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Home My WebLink AboutPR 13-1911C1TY OF DIAMOND BAR I ( cal i' Ii D PARTMENT OF COMMUNITY&DEVELOPMCNT SFRVICES fll.i : ` '' 21810 Copley Drive,Diamond 13ar,CA 917fi5 ESS 909 839-7020 Fax: 909 861-3117 Buildin Ins ection H tlin 7 _7gpoc(909)839 o FI iMLYBUILDINGPERiV1ITAPPLICATION j t— t,, i n 1 APPLICATION DATE: `1 a I 3 P/C# JOB SITE ADDRESS V'ZlX G/` I l . a ISSUE DATE: ,I \a. 1 J PERMIT# '0. " z APN LOT TRACT o OWNER O TYPE CONST. OCC GROUP: w ADDRESS I N CITY Gl ZIP II uS TELQI ZONING F ONTCKS RW APPLICANT G1 TEL. REAR N 5, (,.,- 1 -. , SIDE/SIDESTREEf RW a CONTRACTO t•l/1 V SIDE o ADDRE^SS `_S G • '1 IV o CITY YC?/vSU ZIP Z TEL. V / PROPOSED USE 0 o ARCH/ENG/DESIGNER w o ADDRESS o DWEL.UNITS STORIES BEDROOMS z CITY ZIP TEL. DESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREANALUATION OWNFA-BUILDEfl OECLAl1ATI0N I hereby affirm under penalry o(perjury Nat I am exempt from the Conlractor's State License Law for the reason s) SFFUADD/REM 0 o intlicated below by the checkmark s),I have placed nezt to the applicable item(s)(Section 7031.5,Buslness and Garage/Carport o Profeuions Code:Any city or county ihat requires a permit to construct,alter,improve,demolish,or repair,any z structure,prior to its issuance,also requires the applicant for the permit to file a signed sfatement that he or she Patio/Deck a is licensed pursuant to lhe provisians of lhe Cairtractor's State License Law(Chapter 9)Cammencing with Section w 7000 of Division 3 of ihe Business and Prolessions Code]or that he or she is exempt from licensure and the basis tor LL Pool/Spa N the alleged exemption.Any violation oi Section 7031.5 by any apD cant tor a permit subjeCis the applicant to a civil penalty of not more than five hundred dollars($500). O Re-Roof o (,I,as owner of the property,or my employees with wages as their sole compensation,will do(ail of or(,portions Commercial of the work,and the sWcture is not intended or ottered for sale(Section 7D44,Business and Professions Code:The m Z Contract rs'State License Law does not apply to an owner of property who,through employees'or personal ettort.builds or improves the Oroperty,provided that the improvements are not intended or ottered tor sale.If however,the building or improvement is sold wilhin one year ol completlon,Ne Owner-Builder will have ihe burden of praving that it was not built p or improved for the purpose af sale.). I,as owner at ihe ro ezUpp rry,am exclusively contracting wilh licensed Contractors to construct the project(Sec6on Valuation: Ad Afea:7044,Business and Protessions Code:Tne CoMractors'Sta e License Law does not appty to an owner of property who buildsorimprovesthereon,andwhocontractsfortheprojeciswithalicensedContractorpursuanttotheConiractors'State QUANTITY DESCRIPTION FEE Y License Law.). o U I am exempt from licensure under the ConVactor's State License law for the following reason(5):a LL By my signature below 1 acknowledge lliat,excep[for my personal residence in which I must have resided tor at least one w o year prior to complelion of the improvemenk covered by this permil,l cannot legally sell a sWcture that I have built as an a owner-builder if it has not been consWcted in its entirety by licensed contractors.I undersFand ll at a copy of the applicable w Q law,Section 7044 of the Business and Professions Code is available upon request when this application is submitled ar at X the following Web site:httphmrw.leginlo.ca.gov/calaw.html. Z o ATE: SIGN: LICENSEU CONTRACTOfl'S DECLAHATION w I hereby affirm untler penalty of perjury that I am licensed untler Drovisions of Chapter 9(commencing with Section 7000) m ol Division 3 of the Business and Protessions Code,and my license is in full force and eftect. LICENSE CLASS: v LIC.NO.: lY S 1 SJ z oZ DATE: CONTRACTOR: i a WORKER'S COMPEN TION UEC ATION g I HEAEBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: I have and will maintain a Cerfificate of Consenl to Self-Insure for Worker's Compensation,as provided 6y CONSTRUCTION: Seclion 3700 of the Labor Code,for the performance of the work for which this permit is issued. p qN REVIEW: I have and will maintain Worker's Compensation Insurance,as repuiretl by Section 3700 of the Labor Code,for ELECTRIC:the performance oi the work for which this Dermit is issued.My WorkePs Compensation Insurance Carrier and a PolicyNumberare: . /],PLUMBING: S` . a 5 CARRIEfl L ( 7 1 i 1 tvn l .w MECHANICAL: POUCY NUMBER L 1 •l P 3( •S b S • ( INSPECTION FEE: I T}iIS SECTION NEED NOT BE COMPLEfED IFTHE PERMR IS FOR ONE HUNDRED DOLLARS 310q OR LESS. ISSUANCE: S `" o I cedi(y llial in ihe peAormance of the work lor which ihis permit is issued,I shall not employ any person in any manner so as to SM I P:0 6ecome subject lo the Waker's Compensation Laws of falifomia.Md agree tha if I shoultl become subject lo ihe Worker's w Compensation pr sof Section 3700 ol th or Code,I shall to i c ' ase pmvisions. ENERGY P/C: J DATE: L I APPLICANT:LL ENERGY PERMIT: WARNING: ailure to secure Workers Compe ion c er e is unla I,a shail subject an employer to criminal REfENTION FEE: o( • UwpenattiesandcivilfinesuptoonehundredthousandII ($100,000),m addiGon to the wst of the compensation, damages as provided for in section 3708 of the lahor code,interest,and attomey's fees PRE-ALT FEE:0 a CONSTAUCTION LENDING AGENCY BSAF: w I hereDy affirm under penalry oi perjury that there is a ConsUuction Lending Agency for ihe pedormance ol ibe work for which this permit is issued(Sec.3097,Civ.C.. LENDER'S NAME: LENDER'SADDRESS: a I certify that I have read this application and state that the above informadon is correct.l agree to comp y with all city and TOTAL FEES q t. Z counry ordinances and state laws relating N building construction,and hereby authorize representatives of Nis counry to COMMENTS: o enter upon the abave-mentianed properry for inspectian purposes. m PERMfTTEE N jPRINn SIGNATURE OF EE DATE RECEIPT N \TS PAID BY: v VALIDATION: W HITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GCLDENROD—File Copy,GREEN—ApplicanYs Copy CITV OF DIAMOND BAR INSPECTION RECORD s e SETBACKI LETTER TRACTAND LEDGER FOO7INGS,FORMS - : =SWITCH GEAR SLAB'; : - ; ; COMMERCIAL HOOD UG:PLUMBIN6;T-BAR UG:fLECTRICAL -r. INTERCEPTER UFER GRDUND,.. HOT MOP/SHOWERPAN SEWER LATERA SEPTIC/CESSPOOL MAIN WATER LINE HERS REPORT RECEIVED SEWER CLEANOUT DEMOLITION ROOF SHEATHING ROOF DRAINS FLOOR SHEATHING ROUGH CONDUIT SHEAR WALLS fXTERIOR. POOL"/SPA' ,, y. SMEARWACLS-1NTcR OR:`.; ROUGHPLUMBING : FEiAMINGNENTING ;:-. .,. `. ".. _ , . ", " . . ROUGH ELECTHICAL.;: , ROUGH MECHANICAL, '' k ,: .. . ' ' ROUGH MECHANICAt _ _ rn.: ROUGH ELECTRICAL W(')C(. ) ;` GAS TEST ROUGH PLUMBING ;:- ' ` ' ° ..,. : _ ". . : ' _ . •" , . P,RE GUNITE INSULATION WALL PpQL PRE'DE K;BONDING <:, , .; :' INSULATION CEILING P:.`=TRAP., DRYWALL fENCE%GATE!ALA M LATH(PRE) F1NAb P,00L LATH EXTERIOR WALLS: LATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL 1sT! \'LND t SCRATCH COAT WA L BOND BEAM ELECTRIC METER RELEASE WALL DRAIN/SEAL GAS METER RELEASE WALL FINAL SPECIAL INSPECTION R0:FRAMING PLANNINGAPPROVAL , FINAL'BUILDING ROUGH FIREAPPROVAL , FINAt'MEGHANICAL ; FINAL FIRE DEPARTMENT ;'= FINAL ELECTRIGAL fINAI:FLAfdNING ,, FINALiPLUMBING FINAL ENGINEER{N6/PW .'E_. , T.C.of OCCUPANCY FINAL COMMUNITY;SERVICES '.- = CERT.'of OCCUPANCY'.' . FINAL HEALTH DEPt' - FINAL'INDUSTRIAL WASTE '. . ' '` t . . COMMENTS: