The URL can be used to link to this page

Home My WebLink AboutPR15-695CITY OF DIAM DEPARTMENT OF COMMUNITY & DE�EL,OPMENT 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 JOB SITE ADDRESS %�. .9 I3 SJ ' J % l%I APN LOT TRACT OWNE ADDRESS I Afr& led CITY _ '/ CEL. APPLICANT TEL. CONTRACTOR ADDRESS CITY {1 14 C ARCH/ENG/DESIGNER X Ij[ a, Gvl s � 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 fmm 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). (_) I, as owner of the property, or my employees with wages as their sole compensation, will do (J all of or (J portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Cade: 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.). (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,) 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.htmt. DATE: SIGN: LICENSED CONTRACTOR'S DECLARATION I here'riaffirm 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.: DITE: 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 Mf ' POLICY NUMBER (THIS SECTION NEED NOT BE COMPLETED IFTHE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS). I certify that in the performance of the work for wh' nnttttsued4+i; t employ any person in any manner so as to become subject to the Worker's Compensati aws of Califomia. A Id become subject to the Worker's Compensation provisions of Section 3700 of a e, sh I forthwith comply with se provisions. DATE: APPLCANT WARNING: Failure to secure Worker's ensa 9e'is unla all subject an employer to criminal penalties and civil fines up to one hundred tho '($t00A0 n additi 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 then: 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 ordinance ws-rele' struction, and hereby authorize representatives of this county to enter a above-mentioned property A�ilding urposes. PER' �E R SIGNATURE OOFFPERMITTEE. , 11DATE APPLICATION DATE: S P/C# PrR \ S - io X15 ISSUE DATE: " J '� PERMIT# TYPE CONST. OCC GROUP: ZONING SETBACKS FRONT RW ❑ REAR ❑ SIDE/SIDE STREET RW ❑ SIDE ❑ PROPOSED US ' d - 0 11f/Qv 0 hlr r a s�a•� # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT FACTOR PSF ADJ. AREA/VALUATION SFR/AD M T�Gd G os C Garage/Carport tE7> rp LU Patio/Deck LL Pool/Spa ZRe -Roof � Commercial m I I Valuation: 1 , Adj. Area: t QUANTITY DESCRIPTION FEE w f J I aI i/ p1. A IU w I CONSTRUCTION: �J� 1 . •�• q �K PLAN REVIEW: ELECTRIC: PLUMBING: s 0- 0 MECHANICAL: ..ir INSPECTION FEE: ` ISSUANCE: SMTP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: •� BSAF: TOTAL FEES([ top COMMENTS: ,O�G+r1r�.� RECEIPT # 7 O PAID BY: _ VALIDATION: WHITE —Department Cop; YELLOW —Finance Copy, PINK —Assessor Copy, GOLDENROD —File Copy, GREEN —Applicant's Copy SEl`BAGKi<LE'CTER , ,°_ FOOTINGS FORMSz IJ SLAB I k UG'PLUMBING r :UG. ELECTRICAL UFEfi GROUND SEWER LATERAL MAIN WATER LINE SEWER CLEANOUT �— ROOF SHEATHING 7 1a FLOOR SHEATHING !/ i b► CITY OF��vN� INSPEC ii6N AECORniv TRACT AND LEDGER SWITCH GEAR COMMERCIAL HOOD T -BAR -- INTERCEPTER HOT MOP/SHOWERPAN SEPTIC/CESSPOOL _ HERS REPORT RECEIVED DEMOLITION ROOF DRAINS ROUGH CONDUIT v u.a rrn�cu v u,uv 'S14WWALLS INTERIOR.... 'FRJ%MIANIN ITNGs I #RbUGH�MECHAkdl I, ROUGH E'ECTRICAL.W( ),C ( )`�• INSULATION WALL INSULATION CEILING v - IDRYWALL LATH (PRE) LATH EXTERIOR �19�� LATH INTERIOR GAS TEST r.., , SCRATCH COAT ELECTRIC METER RELEASE A GAS METER RELEASE �a SPECIAL INSPECTION I FINAL,BUILOING�"„ ,,;: 7�� 7 : �:�•...: 'FINAL MECHANICAL "f FINAL ELECTRICAL 9) FINAL PLUMBING:° -A+ j. T.C'li OCCUPANCY , 1 . `',�' v - ROUGH PLUMBING r.., , - ROUGHELECTRICAL . P..` A a, rvv�r.arM ROUGH PLUMBING r.., , - ROUGHELECTRICAL . P..` ROUGH MECHANICAL ., GAS TE5 PRE GUNITE POOL,PRE DECK.BONOING a P -TRAP FENCE / OATU ALARM = _ FINAL POOL WALLS: WALL FOOTING/STEEL WALL STEEL 1-( ) 2N°( ) LIFT WALL BOND BEAM —� WALL DRAIN/ SEAL WALL FINAL I R0. FRAMING PLANNING APPROVAL ROUGR f IRE APPROVAL FINAL ORE DEPARTMENT FINAPLANNING I �p _.. FINA(ENGINEERING/ PW <., FINAL@CUMMUNITY;SERVICES ' FINALHEALTH DEPT. FINALINDUSTRIAL WASTE . ;..�