTRIC METER RELEASE
RNA MECHANCA),
GAS METER RELEASE
FINAL ELECTRICAL
4-7
SPECIAL INSPECTION
FINAL PLUMBING
SMOKE & CARBON
MONOXIDE DETECTORS
TC OF OCCUPANCY
CERT OF OCCUPANCY
COMMENTS
PERMIT #: PR20190000695
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the reasons) indicated
below by the checkmark(s) I have placed next to the applicable item(s) [Section 7031 S, 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 ($500) ]
(_) I as owner of the property, or my employees with wages as their sole compensation, will do (_) 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 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 improved for
the purpose of sale )
(_) 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 )
(_) I am exempt from hcensure 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 http/www legmfo ca govjcalaw html
ER 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 C10 LICENSE NUMBER 1044759
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 ATTORNEY'S FEES
1 HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS
I have and will maintain a certificate of consent to sell -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 career and
policy number are
CARRIER <Enter Workers Comp> POLICY #.
NAME OF AGENT 0
EXPIRATION DATE
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
By my signature below, I certify to each of the
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 building construction
I authorize representatives of the City of Diamond Bar to enter the ab identifi d pr j e f insp ction purposes
SIGNATURE OF PROPERTY OWNER OR AUTHORIZED AGENT �''-��--
DATE