The URL can be used to link to this page

Home My WebLink About14-4977CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES(K Z I2P A— 21810 Copley Drive, Diamond Bar, CA 91765 )_ PRESS z•°> (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 BUILDING PERMIT APPLICATION FIRMLY JOB SITE ADDRESS '�� /� y ' `'� T `�✓ T/� c APN LOT TRACT OWNER ADDRESS 2 CITY ZIP TEL. APPLICANT TEL. i C CONTRACTOR G ADDRESS a/ CITY ZIP b TEL. i ARCH/ENG/DESIGNER ADDRESS NO CITYZIP QodlbTL I oWNEfl ILDER DECLABATIO - 1 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 i Professions Code: Any city or county that requires a permit to construct, after, 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 Contractor's 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 ($500). U I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U 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. 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.). U I, 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.). U 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 not legally sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by Iicen contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code is a able upon request when this application is submitted or at the following W b site: ttp/www.Ieginfo.ca ov/calaw.htm DATE: SIGN: LICENKO CON TOR'S DEC TION I hereby affirm under penalty of perjury that I am licensed under provisions of Ch ter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license Is in full force and effect. LICENSE CLASS: - -3- LIC. B DATE: CONTRACTOR: WORKER'S CO IHER Y AFFIRM UNDER PENALTY OF PERJURY ONE O I have and will maintain a Certificate of Consent to Self -Insure for Worker's Compensation, as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit Is Issued. I have and will maintain Worker's Compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My Worker's Compensation Insurance Carrier and Policy Number are: CARRIER POLICY NUMBER (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1 DO) 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 became subject to the Worker's Compensation Laws of Califomia. And agree that If I should became subject to the Worker's Compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions, DATE: APPLICANT: WARNING: Failure to secure Worker's Compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,000), In addition to the cost of the compensation, damages as provided for in section 3708 of the labor code, interest, and attorney's fees. 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 (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 and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes. PERMITTEE NAME (P l0 3� 20i SIGN RE OF P 4 4DATE1 J (/ APPLICATION DATE/: ISSUE DATE: / �/y 'CJV �y TYPE CONST. P/ C# PERMIT# _ i -,I' y9 7 OCC GROUP: ZONING SETBACKS FRONT REAR SIDE/SIDE STREET SIDE RW ❑ ❑ RW ❑ ❑ PROPOSED U # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport rn LU Patio/Deck LL Pool/Spa ZRe D -Roof M Commercial M Valuati Adj. Area: QUANTITY DESCRIPTION FEE U � I w z in a =d IU CONSTRUCTION: PLAN REVIEW: %. 1 �I ELECTRIC: J-7 n PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: f, SMTP: ! f ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: DQ BSAF: TOTAL FEES 117,3 COMMENTS: 141, / RECEIPT # _)_I PAID BY: 1A VALIDATION: WHITE — Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy, GOLDENROD — File Copy, GREEN — Applicant's Copy CITY OF DIAMOND BAR INSPECTION RECORD ,SETBACIU�LETIER r + TRACT AND LEDGER *- FOOTINGS FQRMS A "�� " '® `� ��: � SWITCH GEAR ,j COMMERCIAL HOOD , .-1 1JG PLUMBING LATH (PRE) T -BAR WALLS: UG¢ELECTRICA '• INTERCEPTER WALL FOOTING/STEEL UFER`GROUND—, a,, HOT MOP/SHOWERPAN SCRATCH COAT SEWER LATERAL WALL BOND BEAM SEPTIC/CESSPOOL MAIN WATER LINE GAS METER RELEASE HERS REPORT RECEIVED WALL FINAL AM6PLANING APLOVAALn7r SEWER CLEANOUT FNAMECHA DEMOLITION �FINAL�FIREQEPAATMENT ROOF SHEATHING ROOF DRAINS FLOOR SHEATHING ROUGH CONDUIT SHE4R WALLS EXTERIOR g` x �z b PflOI/SPkx a � s SHEAR WALLS � �,� -ROUGH ;INTERIOR lNGNENTING� x� FRAM f R �`� � =ROH�ECECTRICAL _ = ROUGHMECHANICAL�. " � — ROUGH MECHANICAL . ROUGH ELECTRICAL W(N) C ( ) GA r_ESTn G urn" `+$"r* ,.",..r'"., ._ _--._._.. .... . .=i'• wSx ...man i°`:..xo-««6 ,-. d.'✓ e� INSULATION WALL r + ru�� rt��3ucun ovrvuu�a aE TRAP *- INSULATION CEILING �° ` d ,P FEN£EslGATE/�AIARM ,j DRYWALL ff=1NAL HEALTH DEPT LATH (PRE) WALLS: LATH EXTERIOR LATH INTERIOR WALL FOOTING/STEEL GAS TEST -#Qom.. 44- 9 to L4/G� WALL STEEL 1 ST( )2 ND( ) LIFT SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELEASE WALL DRAIN/ SEAL GAS METER RELEASE WALL FINAL AM6PLANING APLOVAALn7r SPECIAL INSPECTION - FNAMECHA �FINAL�FIREQEPAATMENT . r + 'FINALENGINEERING/IPW -8 _ _ -_ *- -PLUMtiiNG �° ` d F N ALCOM0Ri1NITY SERItIGES ,j P,OCCUPANCY' `. ff=1NAL HEALTH DEPT OCCUPANCY Of COMMENTS: COy"-d0f`. LOA C&kj d!.. -#Qom.. 44- 9 to L4/G�