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HomeMy WebLinkAboutPR2022-1865 (GRADING PERMIT)Grading Permit City of Diamond Bar 21810 Copley Drive, Diamond Bar, CA 91765 909-839-7040 PR2022-1865 The undersigned hereby makes application for Grading on private property at the location described below with the understanding all work is subject to the provisions of City Municipal Code, the plans and General and Special Provisions approved by the City Engineer. I am aware that in the interest of public safety, special regulations apply in hillside areas and that geological or engineering reports, or both, may be required before a permit is issued. If excavated materials are to be obtained from or are to be displosed on a separate, non-contiguous site, located within the City of Diamond Bar, a grading permit shall be required for that site also. Permittee shall indemnify and hold harmless City (including its officers, employees and agents) from and against all claims, causes of action, liabilities, losses and damages for injuries to persons and property, including reasonable costs of defense and attorney and expert fees, arising from Permittee’s work described in and undertaken under and pursuant to this Permit. Permittee shall promptly pay the amount of any judgment rendered against City (including its officers, employees and agents) for any such indemnified claims, and reasonable costs and attorney and expert fees incurred by City in the defense of such claims. Traffic control devices shall be installed per Caltrans Traffic Control Manual and W.A.T.C.H. Handbook before start of construction. This permit shall expire twelve (12) months after the date of issuance unless otherwise indicated below. SITE ADDRESS CANYON LOOP TRAIL (24210 PEAK COURT, DIAMOND BAR, CA 91765) PARCEL NUMBERS 8701-006-910 & 8701-059-904 TRACT/LOT NUMBERS N/A OWNER CITY OF DIAMOND BAR MAILING ADDRESS 21810 COPLEY DRIVE DIAMOND BAR, CA 91765 TEL NO. 909-839-7040 ENGINEER MOHAMMAD MOAMMADABADI REG NO. / EXPIRATION 42615 / 3-31-2024 MAIL ADDRESS ADAMS STREETER CIVIL ENGINEERS 16755 VON KARMAN, SUITE 150, IRVINE, CA 92606 TEL NO. 949-474-2330 Grading Contractor DD Systems Inc. TEL NO. (626) 852-0257 ADDRESS 147 W Route 66 #43, Glendora, CA 91740 PROPOSED USE OF SITE(S) TRAIL IMPROVEMENTS Construction Type: CHECK IF SUPERVISED Grading □ SIGNATURE OF APPLICANT ADDRESS DD Systems 147 W Route 66 #43, Glendora, CA 91740 TEL NO. 626-852-0257 PERMIT IS REQUIRED BEFORE COMMENCING WORK. INSPECTION IS REQUIRED. CALL 909-839-7040 AT LEAST 24 HOURS BEFORE STARTING WORK. SITE ADDRESS CANYON LOOP TRAIL NEAREST CROSS STREET MAP NO.STATE HWY Y/N PROCESSED BY Nicholas Delgado CUBIC YDS. HANDLED: 500 PERMIT NO. PR20220001865 USE ZONE SPECIAL CONDITIONS - Soils Engineer Rough Grading Certification - Civil Engineer Rough Grading Certification - As-Graded Geotechnical Report - As-Built Grading Plan - Civil Engineer Final Grading Certification SURETY BOND BOND NO SURETY COMPANY DATE FILED REC'D BY CASH DEPOSIT REC'D BY DATE FILED THIS IS A LIMITED TIME PERMIT ALL WORK AUTHORIZED MUST BE COMPLETED BY May 01, 2023 EXTENDED TO:BY: PLAN CHECK FEE:PERMIT ISSUANCE FEE: $0.00 GRADING BOND: $0.00 TOTAL FEE: $0.00 - NO FEE WORKER'S COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof (Sec. 3800, Lab. C) Policy No.Company Date May 01, 2023 Applicant DD Systems Inc. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the work involved by the permit 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 the Workers' Compensation Laws. Date May 01, 2023 Applicant DD Systems Inc. NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. LICENSED CONTRACTORS DECLARATION I hereby affirm 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 Number Lic. Class Contractor DD Systems Inc.Date November 01, 2022 □ I am exempt from the licensing requirements as I am a licensed architect or a registered professional engineer acting in my professional capacity (Section 7051, Business and Professions Code). Lic. or Reg. No.:Date: HOME OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor’s License Law for the following reason (Section 7031.5, Business and Professions Code): □I, as owner of the property, or my employees with wages as their sole compensation, will do the work and the structure is not intended or offered for sale (Section 7.44, Business and Professions Code). □I, as owner of the property, am exclusively contracting with licensed contractors to contstruct the project (Section 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec 3097, Civ. C.) Lender’s Name Lender’s Address I certify that I have read this application and state that the above information is correct. I agree to comply with all City ordinances and State laws relating to building construction, and hereby authorize representatives of this City to enter upon the above mentioned property for inspection purposes. Signature of Permittee:Date: