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Home My WebLink AboutPR20190000876PERMIT III. CITY OF DIAMOND BAR COMMUNITY DEVELOPMENT DEPARTMENT 21810 Copley Drive, Diamond Bar, CA 9176S 1909► 839-7020 Fax: (909) 861-3117 Building Inspection Hotline 1909) JJ89-7027 C11J1%NC1ND BAR BUILDING PERMIT APPLICATION www.cltvofdlamandbar.com buildblg@diamondbarca.gov JOB SITE ADDRESS: 24117 DECORAH RD, DIAMOND BAR, CA 91765 APN $703006022 LOT# TRACT# OWNER NAME FLOWERS MARY ADDRESS 8861 W SAHARA AVE #260 CITY LAS VEGAS ZIP 89117 TEL <NO PRIMARY PHONE> APPLICANT NAME. TEL CONTRACTOR NAME Future Energy ADDRESS 9211 Greenleaf Ave CITY Santa Fe SoraW STATE CA ZIP 90670 TEL 562 941-7459 ARCH/ENG/DES NAME ADDRESS CITY STATE CA ZIP TEL P/C DATE P/C# ISSUE DATE 28 May 2019 PR# PR2019DOD0876 TYPE CONSTRUCTION OCC GROUP SCOPE OF WORK: SLIDING GLASS DOOR CRANGEOUT SAME SIZE AND LOCATION (79x94) jj MECHANICAL VENT CNANGEOUT SAME LOCATION WALL INSULATION 1076 SQFT R-13 CHANGEOUT IN BATHROOM #DWELL UNITS #STORIES #BEDROOMS BUILDING FEES DESCRIPTION SQ. FT FACTOR PSF AEU AREAIVALUATION SFR/AOD/R£M GARAGE/CARPORT PATIO/DECK POOL/SPA RE -ROOF COMMERCIAL TOTAL VALUATION. TOTAL. $1200 D0D0 Mechanical TYPE QUANTITY AMOUNT TOTAL Ventilation Fans 1 $19 08 $7715 PLAN CHECK FEES PERMIT FEES CONSTRUCTION $10737 PLAN REVIEW ELECTRICAL. PLUMBING MECHANICAL $7715 INSPECTION FEE ISSUANCE $78 69 SMIP $016 ENERGY RETENTION FEE $5 36 PRE/ALT FEE BASF $100 PLOT PLAN ZONING CLEARANCE RECYCLING AND WASTE DEPOSIT PERMIT SYSTEM REPLACMENT FEE $4 29 TOTAL FEES.• $274 02 COMMENTS P/C RECEIPT# PAY METHOD VALIDATION PERMIT RECEIPT# 44765 PAY METHOD CHECK 4142 VALIDATION CR rr � PERMIT #; PR20190000976 CITY OF DIAMOND BAR INSPECTION RECORD SETBACK/LETTER DATE: INSPECTOR:INSPECTION TRACK AND LEDGER .•INSPECTOR: FOOTINGS FORMS T-BAR SLAB POOL DEMOLITION US PLUMBING ROOF DRAINS US ELECTRICAL FOOL/SPA 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 / GATE / ALARM FLOOR SHEATHING FINAL POOL SHEAR WALLS EXTERIOR WALLS, SHEAR WALLS INTERIO R WALL FOOTING/STECL FRAMING/VENTING WALL STEEL ISTO j PSI) LIFT RO MECHANICAL WALL DRAIN/SEAL RO ELECTRICAL W () C i 1 WALL FINAL RO PLUMBING RO FRAMING PLANNING APPROVAL INSULATION WALL ROUGH FIREAPPROVAL INSULATION CEILING FUJALFIREDEPARTMENT HOT MOP/SHOWERPAN ANAL PWFIVIIVIS DRYWALL FRKALPWENG/NEERMTG LATH EXTERIOR FWAL PW MAINTENANCE LATH INTERIOR FINAL MUTH DIM GAS TEST FWAL INDUSTRIAL WASTE SCRATCH COAT FINAL BUILDING L 3 f ELECTRIC METER RELEASE FUKAL MECHANICAL GAS METER RELEASE FUFAL ELECTRICAL SPECIAL INSPECTION FBVAL PLUMBING SMOKE & CARBON MONOXIDE DETECTORS TC OF OCCUPANCY CEflT OFCCCUPANCY .A PERMIT #: PR20190000976 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) or that he or she Is exempt from hcensure 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 ($Soo).]. (_] I as owner of the property, or my employees with wages as their sole compensation, will do U all of or (_j portions of the work, and the structure Is not intended or offered for sale. {Section 7044, Business and Professions Cale: 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.) U I, as owner of the property, am exclusively contracting with licensed Contractors to construct the protect. (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 hcensure under the Contractor's State License law for the following reason(s) By my signature below 1 acknowledge that, except for my personal residence In which I must have resided for at feast 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: httplwww 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, C20 LICENSE NUMBER- 995827 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 TRUMBULL INSURANCE POLICY III EXPIRATION DATE COMPANY NAME OF AGENT- 76W EGG87317 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 shalt 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.