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Home My WebLink AboutPR2020000120PERMIT ##: PR20200000120 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.citVofdiamondbar.corn building@diamondbarca.gov e AIIFRRMfA JOB SITE ADDRESS: 303 DIAMOND BAR BLVD, Unit:M, DIAMOND BAR, CA 91765 APN: 8717008020 LOT#: TRACT#: OWNER NAME: DIAMOND SPRINGS LLC ADDRESS: 9034 W SUNSET BLVD CITY: WEST HOLLYWOOD ZIP: 90069 TEL: <NO PRIMARY PHONES APPLICANT NAME: TEL: CONTRACTOR NAME: ADDRESS: CITY: STATE: ZIP: TEL: ARCH/ENG/DES. NAME: ADDRESS: CITY: STATE: ZIP: TEL: P/C DATE: P/C#: ISSUE DATE: 03 Mar 2020 PR#: PR20200000120 T Y P E OCC GROUP: CONSTRUCTION: SCOPE OF WORK: Tenant Improvement for Gym - 3,000 SF "F45 Gym" #DWELL UNITS: #STORIES: #BEDROOMS: BUILDING PEES DESCRIPTION SO, FT. FACTOR PSF ADJ AREA/VALUATION SFR/ADD/REM GARAGE/CARPORT PATIO/DECK POOL/SPA RE -ROOF COMMERCIAL TOTAL VALUATION: TOTAL: Mechanical TYPE QUANTITY AMOUNT TOTAL Exhaust Hood / Fan Duct 3 $78.35 $23S.05 Electrical TYPE QUANTITY AMOUNT TOTAL Receptacle, Switch, Lighting or other Outlets 24 $4.82 $115.68 Lighting Fixtures, Sockets, or Other Lamp Holding Devices 17 $2.41 $40.97 Plumbing TYPE QUANTITY AMOUNT TOTAL Plumbing Fixture / Trap or Set of Fixtures 9 $20.36 $183.24 PLAN CHECK FEES PERMIT FEES CONSTRUCTION: $1,181.92 $1,390.49 PLAN REVIEW: ELECTRICAL: $118.19 $156.65 PLUMBING $183.24 MECHANICAL: $235.05 INSPECTION FEE: ISSUANCE: $149.97 SMIP: $20.78 ENERGY: $139.05 RETENTION FEE: $163.28 PRE/ALT FEE: BASF: PLOT PLAN: ZONING CLEARANCE: $80.01 RECYCLING AND WASTE DEPOSIT: PERMIT SYSTEM REPLACMENT FEE: $130.61 TOTAL FEES: $3,949.24 COMMENTS: P/C RECEIPT #: PAY METHOD: VALIDATION: PERMIT RECEIPT 48716 PAY METHOD: CHECK : 131 VALIDATION: CR I #- PERMIT #: PR20200000120 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law forthe 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 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 forthe 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 forthe projects with a licensed Contractor pursuant to the Contractors' State License Law.) (J I am exempt from licensure underthe 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. 63 SIGNATURE OF ROPERTY 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: LICENSE NUMBER: 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 COSTOF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. I HEREBYAFFIRM UNDER PENALTYOF 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, forthe performance of the work for which this permit is issued. 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: POLICY#: EXPIRATION DATE: NAME OF AGENT: PHONE #: 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 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: 1411 • p Gli•1 I d��. PERMIT #: PR20200000120 INSPECTION RECORD COMMENTS: