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Home My WebLink AboutPR16-2786DLIVNOND 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 www.cityofdiamondbar.com building@diamondbarca.gov JOB SITE ADDRESS 2-6 (a 1 1, ; 1) i- . APN LOT TRACT OWNER ADDRESS Z � CITY `D f�; LA ZIP 46 TEL. APPLICANT Ltilc~&- DC nrro..y TEL. 6-_Z-6 °-I • .SZ i q CONTRACTOR S L tO,- L(,'4 ADDRESS r— , (..c t k__ CITY k - ✓' ZIPSLW-,-LTEL. 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 70DO of Division 3 of the Business and Professions Code] or that he or she is exempt from Iicensure 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 mole than five hundred dollars ($500). U 1, 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 Iicensure under the Contractor's State License law for the following reason(s): Date: Sign: 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,[ 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 my license is in full force and effect. LICENSE CLASS: b C La LIC. NO.: D 98 l pj EXP. DATE: I' Z- I I CONTRACTOR: 4� � 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 `n Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. —to—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 ZC�►''Y POLICY NUMBER U/ %t� t S- 2• f c'I (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 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 (PRIN SIGNATURE OF PERMITTEE DATE PRESS FIRMLY APPLICATION DATE: tZ,� r ISSUE DATE: 12/3/I W PERMIT# : TYPE CONST. P/C#/ PJ1I(r 2Tg�/1 f �7 R I �o —2 OCC GROUP: r Scope of Work ( S dc+ �y )LOi , r/4i L.t� � i✓L �� # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport w Patio/Deck - w LL Pool/Spa ZRe -Roof Commercial co m Valuation: S`C�D Adj. Area: QUANTITY DESCRIPTION FEE U U w w z in J a , U_ zd x U CONSTRUCTION: PLAN REVIEW: '7 �1 1 ELECTRIC: 3(O PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: n �1• SMIP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE-ALT FEE: (i BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: P/C: rs�� PAIDBY: �O.Q VALIDATION: RECEIPT # 3q 2 1 -11 PAID BY: 7 D D 14 I b VALIDATION: WHITE — Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy CITY OF DIAPOKE-) BAR INSPECTION RECORD - COMMENTS: The alarms are required to be installed in the following locations: •S Smoke alarms in all sleeping rooms. ❖ CO alarms in all sleeping rooms where fuel burning appliances are installed. ti• Smoke alarm and CO alarm in hallways preceding sleeping rooms. Smoke alarm and CO alarms on each dwelling level including basements and habitable attic rooms. The smoke and CO alarms are required to comply with the above when requesting a final inspection. Please make sure an adult is present to allow the Inspector access to the home to verify compliance with the above requirements. If no one will be available, you may opt to complete the Installation Certification below and leave it with the job card. (Piease till out and tear off this portion to leave with the job card if no one will be available to allow the inspector inside the house.) INSTALLATION CERTIFICATION Q / For the property located at �g l'1 Y I hereby certify that the required smok alarms and carbon monoxide alarm have been installe as listed above. Signature 0 Print Name Date Relationship to project (please check one): ❑ Owner ❑ Agent for Owner ❑ Licensed Contractor ❑ Agent for Licensed Contractor If "Licensed Contractor" or "Agent for Licensed Contractor' is checked, please complete the following: Contractor Contractor's State License Number O . . - CITY OFDL4MOND BAR BUILDING & SAFETYDIVMION 21810 Copley Drive Diamond Bar, CA 91765 (909) 839-7020 SMOKE ALARM AND CARBON MONOXIDE CERTIFICATION In order to help assure the life and safety within existing dwellings, the 2013 California Residential Code (CRC) Section R314 and R315, along with the California Building Code Section 420.5 and 420.6 requires existing dwellings to have smoke alarms and carbon monoxide alarms installed within the upper 12" of the ceiling when a building permit is issued for, worked on, or in a building that is valued at $1,000 or more. Alarms may be solely battery operated where repairs or alterations do not result in the removal of wall and ceiling finishes or there is no access by means of attic, basement or crawl space. Starting July 1, 2014 all smoke alarms including combination smoke alarms, that are solely battery powered shall contain a non -replaceable, non -removable battery that is capable of powering the smoke alarm for at least 10 years. CARBON MONOXIDE ALARMS REQUIRED IN EXISTING DWELLINGS: • Where a permit is required for alterations, repairs or additions exceeding $1,000. • Existing dwellings or sleeping units that have attached garages or fuel burning appliances. Carbon monoxide alarms shall be installed: • Outside of each separate dwelling unit sleeping area in the immediate vicinity of the bedroom(s). • On every level of a dwelling unit including basements. REQUIRED IN NEW DWELLINGS: Carbon monoxide alarms shall be installed: • Outside of each separate dwelling unit sleeping area in the immediate vicinity of the bedrooms(s). • On every level of a dwelling unit including basements. Alarms shall receive their primary power from the permanent building wiring without a disconnecting switch other than as required for overcurrent protection. Battery backup is required. NOTE: Multiple purpose alarms. • Listed and labeled combination carbon monoxide /smoke alarms are acceptable in new and existing dwellings. Carbon Monoxide Alarms is a requirement that is in addition to required Smoke Alarms.