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Home My WebLink AboutPR20190001950PERMIT #: PR20190001950 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 i;UI OND BAR BUILDING PERMIT APPLICATION www.citvofdiamondbar.com building@diamondbarca.gov JOB SITE ADDRESS: 22700 BEAVERHEAD DR, DIAMOND BAR, CA 91765 APN: 8718025007 LOT##: TRACT#: OWNER NAME: ODA STUDDARD IRENE K ADDRESS: 22700 BEAVERHEAD DR CITY: POMONA ZIP: 91765 TEL: <NO PRIMARY PHONE> APPLICANT NAME: TEL: CONTRACTOR NAME: Jose Gonzalez dba Affordable Roofing Services ADDRESS: 13581 GOLD MEDAL AVENUE CITY: Chino STATE: CA ZIP: 91710 TEL: (626)216-9374 ARCH/ENG/DES. NAME: ADDRESS: CITY: STATE: CA ZIP: TEL: P/C DATE: P/C#: ISSUE DATE: 05 Nov 2019 PR#: PR20190001950 TYPE CONSTRUCTION: OCC GROUP: SCOPE OF WORK: TEAR OFF OLD HOUSE AND GARAGE FLAT ROOFS, INSTALL CLASS A 30 YEAR CRRC 0890-0008 TORCH DOWN ON GARAGE #DWELL UNITS: 0 #STORIES: #BEDROOMS: BUILDING FEES DESCRIPTION SQ. FT. FACTOR PSF ADJ AREA/VALUATION SFR/ADD/REM GARAGE/CARPORT PATIO/DECK POOL/SPA RE -ROOF $10,000.00 COMMERCIAL TOTAL VALUATION: TOTAL: $10,000.0000 PLAN CHECK FEES PERMIT FEES CONSTRUCTION: $291.39 PLAN REVIEW: ELECTRICAL: PLUMBING MECHANICAL: INSPECTION FEE: ISSUANCE: $46.23 5MIP: $1.30 ENERGY: RETENTION FEE: $14.56 PRE/ALTFEE: BASF: $1.00 PLOT PLAN: ZONING CLEARANCE: RECYCLING AND WASTE DEPOSIT: $250.00 PERMIT SYSTEM REPLACMENT FEE: $11.65 TOTAL FEES: $616.13 COMMENTS: P/C RECEIPT#: PAY METHOD: VALIDATION: PERMIT RECEIPT #: 47220 PAY METHOD: CHECK : 2339 VALIDATION: CR PERMIT #: PR20190001950 CITY OF DIAMOND BAR INSPECTION RECORD SETBACK / LETTER TRACK AND LEDGER FOOTINGS FORMS T-BAR SLAB POOL DEMOLITION UG: PLUMBING ROOF DRAINS UG. ELECTRICAL POOL/SPA:- LIFER GROUND GAS TEST, EL, PL ME SEWER LATERAL PRE GUN ITE 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 INTERIOR - _ ... WALL FOOTING/STEEL FRAMMG/VENTING WALLSTEEL 1ST{ ZND{ y LIFT ROI MECHANICAL i !i WALL DRAI N / SEAL RO[ ELECTRICAL W O C {) WALL FINAL RO[ PLUMBING RO. FRAMING PLANNING APPROVAL INSULATION WALL i ROUGH FIREAPPROVAL INSULATION CEILING FINAL FIRE DEPARTMENT HOT MOP/SHOWERPAN FINAL PLANNING DRYWALL FINAL PW ENGINEERING LATH EXTERIOR FINALPWMAINTENANCE LATH INTERIOR FINAL HEALTH DEPt GAS TEST FINAL INDUSTRIAL WASTE SCRATCH COAT FINAL BUILDING ELECTRIC METER RELEASE FINAL MECHANICAL GAS METER RELEASE FINALELECTRICAL SPECIAL INSPECTION FINAL PLUMBING SMOKE & CARBON MONOXIDE DETECTORS T.C. OF OCCUPANCY CERT. OF OCCUPANCY COMMENTS: PERMIT #: PR20190001950 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 7031.5, 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 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).j: (_) I as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) 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.) (_) 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.) (_) I am exempt from licensure 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: http/www.1eginfo.ca.gov/calaw.htm1. SIGNATURE OF PROPERTY OWNER OR AUTHORIZED AGENT: DATE: LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that l 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: C39 LICENSE NUMBER: 947589 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 ATTORNEYS 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: STATE COMPENSATION POLICY #: EXPIRATION DATE: INSURANCE FUND NAME OF AGENT: 9018316 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 c ect. agree to comply with all applicable city and county ordinances d state laws elating to building construction. authorize representatives of the City of Diamond Bar to enter he above -id i operty for inspection purposes. SIGNATURE OF PROPERTY OWNER OR AUTHORIZED AG�NT: DATE: