The URL can be used to link to this page

Home My WebLink AboutPR15-738CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, C.. 9? 76? (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 BUILDING PERMIT APPLICATION Y. 7-4+-31. ~ tq t Ziftq JOB SITE ADDRESS PROPOSED USE90VA0vot—if OPOICUA;: CPA # DWEL. UNITS # STORIES APN LOT TRACT OWNER X Vl"f^ ADDRESS Vi e CITY' ZIP TEL.'2- / APPLICANT TEL. i 91" CONTRACTOR £US n ADDRESS 2—ct✓�) �y' Ci,�!— CITY Pirii ZIP IHO D TEL. lr 9 / ARCH/ENG/DESIGNER Z to -r ADDRESSrSj`%S 1✓1CO3 IV CITY ZIP !J71I TEL. 0 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). () 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 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 1, 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 pu rsuant 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 fallowing Web site: http/www.leginfo.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 C S. DATE: CONTRACTOR ' WORKER'S PEN ION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OFTHE 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. have and will maintain Worker's Compensation Insurance, as required by Section 3700 of the Labor Cade, for performance of the work for which this permit is issued. My Worker's Compensation Insurance Carrier and Policy Number are CARRIER POLICY NUMBER D I L (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 foryrpielrWi p�ishall�notlarson in any manner so as to become sub'e to a Worker's Compen n Lawome subject to the Worker's Comprlsarosions of Sector 37 the Lab dovisions. DATE:I APPLIC WARNIN ail a to secure Worompen on "coverage unlawfu s all subjec criminal penalties and civil fines up to on undyed 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 c rtes and state laws relating to building construction, and hereby authorize representatives of this county to nter upon th above- s tioned property for insjpec urpose . PE EE NAME (PRI F P DATE PRESS FIRMLY APPLICATION DATE: a 31 5 P/C#p_PVR %S — —1 ISSUE DATE: MD PERMIT# 1J — U /_ TYPE CONST. OCC GROUP: ZONING SETBACKS FRONT REAR SIDE/SIDE STREET SIDE RW ❑ ❑ RW ❑ ❑ PROPOSED USE90VA0vot—if OPOICUA;: CPA # DWEL. UNITS # STORIES S �.0 S # BEDROOMS DESCRIPTION SQ. Fr. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport rn w Patio/Deck LL Pool/Spa ZRe -Roof u Commercial m Valuation. Adj. Area: QUANTITY DESCRIPTION FEE U U w I w CD m J w CONSTRUCTION: PLAN REVIEW: > ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMIP: ENERGY P/C: r ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: io, BSAF: e a TOTAL FEES COMMENTS: RECEIPT# e}- O PAID BY: fOW011 _ VALIDATION: WHITE — Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy, GOLDENROD — File Copy, GREEN — Applicant's Copy ,UU�PLUMBING`�" �" ,UGrELECTM AL UFER GROUND SEWER LATERAL MAIN WATER LINE SEWER CLEANOUT ROOF SHEATHING FLOOR SHEATHING SHEAR WALLS INTERIOR i FRAMING/VENTING , ROUGH MECHANICAL CITY OF DIAIUIOI,D BAR RbDS_H'ELEC,T'&:. 'bGAL W( ) C (' j INSPEC.TI4N RL -CORD 'Y LATH EXTERIOR _ LATH INTERIOR GAS TEST g! SCRATCH COAT 7TRACTAND LEDGER s GAS METER RELEASE GEARERCIAL SPECIAL INSPECTION j FINAL BUILDING HOOD `,,,;,, ''. ,z T44 BAR ----- � FINAL PLUMBING y ;, INTERCEPTER ` CERT of OCCUPANCY" HOT MOP/SHOWERPAN COMMENTS: ' SEPTIC/CESSPOOL HERS REPORT -RECEIVED _ ! ; DEMOLITION ROOF DRAINS _ ROUGH CONDUIT SHEAR WALLS INTERIOR i FRAMING/VENTING , ROUGH MECHANICAL DRYWALL RbDS_H'ELEC,T'&:. 'bGAL W( ) C (' j m. R(IIIGH PLJIMRING` LATH EXTERIOR _ INSULATION WALL i INSULATION CEILING ROUGH PLUMBING DRYWALL LATH (PRE) ROUGH ELECTRICAL LATH EXTERIOR _ LATH INTERIOR GAS TEST GAS TEST SCRATCH COAT ELECTRIC METER RELEASE s GAS METER RELEASE POOL,PRE DECK BONDING t SPECIAL INSPECTION j FINAL BUILDING P -TRAP° 'FINAL MECHANICAL _ FINAL'ELECTO L FINAL PLUMBING y ;, TC, of OCCUPANCY CERT of OCCUPANCY" WALLS: COMMENTS: POOLISPA ROUGH PLUMBING ROUGH ELECTRICAL ROUGH MECHANICAL GAS TEST PRE;GUNITEww • s POOL,PRE DECK BONDING t P -TRAP° FENCE / GATE/ ALARM 6� q✓ a, "'r .;" FINAL'POOL WALLS: ' WALL FOOTING/STEEL WALL STEEL 1S`( ) 2NQ( ) LIFT ! ; WALL BOND BEAM WALL DRAIN/ SEAL WALL FINAL RO, FRAMING PLANNING APPROVAL ROUGH FIRE APPROVAL - FINAL FIRE DEPARTMENT FINAL PLANNING"Rf FINAL ENGINEERING/ PW ?. " ;e FINAL COMMUNITY SERVICES ;B FINAL HEALTH DEPT. FINAL�INDUSTRIAL WASTE 1. _ ..`"."... :.