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Home My WebLink About14-4763 _..........� :-,�,;,,W,..� , CITY OF DIAMOND BAR � �' DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES c 21810 Copley Drive,Diamond Bar,CA 91765 PRESS ,,,h„,�,�� (909)839-7020 Fax:(909)8f�-3117 -huilding Inspection Hotline(909)839-7027 FIRMLY ''g"'" BUILDING PERMIT APPLICATION � JOB SITE ADDRESS I^-2 �C APPLICATION DATE: `�l� I��} P/C# PR �4-- '"�',��I i ISSUE DATE: ��ad/ �O� PERMIT# �y^ ��6,,,�__ I z APN LOT TRACT � OWNEFi��jj, D ZI2ll%jfi !� Li%74 iU/� TYPE CONST. OCC GROUP: � n ADDRESS ��— n CITY ZIP TEL. Z�NING F ONTCKS RW ❑ z APPLICANT TEL. REAR ❑ � n � � SIDE/SIDE STREEf RW_ ❑ � CONTRACTOR SIDE ❑ � ADDRESS 2 PROPOSED USE � 1 \S s CITY ZIP TEL. 62�� 1 ARCH/ENG/DESIGNER�( .. I� � I C. � ��l —T �\� 1 1�v: � � ADDRESS `�q w u [�!+�' 'r+r�l�- #DWEL.UNITS #S1 ORIES #BEDROOMS z CITY Z�P TEL. � DESCRIPTION SQ.Fi. FACTOR PSF ADJ.AREANALUATION � OWNEH-BUILDEH DECLAHATION = I hereby affirm under penalTy of perjury that I am exempt from the Contractor's State License Law for the reason(s) SF ADD/ M �p I � indicated below by the checkmark(s),I have placed ne#to the applica6le item(s)[Section 7031.5,Business and Garage/Carport I Professions Cade:Any city or caunty that requires a permit to construct,alter,improve,demolish,or repair,any z structure,prior fo its issuance,also requires the applicant for the pertnit to file a signed statement that he ar she � Patio/Deck I L i is licensed pursuant to the provisions oT the Contrador's State License Law(Chapter 9)Commencing with Section w j 70W of Division 3 af the Business and Professians Code]or that he or she is exempt from licensure and the basis for � Pool/Spa I � the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjecLc the applicant to a civil penalty Z Re-Roof ,= oi not more than five hundred dollars($500). � I � ()I,as owner of the property,or my employees with wages as their sole compensation,will do�1 all of or U portions � Commercial I y of the work,and the strudure is not intended or ottered for sale(Section 7044,Business and Professions Code:The m I z Contractors'State License Law does not apply to an owner of properry who,through employees'or personal effort,builds • i y or improves the pmperty,provided that the improvements are not intended or otfered for sale.If however,the building or I � 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 ot the property,am exclusively contracting with licensed Contracturs to construct the projeci(Section Valuation. ,9 0lP� Ad Area: � ` Z 7044,Business and Protessions Code:The Contractors'State License Law does not apply to an owner of property who � �--�.� 1� I n buildsorimprovesthereon,andwhocontractsfortt�eprojeciswithalicensedConfradorpursuanttotheContractors'State QUANTITY DESCRIPTION FEE I License Law.). � (,I am exempt from licensu2 under the Contractor's Sfate License law tor the following reason(s): � ,/-� I 2 C- I zBy my signalure below I acknowledge that,except for my personal residence in which I must have resided for at least one w 2 � � year prior to completion of the improvements covered by this permit,l cannot legally sell a struc[ure that I have built as an � — owner-builder if it has not been constructed in i15 entirety by licensed contradors.I understand that a copy of the applicable i � law,Section 7044 of the Business and Professions Code is available upon request when this application is submitted or at i �, X the following Web site:httphwrw.leginfo.ca.gov/calaw.htmL �' _� z � DATE: SIGN: � j — LICENSED CONTRACTOH'S DECLAflATION � � � a ! ' 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. � I 'lJ �� U � � LICENSE CLASS: LIC.NO: � � Z DATE:h T CONTRACTOR: = i U ¢ WOfll�fl'S CO PENSATION OECLAFIATION W � � i y I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: i ' � I have and will maintain a Certificate of Consent to Self-Insure for Worker's Compensation,as provided by CONSTRUCTION: �9$. �j4 CXo�� Section 3700 of the La6or Code,for the performance of the work for which this permit is issued. p�qN REVI EW: �7JS, a i � I have and will maintain Worker's Compensation Insurance,as required by Section 3700 of the Labor Code,for � the performance of the wor for which this permit is issued.My WorkeYs Compensation Insu2nce Carner and ELECTRIC: J fkZ�� ' ¢ PolicyNumherare: PLUMBING: � � CARRIER i � M EC HAN I CAL: ' � POLICYNUMBER INSPECTION FEE: � (THIS SECIION NEED NOT BE COMPLEfED IFTHE PERMR IS FOR ONE HUNDRFD DOLLAAS($100)OR LESS). — ISSUANCE: ��.I i � I cerMy that in the performance of the work for which this permR is issued,I shall not employ any person in any manner so as to - become subject to the Worker's Compensation Laws of Califomia.Md agree that rf I should become subject tn the Worker's SMIP: � '.�,� J� ^ 33• �3(o Compen ion vi ns af Section 3700 of the Laboy Code,I sh I�I forttiwi compy wim those provisions. ENERGY P/C: DATEV �� APPLICANT: ��•�V1- 1 ENERGY PERMIT: _ 7j� $4 Y WARNING:Fai ure to secure WorkeYs Compensation coverage is unlawful,and shall subject an employer to criminal RETENTION FEE: [„� n(� - y penalties and civil fines up to one hundred thousand dollars(5100,000),in addition to the cost of the compensation, —�-r-- ' � damages as provided for in section 3708 of lfie labor code,interest,and attorney's fees. PRE-ALT FEE: � i CONSTqUCTION LENDING AGENCY BSAF: � , ,q�1 I itir— = I hereby affirm under penalty of perjury that there is a Construdion Lending Agency for the performance of the work for � which this permit is issued(Sec.3097,Civ.C.�. � LENDER'S NAME: , I r LENDER'SADDRESS: TOTAL FEES i I certry that I have read this application and state that the above information is correct.I agree to comply with all city and �,a • �"'� � �P��.// � Z counry ordinances and state laws relating to building construction,and hereby authorize representatives of this county to COMMENTS: " � ''U / � enter upon the above-mentioned property for'nspedion purposes. J N 9 W ¢ PERMITTEE NAME(PRINn P�C a�359 ��9 � = SIGNARIRE OF PERMITTEE DATE O �Z RECEIPT#� /�'X_ PAID BY:✓��/U%� VA�IDATION: � WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy CITY OF DIAMUND BAR IIVSPECTION`FtECORQ .., - . . � � , . � . . � � , � . ;SETBAGKI LETTER � � � � � TRACT ANO LEDGER ��ObTIIVGS FORMS • • �� SWITCH GEAR �SLAB ` COMMERCIAL HOOD ;U��'PLi1M81NG�� , � � � T-BAR �UG:ELECT�RI�AL � ° -��' � ` ` � INTERCEPTER ,em . s UF€R GRO,UND ' ' : ( HOT MOP/SHOWERPAN SFWER IATERAL SEPTIC/CESSPOOL MAIN WATER LINE ___ HERS REPORT RECEIVED SEWER CLEANOUT DEMOLITION ROOF SIiEATHING ROOF DRAINS -- IFLOOR SHEATHING ROUGH CONDUIT SHEAR WALLS EXTERIOR POOUSPA �SHFAR6NALLS INTERIOR ROUGH PLUMBING I FRAMINGNENT(NG � '� � , RQUGH ELECTRICAL RQUGH MECHANICAL ROUGH MECHANICAL 'RO(JGH E1�€CT{iICAL W(_�}�C( j ` — �D GAS TEST �ROUGN Pll1MBING PRE GUNITE _. INSULATION WALL POOL PRE DECK BONDING INSULATIpN CEILING • P-TRAP DRYVJALL FENCE/GATE/AI1aRM LA7N(PRE) ' FINAL POOL l�1TH EXTERIOR WALLS: LATH INTERIOR WALL FOOTING/STEEL GAS TFST WALL STEEL 1 sr� �2r+e� )LIFT SCRF,TCH COAT WALL BONQ BEAM ELECTRIC METER RELFASE WALL DRAIN/SEAL �' GAS METER RELEASE WALL FINAL � SPECIAL INSPECTION R0.FRAMING PIANNINGAPPROVAL �'INAL 6lJIL01�lG � °� ° � ROUGH FIRE APPROVAL ; A �INAL MEC}�ANIC�lI FINAL FIRE DEPARTMENT fiINAC ELEC7RICAL� = FINAL PLANNING � � FINAL PLUMBING� °° � � FfNAI ENGINEERINGI PW � i'.G.of�CCUPANCY � •A � � FINAL COMMUNITY SERVICES CL��T u1�OCCUPANCY `�; a F x ' FINAL HEALTH DEPT, FINAL INQUSTRIAL WASTE COMMENTS: _ � ` �.t �a„"` ��— l