The URL can be used to link to this page

Home My WebLink AboutPR1414586Dl�01D=B1P' CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 BUILDING PERMIT APPLICATION JOB SITE ADDRESS 8 N LOT TRACT WNER ADDRESS - F' # , CITY iiX €='1 `=3ZIP :fTEL. APPLICANT �r � rr n5 Y. } 4 .22 2 E I CONTRACTOR)( 1 3- ADDRESS CITY ZIP TEL. ARCH/ENG/DESIGNER ADDRESS CITY ZIP TEL. 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 cbeckmark(s), I have placed next to the applicable itam(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 111e a signed statement that he or she is licensed pursuanttothe provisions of the Contractor's State License Law (Chaptero) Commencing with Section 7000 of Division 3 of the Business and Professions Code] or that he or she Is exempt from Ilcensure and the basis for the alleged exemption. Any violation of Section 7031 L by any applicant for apermit subjects the appllcant to a civil penalty of notmore than five hundred dollars ($500). () I,as owner of the property, ormy employees with wages as their sole compensation, will duo all of or(J portions of the work, and the structure Is not intended or offered for sale (Section 7044, Business and Professions Coda: The Contractors' State License Law does not apply to an owner of property who, through employees' ur 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.). (a I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professfons Code: The Coniraciom' 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 Vie Contractors' State License Law.). U I am exempt from Ocensme under the Contractor's State License law torthe following reason(s): By my signature below I acknowledge that, except for my personal residence in which I mast hava resided for at least one year prior to completion of the Improvements covered by this permit,(carrnot legally sell a structure that t 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 Cade is available upon requestwhen Ws application is sutsmltted or at the follov.ng Web site: httpfvmv.leglnfa.ua.gov/calavi.litmt. DATE: ,_— SIGN: LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalt�of, pq'iny that i Pro licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the sines and P sloe, and my license is in full force and effect. } EN 3E G S:,' _.r � ^ - - '� `'� LIC. NO" CONTRACTOR: _ .. WORKER'S COMPENSATION DECLARATION I HEREBY AFF[RM 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 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 the performance of the work forwhich this permit is issued. My Worker's Compensation insurance Carrier and Pollcy Number are: CARRIER �........._ POLICY NUMBER (TEAS SECTION NEED NOT BE COMPLETED IFTHE PEaMTT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS). 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 Ore 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. DATE— APPLICANT: ............... WARNING: Failure to secure Worker's Compensation coverage Is unlawful, and shall subject on employer to criminal penalties and civil Ones up to one hundred thousand dollars ($1011,00), In addition to the cost of the compensation, damages as provided for In section 3708 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 wIVch this permit Is Issued (Sec. 3097, Civ. C.). LENDER'S NAME: LENDFR'SADDRESG: I certify 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 larding to building construction, and hereby authorize representatives of this county to enter upon the above eboned_Rifp�JOTJOspefionpurposes. l? DATE GN RE FPERM . APPLICATION DATE:/�J1 I� P/C# ISSUE DATE: PERMIT# TYPE CONST. OGG GROUP: ZONING SETBACKS FRONT HEAR SIDF/SIDE STREET SIDE RW I Q RW E] E] PROPOSED USE Q r f # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport w PatiufDeck u_ PooUSpa Z Re -Roof i 0 Commercial l m i Valuation: Adj. Area: QUANTITY DESCRIPTION FEE U LC w c� z rn a a i uW.r 2 CONSTRUCTION: �y PLAN REVIEW: ELECTRIC: PLUMING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMIP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE-ALT FEE: I 13SAF: i TOTAL FEES �" COMMENTS: ��99 I E �1 RECEIPT 1; PAID BY: VALIDATION: v .,......- WHITE — Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy, GOLDENROD File Copy, GREEN Applicant's Copy CITY OF DIAMOND BAR INSPECTION RECORD SETBACKl: LETJ ER TRAGT AND LEDGER FOOTINGS FDRM8 SWITCH GEAR COMMERCIAL HOOD ua P00MiO,:1. j ku�_ 1. T-BAR U& ELEGfk!bALl:".. INTERCEPTER w: HOT MOP/SHOWERPAN SEWER LATERAL SEPTIC/CESSPOOL MAIN WATER LINE HERS REPORT RECEIVED SEWER CLEANOUT -DEMOLITION ROOF SHEATHING ROOF DRAINS FLOOR SHEATHING ROUGH CONDUIT SkEAR WALES 'EN"TERJOR 8fiEARWALLSINTERIOR', ROUGH PLUMBING F,RAMING/VENTING. Z� 'At... U H ELE&Rlb ROUGH MECHANICAL, ROUGH KECHMRIAL BOUGH ELECTRICAL, Vkl Q GASjE8T: - INSULATION WALL .............. POOL ERE BECK �3dkIDiNin�,�''. ,:.,. INSULATION CEILING P TRAP DRYWALL . . .. .... .... LATH WREI -- ----------- . .. ..... LATH EXTERIOR LATH INTERIOR GAS TEST SCRATCH COAT ELECTRIC METER RELEASE GAS METER RELEASE SPECIAL INSPECTION FINAL BUJOEW LLIHU - ovAL, .1FIN&WCHANICA HN'kTilo DEPARTM- E FfNAL CAL FINAL PLANNINa' FINAL PLUMBING E11U L EIl INFER# V Pik TQ:bf.0GCUPAN . :RNAL COMMUNITY SEAqid'E§�i ...... . ........... . . ... FINAL HEALTH Dfft COMMENTS: