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Home My WebLink AboutPR16-0874CL z 0 0 LUJ ac 0 0 C) rz 0 LL 0 z 0 a z M C) 0 0 z a N c=n rn 2 0 63 U Z C) 0 U H O z _W Y rr 0 3 z O Q Cr a Lu 0 U W m W W u) z a Q 0 J j t o 0 w z c� rn U. Lk 11110ND BAR - :: 1: CITY OF DIAMOND BAR I`♦ �� DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 d I 1�"ESS (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 FIRMLY �7B1fILDING PERMIT APPLICATION www.cityofdiamondbar.com building@diamondbarca.gov JOB SITE ADDRESS L 1J �W 1 N on APN LOT TRACT OWNER PT0-A G( A C40'- C-(-1 ADDRESS CITY PWY% ZIP�I�$TEL. APPLICANT SAS Iii O'10_A CONTRACTOR M��e l 111:7 GL iJ ADDRESS OI CITY nVV✓Lin//ZIPe 107-1ZTEL. ARCH/ENG/ DESIGNER ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION I 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 Professions Code: Any city or county that requires a permit to construct, alter, 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 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 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,l cannot legally sell a structure that I have built as an owner -builder if it has not been 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. LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and mry license is in full forceandeffect. LICENSE CLASS: LIC. NO.: b�� p _ DATE: CONTRACTOR: f� CONTRACTOR: O C Sriy t Cfin 1�-( WORKER'S COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: 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 Insu�fnce Carrier and Policy Number are ^ ' f) /y.�,� .p p �� 1 CARRIER .1� 1 r✓ e= T` POLICY NUMBER 77 O (THIS SECTION NEED NOT BE COMPLETED IF 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 Worker's Compensation Laws of California. And agree that if I should become subject to the Worker's Compen ti provisions of Section 3700 of the Labor Code II forthwith comply with those provisions. DATE: APPLICANT: WARNING: Failure to secure Worker's Compensati unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand d&lrrs ($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 1 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. S 115�N PERMITTEE NAME (PRINT) / SIGNATURE OF PERMITTEE DATE AW1 APPLICATION DATE: Y - k k- I(. P/C# ISSUE DATE: PERMIT# : to R 16 ^ Dav % TYPE CONST. OCC GROUP: L�- ' \ Scope of Work �( IN l��-%.row w• # DWEL. UNITS If STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport WL Patio/Deck LU LL Pool/Spa ZRe -Roof 3 Commercial 7 [D Valuation: Adj. Area: QUANTITY DESCRIPTION FEE U U w w CD z f a zd 2 U CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMIP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: a OA BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: P/C: PAID BY: VALIDATION: RECEIPT # 1�4 r C 0 PAID BY: V I y 11'r VALIDATION: WHITE — Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy CITY OF DI/,ezMOND BAR INSPECTION RECORD INSPECTIONDATE INSPECTION DATE INSPECTOR SETBACK/ LETTER SWITCH GEAR FOOTINGS FORMS T -BAR SLAB HOT MOP/SHOWERPAN UG. PLUMBING HERS REPORT RECEIVED UG. ELECTRICAL ROOF DRAINS UFER GROUND POOL/SPA SEWER LATERAL ROUGH ELECTRICAL MAIN WATER LINE GAS TEST SEWER CLEANOUT POOL PRE DECK BONDING ROOF SHEATHING FENCE/GATE/ALARM FLOOR SHEATHING WALLS: SHEAR WALLS EXTERIOR WALL STEEL 1-( ) 2ND( ) LIFT SHEAR WALLS INTERIOR WALL DRAIN/ SEAL FRAMINGNENTING RO. FRAMING PLANNING APPROVAL ROUGH MECHANICAL FINAL FIRE DEPARTMENT ROUGH ELECTRICAL W( ) C ( ) ROUGH PLUMBING I / // Av INSULATION WALL INSULATION CEILING DRYWALL LATH (PRE) LATH EXTERIOR LATH INTERIOR GAS TEST SCRATCH COAT ELECTRIC METER RELEASE GAS METER RELEASE SPECIAL INSPECTION FINAL BUILDING FINAL MECHANICAL jr _ r FINAL ELECTRICAL FINAL PLUMBING d T.C. of OCCUPANCY CERT. of OCCUPANCY COMMENTS: INSPECTION DATE O. TRACT AND LEDGER SWITCH GEAR COMMERCIAL HOOD T -BAR INTERCEPTER HOT MOP/SHOWERPAN SEPTIC/CESSPOOL HERS REPORT RECEIVED DEMOLITION ROOF DRAINS ROUGH CONDUIT POOL/SPA ROUGH PLUMBING ROUGH ELECTRICAL ROUGH MECHANICAL GAS TEST PRE GUNITE POOL PRE DECK BONDING P -TRAP FENCE/GATE/ALARM FINAL POOL WALLS: WALL FOOTING/STEEL WALL STEEL 1-( ) 2ND( ) LIFT WALL BOND BEAM WALL DRAIN/ SEAL WALL FINAL RO. FRAMING PLANNING APPROVAL ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT FINAL PLANNING FINAL ENGINEERING/ PW FINAL COMMUNITY SERVICES FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE CITY OF DIAMOND BAR Community and Development Services Department 21810 E. Copley Drive • Diamond Bar, CA 91765 Building Inspection Request Hotline (909) 839-7027 Building Planning Engineering (909)839-7020 (909)839-7030 (909)839-7040 CORRECTION NOTICE PERMIT NO. lb —S-7 4-7i105ATE: TIME:'m pm CONTRACTOR/ OWNER BUILDER ADDRESS (Project Site) 1153 Irl"-� 10-4 4f-,4-AJy0A/ LAI • _ fin►—rG1.4 S /AJ ❑ PLEASE CONTACT THE UNDERSIGNED rEASE MAKE CORRECTIONS AND CALL FOR REINSPECTION INSPECTION FEE REQUIRED ❑ PLEASE MAKE CORRECTIONS AND PROCEED WITH WORK INSPECTOR: =x (print name) SIGNATURE OF INSPECTOR: