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Home My WebLink AboutPR20190001187PERMIT#: PR20190001187 CITY OF DIAMOND BAR COMMUNITY DEVELOPMENT DEPARTMENT 21810 Copley Drive, Diamond Bar, CA 91765 (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 DIAMOND BAR BUILDING PERMIT APPLICATION www.citygNiamondbar.com buddrng@diamondbarca.gov JOB SITE ADDRESS. 21364 BROKEN ARROW DR, DIAMOND BAR, CA 91765 APN 8292004014 LOT# OWNER NAME 08ARR STEPHEN A & SERONICA 8 TRACT# ADDRESS 21364 BROKEN ARROW DR CITY DIAMOND BAR ZIP 91765 APPLICANT NAME TEL <NO PRIMARY PHONE> TEL CONTRACTOR NAME TROUT ELECTRIC ADDRESS 7056 Archibald Ave #102-191 CITY Carona STATE CA ZIP 92880 TEL (951) 745-0702 ARCH/ENG/DES NAME ADDRESS CITY STATE CA ZIP TEL P/C DATE ISSUE DATE 10Jul 2019 P/C# PR# PR20190001187 TYPE CONSTRUCTION OCCGROUP SCOPE OF WORK 200 AMP SERVICE UPGRADE #DWELL UNITS #STORIES #BEDROOMS BUILDING FEES DESCRIPTION SO, FT FACTOR PSF ADJ AREA/VALUATION SFR/ADD/REM GARAGE/CARPORT PATIO/DECK POOL/SPA RE -ROOF COMMERCIAL TOTALVALUATION' TOTAb Electrical TYPE QUANTITY AMOUNT TOTAL Panel Upgrade (200.1000 amps) 1 7228 $72 28 PLAN CHECK FEES PERMIT FEES CONSTRUCTION PLAN REVIEW ELECTRICAL $72 28 PLUMBING MECHANICAL INSPECTION FEE ISSUANCE $46 23 SMIP ENERGY RETENTION FEE $3 61 PRE/ALT FEE BASF PLOT PLAN ZONING CLEARANCE RECYCLING AND WASTE DEPOSIT PERMIT SYSTEM REPFACMENT FEE $2 89 TOTAL FEES: $125 01 COMMENTS P/C RECEIPT # PAY METHOD VALIDATION PERMIT RECEIPT# 4SS13 PAY METHOD CHECK 16SS1 VALIDATION CR PERMIT #: PR2019LI0611W SETBACK (LETTER DATE: INSPECTOR: INSPECTIONINSPECTION TRACK AND LEDGER INSPECTOR: FOOTINGS FORMS I T BAR SLAB POOL DEMOLITION UG PLUMBING ROOF DRAINS UG ELECTRICAL POO4S'PA UFFR GROUND GAS TEST, EL, PL. ME SEWER LATERAL PRE GUTIITE SEWER CLEANOUT POOL PRE DECK BONDING MAIN WATER LINE P-TRAP ROOF SHEATHING FENCE/ GATE j ALARM FLOOR SHEATHING FINAL POOL SHEAR WALLS EXTERIOR WALLS SHEAR WALLS INTERIOR WALL FOOTING/STEEL FRAMING/VENTING WALL STEEL 1ST{ i 2ND(} LIFT RO MECHANICAL WALL DRAIN I SEAL RO ELECTRICAL W () C WALL FINAL RO PLUMBING RO FRAMING PLANNING APPROVAL INSULATION WALL ROU6HFIREAPPROVAL INSULATION CEILING FRPAL FIRE DEPARTMENT HOT MOPJSHOW ERPAN FINAL PLANNING DRYWALL FINAL PINENGINEERIN6 LATH EXTERIOR RNALPW MAINTENANCE LATH INTERIOR FINAL HEALTH DEPT GAS TEST FINALNiDUSTRIALWASM SCRATCH COAT FINALBUILDRM6 ELECTRIC METER RELEASE FINAL MECHANICAL GAS METER RELEASE FINALELEtTRICAL -g.- SPECIAL INSPECTION FINALPWMISIN6 SMOKE & CARBON MONOXIDE DETECTORS T C OF OCCUPANCY CERT OF OCCUPANCY COMMENTS 4 .;, PERMIT M PR20190001187 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law far 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 Iicensure 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) I (_) 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 building 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 ) (_) 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 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 legmfo ca 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 7000) of Division 3 of the Business and Professions Code, and my license is In full force and effect LICENSE CLASS C10 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 NORGUARD INSURANCE POLICY# EXPIRATION DATE COMPANY NAME OF AGENT. TRWC008819 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 forwhich 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 budding construction I authorize representatives of the City of Diamond Bar to enter the above-i a perty for inspection purposes SIGNATURE OF PROPERTY OWNER OR AUTHORIZED AGENT DATE