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Home My WebLink AboutPR15-2024L'�&MONDRA7F 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 V'I 3019 FA _rf f f; A k1 JZ -b APN LOT TRACT OWNER 2��.�I✓�/r-i6H-�% ADDRESS CITY WC-Si—COV/ Nf/ ZIP TEL.IrZl! 'Z�'Sy"' STi APPLICANT �}I✓iQT7%/7P TEL. /��``�_5�2 -% CONTRACTOR ADDRESS 3/IeG CITY 1,,� 69 AJ ZIP TEL. ARCH/ENG/DESIGNER /D ADDRESS -b ORZ CIrY64;VA';1 A11b_ZZIP TEL 95 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 Srofessions 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 far a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). (J I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or () 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 licensure under the Contractor's State License law for the following reason(s): By my signature below I acknowledge that, except far my personal residence in which I must have resided for at least one year prier 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. DATE: SIGN: 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'gG OL7 & LIC NO.. c27r. '� DATE:/� CONTRACTOR: r F 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 Poli y Number e: CARRIER POLICY NUMBERLJ'Z (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 fo ich this pe it is issued, I shall not employ any person in any manner so as to beceme suWnp?, je Worker's Compens on ws of ifomia. And agree that if I should become subject to the Worker's Compen io f Section 3700 f labor ode I shall forthwith comply with those provisions. DA706 TE: APPLICANT: - WARNING: Failure tc secure Worker's Compens ion c rage unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred th sand dollars ($400,000), 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 i s d (Se 3097, Civ. C.). LENDER'S NAME: WO 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 on the above-mentioned property for inspection purposes. 2�7✓� PERMI AME(P SIG DTE PRESS FIRMLY APPLICATION DATE: lP/C# /S'- 67dol -11 ISSUE DATE: . ! PERMIT# )ORkV �111!) a V TYPE CONST. 5191&t OCC GROUP: �BJO► cti� ZONING SETBACKS FRONT RW ❑ REAR El- SIDE/SIDE SIDE/SIDE STREET RW ❑ SIDE ❑ PROPOSED USE 2-.G G �(>!✓AR S�sTG�, . X _ � 77,14- �1' a ,v pl�2TiA-� t'r9��G wi # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport V) LU Patio/Deck LL Pool/Spa ZRe -Roof 0 Commercial Ica Valuation: Adj. Area: J ANTITY DESCRIPTION FEE U U J � w cc z m a U Q W � �)jV f �l�O/lr• i CONSTRUCTION: PLAN REVIEW: _92I ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: n SMIP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: I PRE -ALT FEE: r� BSAF: f 00 Dyer Fl�,h !'�(r, � In. J.�ld•.,i�7 •� ��C�(1� �•Q �'C�CYYYE�n � ��) S� TOTAL FEES COMMENTS: , �� ,.��,�% RECEIPT # PAID BY:,�i.3 VALIDATION:— - — WHITE — Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy, GOLDENROD — File Copy, GREEN — Applicant's Copy FORMS ta �ING TICAL JND SEWER LATERAL MAIN WATER LINE SEWER CLEANOUT ROOF SHEATHING FLOOR SHEATHING ROUGHPLUMBING INSULATION WALL INSULATION CEILING DRYWALL LATH (PRE) LATH EXTERIOR LATH INTERIOR GAS TEST SCRATCH COAT ELECTRIC METER RELEASE GAS METER RELEASE SPECIAL INSPECTION CITY OF.' F .DIAMOND BAR INSPECTION RECORD COMMENTS: WALL DRAIN/ SEAL WALL FINAL RO. FRAMING PLANNING APPROVAL µ,. ROUGH FIRE APPROVAL, FINAL"FIRE DEPARTMENT FINAL PLANNING �;y TRACT AND LEDGER SWITCH GEAR COMMERCIAL HOOD T -BAR ;. INTERCEPTER [HOT MOP/SHOWERPAN SEPTIC/CESSPOOL HERS REPORT RECEIVED DEMOLITION ROOF DRAINS ROUGH CONDUIT mry POOL/SPA ;ROUGFI, PLUMBING' a w <: „ „,L;" `ROUGH ELECTRICAL �, F^ , . ,9 13OUGH'MECHANICAL "�� ,� �� GAS TEST PRE GUNITE POOL PRE DECK BONDING rR xrt P -TRAP ff FENCE / GATE/ ALARM FINAL POOL � _ WALLS: WALL FOOTING/STEEL WALL STEEL 1S'( ) 2NO( _ ) LIFT WALL BOND BEAM COMMENTS: WALL DRAIN/ SEAL WALL FINAL RO. FRAMING PLANNING APPROVAL µ,. ROUGH FIRE APPROVAL, FINAL"FIRE DEPARTMENT FINAL PLANNING �;y CITY OF DIAMOND BAR 1 C 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 www.cityofdiamondbar.com building@diamondbarca.gov JOB SITE ADDRESS 3 D lb y Irl FI APN LOT TRACT OWNER ADDRESS CITY ZIP TEL. APPLICANT TEL. CONTRACTORD L ADDRESS r'7 '.J K I O—C� & ( CITY I TEL. 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 reasons) 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 br 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 licensure 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,i 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: hnp/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/lice a is - in full force and effect. 72 LICENSE CLASS: LIC. NO.: l P.DATE: CONTRACTOR. - - , WORKER'S COMPENSATION DECLARATION 1 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 Num are: l __ CARRIE _� A POLICY NUMBER (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS $100 OR LESS). 1 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 slate 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 �1 PER E NAME FIN SIGATMEUFFtHMIIIM DATE APPLICATION DATE: 0L9_/5__/ P/C# ISSUE DATE: I 14R I \-4" PERMIT# : PA /S ' 2O 0;L_4 TYPE CONST. OCC GROUP: Scope of Work S 1 M U -I I— • LVC_ - G Akio xkP # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport wWO Patio/Deck W L- Pool/Spa zRe -Roof FD Commercial 5 co Valuation: Adj. Area: QUANTITY DESCRIPTION FEE a U w J W co m J a _U zd x U CONSTRUCTION: PLAN REVIEW4g6_9a ELECTRIC: S �b PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: _ �Jir • �'a SMIP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES IM 8 D, COMMENTS: P/C: 3130 3 PAID BY: C 4lSF1J VALIDATION: RECEIPT a �a PAID BY: 4 I 'q -/ VALIDATION: WHITE — Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy CITY OF DI.A.NlOND BAR -- INSPECTION RECORD COMMENTS: