HomeMy WebLinkAboutPR20200000388PERMIT #: PR20200000388
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.cityofdiamondbar.com building@diamondbarca.gov
C�IiPOR N.i
JOB SITE ADDRESS: 20602 Peaceful Woods Dr
APN: LOT#: TRACT#:
OWNER NAME:
ADDRESS:
CITY: ZIP: TEL:
APPLICANT NAME: TEL:
CONTRACTOR NAME: Perspective Landscaping, Inc.
ADDRESS: 12995 Roswell Avenue
CITY: Chino STATE: CA ZIP: 91710 TEL: <NO PRIMARY PHONE>
ARCH/ENG/DES. NAME:
ADDRESS:
CITY: STATE: CA ZIP: TEL:
P/C DATE: P/C#:
ISSUE DATE: 09 Mar 2020 PR#: PR20200000388
TYPE CONSTRUCTION: OCC GROUP:
SCOPE OF WORK- Plumbing & Electric - BBQ Sink & Sewer, Gas line to BBC, (3) Outlets, (1) Motion Sensor Light
#DWELL UNITS: #STORIES: #BEDROOMS:
BUILDING FEES
DESCRIPTION
SQ, FT.
FACTOR PSF
ADJ AREA/VALUATION
SFR/ADD/REM
GARAGE/CARPORT
PATIO/DECK
POOL/SPA
RE -ROOF
COMMERCIAL
TOTAL VALUATION:
TOTAL:
Electrical
TYPE
QUANTITY
AMOUNT
TOTAL
Lighting Fixtures, Sockets, or Other Lamp Holding Devices
1
$2.41
$2.41
Plumbing
TYPE QUANTITY
AMOUNT
TOTAL
Gas Piping System 1
$101.80
$101.80
PLAN CHECK FEES
PERMIT FEES
CONSTRUCTION:
PLAN REVIEW:'
ELECTRICAL: -
PLUMBING
$112.97
$57.27
$57.27
MECHANICAL:
INSPECTION FEE:
ISSUANCE:
$80.81
SMIP:
ENERGY:
RETENTION FEE:
$5.72
PRE/ALT FEE:
BASF:
PLOT PLAN:
ZONING CLEARANCE:
$80.01
RECYCLING AND WASTE DEPOSIT:
PERMIT SYSTEM REPLACMENT FEE:
$4.58
TOTAL FEES:
$398.63
COMMENTS:
P/C RECEIPT* PAY METHOD: VALIDATION:
PERMIT RECEIPT#: 48791 PAY METHOD: CK #1209 VALIDATION: SJ
PERMIT #: PR20200000&-%8
CITY OF DIAMOND BAR
INSPECTION RECORD
®.
�.
SETBACK/LETTER
AND LEDGER
FOOTINGS.FORMS
SLAB
POOL DEMOLITION
UG. PLUMBING
ROOF DRAINS
UG. ELECTRICAL
POOL/SPA:
UFER GROUND
GAS TEST, EL, PL, ME... .
SEWER LATERAL
PRE GUNITE
SEWER CLEANOUT
POOL PRE DECK BONDING
MAIN WATER LINE
P-TRAP
ROO F SH EATH I NG
FENCE / GATE / ALARM ..:.
FLOOR SHEATHING
FINAL POOL
SHEAR. WALLS EXTERIOR
WALLS:
SHEAR WALLS INTERIOR
WALL FOOTING/STEEL
FRAMING/VENTING
WALL STEEL 1ST(} 2ND( ) LIFT
R0. MECHANICAL
WALL DRAIN / SEAL
RO. ELECTRICAL W ().0 (}
WALL FINAL
RO. PLUMBING
g
RO. FRAMING PLANNING
APPROVAL
INSULATION WALL
ROUGNFIREAPPROVAL
INSULATION CEILING
FINAL FIRE DEPARTMENT
HOT MOP/SHOWERPAN
FINAL PLANNING
DRYWALL
FINAL PIA/ ENGINEERING
LATH EXTERIOR
FINAL PWMAINTENANCE
LATH INTERIOR
FINAL HEALTH DEPT,
GAS TEST
FINAL INDUSTRIAL WASTE
SCRATCH COAT
FINAL BUILDING
ELECTRIC METER RELEASE
FlAIALMECHANICAL
GAS METER RELEASE
FINAL ELECTRICAL
SPECIAL INSPECTION
FINAL PLUMBING
SMOKE & CARBON
MONOXIDE. DETECTORS
T.C; OF OCCUPANCY
CERT. OF OCCUPANCY
COMMENTS:
PERMIT #: PR20200000388
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 Iicensure 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.)
(_) 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 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 Iicensure 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.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: B LICENSE NUMBER: 541581
EXPIRATION DATE: CONTRACTOR SIGNATURE:
WORKERS' COMPENSATION DECLARATION:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALLSUBJECTAN 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: NATIONAL LIABILITY & FIRE INS POLICY #: EXPIRATION DATE:
CO
NAME OF AGENT: A9WC903167 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 stala rel ing t Will ing construction.
I authorize represent# ves of the City of Diamond Bar to enter the a ove-ide . ie r e r inspection purposs.
SIGNATURE O PR ERTY OWNER OR AUTHORIZED AGENT:
DA E: =