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Home My WebLink About15-0219l Y . CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21810 Copley Drive,Diamond Bar,CA 91765 PRESS j 909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 FIRMLYR"" BUILDING PERMIT APPLICATION APPLICATION DATE: / P/C# ^Dd Q s JOB SITE ADDRESS 3 3 /' 4.h tq, z APN b7I 7-D I LOT Z TRACT ISSUE DATE: 'y`7 f PERMIT# .I` OWNER J I a 7', if.Ntasfo I z/' ie e J`v C TYPE CONST. OCC GROUP: ADDRESS ZO O Wl di 1 S'' ., ' ZO CITY/`i^+- ZIPr 7 TEL. ZONING F ONACKS RW APPLICANTS(J71.-i1I7. TS/T TE l0 3 Z y 6 Z L REAR j_yes /Lr,'C4 r r SIDE/SIDE STREET RW CONTRACTOR P4U`T C w C.- SIDE ADDRE`SS C . u CITY.LK %'r+aS ZIP `/773 TEL. 70 I 7 Z PROPOSEDUSE I 'Cj- f' 14v1 p t4 li/1 1F{ E'- cLH 7 c 1 ARCH/ENG/DESIGNER ON 1 Sf '1•1 C 1 Ov p ew CJp rad gu:u- . z ADDRESS{,2, 6 7 S_S L/ i t Nt- 0 4 1 4,Y `oc/i t C` -' z CITY/t /'t S 7 ZIP 2G a TEL.C y J Oh--76 y DWEL.UNITS STORIES BEDROOMS DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION OWNEH-BUILDER DECLAHATION s I hereby affirm under penalty of perjury Mat I am exempt from the Contractor's STate License Law for the reason(s) SFFVADD/REM I L indicated below by the checkmark(s,I have placed next to the applirable item(s)[Section 7031.5,Business and IGarage/Carport Professlons Code:Any city or county that requires a permit to construc[,alter,improve,demalish,or repair,any z shuclure,prior ta it5 issuance,also requires the applicant tor the permit to file a signed statement that he ar she Patio/Deck IiislicensedpursuanttotheprovisionsoltheContractor's State License Law(Chapter 9)Commencing with Section w 7000 of Division 3 of the Business and Professions Code]or that he or she is exempt from licensure and the basis for Pool/Spa I n the alleged exemption.Any violation of Section 7031.5 6y any applicant for a permit subjects the applicant to a civil penalty C7 s of not more than five hundred dollars($500). QZ Re-Roof I U I,as owner of the property,or my employees with wages as iheir soie compensation,will do()all of or(,portions Commercial Iyofthework,and the structure is not intended or offered for sale(Section 7044,Business and Professions Code:The m IZContractors'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 oftered 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.). II,as owner of the ro e am exclusivel contractin with licensed Contractors to construct the ro ect SectionUPp Y 9 p ( Valuation: Adj.AreaZ7044,Business and Professions Code:The Contractors'State License Law does not apply to an owner of property who buildsorimprovesthereon,andwhocontractsfortheprojectswithalicensedContractorpursuanttotheConVactors'State QUANTITY DESCRIPTION FEE I Y License Law.). IIamexemptfromlicensureundertheContrac[or's STate License law for the following 2ason(s): I 1 By my signature below I acknowledge that,except for my personal residence in which I must have resided for at leas[one w Iyearpriortocompletionoftheimprovementscoveredbythispermit,l cannot legally sell a structure that I have built as an w owner-builder if it has not been constructed in its entirety by licensed contractors.l undersiand that a copy of the applicable law,Section 7044 of the Business and Professions Code is available upon request when this application is submitted or at X the following Web site:http/www.leginfo.ca.gov/calaw.hVnl. I z DATE: SIGN: LICENSED CONTHACTOH'S DECLAflATION I a IIherebyattirmunderpenaltyofperjurythatIamlicensedunderprovisionsofChapter9(commencing with Section 7000) of Division 3 of the Business and Professions Code,and my license is in full force and ettect. J I j LICENSE CLASS C 7 f w LIC.NO.: 6 7 z I DATE:y'Zy k`CONTRACTOR: /'ufi L WONI H'S COMP CLAHA ION I y I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE POLLOWING DECLARATIONS: 1 I I have and will maintain a Certificate of Consent to Self-Insure for Worker's CompensaUon,as provided by CONSTRUCTION:!/ 7'V Section 3700 of the Labor Code,for the pertormance of the work for which this permit is issued. p qN REVI EW: /`S O J I have and will maintain Worker's Compensation Insurance,as required by Section 3700 of the Labor Code,for Z the pertormance of the work for which this permit is issued.My Worker's Compensation Insurance Carrier and ELECTRIC: PolicyNumberare:y (_ PLUMBING: CARRIER__Q .O /C e Y/l/ MECHANICAL: POLICYNUMBER C SL;.S INSPECTION FEE: n iHIS SECf10N NEED NOT BE CAMPLEfED IFhIE PFRMIT IS fOR ONE HUNDRED DOLLARS($100)OR LESS). ISSUANCE: L I certify that in the pertormance of fhe work for which this permit is issued,I shall not employ any person in any manner so as fi becrome subject to the Worker's Compensation Laws of Califomia.Md agree that rf I should become subject to the Worker's SM IP: r JCompensa on provisions of Section 3700 of the Labor Code,I shall forthwith comply with those prpvisions. ENERGY P/C: J DATE:-2 yJ APPLICANL ,i- r f./1 ENERGY PERMIT:i WARNING:Failure to secure Worker's Compensation coverage is unla ul,and shall subject an employer to criminal RETENTION FEE:rypenaltiesandcivilfinesuptoonehundredthousanddollars(5100,000),in addition tn the cost of the compensation, damages as provided for in section 3708 of the labor code,interest,and attomey's fees. PRE-ALT FEE: i CONSTRUCTION LENDING AGENCY BSAF: IyIhe2byaffirmunderpenaltyofperjurythatthereisaConstructionLendingAgencyforthepertormanceoftheworkfor which this permit is issued(Sec.3097,Civ.C.). LENDER'S NAME: s LENDER'SADDRESS: i I certi/y that I have read this appliration and state that the above information is correct.I agree to comply with all city and TOTAL FEES , f f ry Z counTy ordinances and state lavrs relating to building construction,and hereby authorize representatives of this counry to COMMENTS: o enter upon the above-mentinned property for inspection purposes. J j/ {/ 1 _rCC •! VY!r PERMITT E AM RI 1 lz._-_ y-Z-2/S`- J . SIGNA OF PT9RERMITTEEDATERECEIPT# L PAID BY:VALIDATION: WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy L CITY OF DIAM4ND BAR 1. INSPECTION RECORD eo e e , SETBAGK/LETTER ° s ` ' ' '° ' ' " TRACT AND LEDGER OOTINGS FORMS , ° " ' ' " SWITCH GEAR SLAB; "°COMMERCIAL HOODT-., = UG.LUM61f G .a_ „ a : ., , _ . _T-BAR UG.ELECTF{CAL _ q_ _ ,,_;,; , ; q , >; ` °' " INTERCEPTER UFER GFiOUND ;t ;, ' .` ;°a = " ` HOT MOPISHOWERPAN SEWER LATERAL SEPTIC/CESSPOOL j MAIN WATER LINE HERS REPORT RECEIVED SEWER CLEANOUT DEMOLITION i ROOF SHEATHING ROOF DRAINS FLOOR SHEATHING ROUGH CONDUIT re z , - SHEAR WACLS EX7ERIO t" POOC/SPA a 9_ , . _ , St{A,R WAL S lNTERIbR k e° ."' _ ROUGH FLOIVIBING a . FRAAAINGNENTING , , ROUGH ELECTRICAL RO JC N MECHAPJIGAL x RQUGH MECNANICAL tp - r 2_, re , _ RO 1GN ELECjRfCP;;V4( }( , m= a , GAS TEST RQUGH PL`OMBING' -.--_s , ° . PRE GUNITE INSULATION WALL POOL PRE DECK BONDING INSULATION CEILING P-TRAP DRYWALL FENCE!GATE!ALARM IATH(PREi FINAL POOL LATH EXTERIOR WALLS: LATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL 1 sr ZNe )LIFT SCRATCH COAT WALL BOND BEAM ELEC?RIC METER RELEASE WALL DRAIN/SEAL GAS METER RELEASE WALL FINAL SPECIAL INSPECTION RO.FRAMING PLAIININGAPPROVAL a_ ., . . .. FIt AI gUILDING' K ) Y f ROUGH fIRE APPROVAL FINE1LfMECHANiCAL FINAL FIRE DEPARThAENT FINAL ELECTRICAL _ :. : j' ' _ - m , ,,., FINAI PLANidING e . INtll.PLUMBiNG..'" `'" _:;, :' ' FINAI ENGINEERING/PW r7;G:of OGCU FANCY "- ; ;'_ , . e FINAL COMMUNITY SERVICES GEF T ofaOCCllPAP1 Y e FINAL HEALTH DEPL FINAL INOUSTRIAL WASTE ° ° a ` COMMENTS: