HomeMy WebLinkAboutPR20-637PERMIT $: PR20200000637
BAR
CIW OF DIAMOND BAR
COMMUNITY DEVELOPMENT DEPARTMENT
21810 Copley Drive, Diamond Bar, CA 91765
(909) 839-7020 Fax: (909) 86L-3177 Building lnspection Hotline (909) 839-7027
BUILDING PERMIT APPLICATION www.citvofdiamondbar.co!! building@diamondbarca.gov
JOB SITE ADDRESS: 22454 STEEPLECHASE LN, DIAMOND BAR, CA 91755
APN: 8713026020 LOT#:TRACT8T _
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TELI
OWNER NAME: CABEBE FRANKLIN & GLORIA
ADDRESS: 22454 STEEPLECHASE LN
CITY: DIAMOND BAR ZlPt 97765
APPLICANT NAME:
CONTRACTOR NAME: Pipe lt Right Plumbing lnc
ADDRESS: 328 E 38th St
CITY: San Bernardino STATE: CA ZIP: 92404 TEL: {818) 430-2264
ARCH/ENG/DE5. NAME, _
ADDRFSS.
CITY: STATE: CA ZlPl TEL:
P/C DATE:
ISSUE DATE:
P /C*:
PRf:
TYPE CONSTRUCTION OCC GROUP:
SCOPE OF WORK: Pex Re-DiDe
#DWELL UNITS:ssloRr Es:#BEDROOMS:
BUII.DING FEES
DESCRI PTION SQ. FT.FACTOR PSF ADJ AREA/VALUATION
5FR/ADD/REM
GARAGE/CARPORT
PATIO/DECK
POOL/SPA
RE-ROOF
COMMERCIAL
TOTAT VATUATION:TOTAT:
Plumbing
TYPE QUANTITY AIVlOUNT TOTAL
Re-Pipe PEX s20.36 | 5773.68
PLAN CHECK FEES PERMIT FEES
CONSTRUCTION:
PLAN REVIEW:
ELECTRICAL:
PLUMBING s773.68
MECHANICAL:
INSPECTION FEE:
ISSUANCE 546.23
SMIP:
ENERGY:
RETENTION FEE:s38.68
PRE/ALT FEE:
BASF:
PLOT PLAN:
ZONING CLEARANCE:
RECYCLING AND WASTE DEPOSIT:
PERMIT SYSTEM REPLACMENT FEE:s30.9s
TOTAL FEES:s889.s4
COMMENTS:
P/C RECEIPT #PAY METHOO:VALIDATION:
PERMIT RECEIPT #: 49286 PAYMETHoD: CC#11360 VALIDATION: EM
PERMIT #: PR20200000537
CITY OF DIAMOND BAR
INSPECTION RECORD
SETBACK / LETTER
POOt DEMOTITION
ROOF DRAINS
poot/ipi
GAS TEST, Et, PL, ME
SEWER LATERAL
ROOF SHEATH NG
FLOOR SHEATHLN6
FENCE/GATE/ALARM
5HEAR WATLS EXTER OR
SHEAR WAILS INTERIOR WAtt FOOTING/5TEEI
wnrr sreer rsrl 1 zNDl 1 r rr
WAtL DRA]N / SEAL
RO.ELECTRICALW{)C()
INSULAT ON CEILING FINAL FIRE DEPARTMENT
LATH EXTER]OR
ELECTRIC METER RELEASE
GAS METER RELEASE
SPEC]AL NSPECTION
MONOXIDE DETECTORS
UG. PLUMBING
ELECTRICAL
UFER GROUND
PRE GUNITF
MAIN WATER I]NF
POOL PRE DECK BONDING
P TRAP
FINAL POOL
WALLS:
FRAMI NG/VENTI NG
RO, MECHANICAL
RO, PLUMBING RO, FRAMING PLANNING
APPROVAL
INSULATION WALL ROUGH FIRE APPROVAL
HOT MOP/SHOWTRPAN FINAL PL,NNING
DRYWATL FINAL PW ENGINEERING
FINAL PW MAINIENANCE
LATH INTERIOR FINAL HEAL|H DEPf.
GAS T€ST FINAL INDUSTRIAL WASTE
\rRAl(lCOAl FINAL BUILDING
FINAL MECHANICAL
FINAL ELECTRICAL
FINAL PLUMBING
T-C. OF OCCUPANCY
CERT. OF OCCUPANCY
COMMENTS:
05/20/20
PERMIT f : PR20200000637
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 appiicable 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 thecontractors' 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 anyapplicant for a permit subiects the applicant to a civil penalty of not more than five hundred dollars (g500).1:
(-) | as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of thework, 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 theproperty, provided that the improvements are not intended or offered for sale. lf 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.)
(-) l, 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 bullt 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 lh'e Business and Professions Code is available upon request when this application is submitted or at the
following Web site: http/www. eginfo.ca.gov/calaw.html.
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 (commcncing with Section 7000) of
Division 3 of the Business and Professions Code, and my license is in full force and effect.
LICENSE CLASS: C36 l.FNrqF Nl l\/RFp. rna?oqnLILEI\5T LLA55: LJb LICENSE NUMBER: 1033950
EXPIRATION DATE: CONTRACTOR SIGNATURE:
WORKERS' COMPENSATION DECLARATION:.VVARNINC: FAILURE TO SiCURE !\lORKERS' CON,IPENSATION COVERAGE IS UNLAWIUL, AND SHALL SUB]ECT AN EMPTOYER TO
cRlMlNAt PEI',iALilES Al\D Cl\1lL F NES UP TO ONE HUNDRED THOUSAND DOIIARS {S100,000), iN ADDiTtO\l rO THE COST OF
COMP[NSATION, DAIVIAGTS AS PROVIDED FOR IN SECTION 3706 OF THt LASOR CODE, INTER[ST, AND ATIORNEY,S F{:ES,
I HEREBY AFFIRM UNDER PENALTY OF PER]URY ONE OF THE FOLLOWING DECLARATIONS:
I have and will maintain a certificate of consent to self lnsure for workers'compensation, issued by the
Director of lndustrial 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: Falls Lake Fire and Casualty pOLtCy #:
NAME OF AGENT: F1A01310400
EXPIRATION DATE:
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 ofsection 3700 ofthe Labor code, I shall forthwith comply with those provisions
SIGNATURE OF APPLICANT:
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 []y srgnJture [relo[,, i iert]fy to eJth of tlte fo iou,,rit,..
i dll) the proDerty o\!ner Of .lLiliroril.tC li),tii itrt thc pi()ileity oiv|er _. behllf
I hevc tr:ari iils applicatror .:nd tlt. inlorntalion I h.:vc llrovrajCd i: aoir[,it.
I ngree to aorrplv witll oliappiriai: r'a ty.[]il aourrtV or(i rJrces ,rri 5t.ltc lJ'.!s reLlt rg t.i i)trFqirr! [olr:tru(tiot
l:ltitlroT/{t.tllrcscritalrv.t:oi lhi,ii\roiL),lloldilir lollllilil..aUlv, Ljr-, tl:,ri 1,,"p.rt,ffd1 r1y'$1t;qrfi(o:q
SIGNATURE OF !IRqPERI/ CIWIFB Qg AIITHOR|ZED nCrri:r. cynthia Rivas