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Home My WebLink AboutPR15-2209Y Z �Q Y i L b Z ¢ z Z Z :2 n M y J 1 J x x Z y x i Z z 5 J_ ¢ z 10ND 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 JOB SITE ADDRESS -7 Ci + Cf APN LOT TRACT OWNER S to V'e C -I Qin ADDR SS 54104 CITY ZIP TEL. APPLICANT TEL. CONTRACTOR S Dry ADDRESS 3 D S� RrV ( P_ (Ai ell. S CITY �dh ,N��en ZIPg 7TEL. ARCH/ENG/DESIGNER � a",e 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 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 (, 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.). () 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 for my personal residence in which I must have resided for at leas ne year prior to completion of the improvements covered by this permit,) cannot legally sell a structure that I have b'It as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the a?pi icable law, Section 7044 of the Business and Professions Code is available upon request when this application is s initted or at the following Web site: http/www.leginfo.ca.gGv/calaw.htmi. DATE: SIGN; LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (comm ting 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: L %� CONT CTOR: 161 C ✓ WORKER'S COMPENSATION DECLARATIO I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DEC TIONS: I have and will maintain a Certificate of Consent to Self-Insur or Worker's Compensation, as provided by Section 3700 of the Labor Code, for the performance of the w for which this permit is issued. VI have and will maintain Worker's Compensation Insurance required by Section 3700 of the Labor Code, for the performance of the work for which this permit is iss d. My Worker's Compensation Insurance Carrier and Policy Number are: CARRIER u r C. Li POLICY NUMBER (THIS SECTION NEED NOT BE COMPLETED IF -T PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS). I certify that in the performance of the work for whicid permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation La of California. And agree that if I should become subject to the Worker's Compen tion,{ ro�v�ision� of Section 3700 of the or Co I shall forthwith/p��pI with those provisions. DATE:�PPLICANT:Q Nyf, / �:�� S WARNING: allure t�s�eccure Worker's Compensation coverage is unlawful, and Zall subject an employer to criminal penalties and civil.fines up to one hundred thousand dollars ($100,000), in addition to the cost of the compensation, damages as provided for in section 3708 of the labor code, interest, and attorney's fees. % CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a Construction Lending Agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). LENDER'S NAME: LENDER'S ADDRESS: I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes. �u �►h if \illy M_,P S PERMITTEE NA (PRINT) SIGNATUR R TTEE DATE PRESS FIRMLY APPLICATION DATE: Cy DATE: E CONST. TYPE ZZ t� % P/C# n PERMIT# fQ It - t -TYPISSUE OCC GROUP: ZONING SETBACKS FRONT REAR SIDE/SIDE STREET SIDE RW ❑ ❑ RW ❑ ❑ PROPOSED USE # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT. F TOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport 0 w Patio/Deck LL Pool/Spa ZRe -Roof O J Commercial m Valuation: i7tAdj. Area: QUANTITY DESCRIPTION FEE J U 2 U J w Lo M J a U w CONSTRUCTION:��r�� PLAN REVIEW: ELECTRIC: F /` l f PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMTP: ENERGY P/C: l •� ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: ) J D' Da BSAF: % Oa TOTAL FEES COMMENTS: fOD, dd RECEIPT # PAID BY: VALIDATION: WHITE — Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy, GOLDENROD — File Copy, GREEN — Applicant's Copy i = r - CITY OF DIAMOND BAR FRAMING VENTING , ,,a�-, , R INSPECTION R-ECOIRD 1300G0ECHANI2AL, ;:,„ . _ AW&ij x_. ROUGH MECHANICAL „ ROUGHELECRI#C4L'!Ni)Ci' 1¢;.^ av;9. +� • s . �,:,_��a.. ROUGH'PLUMBING ``7 ®� e SETBACKt LETTER '?' ''; ' _ -- ° ;' TRACT AND LEDGER 6 F04TINGS,QFORMS .POOL„PRE DECWBONDING,� __ �._ �. SWITCH GEAR SLAB tis_: DRYWALL COMMERCIAL HOOD _3 . UG.PLUM$INf ��, .".�,".. �� z - , -� ,a„ - ;T -BAR ,6&: ELEVRICAL WALLS: INTERCEPTER a ,UFER GROUND '^ ^ -�` GAS TEST HOT MOP/SHOWERPAN SEWER LATERAL WALL STEEL 1-( ) 2N°( ) LIFT SCRATCH COAT SEPTIC/CESSPOOL MAIN WATER LINE ELECTRIC METER RELEASE HERS REPORT RECEIVED SEWER CLEANOUT WALL FINAL DEMOLITION ROOF SHEATHING ROOF DRAINS FLOOR SHEATHING I ROUGH CONDUIT SHEARWALLS INTERIOR = r - ROUGH PLUMBING FRAMING VENTING , ,,a�-, , R _ ROUGH ELECTRICAL 1300G0ECHANI2AL, ;:,„ . _ AW&ij x_. ROUGH MECHANICAL „ ROUGHELECRI#C4L'!Ni)Ci' 1¢;.^ av;9. AV - `GaASTEST s . �,:,_��a.. ROUGH'PLUMBING ``7 s^, e PRE GUNITE s` INSULATION WALL CER7of; OCCUPANCY. - .POOL„PRE DECWBONDING,� INSULATION CEILINGP-TRAP'S COMMENTS: FINAL INDUSTRIAL WASTE; DRYWALL FENCE / GATE/ ALARM LATH (PRE) FINAL POOL LATH EXTERIOR WALLS: LATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL 1-( ) 2N°( ) LIFT SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELEASE WALL DRAIN/ SEAL GAS METER RELEASE WALL FINAL e , r - RO. FRAMING PLANNING APPROVAL m FINAL�BUILDING . �qm �a FINAL MEOICAL` - r �, "i: ROUGH FIRE APPROVAL, : „p; x_. 'SUPeilk' ;FINAL ELECTRICAL _ : ,FINAL PLUMBING - ` °. : FINAL ENGINEERING/ PW "Imm e : TCN�of OCCUcPANCY ,. ., "' FINALCOMMUNITY SERVICES' -: '. � CER7of; OCCUPANCY. - tet” FINAL HEALTH DEPT.,, .... .� r �. COMMENTS: FINAL INDUSTRIAL WASTE; SPECIAL INSPECTION r - RO. FRAMING PLANNING APPROVAL m FINAL�BUILDING . �qm �a FINAL MEOICAL` - r �, "i: ROUGH FIRE APPROVAL, : „p; x_. FINAL FIDE DEPARTMENTvim i FOAL PLANNING p": ;FINAL ELECTRICAL _ : ,FINAL PLUMBING - ` °. : FINAL ENGINEERING/ PW "Imm e : TCN�of OCCUcPANCY ,. ., "' FINALCOMMUNITY SERVICES' -: '. � CER7of; OCCUPANCY. - tet” FINAL HEALTH DEPT.,, .... .� r �. COMMENTS: FINAL INDUSTRIAL WASTE;