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Home My WebLink AboutPR15-2154n��lonnB�� CITY OF DIAMOND BAR i DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 PRESS (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 FIRMLY BUILDING PERMIT APPLICATION wwiv.eityofdiamondbar.com building@diamondbai-ea.gov diamondbarca.gov JOB SITE AD(]RESSn APN LOT TRACT OWNER Enw�,r= ADDRESS Dcrrl,r CITY ic, c and ar ZI _TEL. t0 O APPLICANT m TEL. ` 441 - '1641 • 4I `J CONTRACTOR C r n a r v't rn ADDRESSV `2_1 9--� S s CITY ZIP TEL.Ili -7 ARCH/ENG/ DESIGNER ADDRESS CITY ZIP TEL. OWNER-BWLU€R DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's Slate License Law for the reason(s) indicated below by the checkmark(s), I have placed next to the applicable Items) [Section 7031.5, Business and Professions Cade: Any city or county that requires it permit to construct, alter, improve, demolish, or repair, any strdcture, 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 prov€siens of the Contractor's State License Law (Chapter9) Commencing with Section 7000 of Division 3 of Dirt Business and Professions Code] or that he or she is exempt from licensure and the basis for Me alleged exemption. Anyviolation of Section 7031.5 by anyapplicomfar a permit subjects the applicantto a civil penally of not more than Five hundred dollars ($500). U I, as owner of the property, army employees with wages as €heirsole compensation, will do(-) all of or U portions of the work, and the structure Is not Intended or offered for safe (Section 7044, Business and Professions Cade: The Contractors' State License law does not apply to an owner of properly who, through employees' or personal effort, builds or Improves the property, provided that the improvements are not Intended or offered for sate. If however, the building or Improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or Improved for the purpose of sale.). (-)1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of properly who builds or improves thereon, and who contracts for the projectswith a licensed Contractor pursuant to the Contractors' Stale License Law.)- () I am exempt from licensor@ under the Contractor's State License law for the following reason(s): By mysignature below I acknowledge that, except for my personal residence in which I must have resided fur at leastone year prior to completion of the improvements covered by this permit,l cannot legally sell a structure that I have built as an owner -builder if it has not been constructed In Its entirety by licensed contractors. I understand that a copy of the applicable law, Section 1044 of the Business and Professions Code €s available upon request when [his application is submitted or atihe following Web site: bttp/vnvw.legiafo.ca.gov/calaw.html. LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license Is In full force and effect. LICENSE C S:. LiC. NO.: i8i f. () -I DATE: 3i 2�6`,$ CONTRACTOR:P_k�rs,,rnn WORKER'S COMPENSATION DECLARATION 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 Worker's Compensation, as provided by I/ Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as required by Section 3700 of the Labor Code, for His performance of the wodc for which this permit is issued. My Worker's Compensation Insurance Carder and Policy Number are: CARRIER 'Al tic V,)14 POLICY NUMBER CAO6 tq I • '3-O 0� (THIS SECTION NEED NOTDE COMPLETED IF THEPMMN€S FORONEHUNDRED OOIJ_ARS ($100) OR LESS). I certify that in the performance of lire work for which this permit is issued, I shall not employ any person hr any manner so as to become subject to the Worker's Compensation Laws of California. And agree that 9I should become subject to the Worker's Compe on visions of Section 3700 of the labor Code, I shall forlim0th comply witty those provisions. DATE: 9 °"r r5 APPLICANT: WARNING: Failure to secure Worker's Compensation coverage Is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,000), in addiiion to the cost of the compensation, damages as provided for in section 3108 of the labor code, interest, and attorney's fees. 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 (Sec. 3097. Civ. C.j. LENDER'S NAME: LENDER'S ADDRESS: I codify that I have read this application and state that the above information Is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon the above -mentioned property for Inspection purposes. PRIM E E (€iiNLJj SIGNA RE OF PERMITITE DATE 11 r } f APPLICATION DATE: /�/ ic ISSUE DATE: 11 1 15 _PERMIT# : TYPE CONST. P/C# PA PVV N S - OCC GROUP: Scope of Work Co f%5 e C> E # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREAIVALUATION SFWAon/REM Garage/Carport Patio/Deck LU tta PooUSpa ' - �^ zRe -Roof Commercial m Valuation: Adj. Area: QUANTITY DESCRIPTION FEE S L_ U c, o L- S t; u.r ( C w c0 rL U_ x U CONSTRUCTION: PLAN REVIEW: ,? .. ELECTRIC: r PLUMBING: MECHANICAL: 'aJ- INSPECTION FEE: ISSUANCE: r 4�,. s SMIP: 3 a ENERGY P/C: ENERGY PERMIT: RETENTION FEE: �f PRE-ALT FEE: �� • O0 BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL PEES COMMENTS: P/C: PAID BY: VALIDATION:_ RECEIPT ff a7-31 i PAID BY: 4 sir a VALIDATION: WHITE Department Copy, YELLOW — Finance Copy, PINK Assessor Copy CITY OF DIAMOND ;R" INSPECTIONRECORD SETBACK/LETTER LETTER TMCT ANO LEDGER ' FOOTINGS FORMS 7 SWITCH GEAR SLAB COMMERCIAL HOOD UG. PLUMBING T-BAR UG. ELECTRICAL - � _ INTERCEPTER _ UFER GROUND HOT MOP/SHOWEIIPAN SEWER LATERAL SEPTIC/GESSPOOL MAIN WATER LINE_ HERS REPORT RECEIVED SEWER CLEANOUT _ DEMOLITION ROOF SHEATHING ROOF DRAINS FLOOR SHEATHING ROUGH CONDUIT SHEAR WALLS EXTERIOR POOL/SPA SHEAR WALLS INTERIOR ROUGH PLUMBING FRAMINGNENTING ROUGH ELECTRICAL ROUGH MECHANICAL ROUGH MECHANICAL ! ROUGH ELECTRICAL W( ) C () GAS TEST ROUGH PLEMBING PRE GUNITE._.. INSULATION WALL POOL PRE DECK BONDING - INSULATION CEILING P-TRAP DRYWALL FENCE / GATE/ ALARM FINAL POOL Z LATH (PRE) LATH EXTERIOR WALLS: f LATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL 1 sr( ) 2r40( ) LIFT SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELFASE WALL DRAIN/ SEAL GAS METER RELEASE WALL FINAL SPECIAL INSPECTION RO. FRAMING PLANNING APPROVAL FINAL BUILDING ROUGH FIRE APPROVAL FINAL MECHANICAL FINAL ELECTRICAL FINAL FIRE DEPARTMENT FINAL PLANNING ......... -- FINAL PLUMBING FINAL ENGINEERING/ PW' T.G. of OCCUPANCY FINAL COMMUNITY SERVICES" CERT. of OCCUPANCY COMMENTS: FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE