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Home My WebLink AboutPR15-3042:a CITY OF DIAMOND BAR i DEPARTMENT OF COMMUNITY & DEVE�,i OPMENT SERVICES I 21810 Copley Drive, Diamond Bar, CA 91765 PRESS (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-702FIRMLY BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building s(w,c v JOB SITE ADDRESS X 78 O APN L T TACT OWNER )s Q�2 /L! ADDRESS CITY ZIP TEL. APPLICANT TE . CONTRACTORX 1101013& &W1 ADDRESS CITY ZIP TEL. ARC NG N r - DESIGNER ADDRE S ! Q CITY ^A ZIP 177 1`4 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 I, as ow of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Bus' es mi Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or i prov s thereon, and who coZtC--f_(t)1'1? the projects with a licensed Contractor pursuant to the Contractors' State License w. U I a e t fro licensure uncle(ctor's State Lice law r t e o I I ing reason(s): By my sigTrif low I acknowledge that, except for my personal r idence in which I must have resided for at least one year prioretion of the improvements covered by this permit,l cannot legally sell a structure that I have built as an owner-buhas not been constructed in its entirety by licensed contractors. I understand that a copy of the applicablection 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.htmi. 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: LIC. NO.: DATE: CONTRACTOR: 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 Insurance Carrier and Policy Number are: CARRIER POLICY NUMBER (THIS SECTION NEED NOT BE COMPLETED IIFA PERMIT IS FOR ONE HUQploy LARS ($100) OR LESS). I certify that in the performance of the work for which th' nni ' issu I shall noty person in any manner so a to become subject to the Worker's Compensation Laws o alifom' . An agree that iecome subject to the Worker's Compensati prov of Sec ion 3700 of the Labo e, all to with comply provisions., DATE. APPLICANT WARNING. Failure to secure Worker's Compensationoverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,000), in addition to the cost of the compensation, damages as provided for in section 3708 of the labor de, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a Construction Lending Agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). LENDER'S NAME: LENDER'S ADDRESS: I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state la ting to building construction, and hereby authorize representatives of this county to enter upave- ntion pro rty for inspec purposes. a PERMITT (PRI X -0,4 SIGNATURE OF PERMITTEE DATE APPLICATION DATE: 1"I -.-5 N 1\ S P/C# T`Ia 1 S- 3'O y_Zk ISSUE DATE: o1 I to >!I t,,*PERMIT# : f)(2� XS - Sdg'o3. TYPE CONST. OCC G�R"O�UP: Scope of Work X %� g I �Q��jrvt a�GL (/✓Q�CJCi # DWEL. UNITS If STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport CO Patio/Deck W LL Pool/Spa ZRe -Roof Commercial C0 C0 Valuation: Adj. Area: QUANTITY DESCRIPTION FEE U 2 w J W co Z M J rL ZU_ Q x U CONSTRUCTION: - CI . 9 PLAN REVIEW: ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE:�SL1- SMIP: sb ENERGY P/C: ENERGY PERMIT: RETENTION FEE: O>J PRE -ALT FEE: BASF: `• C� PLOT PLAN: all,, ZONING CLEARANCE: TOTAL FEES 9 ;k • b S, O3 COMMENTS: = �r� • �� P/C: PAID BY: VALIDATION: RECEIPT q �$ W ISI PAID BY: 3 VALIDATION: �r WHITE — Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy CITY,0V,D;KMq_OND INSPECT1I6N BAR 'RECORD INSPECTION DATE INSPECTOR TRACT AND LEDGER INSPECTION DATE INSPECTOR SETBACK/ LETTER FOOTINGS FORMS SLAB ,4y 6' SWITCH GEAR COMMERCIAL HOOD UG, PLUMBING T-BAR UG. ELECTRICAL INTERCEPTER UFER GROUND HOT MOP/SHOWERPAN SEWER LATERAL SEPTIC/CESSPOOL MAIN WATER LINE HERS REPORT RECEIVED SEWER CLEANOUT DEMOLITION ROOF SHEATHING ROOF DRAINS FLOOR SHEATHING ROUGH CONDUIT SHEAR WALLS EXTERIOR P00IJSPA SHEAR WALLS INTERIOR ROUGH PLUMBING FRAMINGNENTING ROUGH ELECTRICAL ROUGH MECHANICAL ROUGH MECHANICAL ROUGH ELECTRICAL W( ) C () GAS TEST ROUGH PLUMBING PRE GUNITE INSULATION WALL POOL PRE DECK BONDING INSULATION CEILING P-TRAP DRYWALL FENCE / GATE/ ALARM _ LATH (PRE) FINAL POOL LATH EXTERIOR WALLS: LATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL 1ST( ) 2` LIFT WALL BOND BEAM SCRATCH COAT ELECTRIC METER RELEASE WALL DRAIN/ SEAL WALL FINAL GAS METER RELEASE SPECIAL INSPECTION R0. FRAMING PLANNING APPROVAL FINAL BUILDING ROUGH FIRE APPROVAL FINAL MECHANICAL FINAL FIRE DEPARTMENT _ _i FINAL ELECTRICAL FINAL PLANNING IV, FINAL PLUMBING FINAL ENGINEERING/ PW ` T.C. of OCCUPANCY FINAL COMMUNITY SERVICES _ CERT. of OCCUPANCY FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE