HomeMy WebLinkAboutPR20-1364PERMIT #: PR20200001354
CIry OF DIAMOND BAR
COMMUNITY DEVELOPMENT DEPARTMENT
. 21810 Copley Drive, Diamond Bar, CA 91765
(909) 839-7020 Fax: (909) 86t-3117 Building lnspection Hotline (909) 839-7027
Dll{MOND Bl\R BUILDING PERMIT APPLICATION w1&q.citygldj34ql^dE3I.ce-m building@diamondbarca.gov
JOB SITE ADDRESS: 2058 PEACEFUL HILLS RD, DIAMOND BAR, CA 91755
APN: 8765002042 LOT#:TRACT#:
OWNER NAME: ZHEN XING ZHANG & XIAO CHENG XU
ADDRESS: 2068 PEACEFUL HILLS RD
CITY: WALNUT ZlPt 91789 TEL: <NO PRIMARY PHONE>
TEL:APPLICANT NAME:
CONTRACTOR NAME: PACIFIC COAST COPPER REPIPE
ADDRESS; 1556 S. ANAHEIM BLVD
CITY: ANAHEIM STATE: CA ZIP: 92805-TEL: 1714\758-7725
ARCH/ENG/DES. NAMEI
ADDRESS:
CITY: STATE: CA ztP:TEL:
P/C DATE:
ISSIJE DATE:
P/C#:
PR#:
TYPE CONSTRUCTION:OCC GROTJP:
SCOPE OF WORK: Re-Pipe - PEX (16) Fixtures & water heater chanqe out
#DWELL UNITS:trSTORI E5:#BEDROOMS:
BUII-DING FEES
DESCRI PTION so. FT.FACTOR PSF ADJ AREA/VALUATION
SFR/ADD/REM
GARAGE/CARPORT
PATIO/DECK
rooL/sPA
RE-ROOF
COMMERCIAL
TOTAL VALUATION:TOTAL:
Plumbing
TYPE QUANTITY AMOUNT TOTAL
Re-Pipe PEX 16 s20.80 s332.80
PLAN CHECK FEES PERMIT FEES
CONSTRUCTION:
PLAN REVIEW:
ELECTRICAL:
PLUMBING s332.80
MECHANICAL:
INSPECTION FEE:
ISSUANCE:547.24
SMIP:
ENERGY:
RETENTION FEE s15.54
PRE/ALT FEE
BASF:
PLOT PLAN:
ZONING CLEARANCE:
RECYCLING AND WASTE DEPOSIT:
PERMIT SYSTEM REPLACMENT FEE:513.31
TOTAL FEES:s409.99
COMMENTS:
P/C RECEIPT #:PAY METHOD:VALIDATION:
PERMIT RECEIPT #:PAY METHOD:VALIDATION:
PERMIT #: PR20200001354
CITY OF DIAMOND BAR
INSPECTION RECORD I
ffi
IrTBAeKJf]tEill TRACK AND LEDGER
.FOO|TINGS F.ORMS T-BAR
SLAB POOL DEMOLITION
u$. ru".M,BiNGii ROOF DRAINS
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UFER GROUND
SEWER LATERAL sREGUN..;1:5,
SEWER CLEANOUT POOL PftE DECK 8ONDING
MAIN WATER LINE PITRAP
ROOF SHEATHING FENCE I €ATE:/:*tARlrrl
FLOOR SHEATHING FINAt PtOOt
S}*EAR WAIIIS EXTEfllOR WALLS:
SI*BAH UU S;INIERIC*WALL FOOTING/STEEL
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*ALL
'TEEL
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BO, MECHANICAI.WALL DRAIN / SEAL
RO::EIE{TIL w.{I}iq:{!}
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WALL FINAL
RO:rPru,\d8lN6 'l'aa
INSULATION WALL *oy,ciff i:lFtmr:a$gYit
INSULATION CEILING FINAL::F.ifr EiAfi f A*,!:MEt{,r
:]11:i 1:
HOT MOP/SHOWERPAN FIil$.L1P.lAf*NINE
DRYWALL rrfvatptt/.El$.6-r{!r.{{,*If*6=
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LATH EXTERIOR F tttAt pw,,m/dl$fEuit{eE
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LATH INTERIOR
fr14.Jtgfafir--HDEP.II
GAS TEST FrtNAi:!,!!b'u57*tat*.*f f,n
SCRATCH COAT
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ELECTRIC METER RELEASE
Illri{rJti,€i0f
t#:fl.1.:9!tr,
GAS METER RELEASE
SPECIAL INSPECTION FINALP"rulAHNg,
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:
COMMENTS:
10/21/20 Victor O.
PERMIT #: PR20200001364
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 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 (5500).1:
(-) 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. 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.)
(_) lam exemptfrom licensure underthe Contractor's State License lawforthefollowing 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 ofthe 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/ca law.html.
SIGNATURE OF PROPERTY OWNER OR AUTHORIZED AGENT:DATE:
LICENSED CONTRACTOR'5 DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of
Division 3 ofthe Business and Professions Code, and my license is in full force and effect.
LICENSE CLASS: C36 LICENSE NUMBER: 738350
EXPIRATION DATE:CONTRACTOR SIGNATURE:
WORKERS' COMPENSATION DECLARATION :
WARNING: FAILURE TO SECURT WORKERS, COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO
CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (S1OO,OOO), IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, lNTEREST, AND ATTORNEY's FETS.
I HEREBY AFFIRM UNDER PENALTY OF PERJURY 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 I ndustrial 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: WEST AMERICAN INS CO EXPIRATION DATE.4III?
NAMEOFAGENT: XWS2158511154 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
sub.ject 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 OFAPPLICANT: DATE:
DECLARATION REGARDING CONSTRUCTION LENDING
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 appiicable city and countv ordinances and state laws relatingt€'trritdin*{anstruction
I auihorize representatives of the City of Diamond Bar to enter the above-identified
SIGNATURE OTIPROPEiTY OWNER OR AUTHORIZED AGENT: DOugIaS