Loading...
HomeMy WebLinkAboutPR20190000845t PERMIT #: PR20190000845 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.citvoidiamondbar com building@diamondbarea.gov JOB SITE ADDRESS, 1341 PORTO GRANDE, Unit:3, DIAMOND BAR, CA 9176S APN $293048069 LOT# OWNER NAME ROTH JULIE A TRACT# ADDRESS 1341 PORTO GRANDE #3 CITY DIAMOND BAR ZIP 91765 APPLICANT NAME TEL <NO PRIMARY PHONE> TEL CONTRACTOR NAME ADDRESS CITY STATE ZIP TEL ARCH/ENG/DES NAME ADDRESS CITY STATE ZIP TEL P/C DATE P/C# ISSUE DATE 21 May 2019 PR# PR20190000845 TYPE CONSTRUCTION OCC GROUP SCOPE OF WORK WINDOW REPLACEMENT IS WINDOWS) AND 15UDER DOOR REPLACEMENT #DWELL UNITS 0 #STORIES #BEDROOMS BUILDING FEES DESCRIPTION SCL FT FACTOR PSF ADJ AREA/VALUATION SFR/ADD/REM GARAGE/CARPORT PATIO/DECK POOL/SPA RE -ROOF COMMERCIAL TOTAL VALUATION: TOTAL $5,400 0000 PLAN CHECK FEES PERMIT FEES CONSTRUCTION $195 53 PLAN REVIEW ELECTRICAL PLUMBING MECHANICAL INSPECTION FEE ISSUANCE $45 02 SMIP $0 70 ENERGY RETENTION FEE $9 77 PRE/ALT FEE BASF $100 PLOT PLAN ZONING CLEARANCE RECYCLING AND WASTE DEPOSIT PERMIT SYSTEM REPLACMENT FEE $7 82 TOTAL FEES: $259 84 COMMENTS P/C RECEIPT # PAY METHOD VALIDATION PERMIT RECEIPT # 44685 PAY METHOD CHECK 3" VALIDATION OR A PERMIT #: PR20190000945 INSPECTION RECORD INSPECTIONi SETBACK/LETTER i TRACK AND LEDGER iINSPECTOR: FOOTINGS FORMS T-BAR SLAB POOL DEMOLITION US PLUMBING ROOF DRAINS UG ELECTRICAL POOLISRA LIFER 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 J ALARM FLOORSHEATHING FINAL POOL SHEAR WALLS EXTERIOR WALLS SHEAR WALLS INTERIOR WALL FOOTING/STEEL FRAMING/VENTING WALL STEEL 1ST{ } 2NO() LIFT RO MECHANICAL WALLDRAIN/SEAL RO ELECTRICAL W (I C (} WALLFINAL RO PLUMBING RO FRAMING PLANNING APPROVAL INSULATION WALL ROUGHFIREAPPROVAL INSULATION CEILING FINAL FIRE DEPARTMENT HOT MOP/SHO WERPAN FINAL PLANNING DRYWALL FINAL PW ENGINEERING LATH EXTERIOR FINAL PIN MAINTENANCE LATH INTERIOR FINAL HEALTHOEPT GAS TEST FINAL INDUSTRIAL WASTE SCRATCH COAT FINAL BU! Lt.+t 0`A•S ELECTRIC METER RELEASE FINALMECHANICAL GAS METER RELEASE FINAL ELECTR'KAt SPECIAL INSPECTION FINAL PLUMBING SMOKE & CARBON MONOXIDE DETECTORS TC OF OCCUPANCY CERT.OFOCCUPANCY COMMENTS 0, PERMIT It: PR20190000845 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that 1 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 forthe 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 Ucensure 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 ($500) J� (_) I as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work, and the structure Is not intended or offered for sale (Section 7044, Business and Professions Code The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or Improves the property, provided that the Improvements are not intended or offered for sale If however, the budding or Improvement Is sold within one year of completion, the Owner -Budder will have the burden of proving that it was not built or Improved for the purpose of sale ) (_) I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code The Contractors' State License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law ) U I am exempt from licensure underthe Contractor's State License law for the following reason($) 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 leglnfo 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 LICENSE NUMBER 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 POLICY # EXPIRATION DATE* NAME OF AGENT 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 $172, 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 relator to buildipi co ruction 1 authorize representatives of the City of Diamond Bar to enter the above-rdent perry or pe poses SIGNATURE OF PROPERTY OWNER OR AUTHORIZED AGENT DATE Job Address &V Mae V/711/e4f -3`4� -S 27>10 ,{ &41-OMA— Dear Property Owner ` An application for a budding permit has been submitted in your name stating yourself as the builder of the property improvements specified For your protection, you should be aware that as "owner -builder' you are the responsible party of record on such a permit Budding permits are not required to be signed by property owners unless they are personally performing their own work If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the City of County They are also required bylaw to put their license number on all permits for which they apply If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 00 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers compensation insurance, disability insurance costs, and unemployment compensation contributions There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers compensation insurance For more specific information about your obligations under the federal law, contact the Internal Review Service (and if you wish, the U S Small Business Administration) For more specific information about your obligations under State law, contact the Department of Benefit -Payments and the Division of Industrial Accidents If the structure is intended for sale, the property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions A frequent practice of unlicensed persons professing to be contractors is to secure an "owner -budder" budding permit, erroneously implying that the property owner is providing his or her own labor and materials personally Budding permits are not required to be signed by the property owners unless they are performing their own work personally Information about licensed contractors may be obtained by contacting the Contractors State License Board at 9821 Business Park Drive, Sacramento, CA 95827, www cslb ca cow or at (800) 321-CSLB (2752) Please complete and return the enclosed "Owner -Budder" verification form so that we can confirm that you are aware of these matters The building permit will not be issued until the verification is returned Building & Safety Division 21925 Copley Drive Diamond Bar, California 91765 (909) 839-7020 Fax (909) 861-3117 Attention Property Owner An "Owner•Butlder' building permit has been applied for in your name and bearing your signature Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit No budding permit will be issued until this venfication is received by us 2 IF9 e/have not) s gned an application for a building permit for the proposed work 3 1 have contracted with the following person (firm} to provide the pip Jul construction 7,9 Name 7ht &qjh rt�u! 1"r✓ Address 25 DuAtT City jr yy R tR. �(2 ' Phone+A' rX ! • ! !!• E P 4 1 plan to provide portions of the work, but I have hired the following person to coordinate IA provide the major work Name Address City 1401ITMIN 0! supervise and e A- 5 1 will provide some of the work but I have contracted (hired) the following persons to provide the work lit indicated �a Signed of-a-d� uwner Address Phone Type of Work Dear Property Owner ©-( 7k;2 Ou t An application for a budding permit has been submitted in your name listing yourself as the builder of the property improvements specified at /,V/ -&ro 6=1_,Clr *_3 We are providing you with an Owner -Budder Acknowledgment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner -Budder We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority OWNER'S ACKNOWLEDGEMENT AND VERIFICATION DIRECTIONS Read and initial each statement below to signify you understand or verify this information �I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner - Budder" budding permit that erroneously implies that the property owner is providing his or her own labor and material personally 1, as an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property My homeowner's insurance may not provide coverage for those injuries I am willfully acting as an Owner -Budder and am aware of the limits of my insurance coverage for injuries to workers on my property Yt/ %2 1 understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility U 3 I understand as an "Owner -Budder" I am the responsible party of record on the permit i understand that i may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own &4 1 understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts understand if I employ or otherwise engage any persons, other than Califorma licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law Az I understand if I am considered an "employer" under state and federal law, 1 must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each "employee " I also understand my failure to abide by these laws may subject me to serious financial risk rly0l�'7 I understand under California Contractors' State License Law, an Owner -Budder who builds single-family residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general budding Contractor JI—et-_ 'junderstand as an Owner -Budder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials f lt_t I understand I may obtain more information regarding my obligations as an "employer' from the Internal Revenue Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents I also understand I may contact the California Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752) or www cslb ca aov for more information about licensed contractors /419' 1 am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the party legally and financially responsible for proposed construction activity at the following address Af 1 1 agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner -Builders as well as employers AtiTr 1 agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I have provided on this form Licensed contractors are regulated by laws designed to protect the public If you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint Your only remedy against unlicensed Contractors may be in civil court It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages If you obtain a permit as Owner -Builder and wish to hire Contractors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit Note A copy of the property owner's driver's license, form notarization, or other verification acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature Sri- iy Signature of Property Owner Date