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Home My WebLink AboutPR15-921IAM 0 BAI: CITY OF DIAMOND BAR DEPARTMENT O&COMMUNITY & DEVELOPMENT SERVICES � � 21810 Cople!Drive, Diamond Bar, CA 91765 PRESS (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 FIRMLY BUILDING PERMIT APPLICATION JOB SITE ADDRESS APN LOT TRACT OWNER r ii ADDRESS 1 [!.(Y Iwr. ffome_ t- ' CITY 1)"61-MOIV(1 (iia (^ ZIP-J(&15�TEL1q. 4R - 9&t -4P 3 . APPLICANT TEL. CONTRACTOR /L/�,,� �d 10e, � P�. Mb(Y &L C(rVt� ADDREESS (.10 �4V>• d7r N -a CITYrI.(UZIP 'I -ZS 3tSTEL. 6C.,?_ 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 applicantto 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 LJ 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 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.loginfo.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 JCLLAg/S: — "/ t L C. NO.: "q45 1-74 DATE: / % ' CONTRACTOR: l� j IZ.ILVeAC A—d pimm,,AeK 41,V61 I WORKER'S COMPENSATIO CLARATION L2 — 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. 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 tpis permit is issued. My Worker's Compensation Insurance Carrier and Policy Numb er/�r CARRIER / / r ICS — tN■ POLICY NUMBER L��11 7+7 (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS). I certfly 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'd I should become subject to the Worker's Domp42_n provisjons of Section NT of the La o:Cod shall hall fo[<h co it pmv idhs. DATE :�y!//,��-APPLICANT: (l. (/,,fy/,,�•,N, ailur to secure Worker's Compensation covers a isti-lawful, and shall subject an ployer 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. PERM177E NA E (PRINT) ) i S N RE OF PERMITTEE DATE APPLICATION DATE: 09 2A (7 P/Cy#� ISSUE DATE: Q74 �5 PERMIT# 1' /Z/S TYPE CONST. OCC GROUP: Q - 7 2- 1 ZONING SETBACKS FRONT RW REAR SIDE/SIDE STREET RW SIDE ❑ ❑ ❑ ❑ PROPOSED USE # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport co W Patio/Deck LL Pool/Spa ZRe -Roof D J Commercial DD Valuation: Adj. Area: QUANTITY DESCRIPTION FEE 2 J w ftk es Z Ri J o_ I U Q U CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: 2(74 lffi%� ala • .20 MECHANICAL: INSPECTION FEE: ISSUANCE: SMTP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: 4 BSAF: �� tb : �'-Zc��n6'�t e►�crnEan� '# �'i 1 . S `6 c� -11 S3 roc X* TOTAL FEES 413 COMMENTS: L' )L i RECEIPT#�.�il3J. q PAID BY: ✓ 6 -7 VALIDATION: WHITE — Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy, GOLDENROD — File Copy, GREEN — Applicant's Copy 03SAAAIAII ,UFER GROUND SEWER LATERAL MAIN WATER LINE SEWER CLEANOUT ROOF SHEATHING FLOOR SHEATHING r CITY OF DIAMOND BAR INSPECTION RECORD r' r PRE` TRACTAND LEDGER — _ SWITCH GEAR COMMERCIAL HOOD INSULATION WALL T -BAR INSULATION CEILING INTERCEPTER DRYWALL_ HOT MOP/SHOWERPAN LATH (PRE) - --- - SEPTIC/CESSPOOL HERS REPORT RECEIVED _- WALLS: DEMOLITION WALL FOOTING/STEEL ROOF DRAINS GAS TEST ROUGH CONDUIT ;PODL/SPA d ROUGH PLUMBING ELECTRIC METER RELEASE ROUGH ELECTRICAL ROUGH MECHANICAL E= GAS TEST SPECIAL INSPECTION RO (NGPLANNING APPROVAL nvuun rLuinonvu / r / / n , GUNITE INSULATION WALL POOL'PRE DECK BONDING INSULATION CEILING F TRAPz= . AME, DRYWALL_ .. FENCES/GATE/.ALARM LATH (PRE) - --- - FINALPOOL LATH EXTERIOR _- WALLS: LATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL 1S'( ) 2N0( ) LIFT SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELEASE WALL DRAIN/ SEAL GAS METER RELEASE WALL FINAL SPECIAL INSPECTION RO (NGPLANNING APPROVAL FINAL BUILDING; �� FINAL MECHANICAL ._ ... z, s, =— se �� r-, .a �, w ,n. ROUGH FIRE APPROVAL a, FINAL FIRE DEPARTMENT _ n ' s v s, u� 3.�1 k ttc. FINALELECTRICALn FINAL PLANNING (FINAL PLUMBING FINAL ENGINEERING/ PW „- T.C..6f OCCUPANCY ' � " FINAL COMMUNITY SERVICES ;CERT. of OCCUPANCY . `..�`. �`r FINAL HEALTH DEPT. , lNAL,,INDUSTRIAL WASTE P ern COMMENTS: CITY OF DIAMOND BAR Community and Development Services Department 1 I i 21810 E. Copley Drive • Diamond Bar, CA 91765 Building Inspection Request Hotline (909) 839-7027 Building Planning Engineering (909)839-7020 (909)839-7030 (909)839-7040 CORRECTION NOTICE PERMIT NO. DATE: 2 (. TIME: CONTRACTOR/ OWNER BUILDER ADDRESS (Project Site) KIC441614. PV ❑ PLEASE CONTACT THE UNDERSIGNED PLEASE MAKE CORRECTIONS AND CALL FOR REINSPECTION //❑ REINSPECTION FEE REQUIRED ❑ PLEASE MAKE CORRECTIONS AND PROCEED WITH WORK INSPECTOR: (print name) SIGNATURE OF INSPECTOR: