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Home My WebLink About14-3621C1TY Or DIAMOND BAR I , I I i Ti,, DEPARTMENT OFCO IMUNITY&DFVELOPMCNT SERVICE5 llll i :r ' 21810 Copley Drive,Diamond t3ar,cA yi s PRESS 909)839-7020 Fax:(909)861-3117 Bailding Inspection Hotline(909)839-7027j BUILDING PERD'i1TAPPLICATION FIRMLY g APPLICATION DATE: S a q I- P/C# P1Q \y-' ' Z JOB SITE ADDRESS naISSUEDATE: _6,9 UI y PERMIT# "'/ z APN LOT TRACT oOWNER 1i TYPE CONST._%. OCC GROUP: ADDRESS CITY ZIP T L. ZONING F ONT KS RW a APPLICANT TEL. REAR 1 SIDE/SIDE STREET RW Q CONTRACTOR L/ SIDE o ADDRESS S , a PROPOSED USE CITY ZIP EL. 0 o ARCH/ENG/DESIGNER w o ADDRESS DWEL.UNITS STORIES BE DROOMS z CITY ZIP TEL. m DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREA/VALUATION a OWNEH-BUILDEfl DECLAflATION I hereby affirm under penalty of perjury that I am ezempt from the Coniractor's State ticense Law for the reason(s) SPR/ADD/REM 0 o indicated below by the checkmark s),I have D aced ne#to the aDDlicable item(s)[Section 7031.5,Busineu and Garage/Carport w Protessions Code:Any city or county that requires a permit to construcf,alter,improve,demolish,or repair,anyzstructure,prior to its issuance,also requires lhe applicant}or the permit to file a signed statement that he or she Patio/Deck a is licensed Dursuant to ihe provisions at the Contraclor's State License Law(Chapter 9)Cammencing with Seclion w 7000 0l 0ivision 3 of the Business and Prolessions Code]or that he or she is ezempt hom Iicensure and the basis for uw. Pool/Spa the aileged exemption.Any violation of Secfion 7031.5 by any aDPlicant for a permif subjects the apDlicant to a civil penalry C7 of not more than five hundred dollars($500). Q Re-Roof o (11,as owner o1 the property,or my employees with wages as their sole compensation,will do(all 01 or(portions Commercial S 01 the work,and the strucNre is not intended or ottered Por sale(Section 7044,Business and Rofessions Code:The m Contractors'State License Law does not apply ro an owner of property who,through employees'or persona effort,builds or improves the property,provitled that lhe improvemenLs are not intended or ottered for sale.If however,the building or improvement is sotd within one year of completlon,the Owner-Builtler will have ihe burden ot proving that it was not Ouilt p or impmved for the purpose of sale.). I,as owner al the ro e y g p U p D rtY am exclusivel canVactin with licensed ConVaclors to conshuct the ro ect(Section ValuatiOn: Ad Area:z 7044,Business and Professions Code:The Contractors'Stale License Law does not apply to an owner of property who buildsorimprovesthereon,andwhocontractsforlheprojectswithalicensedContractorpursuanttotheContractors'Sbte pUANTITY DESCRIPTION FEE Y license Law.). o U I am exempt hom licensure under the Contractor's State Ucense law for ihe following reason(5): zBy my signature below I acknowledge that,excepl for my personal residence in which I must have resided for at least one w o year prior to compledon of Ne improvements covered 6y this permit,l cannot egally sell a sWcNre ihat I have built as an W a owner-builder if it has not been constructed in its entirety by licensed contractors.I understand ihat a copy of the applipblelaw.Section 7044 of the Business and Professions Code is available pon request when this application is submitled or at X the tollowing Web site:httpMvnv.leginlo.ca.gov/calaw.html. Z o DATE: SIGN: r LICENSED CONTHACTON'S DECLANATION w I hereby aBirm under penalty of perjury that I am licensed under provisions of Chapter 9(commencing wilh Section 7000) m of Division 3 of the Business and Professions Code,and my ticense is in full force and ettect. J LICENSE CLASS: LIC.NO.: L a O DATE: CONTflACTOR: w WORKEH'S COMPENSATION DECLA ATION I HEREBY AFFIRM UNDER PENAL7Y OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: oI have and will maintain a Certificate of Consent lo Setl-Insure for Worker's Compensation,as provided 6y CONSTRUCTION: a. Seclion 3700 of Ihe Labor Code,tor the performance of the work for which this permit is issued. p,qN REVIEW: • -7 0 I have and will maintain Worker's Compensation Insu2nce,as repuiretl by Section 3700 0(ihe Labor Code,for ihe pedormance af the work for which ihis Dermit is issued.My Worker's Compensation Insurance Carrier and ELECTRIC: a Pali yNumberare: PLUMBING: CARRIER MECHANICAL' x POLICYNUMBER INSPECTION FEE: THIS SECTION NEED NOT BE CAMPLEfEO IF THE PERMR IS FOR ONE HUhDRFD DOLLNiS S10fn OR LESS.ISSUANCE:T-i 0 I ceAi(y that in thr,peAormance of the wark Iw which Ihis permit is issued,I shall not enploy any person in any manner so as to SM I P: become subjecllo Ne Workers Compensalian laws o1 Califomia.Md agree Ihat if I shwld become subject tu ihe Worker's Compensation o''on o( tion 3700 of Ihe}LaM Ca/l/E,I sha111aUnvith compry wifh those pmvisions. ENERGY P/C: ' `' J DATE: UCANT: V iLL J'--- ENERGY PERMIT: WARNING:F ilure o ecure Workers Compensalion coverage is unlawlul,and shall subject an employer to criminal REfENTION FEE: D w penafties and civil fines up to one hundred thousand dollars($100,000),in addition to the cost of the compensation, o damages as provided tor in section 3708 ot the labor code,interest,and attomey's tees. PRE-ALT FEE: yaCONSTHUCTIONLENDINGAGENCYBSAF: I/O w I hereby affirm wder penalry oi perjury thal lhere is a ConsVuction Lending Agency tor ihe pedormance of the work lor which ihis permit is issued(Sec.3097,Civ.C.. LENDER'S NAME: LENDER'SADDRESS: l a I certify ihat I have read this aDPlication and state that the above informaUon is correct.I agree to comply vnth all ciry and TOTAL FEES dQ. S' Z counry ordinances and state laws relaling to 6uilding consWcUon,and hereby authorize representatives of this counry to COMMENTS: o enter upon the ab ve-mentioned pmperty lor inspection purposes. J m a PERMITTEE E RI n G 4 S S SIGNATU OF PE DATE RECEIPT k 9 PAID BY:C VALIDATION:_, WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—AppiicanYs Copy r CITY OF DIAMOND BAR INSPECTIOfV RECORD e. , l e SETBACKt LEiTER TRACT AND LEDGER r FDOTiNGS FORMS t' . - SWITCH GEAR g qg ' e COMMERCIAL HOOD UC:PLUMBfNG== . T-BAR UG.ELECTRICAL INTERCEPTER UFER GROUND HOT MOP/SHOWERPAN SEWER LATERAL SEPTIClCESSPOOL MAIN WATER LINE HERS REPORT RECEIVED SEWER CLEANOUT DEMOLITION ROOF SHEATHING ROOF DRAINS FLOOR SHEA7HING ROUGH CONDUIT SHEAR WALLS"EXTERIOR : POOUSPA, SHEARWALLS INTERIOR,:,` ROUGH PEUMBING FRAMINGNENTING : '-. :. '` - . . ..' : . .; ; ROUGH ELECTRICAL; ROUGH MECHANICAL a;; .... ;.= ROUGH MECHANICAC GAS TESTROJGHELECTRICALW(.;:C( ) .: ROUGH;PLUMBWG, . PREGUNITE ' a ` _ INSUlATiON WALL POOL PRE`DECK BONDING . s , INSULATION CEILING P.`1 P DRYWALL F.ENCE Y GATE/ALARM LATH(PRE)FINAL POOL - LATH EXTERIOR WALLS: LATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL 1 T( )2N0( )LIFf SCRAT.f,H COAT WALL BOND BEAM ELECTRIC METER RELEASE WALL DRAIN/SEAL CAS METER RELEASE WALL FINAL SPECIAL INSPECTION R0.FRAMING PLANNINGAPPROVAL FINAL BUILDING . -. ROUGH FIREAPPROVAL FINAC MECHANICAL FINAL fIRE DEPARTMENT = . EINAL ELECTRICAL : .; :.-' ' ' : .._ ,. ;- FINAL PLANNIN6_-:: FINAL PLUMBING_ FINAGENGINEERING/PW T.C.-of OGCUPANCY : 'FINAL COMMUNIi'Y:SERVICES ..: . . CERT.of OCCUPANCY, FINAL HEALTH DEPT. ':: i. . fINAL INDUSTRIAL`WASTE COMMENTS: