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Home My WebLink AboutPR16-2701U11111OIND BAK A� CI9Y OF DIAMOND BAR 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 Zy'D�o rf e&0-'✓tL d . APN e ALOT TRACT OWNER 'Pyet�- /milCtc,4:-ypf.--C— ADDRESS ' 41_ ✓: �'C•d. CITY 17 P7 C KIt ZIP ` / ' fEL. / APPLICANT /�`� %wyYt i TEL. CD Z61 y7-y / Q CONTRACTORO ADDRESS S t'- Z-c,6y— CITY ZIP 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 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 70DO 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 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 w builds or improves thereon, and who contracts forthe projects with a licensed Contractor pursuant to the Contactors' to 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 res d for at least one year prior to completion of the improvements covered by this permit,l cannot legally sell a structur at I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I under nd that a copy of the applicable law, Section 7044 of the Business and Professions Code is available upon requ when this application is submitted or at the following Web site: http/www.leginfo.ca.gov/calaw.html. LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chap 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full fort nd effect. LICENSE CLASS: 13 C lc7 LIC. NO.: '9i�'�� EXP. DATE: CONTRACTOR: WOR/Consent PENSATION CLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJF THE FO WING DECLARATIONS: I have and will maintain a Certnsent Self -Insure for Worker's Compensation, as provided by Section 3700 of the Labor Codeor nce of the work for which this permit is issued. have and will maintain Worker'n Insurance, as required by Section 3700 of the Labor Code, far he performance of the work forermit is issued. My Worker's Compensation Insurance Carrier and Policy Number are: CARRIER L~ 7 POLICY NUMBER W 19 (T/atroh TION NEED NOT BE PLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS $100 OR LESS). I certify that inormance of the rk for which this permit is issued, I shall not employ any person in any manner so a; to become subjeWorker's Co ensabon Laws of California. And agree that if I should become subject to the Worker's Compensatioons of Secb 3700 of the Labor Code, I shall forthwith comply with those provisions. DATE:LICANT:WARNING: Fse re Worker's Compensation coverage is unlawful, and shall subject an employer to criminal penalties ann up to one hundred thousand dollars ($100,000), in addition to the cost of the compensation, damages as for in section 3708 of the labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY I hereby affirr 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. Q. 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. PERMITTEE NAME (P INT) SIGNATURE OF PERMITTEE DATE APPLICATION DATE: I /• /h • 4 ISSUE DATE: Z G PERMIT# : TYPE CONST. P/C# ?No 'Z�-fvk PRILO OCC GROUP: Scope of Work vtrG-e�i- t �u►� If DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. Ff. FAC R PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport w Patio/Deck w LL Pool/Spa zRe -Roof Commercial 7 m Valuation: CfO Adj. Area: QUANTITY DESCRIPTION FEE a U U W J w c� z in J a ZU_ Q x U CONSTRUCTION: /� q PLAN REVIEW: - 9g. S 1 2y 1. -Q 1 ELECTRIC: c PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE:Z- SM I P: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE-ALT FEE: Zb. OO BASF: I r Q PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: Ll G 1. I I P/C: 3 i.Z- PAID BY: 011 tg RECEIPT # 2) IT PAID BY: VALIDATION: VALIDATION: LC WHITE — Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy CITY OF DIAMOND BAR INSPECTION RECORD COMMENTS: DocuSign Envelope ID: 3D7DEF47-67F5-45B8-A689-33E80E97544A The alarms are required to be installed in the following locations: ❖ Smoke alarms in all sleeping rooms. t• CO alarms in all sleeping rooms where fuel burning appliances are installed. Smoke alarm and CO alarm in hallways preceding sleeping rooms. •P Smoke alarm and CO alarms on each dwelling level including basements and habitable attic rooms. The smoke and CO alarms are required to comply with the above when requesting a final inspection. Please make sure an adult is present to allow the Inspector access to the home to verify compliance with the above requirements. If no one wlll be available, you may opt to complete the Installation Certification below and leave it with the job card. (Please fill out and tear off this portion to leave with the job card if no one will be available to allow the inspector inside the house.) INSTALLATION CERTIFICATION For the property located at 24040 Decorah Rd I hereby certify that the required s alw as:and carbon monoxide alarms have been installed as listed above. xz� Robert Cadiz 11/10/2016 _tune; Print Name ;Date; Relationship to project (please check one): downer ❑ Agent for Owner a licensed Contractor ❑ Agent for Licensed Contractor If "Licensed Contractor' or "Agent for Licensed Contractor" Is checked, please complete the following: Contractor Contractor's State License Number DocuSign Envelope ID: 3D7DEF47 b7F5-45BS-A689-33E80E97544A CITY OFDIAMOND BAR BUILDING & SAFETYDIVISION 21810 Copley Drive Diamond Ran CA 91765 (909) 839-7020 SMOKE ALARM AND CARBON MONOXIDE CERTIFICATION in order to help assure the life and safety within existing dwellings, the 2013 California Residential Code (CRC) Section R314 and R315, along with the California Building Code Section 420.5 and 420.6 requires existing dwellings to have smoke alarms and carbon monoxide alarms installed within the upper 12" of the ceiling when a building permit is issued for, worked on, or in a building that is valued at $1,000 or more. Alarms may be solely battery operated where repairs or alterations do not result In the removal of wall and ceiling finishes or there is no access by means of attic, basement or crawl space. Starting July 1, 2014 all smoke alarms including combination smoke alarms, that are solely battery powered shall contain a non -replaceable, non -removable battery that is capable of powering the smoke alarm for at least 10 years. CARBON MONOMDE ALARMS REQUIRED IN EXISTING DWELLINGS: • Where a permit is required for alterations, repairs or additions exceeding $1,000. Existing dwellings or sleeping units that have attached garages or fuel burning appliances. Carbon monoxide alarms shall be installed: • Outside of each separate dwelling unit sleeping area in the immediate vicinity of the bedroom(s). • On every level of a dwelling unit including basements. REQUIRED IN NEW DWELLINGS: Carbon monoxide alarms shall be installed: • Outside of each separate dwelling unit sleeping area in the Immediate vicinity of the bedrooms(s). • On every level of a dwelling unit including basements. Alarms shall receive their primary power from the permanent building wiring without a disconnecting switch other than as required for overcurrent protection. Battery backup is required. NOTE: Multiple -purpose alarms. Listed and labeled combination carbon monoxide I smoke alarms are acceptable in new and existing dwellings. Carbon Monoxide Alarms is a requirement that is in addition to required Smoke Alarms.