HomeMy WebLinkAboutPR20180034167f( R
t #: PR201800341 T
CITY OF DIAMOND BAR
COMMUNITY DEVELOPMENT 1RTMENT
21810 Copley Drive, Diamond Bar, CA 91765
(909) 839_7020 Fax: (909) 861-3117 Building Inspection Hotline (909) $39-7027
DIAMOND BAR BUILDING PERMIT APPLICATION www.citvofdiamondbar.com building@diamondbarca.gov
JOB SITE ADDRESS: 20965 GLENBROOK DR, DIAMOND BAR, CA 91765
APN $763012009 LOT# TRACT#
OWNERNAME PAI YI SU&CHING YU LU
ADDRESS 20995 GLENBROOK DR
CITY WALNUT ZIP 91789 TEL <NO PRIMARY PHONE>
APPLICANT NAME TEL
CONTRACTOR NAME We Care Plumbing Heating and Air Conditioning
ADDRESS 41085 Golden Gate Cir
CITY Munieta STATE CA ZIP 92562 TEL (951) 600.07DO
ARCH/ENG/DES NAME
ADDRESS
CITY STATE CA ZIP TEL
P/C DATE PIC#
ISSUE DATE 10 Sep 2018 PR# PR20180034167
TYPE CONSTRUCTION OCCGROUP
SCOPE OF WORK Relocate S•ton WC to side yard, FAU 120k BTU and (13) ducts, (Z) circuits (1) gas line
#DWELL UNITS #STORIES #BEDROOMS
BUILDING FEES
DESCRIPTION
SCL FT
FACTOR PSF
ADJ AREA/VALUATION
SFR/ADDJREM
GARAGE/CARPORT
PATIOIDECK
POOL/SPA
RE -ROOF
COMMERCIAL
TOTAL VALUATION,
TOTAL:
Mechanical
TYPE
QUANTITY
AMOUNT
TOTAL
A/C Residential (< 100,001 BTU)
1
23242
$32 42
Furnace F A U , Floor (< 100,001 BTU)
1
$32 42
$32 42
Alterations of Duct System
13
$156 69
$156 69
Mectrlal
TYPE
QUANTITY
AMOUNT
TOTAL
Lighting Fixtures, Sockets, or Other Lamp Holding Devices
2
$2 35
$4 70
PlumbIn
TYPE
QUANTITY
AMOUNT
TOTAL
Gas Piping System,
1
$9912
$d112
PLAN CHECK FEES
PERMIT FEES
CONSTRUCTION
PLAN REVIEW
ELECTRICAL
$55 76
PLUMBING
59912
MECHANICAL
$221 53
INSPECTION FEE
ISSUANCE
$112 36
SMIP
ENERGY
RETENTION FEE
$1108
PREJALT FEE
BASF
PLOT PLAN
-....
ZONING CLEARANCE
S7791
RECYCLING AND WASTE DEPOSIT
TOTAL FEES:
$57776
COMMENTS
P/C RECEIPT # PAY METHOD VALIDATION
PERMIT RECEIPT PAY METHOD VALIDATION
,F 4
PERMIT M PR2018064167
INSPECTION
SETBACK / LETTER
._
OR:
•
TRACK AND LEDGER
DATE:
FOOTINGS FORMS
T-BAR
SLAB
POOL DEMOLITION
UG PLUMBING
ROOF DRAINS
UG ELECTRICAL
POOLtSPA
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
FLOORSHEATHING
FINAL POOL
SHEAR WALLS EXTERIOR
WALLS
SHEAR WALLS INTERIOR
WALL FOOTING/STEEL
FRAMING/VENTING
WALL STEEL AST{ i 2ND() LIFT
RO MECHANICAL
WALLDRAIN/SEAL
RO ELECTRICAL W C ))
WALL FINAL
RO PLUMBING
RO FRAMING PLANNING
APPROVAL
INSULATION WALL
ROUGH FIRE APPROVAL
INSULATION CEILING
FINAL FIRE DEPARTMENT
HOT MOP/SHOW ERPAN
FINAL PLANNING
DRYWALL
FINAL PW ENGINEERING
LATH EXTERIOR
FINAL PW A&UNTENANLE
LATH INTERIOR
FINAL HEALTHDEPT
GAS TEST
FINAL LNDGSTRIAL WASTE
SCRATCH COAT
FINAL BUILWNG
ELECTRIC METER RELEASE
FINAL MECHANICAL Go'~
Y
GAS METER RELEASE
FINAL ELECTRICAL
SPECIAL INSPECTION
FINAL PLUMBING
SMOKE & CARBON
MONOYJDE DETECTORS
T C OF OCCUPANCY
CERT OF OCCUPANCY
COMMENTS
i A
PERMIT M PR20190034167
u i
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 nem(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 bans for the alleged exemption Arry violation of Section 70315 by any
applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($S00) 1.
(_) 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 building 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 )
(J 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 leginfo ca gov/calaw html
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, 779604
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
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 Cypress Insurance POLICY q
NAME OF AGENT WCWC907593
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 37DO 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 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 la re ating udding construction
I authorize representatives of the City of Diamond Bar to enter the abc , ed r for inspection purposes
SIGNATURE OF PROPERTY OWNER OR AUTHORIZED AGENT