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Home My WebLink AboutPR 27261)la,�f01'D BAR CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 BUILDING PERMIT APPLICATION JOB SITE ADDRESS O APN LOT TRAdT OWNER Q n ADDRESS O �TEL. CITY�XQYY1(1 Y1 A 6ttY ZI�MW_190 �1O 0II-1 —VQ APPLICANT TE SO •, CONTRACTOR Afft V__eO[ ADDRESS Co 0 -1#'Fr T CITY�C\0- ZIP9\3C$TEt. h - 081 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 (J 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.). (J 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.). (J 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 oo owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicab law, Section 7044 of the Business and Professions Code is available upon request when this application is submitte at the following Web site: httpAvww.leginfo.ca.gov/calaw.html. DATE: SIGN: LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commend with Section 7000) of Division 3 of the Business and Professions Cade, and my license is infull force and effect. ? ` LICENSE CLASS: G ] LIC. NO � 9 �. DATE: • Ia ,X CONTRACTOR: WORKER'S COMPEN ON ECLARAT10 I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DEC RATIONS: I have and will maintain a Certificate of Consent to Self -Ins for Worker's Compensation, as provided by Section 3700 of the Labor Code, for the performance of the ork for which this permit is issued. I have and will maintain Worker's Compensation Insura , as required by Section 3700 of the Labor Code, for • the performance of the work for which this permit is* ued. My Worker's Compensation Insurance Carrier and .Policy Number are: CARRIER i7' Y �. p e ^ 4 - POLICY NUMBER In (THIS SECTION NEED NOT BE COMP FTHE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS). I certify that in the performance of the work for ich this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compens ' n Laws of California. And agree that if I should become subject to the Worker's Comper n pro Bions of Section 370 f the Labor Cody Fs II forthwith comply with those provisions. DATE. QAPPLIC : � G �\ WARNING: ailure to secure rker's Compensationverege 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 (PRI M]��1 '/ Zp SIGNATURE OF PERMITTEE DATE FINAL17FORESS FIRMLY APPLICATION DATE: (I;l ISSUE DATE: 11 111213,1116 TYPE CONST. P/C# PERMIT# FIR -ZID OCC GROUP: ZONING SETBACKS FRONT REAR SIDE/SIDE STREET SIDE RW ❑ ❑ Rye/ ❑ ❑ PROPOSED USE # DWEL. UNITS # STORIES Y # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATIONSFR/ADD/REM Garage/Carport rn w Patio/Deck LL Pool/Spa ZRe D -Roof J Commercial m Val on:. Z �Adj. Area: QUA Il DESCRIPTION FEE U U J W CM d rL lT ott Q C_Ora J U CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING:(pZ- MECHANICAL: INSPECTION FEE: ISSUANCE: i2 SMTP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: BSAF: TOTAL FEES COMMENTS: A ` �1 RECEIPT# 32 PAID BY: i VALIDATION: WHITE — Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy, GOLDENROD — File Copy, GREEN — Applicant's Copy LIFE91 OUNP_,,,,"�,�, . ............. . - SEWER LATERAL MAIN WATER LINE SEWER ILIA101T ROOF SHEATHING FLOOR SHEATHING 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. ICM Ail".6 rrw Amir.Al CITY OF DIAMOND BAR INSPECTION RECORD 0 � - mmmmmmmmmmmmw.. PRE�GUNITE,�,,. POOL PRE DECK BONOING° A� ,O -TRAP FENCE / GATE/ALARM. FINAL POOL WALLS: WALL FOOTING/STEEL -WALL STEEL 1-( ) 2 NO( LIFT WALL BOND BEAM WALL DRAIN/ SEAL WALL FINAL FRAMING PLANNINGwAPP_ROVA 1ROUGH FIRE APPROVAL-,','." TRACT AND LEDGER FINAL FIRE DEPARTIVIERT SWITCH GEAR `FINAL PLANNING COMMERCIAL HOOD FINAL ENGINEERING/ PW' T -BAR FINAL COMMUNITY SERVICES INTERCEPTER ---------- FINAL HEALTH DEPT, HOT MOP/SHOWERPAN LIND�IAL WASTE NAj�T SEPTIC/CESSPOOL HERS REPORT RECEIVED DEMOLITION ROOF DRAINS ROUGH CONDUIT P00USPA 0 � - mmmmmmmmmmmmw.. PRE�GUNITE,�,,. POOL PRE DECK BONOING° A� ,O -TRAP FENCE / GATE/ALARM. FINAL POOL WALLS: WALL FOOTING/STEEL -WALL STEEL 1-( ) 2 NO( LIFT WALL BOND BEAM WALL DRAIN/ SEAL WALL FINAL FRAMING PLANNINGwAPP_ROVA 1ROUGH FIRE APPROVAL-,','." FINAL FIRE DEPARTIVIERT `FINAL PLANNING FINAL ENGINEERING/ PW' FINAL COMMUNITY SERVICES FINAL HEALTH DEPT, LIND�IAL WASTE NAj�T