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"i, E9PERMIT #: PR20190001112 fI CITY OF DIAMOND BAR COMMUNITY DEVELOPMENT DEPARTMENT 21810 Copley Drive, Diamond Bar, CA 9176S 1909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 DI'AMONO BAR BUILDING PERMIT APPLICATION www.cityofdiamandbar.com building@dtamondbarca.gov JOB SITE ADDRESS 23330 STIRRUP OR, DIAMOND BAR, CA 91765 APN 8717017031 LOT# OWNER NAME CHANG, DEBBIE TRACT# ADDRESS 23330 STIRRUP DR CITY DIAMOND BAR ZIP 91767 APPLICANT NAME TEL (909) S69-9112 TEL CONTRACTOR NAME ADDRESS CITY STATE ZIP TEL ARCH/ENG/DES NAME ADDRESS CITY STATE ZIP TEL P/C DATE ISSUE DATE 28 Jun 2019 P/C# PR# PR20190001112 TYPE CONSTRUCTION OCC GROUP SCOPE OF WORK KITCHEN % BATHROOM REMODEL 8 ELARGED MASTER CLOSET #DWELL UNITS 0 #STORIES #BEDROOMS BUILDING FEES DESCRIPTION SQ FT FACTOR PSF ADJ AREA/VALUATION SFR/ADD/REM GARAGE/CARPORT PATIO/DECK POOL/5PA RE -ROOF COMMERCIAL TOTAL VALUATION' TOTAL: $1,000 0000 Electrical TYPE QUANTITY AMOUNT TOTAL Receptacle, Switch, Lighting or other Outlets 62 5162 1 $115 04 Plumbing TYPE QUANTITY AMOUNT TOTAL Plumbing Fixture / Trap or Set of Fixtures 9 $19 82 $178 38 PLAN CHECK FEES PERMIT FEES CONSTRUCTION $85 33 PLAN REVIEW ELECTRICAL $230 08 PLUMBING $356 76 MECHANICAL INSPECTION FEE ISSUANCE $112 36 SMIP $0 50 ENERGY RETENTION FEE $18 94 PRE/ALT FEE BASF $100 PLOT PLAN ZONING CLEARANCE RECYCLING AND WASTE DEPOSIT PERMIT SYSTEM REPLACMENT FEE $15 15 TOTAL FEES. $82012 COMMENTS P/C RECEIPT # PAY METHOD VALIDATION PERMIT RECEIPT# 45377 PAY METHOD CKX390 VALIDATION RC 'f + PERMITM PR20190001112 CITY OF ! � ► L`7 �l - � l!J l' � i�+t�ll�iitl e' INSPECTION1+ SETBACK/LETTER ! TRACK AND LEDGER i•INSPECTOR: FOOTINGS FORMS T-BAR SLAB POOL DEMOLITION UG PLUMBING ROOF DRAINS US ELECTRICAL PDOLJSPA 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 I GATE / ALARM FLOOR SHEATHING FINAL POOL SHEAR WALLS EXTERIOR WALLS SHEAR WALLS INTERIOR WALL FOOTI NG/STEEL FRAMING/VENTING WALL STEEL SST() ZND() LIFT , RO MECHANICAL WALL DRAIN/SEAL RO ELECTRICAL W O C O WALL FINAL RO PLUMBING RO FRAMiNG PLANNING APPROVAL INSULATION WALL ROUGH FIREAPPROVAL INSULATION CEILING FINAL FIREDEPARTMENT HOT MOP/SHOWERPAN FINAL PLANNING DRYWALL FINAL PW ENGINEERING LATH EXTERIOR FINAL PW MAINTENANCE LATH INTERIOR FINAL HEALTH DEPT GAS TEST FINAL INDUSTRIAL WASTE SCRATCH COAT FINAL BUILDING ELECTRIC METER RELEASE FINAL MECHANICAL t \ GAS METER RELEASE FINAL ELECTRICAL U _\ SPECIAL INSPECTION I"PLUMBING SMOKE & CARBON MONOXIDE DETECTORS TC OFOCCUPANCY CERT OF OCCUPAN COMMENTS PERMIT M PR20190001112 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjurythat 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) or that he or she is exempt from licensure 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 ($S00) ] (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 building 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 ) (_) 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 ) (_) 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 an Owner -builder 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 SIG RE OF PROPERTY OWNER OR AU 22.CZED 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 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 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 property for inspection purposes SIGNATURE OF PROPERTY OWNER OR AUTHORIZED AGENT DATE