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HomeMy WebLinkAboutPR20190000450PERMIT #: Aw CITY O DIAMOND BAR COMMUNITY DEVELOPMENT DEPARTMENT 21810 Copley Drive, Diamond Bar, CA 91765 (909) 839-7020 Fax: (909) 861-3117 Budding Inspection Hotline (909) 839.7027 DIAWI4ND BAR BUILDING PERMIT APPLICATION www.cltvofdiamondbar.com building@dlamondbarca.gov JOB SITE ADDRESS: 22628 RED FIR LN, DIAMOND BAR, CA 91765 APN 8293018023 LOT# OWNER NAME KATRIB GABY G & UNDA TRACT# ADDRESS 22628 RED FIR LN CITY DIAMOND LIAR ZIP 9176S APPLICANT NAME TEL <NO PRIMARY PHONE> TEL CONTRACTORNAME ADDRESS CITY STATE ZIP TEL ARCHJENGJDES NAME tCfti' ADDRESS CITY STATE ZIP TEL P/C DATE PjC# ISSUE DATE 01 Apr 2019 PR# PR201900DO450 TYPE CONSTRUCTION OCCGROUP SCOPE OF WORK 200 amp panel upgrade #DWELL UNITS #STORIES #BEDROOMS BUILDING FEES DESCRIPTION SO, FT FACTOR PSF ADJ AREA/VALUATION SFRfADD(REM GARAGE/CARPORT PATIO/DECK POOLISPA RE -ROOF COMMERCIAL TOTAL VALUATION, TOTAV Electrical TYPE QUANTITY AMOUNT TOTAL Panel Upgrade (less than 200 amps) 1 $36 93 $36 93 PLAN CHECK FEES PERMIT FEES CONSTRUCTION PLAN REVIEW ELECTRICAL $55 76 PLUMBING MECHANICAL INSPECTION FEE ISSUANCE $45 02 SMIP ENERGY RETENTION FEE $2 79 PRE/ALT FEE BASF PLOT PLAN ZONING CLEARANCE RECYCLING AND WASTE DEPOSIT PERMIT SYSTEM REPLACMENT FEE $2 23 TOTAL FEES: $105 80 COMMENTS P/C RECEIPT # PAY METHOD VALIDATION PERMIT RECEIPT # 43953 PAY METHOD Cheek # 449U VALIDATION EM PERMIT #: PR20190000450 INSPECTION• ' i INSPECTION SETBACK/ LETTER DATE: INSPECTOR: INSPECTION TRACK AND LEDGER DATE: INSPECTOR: FOOTINGS FORMS T-BAR SLAB !,. POOL DEMOLITION , UG PLUMBING ROOF DRAINS UG ELECTRICAL POO41SPA UFER GROUND GAS TEST, EL, PL, ME SEWER LATERAL - PRE GUNITE SEW ER CLEANOUT POOL PRE DECK BONDING MAIN WATER LINE P-TRAP ROOFSHEATHING FENCEIGATEJ ALARM FLOOR SHEATHING FINAL POOL SHEAR WALLS EXTERIOR WALLS SHEAR WALLS INTERIOR WALL FOOTINGISTEEL FRAMINGIVENTING WALL STEEL 1ST( l 2NOj j LIFT RO MECHANICAL WALL DRAIN I SEAL RO ELECTRICAL WO CO WALLFINAL RO PLUMBING RO FRAMING PLANNING APPROVAL INSULATION WALL ROUGH FIREAPPROVAL INSULATION CEILING FINAL FIRE DEPARTMENT HOT MID PISHOW ERPAN FINAL PLANNING DRYWALL FINALPW ENGINEERING LATH EXTERIOR FINAL PW MAINTENANCE LATH INTERIOR FINAL HEALTH DEFT GAS TEST FINAL INDUSTRIAL WASTE SCRATCH COAT FINAL BUILWNO ELECTRIC METER RELEASE FINAL MECHANICAL GAS METER RELEASE FINALELECTRICAL SPECIAL INSPECTION FINAL PLUMBING SMOKE & CARBON MONOXIDE DETECTORS ---� TO OF OCCUPANCY CERT OF OCCUPANCY COMMENTS L- r PERMIT M PR20190000450 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 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) orthat 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) ] U i as owner of the property, or my employees with wages as their sole compensation, will do (j 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 -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 ) (j I am exempt from licensure 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 Cade is available upon request when this application is submitted or at the following Web site hop#vww leginfo ca gov/calaw Mint / SIG TURF F PROPERTY OWNER OR AUTHORIZED AGENT DATE LICENSED CONTRACTOR'S DECLARATION I ereby 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 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 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 8172, Civil Cade) 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 relating to building construction I authorize representatives of the City of Diamond Bar to enter the above -identified property for mspectWur SIGNATURE OF PROPERTY OWNER OR AUTHORIZED AGENT Gaby G Katnb DATE zf _ 6 Job Address tf1.1�l1ifiU Ij�1CC Building & Safety Division 21810 Copley Drive Diamond Bar, California 91765 (909) 839-7020 Fax (909) $61-3117 22628 RED FIR LANE DIAMOND BAR CA 91765 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 -budder" 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 d 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 -builder" building 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 wok personally Information about licensed contractors may be obtained by contacting the Contractors State License Board at 9821 Business Park Drive, Sacramento, CA 95827, www csib ca cov or at (800) 321-CSLB (2752) Please complete and return the enclosed "Owner -Builder" 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 4 I wT`r• Building & Safety Division 21825 Copley Drive Diamond Bar, California 91765 (909) 839-7020 Fax (909) 861-3117 Attention Property Owner An "Owner -Budder" 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 building permit will be issued until this venfication is received by us 1 1 personally plan to provide the major labor and materials for construction of the proposed property improvement (yes or no) YES 2 1 (have/have not) YES signed an application for a building permit for the proposed work 3 1 have contracted with the following person (firm) to provide the proposed construction N/A Name Address City 1:2, a Contractors License No 4 1 plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work N/A Name Address City Phone Contractors License No 5 1 will provide some of the work but I have contracted (hired) the following persons to provide the work indicated N/A Name Signed Date Address Phone Type of Work NOTICE TO PROPERTY OWNER Dear Property Owner An application for a building permit has been submitted an your name listing yourself as the budder of the property Improvements specified at 2mg "Co Fall LANE DIAMOND BAR CA 91765 We are providing you with an Owner -Builder 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 budding 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 ✓ t I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner - Builder" budding permit that erroneously implies that the property owner as providing has or her own labor and material personally I, as an Owner -Budder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and has or her employees while working on my property My homeownees insurance may not provide coverage for those injuries I am willfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers on my property __%t/2 I understand budding 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 43 1 understand as an "Owner -Builder" 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 has 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 _.S4/5 I understand of I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction as at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law ,L6 I understand of I am considered an "employer" under state and federal law, I 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 _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 as performed under contract with a licensed general budding Contractor --,,/ 8 I understand 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 --V9 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 csib ca oov for more information about licensed contractors • i Yk • f i • • Y' .•Y Y' •. �. t i# k 3 t t t•+ f Tt • J•t --\/ i i I 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 V 12 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 venfication acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature Date