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Home My WebLink About14-4509DIAJIO�rD BAR CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 PRESS (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 FIRMLY BUILDING PERMIT APPLICATION .JOB SITE ADDRESS APN LOT TRACT OWNER Q ADD SS CITY ZIP TEL. APPLICANTTEL. CONTRACTOR t ADDI S CITYADMIA iENN ZIP97M TEL. _ ARCH/ENG/DESIGNER N�I� ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION 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 Bern(s) [Section 7031.5, Business and 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 Rte a signed statement that he or she Is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9) Commencfng 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 o1 the property, or my employees with wages as their sore 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 Pmfesslons 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 vall have the burden of proving that it was not built or improved for the purpose of sale.). U 1, 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 fur 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 pdor to completion of the improvements covered by this permiLl cannot legally sell a structure that I have built as an owner -builder if it has not bean constructed In its entirety by licensed contractors. I understand 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 the following Web site: http/www.leginfo.ca.gov/calaw.html. DATE: SIGN: LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that l am licensed under provisions o1 Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Proffer 'ons Code, and my license Is in full force and effect. LICENSE C SS: 1/ C. 0. DATE: CONTRACTOR: WORKER'S COMPENSATION DECLARATION I HERE AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: I have and will maintain a Certificate of Consent to Seff-Insure for Worker's Compensation, as provided by Section 3700 of the Labor Code, for the performance of the work for vfioh 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 for which this permit Is issued. My Worker's Compensation Insurance Carrier and Policy pe=a CARRIER 1 ` t •1�, POLICY NUMBER 9.10 BOO" (THIS SECTION NEED NOT BE COMPLETED IF THE PEAMR ts FOR ONE RINDRED 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 of California. And agree that 8I should become subject to the Worker's Compen 6� Settler 3700 La r Code. I Ifo i campy with those provisions. DATE: APPLICANT: WARNIN Failu to secure Worker's Ca nation coverage Is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundr mmnd 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 lees. CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a Constru4Lend Agency for the performance of the work for which this permit is Issued (Sec. 3097, CW. C.). LENDER'S NAME- LENDER'S AMELENDER'S ADDRESS: I certify that I have read this application and state that the libulinformation is correct I agree to comply with all city and county ordinances and state laws relating to building construe on, and hereby authorize representatives of this county to enter upon the above-mentioned property for Inspection purposes. PERMITTEE NAME (PRINT) SIGNATURE OF PERMITTEE DATE APPLICATION DATE: P/C# (/ ISSUE DATE: C�%.—. ZaJY PERMIT# TYPE CONST. OCC GROUP: ZONING SETBACKS FRONT RW . ❑ REAR ❑ SIDE/SIDE STREET RW ❑ SIDE ❑ PROPOSED USE UI Up # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREANALUATION SFR/ADD/REM Garage/Carport u). Lu Patio/Deck LL Pool/Spa ZRe O -Roof —J 7 Commercial D] Valuation: Adj. Area: QUANTITY rPESCRIPTION FEE w z m a c�. Iz CONSTRUCTION: PLAN REVIEW: ELECTRIC: _r—] PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMIP: ENERGY P/C: ENERGY PERMIT.- ERMIT:RETENTION FEE: 1.09 RETENTION PRE -ALT FEE: BSAF: TOTAL FEES COMMENTS: RECEIPT # 9 PAID BY: J �P-�% VALIDATION: WHITE — Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy, GOLDENROD — Fie Copy, GREEN — Applicant's Copy CITY OF DIAMOND BAR INSPECTION RECORD COMMENTS: MAIM '7LEDGER 4; TRACT AND LEDGER W.2 gom,"W'ss a jo SWITCH GEAR 7 AMI -PAM!, 57,4 MIN R , H CIAL 00 D COMMERCIAL HOD COMMERCIAL "bMM 'IN, T BAR INTERCEPTER HOT MOP/SHOWERPAN SEWER LATERAL SEPTIC/CESSPOOL MAIN WATER LINE HERS REPORT RECEIVED SEWER CLEANOUT . DEMOLITION ROOF SHEATHING ROOF DRAINS FLOOR SHEATHING ROUGH CONDUIT qg- HEO :S ' MALLS . jEjTOR WALLSSHEAR RT 0. MRWC T 21218 INSULATION WALL INSULATION CEILING gg,yq , DRYWALL ALAR(; LATH (PRE) LATH EXTERIOR WALLS: LATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL 1-( )2-( )LIFT SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELEASE WALL DRAIN/ SEAL GAS METER RELEASE WALL FINAL SPECIAL INSPECTION V 1� NAL tCH"UNK -5 Nl- COMMENTS: