HomeMy WebLinkAboutPR20190000110\ / PERMIT #: PR20190000110
CITY OF DIAMOND BAR
COMMUNITY DEVELOPMENT DEPARTMENT
21810 Copley Drive, Diamond Bar, CA 91765
(909) 839-7020 Fax: (909) 961-3117 Building Inspection Hotline (909) 839-7027
DIAMOND BAR BUILDING PERMIT APPLICATION www.citvofdiamondbar.com building@diamondbarca.gov
JOB SITE ADDRESS' 21523 AMBUSHERS ST, DIAMOND BAR, CA 91765
APN 8714003012 LOT# TRACT#
OWNER NAME XI FANG
ADDRESS 7 HUTAN RD ZHONG SHAN
CITY DALIAN LIAON ZIP C NA TEL <NO PRIMARY PHONE>
APPLICANT NAME TEL
CONTRACTOR NAME PERFECT D 1 E INC
ADDRESS 309 WEST NEWBY AVENUE #E
CITY SAN GABRIEL STATE CA ZIP 91776 TEL <NO PRIMARY PHONE>
ARCH/ENG/DES NAME Ideal Design Group Inc
ADDRESS 21671 Gateway Center Dr STE 201
CITY Diamond Bar STATE CA ZIP 91765 TEL (909) 569-2069
P/C DATE P/C#
ISSUE DATE 11 Apr 2019 PR# PR20190000110
TYPE CONSTRUCTION OCCGROUP
SCOPE OF WORK 1st. FLOOR - CONVERT EX BAR AREA TO POWDER ROOM (37 Sq Pt.)
2nd FLOOR - Redesign Bedroom #2 & Bathroom 02 (116 Sq FT I - 2nd Floor - Reduce size of Bathroom 03 (S3 Sq. Ft.) - 2nd.
Floor - Relocate Closet In Bedroom 04 - 2nd. Floor - Add Bathroom #4 to Bedroom #4
#DWELL UNITS #STORIES #BEDROOMS
BUILDING FEES
DESCRIPTION
SQ, FT
FACTOR PSF
AD) AREA/VALUATION
SFR/ADD/REM
GARAGE/CARPORT
PATIO/DECK
POOL/SPA
RE -ROOF
COMMERCIAL
TOTAL VALUATION*
TOTAL:
$8,987 7800
Mechanical
TYPE
QUANTITY
AMOUNT
TOTAL
Ventilation Fans
2
$1908
$7715
Electrical
TYPE
QUANTITY
AMOUNT
TOTAL
Fixed Residential Appliances or Receptacle Outlets
30
$12 96
$129 60
Plumbing
TYPE
QUANTITY
AMOUNT
TOTAL
Plumbing Fixture / Trap or Set of Fixtures
8
$19 82
$158 56
PLAN CHECK FEES
PERMIT FEES
CONSTRUCTION
$26165
PLAN REVIEW
$222 40
ELECTRICAL
$129 60
PLUMBING
$158 56
MECHANICAL
$77 15
INSPECTION FEE
ISSUANCE
$146 03
SMIP
__ $117
ENERGY
$2224
RETENTION FEE
$13 08
PRE/ALT FEE
BASF
$100
PLOT PLAN
ZONING CLEARANCE
RECYCLING AND WASTE DEPOSIT
PERMIT SYSTEM REPLACMENT FEE
$10 46
TOTAL FEES:
$1,043 34
COMMENTS
P/C RECEIPT# PAY METHOD VALIDATION
PERMIT RECEIPT # PAY METHOD r&4h VALIDATION 170
PERMIT M PR20190000110
CITY OF DIAMOND BAR P
INSPECTIO
SETBACK%LETTER
OR:
i
TRACK AND LEDGER
DATE:
FOOTINGS FORMS
T-BAR
SLAB
POOL DEMOLITION
UG PLUMBING
a _ q
!
ROOF DRAINS
UG ELECTRICAL
POOL/SPA
UFER GROUND
GAS TEST, EL, PL, ME
SEWER LATERAL
PRE GVNITE
SEWER CLEANOUT
POOL PRE DECK BONDING
MAIN WATER LINE
P-TRAP
ROOFSHEATHING
FENCE J GATE( ALARM
FLOOR SHEATHING
FINAL POOL
SHEAR WALLS EXTERIOR
WALLS
SHEAR WALLS INTERIOR
WALL FOOTING/STEEL
FRANUNGjVENTING
WALL STEEL SSTt j LND( I LIFT
RO MECHANICAL
WALL DRAIN j SEAL
RO ELECTRICAL W()Cj}
JM /I
WALL FINAL
RO PLUMBING
! j� a
(d f')
RO FRAMING PLANNING
APPROVAL
INSULATION WALL
ROUGH FIRE APPROVAL
INSULATION CEILING
FINAL FIRE DEPARTMENT
HOT MOP/SHOWERPAN
FINAL PLANNING
DRYWALL
FINAL PW ENGINEERING
LATH EXTERIOR
FINAL PIN MALIMMANCE
LATH INTERIOR [" ff
J (
FINALHEALINDEPT
GAS TEST
NfAL JWOUSMIAL WASTE
SCRATCH COAT
FINAL BUILDING
ELECTRIC METER RELEASE
FINAL MECHANICAL
l
GAS METER RELEASE
FINAL ELECTRICAL
A
SPECIAL INSPECTION
FINAL PLUMBING
SMOKE & CARBON
MONOXIDE DETECTORS
T C OF OCCUPANCY
4€RT OK OCCUPANCY
I
OWNER-BUiLDER DECLARATION
I hereby affirm under penalty of perjurythat I am exempt from the Contractor's State License Law forthe 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 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 ($S00) )-
(_) 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 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 )
(J 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 forthe projects with a licensed Contractor pursuant to the Contractors' State License
Law )
(_) 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 -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 httpfwww leginfo ca govjcalaw 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 B LiCENSE NUMBER 961610
EXPIRATION DATE CONTRACTOR SIGNATURE
WORKERS' COMPENSATION DECLARATION:
WARNING FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECTAN 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 carver and
policy number are
CARRIER <Enter Workers Comp> POLICY* EXPIRATION DATE
NAME OF AGENT 0 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 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 inspection purposes
SIGNATURE OF PROPERTY OWNER OR AUTHORIZED AGENT
DATE