HomeMy WebLinkAboutPR20180034288PERMIT #. PR20180034288
CITY OF DIAMOND BAR
COMMUNITY DEVELOPMENT DEPARTMENT
21810 COPIeV Drive, DiamDnd Bar, CA 91765
(909) 839-7020 Fax. (909) 961.3117 BUiiding InSpeCtion NoUine (909) 839-7027
DIAMOND BAR BUILDING PERMIT APPLICATION www divotdiamondbar #om building@dtamondbarca gov
JOB SITE ADDRESS 2443S TALLYRAND OR, DIAMOND BAR, CA 91765
APN 8701049017 LOT# TRACT#
OWNER NAME ALVARADO FRANCISCO B ANAM
ADDRESS 24435 TALLYRAND OR
CITY CIAMONDBAR ZIP 91765 TEL <NO PRIMARY PHONES
APPLICANT NAME TEL
CONTRACTOR NAME
ADDRESS
CITY STATE ZIP TEL
ARCH/ENGICES NAME
ADDRESS
CITY STATE ZIP TEL
P/C DATE PIC#
ISSUE DATE 27 SPP 2018 _ _ PRO PR20IM34299
TYPE CONSTRUCTION OCCGROUP
SCOPE OF WORK DEMOUTION Of UNPERMTTTEO PATIO COVER APPROXIMATELY 2805% Fr - MATERIAL TO BE RE -PURPOSED NO CBD DEPOSIT
REQUER D
#DWELLUNITS D #STORIES #BEDROOMS
BUILDING FEES
DESCRIPTION
SOFT
FACFOR PSF
AD! ARWVALUATICN
SFPVADDFREM
GARAGE/CARPORT
PATIO/DECK
POOL/SPA
RE -ROOF
COMMERCIAL
TOTALVALUAMON
TOTAL
PLAN CHECK FEES
PERMIT FEES
CONSTRUCTION
$17349
PLAN REVIEW
ELECTRICAL
PLUMBING
MECHANICAL
INSPECTION FEE
ISSUANCE
$45 02
SMIP
$0 65
ENERGY
RETENnON FEE
$17 35
PRE/ALT FEE
BASF
$100
PLOT PLAN
ZONING CLEARANCE
RECYCLING AND WASTE DEPOSIT
_ TOTAL FEES
COMMENTS
$237 51
..................
Pk RECEIPT# PAY METHOD VALIDATION
PERMIT RECEIPT# PAY METHOD VALIDATION
PERMIT # PR20IM34288
INSPECTION
SETBACK /LETTER
CATE:
INSPECTOR:
INSPECTION
TRACK AND LEDGER
DATL
INSPECTOR:
FOOTINGS FORMS
T RAN
SLAB
POOL DEMOLITION
US PLUMBING
ROOFORAINS
UG ELECTRICAL
P0041VA
UFERGROUND
GASTEST, E4 K ME
SEWERLATERAL
PREGUNRE
SEWER CLEANOLTT
POOLPRE DECK BONDING
AWN WATER LINE
P TRAP
ROOF SHEATHING
FENCE /SATEIALARM
FLOOR SHEATHING
FixRL POOL
SHEAR WAU3 EKTEGOR
WALLS,
SHEAR WALLS INTERIOR
WAIL FOOTING(STEEL
FRAMINGIVENTING
WALSTEEL LN{ a 2NO{ a UFT
RO MECHANICAL
WALL DAMN I SEAL
RO ELECTRICAL W S 7 C Q
WALL FINAL
WO FLUSHING
GO FRAMING PLANNING
APPROVAL
INSULATION WALL
ELTOGRIPMEAPPROVAL
INSUUTION CEILING
FNGR AREOEPANTMENT
HOT MOPjSHOWEPPAN
NNALRLA.AMW
VRVVFALL
FINRLPW ENGINFEMNG
LATH EXTERIOR
FMVILPWMAINTENANCE
LATH INTERIOR
FINAL HEALTH DEFT
GASTEST
FINAL INOUSTRML WASTE
SCRATCH COAL
FLNALAFAOING
11n
E
11
ELECTRIC METER RELEASE
FINAL MECHANICIL
GASMETERRELEASE
FINAL ELECTRICAL
SPECIAL INSPECTION
RmAt PtUMAINIS
SMOKE&CARBON
MONOXIDE DETECTORS
TC OF OCCUPANCY
CEM OF OC: &ma
COMMENTS
PERMIT # PR2O18003
5
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 bcenwre 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 U 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 )
( 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 taw 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 hoonsure 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 1 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 70" of the Business and Professions Code is available upon request when this application is submitted or at the
following Web site http/www legmfo w 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 MOD) 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'[OMPENSATION 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 selfdnsure 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 carver 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
provaions of Section 3704 of the Labor Code, I shall forthwith comply with those provsions
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 owner's behalf
I have read this application and the Information 1 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 Olamond tsar to enter the above identified property for Inspection purposes
SIGNATURE OF PROPERTY OWNER OR AUTHORIZED AGENT
DATE