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Home My WebLink AboutPR15-2680Dli1�10ND BAR S � CITY OF DIAMOND BAR` ` DEPAR'1'MENT'017 COMMUNITY & DEYECOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765- (909) 1765(909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@Cndbarca.gov JOB SITE ADDRESS APN 19 0[:0Q_t6iQ!VQTRACT OWNER t r i Fl7J ADDRE5,Sft S CITY— IP L117igTEL. APPLICANT�(�A,�/� CONTRACTOR ADDRESS CITY ZIP TEL. ARC /ENG/ DESIG ADDR t SS!'o CITY ZIP I 1770 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 e-.emption. 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 owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' Stale 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 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 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.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: I—� LIC. NO.: O --?-/1Z7_9 DATE: CONTRACTOR: 5. , �— 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 (PHIS 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 hould become subject to the Worker's Compensation pro slon f Section 370 7of the Lao de, I shalliorth rith comply with hose p visions. DATE:�APPLICANT: WARNING: Failure to secure Worker's Com nsa o overage is unlawful, and sha0subject 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. .¢ N c �PNO G PE AME (Pf]jplT) SIGNATUhE 4 PERMITTEE DATE LONVA PRESS FIRMLY APPLICATION DATE: ) P/C# ISSUE DATE: PERMIT# : TYPE CONST. OCC GROUP: Scope of Work ApIDIMOA) OFF Z i �- L�'rrrl� e r>C--t, �e / Rfto /Z_ z -rte 20'eZd r'I'fR- S; rn1SI # DWEI UNITS # STORIES 2 If BEDROOMS I DESC PTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/fIREM 49 Garag Carport LO Patio/Deck LU LL Pool/Spa ZRe -Roof Commercial m Valuation Adj. Area: QUANTITY DESCRIPTION FEE U U w w co m / a f va ,ems 1:4-<Z ZU t JCSC- f�- Q �,• 2 �p, � CONSTRUCTION: / / PLAN REVIEW: 2V�r 3 Gp ELECTRIC: Q �S PLUMBING: 0• jo MECHANICAL: 6ay7 INSPECTION FEE: ISSUANCE: y Z. SMIP: L ENERGY P/C: 7 i ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: yy i70 i 3 �D• BASF: qS PLOT PLAN: ZONING CLEARANCE: TOTAL FEES�7/ i/ COMMENTS: 13 P/C: f211Z_L PAID BY:X/11 / RECEIPT # I?o / b PAID BY: (,�_'T� VALIDATION: VALIDATION: WHITE — Department Copy, YELLOW — Finance Copy, PINK —Assessor Copy •t CITY OF :Dl '-7 '!�!D`43AR INSPEC`TI3.ARECORD SETBACK/ LETTER FOOTINGS FORMS SLAB DAO. UG. PLUMBING UG. ELECTRICAL LIFER GROUND SEWER LATERAL MAIN WATER LINE SEWER CLEANOUT ROOF SHEATHING FLOOR SHEATHING SHEAR WALLS EXTERIOR _71. "., SHEAR WALLS INTERIOR FRAMINGNENTING ROUGH MECHANICAL ROUGH ELECTRICAL W(- ) C ( ) ROUGH PLUMBING 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 rl Arm 44ww FINAL MECHANICAL FINAL ELECTRICAL FINAL PLUMBING T.C. of OCCUPANCY CERT. of OCCUPANCY AN DAtE O. TRACT AND LEDGER SWITCH GEAR COMMERCIAL HOOD T -BAR INTERCEPTER HOT MOP/SHOWERPAN SEPTIC/CESSPOOL HERS REPORT RECEIVED DEMOLITION ROOF DRAINS ROUGH CONDUIT POOUSPA ROUGH PLUMBING ROUGH ELECTRICAL ROUGH MECHANICAL GAS TEST PRE GUNITE _ POOL PRE DECK BONDING P -TRAP _ FENCE / GATE/ ALARM FINAL POOL WALLS: WALL FOOTING/STEEL WALL STEEL 1-( ) 2"D( ) LIFT WALL BOND BEAM WALL DRAIN/ SEAL WALL FINAL R0. FRAMING PLANNING APPROVAL ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT FINAL PLANNING FINAL ENGINEERING/ PW FINAL COMMUNITY SERVICES FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE