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Home My WebLink AboutPR16-06340 a a J 0 LU co Cn F - CITY OF DIAMOND BAR. AMLIZE D DEPARTMENT OF COMMUNITY &DEVELOPMENT _ SERVICES ` 21810 Copley Drive Diamond Bar CA 91765 _ PRESS o� (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 960 LIMOK APN LOT TRACT OWNER Mile -0:' NA u rA ADDRESS `3! G� La L oAt1> 10z" ie; .1 412 !P CITY T)IAh L-AZIP�t� jEL. '�:l U C1 ^ A40 - 96 0."1 APPLICANT �. ,r r� 7 G•� ..^,,7 i >wT'�L. q + 4 n,� = a, y CONTRACTOR I f' )?,V f I ji,t ;) 7 144 L ADDRESS Z A 1 L 2 0A P) . I•'% CIN /15Z CA)A ZIP '1 i, 4t1cTEL. C% Ai- 7 7 %- e, 87ti 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 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 1, 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.). (J I, as owner of the prbperty, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Proiessions 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' Stale 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,) 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: .- L/ LIC. NO.: DATE: �- ^? I ! t.7 r' 1 CONTRACTOR: b F _f �" i _� D ?� F.? '� A L WORKER'S COMPENSATION DECLARATION -1 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. 1 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 T � 0 Zit R`) -7 �+r �P�1� AI POLICY NUMBER Ae h L• i 7 ri e 2 15 %:!� (THIS 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 should become subject to the Worker's Compensation provisions of Section 3700 of the IaboT Code, I shall forthwith comply with those provisions. DATE: _.) I i In l it. APPLICANT: t,/f�.�' WARNING: Pollute '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 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. A f3 0-T 61017-0110 PE=NT) SIGNATURE OF PERMITTEE DATE a APPLICATION DATE: ISSUE DATE:r/! ell PERMIT# TYPE CONST. • S�nr..r" �j—P/C# : OCC GROUP: !wC 3 Scope of Work '�C:� i•�'!i''t11'.�T,iC'!� ilk # DWEL. UNITS # STORIES �il.ti k !J -:td 2zs t ,y,f Y -n f iLA I # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport OL Patio/Deck w LL Pool/Spa ZRe -Roof Commercial 7 In Valuation: i!f Adj. Area: QUANTITY DESCRIPTION FEE s w w m - J d U Z Q x U CONSTRUCTION: PLAN REVIEW: I;z 6 • f ELECTRIC: csli.`�r PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMIP:�� ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: 1 �L BASF: �• PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: V::�42A' oP\S 09 2-5 Ito 040_ $ aa5 oy-Y\v7 Y177 a \V\ P0.y\w\ C P/C: PAID BY: VALIDATION: ,ry� RECEIPT# 1"N4?10 PAIDBY: VALIDATION: O l WHITE — Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy 13SUAM CITY OF ®DAr-jldN u BAR INSPECTION RECORD INSPECTlIGN SETBACK/ LETTER DATE IN TRACT AND LEDGER FOOTINGS FORMS SWITCH GEAR SLAB COMMERCIAL HOOD UG. PLUMBING T -BAR UG. ELECTRICAL INTERCEPTER UFER GROUND HOT MOP/SHOWERPAN SEWER LATERAL SEPTIC/CESSPOOL MAIN WATER LINE HERS REPORT RECEIVED SEWER CLEANOUT DEMOLITION ROOF SHEATHING ROOF DRAINS FLOOR SHEATHING ROUGH CONDUIT SHEAR WALLS EXTERIOR POOUSPA SHEAR WALLS INTERIOR ROUGH PLUMBING FRAMING/VENTING ROUGH ELECTRICAL ROUGH MECHANICAL ROUGH MECHANICAL ROUGH ELECTRICAL W( ) C ( GAS TEST ROUGH PLUMBING PRE GUNITE INSULATION WALL POOL PRE DECK BONDING INSULATION CEILING P -TRAP DRYWALL FENCE / GATE/ ALARM LATH (PRE) FINAL POOL LATH EXTERIOR / r WALLS: LATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL 1ST( )2 ND( ) LIFT SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELEASE /r WALL DRAIN/ SEAL GAS METER RELEASE WALL FINAL SPECIAL INSPECTION R0. FRAMING PLANNING APPROVAL FINAL BUILDING / ROUGH FIRE APPROVAL FINAL MECHANICAL FINAL FIRE DEPARTMENT FINAL ELECTRICAL / J FINAL PLANNING FINAL PLUMBING FINAL ENGINEERING/ PW T.C. of OCCUPANCY CERT. of OCCUPANCY COMMENTS: FINAL COMMUNITY SERVICES FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE (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 - ( LQ N . Lodi, h ' o1SS b I --- I hereby certify that the required smoke alarms and carbon monoxide alarms have been in ailed as listed above. ig ature Print Name Date F3plationship to project (please check one): caner ❑ Agent for Owner ❑ 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