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Home My WebLink AboutPR20190000001PERMIT #: AIA CITY OF DIAMOND BAR COMMUNITY DEVELOPMENT DEPARTMENT 21810 Copley Drive, Diamond Bar, CA 91765 (909) 939-7020 Fait: (909) 861-3117 Building Inspection Hotline (909) 939-7027 DIAMC>ND BAR BUILDING PERMIT APPLICATION www.ciWMiamondbar.com budding@dlamondbarca.gov JOB SITE ADDRESS, 1840 PEACEFUL HILLS RD, DIAMOND BAR, CA 9176S APN 8765004057 LOT# OWNER NAME KAWANO KERRY&JENNY G TRACT# ADDRESS 1840 PEACEFUL HILLS RD CITY WALNUT ZIP 91789 APPLICANT NAME TEL <NO PRIMARY PHONES TEL CONTRACTOR NAME LIFETIME SOLUTIONS INC ADDRESS 15400 VILLAGE OR CITY VICTORVILLE STATE CA ZIP 92394 TEL (760) 951-7605 ARCHJENGJDES NAME ADDRESS CITY STATE CA ZIP TEL P/C DATE PJC# ISSUE DATE PR# TYPE CONSTRUCTION OCCGROUP SCOPE OF WORK Water Softner #DWELLUNITS #STORIES #BEDROOMS BUILDING FEES DESCRIPTION SO FT FACTOR PST ADJ AREA/VALUATION SFRJADOJREM GARAGE/CARPORT PATIO/DECK POOL/SPA RE -ROOF COMMERCIAL TOTAL VALUATION. TOTAL, Plumbing TYPE QUANTITY AMOUNT TOTAL Water Softener 1 $1982 $1982 PLAN CHECK FEES PERMIT FEES CONSTRUCTION PLAN REVIEW ELECTRICAL PLUMBING $55 76 MECHANICAL INSPECTION FEE ISSUANCE $45 02 SMIP ENERGY RETENTION FEE $5 02 PREJALT FEE BASF PLOT PLAN ZONING CLEARANCE RECYCLING AND WASTE DEPOSIT TOTAL FEES: $105 80 COMMENTS P/CRECEIPT # PAY METHOD VALIDATION FERMIT RECEIPT # 42772 PAY METHOD VALIDATION hm PERMIT M PRIOAOC dl INSPECTIOND+ SETBACK / LETTER •INSPECTOR: TRACK AND LEDGER FOOTINGS FORMS T-BAR SLAB POOL DEMOLITION UG PLUMBING ROOF DRAINS UG ELECTRICAL POOLISPA UFERGROUND '�, OAS TEST, EL, AL, ME SEWER LATERAL PRE GUNITE SEWER CLEANOUT POOL POE 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 FRAMINGIVENTING WALL STEEL ISTO j ZND( ) LIFT RO MECHANICAL WALLDRAIN/SEAL RO ELECTRICAL W I I C(j WALLFINAL RO PLUMBING RO FRAMING PLANNING APPROVAL INSULATION WALL ROUGH FIRE APPROVAL INSULATION CEILING FINAL FIREDEPARTMENT HOT MOP/SHOW ERPAN FINAL MANNING DRYWALL F1A4L P IN ENGI NEERING LATH EXTERIOR FINALPW MAINTENANCE LATH INTERIOR FtNALHEALTN DEPT GAS TEST FINAL INDUSTRIAL WASTE SCRATCH COAT FINAL BUILDING ELECTRIC METER RELEASE FINAL MECHANICAL GAS METER RELEASE FINAL ELECTRICAL SPECIAL INSPECTION FINAL PLUMNNG t IA i SMOKE &CARBON MONOXIDE DETECTORS TC OFOCCUPANCY CERT. OF OCCUPANCY COMMENTS r � r PERMIT #: PR20190000001 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 items) (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 licensure 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) ) (_) 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 -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 ) U 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 htmi 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 C36 LICENSE NUMBER 588619 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 HDI Global Insurance POLICY If, EXPIRATION DATE NAME Of AGENT EWGCC0002177 PHONE k 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 owners 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 building construction I authorize representatives of the City of Diamond Bar to enter the above -identified prope for inspection purposes SIGNATURE OF PROPERTY OWNER OR AUTHORIZED AGENT Fred Salazar DATE > 1-"4— 11