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Home My WebLink AboutPR14-36605 TDI I 901T MDQ M1 CITY OF DIAMOND 13AR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond liar, CA 91765 (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 BUILDING PERMIT APPLICATION JOB SITE ADDRESSZ;4742 r kL(DiJa VlEk) DQ APNl3 off- �lf%I T TRACT OWNER 2 U ADDRESS ' WP. lel✓ Dr CITY iwvrey�_ / ,,Z,IP CA 1 APPLICANT LJtt�YlclPj L/J— TEL.CO CONTRACTOR 110 4!V _6_ r2 : ADDRESS 51 !;�-[1 4:14 k- ~--e CITY `7c tn� n P rc'Cl ZIP C� TEL. C� (3z2 '�j Off O 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 reason(s) indicated below by the checkmark(s), I have placed next to the applicable ilem(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 exemplion. 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' 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 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.legfnfo.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: A LI . NO.: Z 2 -c -P3 DATE:y CONTRACTOR: J eye �1 a, N 7� WORKER'S COMPENSATION DECLARATION I I IEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: I have and will maintain a Certificate of Consent to Self-tnsure 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 C' POLICY NUMBER 96 7 1- 32-4 -- 2 0 1 (THIS SECTION NEED NOT BE C&PLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS (S100) 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 Cale, 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 attomey'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. A/V Gj PERMITTEE NAME (PRINT) SIGNATURE OF PERMITTEE DATE y PRESS l FIRMLY APPLICATION DATE: aI P/C# ISSUE DATE: -7 PERMIT# P' k \��- �bb0 TYPE CONST. V - g OCC GROUP:�� Z a ZONING SETBACKS FRONT RW ❑ REAR ❑ SIDE/SIDE STREET RW ❑ SIDE ❑ PROPOSED USE Xy&,,,t 6,C 6i.. a Pc�,� n A 0, /fig j..B�Zle r cd # DWEL. UNITS _ I If STORIES 2 # BEDROOMS- 57 - DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport to w Patio/Deck LL Pool/Spa 0 Z Re -Roof 0 J M Commercial M Valuation: %'Y'006 Adj. Area: QUANTITY DESCRIPTION FEE L) ` z J n. Q t \ hLy U Z CONSTRUCTION: PLAN REVIEW: ELECTRIC: S Issit PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: \4-Q . a a SMIP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: 3 Q�, be PRE -ALT FEE: BSAF: TOTAL FEES / / 1 (/ 7 COMMENTS: 1� W 114 RECEIPT # aL��J 49 PAID BY: 1 g A3 VALIDATION: WHITE — Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy, GOLDENROD — File Copy, GREEN — Applicant's Copy CITY OF DIAMOND BAR INSPECTION RECORD • o SETBMK/:LETTER �, o- - o o- TRACTAND LEDGER FOOTINGS'FORMS . '_i s SWITCH GEAR SLAB COMMERCIAL HOOD UG. PLUMBING UG, ,ELECT RIGAL..:. �{ '- �. � � - �� T -BAR INTERCEPTER UFER GROUND' HOT MOP/SHOWERPAN Wgi4cok SEWER LATERAL SEPTIC/CESSPOOL MAIN WATER LINE HERS REPORT RECEIVED SEWER CLEANOUT DEMOLITION ROOF SHEATHING ROOF DRAINS FLOOR SHEATHING ROUGH CONDUIT SHEAR WALLS EXTERIOR POOL/SPA , SHEAR WALLS INTERIOR ROUGH PLUMBING FRAMINGNENTING �. '` ROUGH ELECTRICAL ROUGH MECHANICAL';.`, ROUGH ELECTRICAL, /° ROUGH MECHANICAL GAS TEST ROUGH PLUMBING .,. INSULATION WALL PRE GUNITE ., . POOL PR&DECK BONDING - , INSULATION CEILING P -TRAP DRYWALL k,rZ FENCE / GATE/ ALARM. LATH (PRE) FINAL POOL LATH EXTERIOR WALLS: LATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL 1ST( )2 ND( ) LIFT SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELEASE WALL DRAIN/ SEAL GAS METER RELEASE WALL FINAL SPECIAL INSPECTION RO. FRAMING PLANNING APPROVAL . FINAL BUILDINGROUGH FIRE APPROVAL FINAL MECHAN.ICAL.:;: ,i. 3 e /6.r .; ` FINAL FIRE DEPARTMENT FINAL ELECTRICAL FINAL PLANNING FINAL PLUM131NG :` , f,t ,JQ /L ' . FINAL ENGINEERING/ PW OCCUPANCY FINAL COMMUNITY SERVICES CERT. ofDCCUPANCY FINAL HEALTH DEPT. COMMENTS: FINAL INDUSTRIAL WASTE /z✓3 cr/ C .� o f d� 1 s Ca.+d /.2<► V t rrl c a j