HomeMy WebLinkAboutPR20190002219PERMIT 9: PR7019fIM7719
CITY OF DIAMOND BAR
COMMUNITY DEVELOPMENT DEPARTMENT
21810 Copley Drive, Diamond Bar, CA 91765
� �l� (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027
DIAMOND BAR BUILDING PERMIT APPLICATION WWW.cityofdiamondbar.com building@diamondbarca.gov
JOB SITE ADDRESS: 348 SAN LEANDRO DR, DIAMOND BAR, CA 91765
APN: 8281012044 LOT#: TRACT#:
OWNER NAME: ENG HENRY & MARILYN R
ADDRESS: 348 SAN LEANDRO DR
CITY: DIAMOND BAR ZIP: 91765 TEL: <NO PRIMARY PHONE>
APPLICANT NAME: TEL:
CONTRACTOR TLP ELECTRIC INTEGRATIONS, INC. dba INFINITY SOLAR
NAME:
ADDRESS: 2460 N. GLASSELL ST., STE. A
CITY: ORANGE STATE: CA ZIP: 92865 TEL: (714) 904-3474
ARCH/ENG/DES.
NAME:
ADDRESS:
CITY: STATE: CA ZIP: TEL:
P/C DATE: P/C#:
ISSUE DATE: 29Jan 2020 PRM PR20190002219
T Y P E OCC GROUP:
CONSTRUCTION:
SCOPE OF WORK: INSTALLATION OF A 6.27 KW DC PV SYSTEM, 19 MODULES & 19 MICRO -INVERTERS // MSP UPGRADED TO 200AMP
#DWELL KNITS: #STORIES. #BEDROOMS:
BUILDING FEES
DESCRIPTION
SQ. FT.
FACTOR PSF
AD1 AREA/VALUATION
SFR/ADD/REM
GARAGE/CARPORT
PATIO/DECK
POOL/SPA
RE -ROOF
COMMERCIAL
TOTAL VALUATION:
TOTAL:
$21,506.0000
Electrical
TYPE
QUANTITY
AMOUNT
TOTAL
Photovoltaic Systems
1
$73.93
$73.93
Panel Upgrade (less than 200 amps)
1
$47.90
$47.90
PLAN CHECK FEES
PERMIT FEES
CONSTRUCTION:
$94.84
PLAN REVIEW:
$50.00
ELECTRICAL:
$121.83
PLUMBING
MECHANICAL:
INSPECTION FEE:
ISSUANCE:
$80.81
SMIP:
$2.80
ENERGY:
RETENTION FEE:
$12.00
PRE/ALT FEE:
BASF:
PLOT PLAN:
ZONING CLEARANCE:
RECYCLING AND WASTE DEPOSIT:
PERMIT SYSTEM REPLACMENT FEE:
$10.00
TOTAL FEES:
$373.28
COMMENTS:
P/C RECEIPT #: PAY METHOD: VALIDATION:
PERMIT RECEIPT 4827 j PAY METHOD: Check # 6481 VALIDATION: EM
#:
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PERMIT #: PR20190002219
INSPECTION RECORD
COMMENTS:
PERMIT #: PR20190002219
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 nextto 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 forthe 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 (J 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 forthe 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.leginfo.ca.gov/calaw.htm1.
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 N UMBER: 824287
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 3705 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
I HEREBYAFFIRM UNDER PENALTYOF PERJURY ONE OFTHE 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 workfor
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: Starnet Insurance Co POLICY#: EXPIRATION DATE:
NAME OF AGENT: BNUWC0137148 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 c struction.
I authorize representatives of the City of Diamond Bar to enter the above -identified propertyffoF ction purposes.
SIGNATURE OF PROPERTY OWNER OR AUTHORIZED AGENT: Make Hi nt. y
DATE: )