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Home My WebLink About15-2410 �.L. ___ ,�� CITY OF DIAMOND BAR� � ` '--� � j; I I i iI DEPARTMENT OF COMMUNiTY&DEVELOPMENT SERVICES �` - � 21810 Copley Drive,Diamond Bar,cA 9»6s PRESS � � (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 F�RMLY � �'a"'� BUILDING PERMIT APPLICAT[ON www.cityofdiamondbar.com building@diamondbarca.gov w APPLICATION DATE: �Dr�� P�C# �S� �C a JOB SITE ADDRESS �� 3 5 �A ln �-l_Lq� o. �,,�, � o APN LOT TRACT , ISSUEDATE:��3�� PERMIT#: �S��a�I� � OWNER TYPE CONST. OCC GROUP: � ADDRESS � � CITY�j fAAwwa, d Q.�IP� EL. r'1 y�-�.'0 Z �-?a 410"@ i � � -'� Scope of Work i o APPLICANT��...2M 11�,�p i 4� �j Cl TEL. q�\-6�o ..� ('11, � v� - a CONTR,4CTOR ' 0 � ADDRESS � � � .t Fe �„A;l,l ��.tns►� �,Z� �*� S� a � CITY #DWEL.UNIT # O S #BEDRO S o �C�"��[a�'�Cl ZIP�-TEL.� L'1��' " ARCH/ENG/ � � �oa 1 �,��°�- z DESIGNER DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION o ADDRESS SFR/ADD/REM z m CITY ZIP TEL. Garage/Carport a � Patio/Deck ¢ OWNER-BUILDEfl DECLAHATION w oI hereby affirm under penalty of perjury ihat I am exempt from the Contractor's State License Law for the reason(s) LL Pool/Spa w inAicated below by the checkmark(s),I have placed ne�to the applicable item(s)[Section 7031.5,Business and Z Re-Roof zProfessions Code:My ciry or county that requires a pertnit tn construct,alter,improve,demolish,ar repair,any � a structure,prior to its issuance,also requires the applicairt for the permR to file a signed statement that he ar she � Commercial = is licensed pursuant tu the provisions of the Contractor's State License Law(Chapter 9)Commencing with Sec6an m N 7000 of Oivision 3 of the Business and Profeuions Code]or that he or she is exempt from licensure and the basis for N the alleged exemption.My violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty � of not more than five hundretl dollars($500). e U I,as owner of the property,or my employees with wages as their sole compensation,will do U all of or(,portions Z of the work,and the struclure is not intended or offeretl for sale(Section 7044,Business and Professions Code:The V8IY8fi0It: Adj.Afea: . � Contractors'STate License Law does not apply to an owner of property who,mmugh employees'or personal effort,builds por improves ihe property,provided that the improvemenis are not intended or offered tor sale.If however,the builtlin9 or QUANTITY DESCRIPTION FEE 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.). � N.a,�> �.�c.s�Cr�u,•� � Z (�I,as owner of the property,am exclusively contracting with licensed Contractors to construd the project(Section ¢ ` � .�r� � 7044,Business and Professions Code:The Contractors'State License Law does not apply to an owner of property who � Y builds or improves thereon,and who contracts for the projecis wim a licensed ConVactor pursuant to the Contractors'State � o License Law.). �-' � ()I am exempt from licensure untler the Contractor's S[ate License law for the following reason(s): � NM� �� Z `. I Z m � By my signature below I acknowletlge 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 Nat I have built as an d a 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 � , o submitted or at the following Web site:http/www.leginfo.ca.gov/calaw.html. � �j LICENSEU CONTflACTOH'S DECU1flATI0N � � � I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9(commencinq with Section 7000) � � of Division 3 0�the Business and Professions Code,and my license is in full force and effect. . ' N LICENSE C/LASS: L_5 �LIC.NO.: 6 D c Q DATE: O I�, O' 11 CON7RACTOR: � �j C� • CONSTRUCTION: .� �..0� p WOBKER'S COMPENSATION DECUIHATION � PLAN REVIEW: ¢ I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: ELECTRIC: _ ��S S � 0 1 have and will maintain a Certificate of Consent to Self-Insure for Worker's Compensation,as provided by PLUMBING: ljrD�� ' � /� Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. MECHANICAL: p �� I have and will mtintain Worker's Compensation Insurance,as required by Section 3700 of the Labor Code,for ? the performance oi the work for which this permit is issued.My Worker's Compensation Insurance Camer and INSPECTION FEE: Policy Number are; l �y� w CnRRIER S �`61.t„�, ISSUANCE:__ I</�p.q� � POLICY NUMBEH ` Ci� r. ��, SMIP: ',9 J� � (IHIS SECTION NEED NOT BE COMPLETED IF 7HE PERMIT IS FOR ONE HUNDRED DOLLARS($100)OR LESS). ENERGY P/C: p I certiry that in tt�e per(ormance of ihe work fur which Nis pertnft is issued,I shall not employ any person in any manner so as to ENERGY PEFMIT: o becnme subject to me Worker's Compensation Lavrs of Califomia.Md agree that if I should become subject m the Worker's y , J� J Compensation�p ov o�s o�Section 3700 of the Labcy,Code,I shall torthwith comply with those provisions. RETENTION FEE: � DAiE: b I PPLICANT:__� �_� 1=_fl�p..�i�jL�r► � PRE-ALT FEE: � WARNING:Failure to secure Worker's Compensation coverage is unlawful,and shall subjec[an employer to criminal gASF: '� �� w� penalties antl civil fines up to one hundred thousand dollars($100,000),in addition to the cost of the compensation, � tlamages as provided for in section 3708 ot the labor code,interest,and attorney's fees. PLOT PLAN: a CONSTHUCTION LENDING AGENCY ZONING CLEARANCE: = I hereby affirm under penalry 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.�. �—. H LENDER'S NAME: � LENDER'S ADDRESS: TOTAL FEES �—( + �� w a I certify that I have read this application and state that the above information is correct.I agree to comply with all city antl COMMENTS: Z county ortlinances and state laws relatin to builtling construclion,and hereby authorize representatives of this county to p enter upon ove-mentianed pra forinspection purposes. � m N PERMITf E(BFiINn P/C: PAID BY: ) VALIDATION: N `b ! ' RECEIPT#��O1 L pAID BY:Y �S 9 a� VALIDATION:� � SIGNAiURE OF PERMITTEE DATE WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy 'l7�I(0� . � ,�;, CITY OF D!��r� RA� � t� INSPECTION REC;OORD • � � • - • • � � • • SETBACK/LETTER 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 FRAMINGNENTING ROUGH ELECTRICAL / ROU6H MECHANICAL ROUGH MECHANICAL � ROUGH ELECTRICAL W( )C( ) GAS TEST ROUGH PLUMBING PRE GUNITE INSULATION WALL POOL PRE DECK BONDING ., � INSULATION CEILING P-T�P DRYWALL FENCE/GATE/ALARM �•�2 �/ ��' ` LATH(PRE) FINAL POOL '� LATH EXTERIOR WALLS: IATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL 1sr! \'zND� )LIFT � � SCRATCH COAT � � •• WALL BOND BEAM ELECTRIC METER RELEASE 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 FINAL PLANNING FIPJAL PLUMBING FINAL ENGINEERING/PW T.C.of OCCUPANCY FINAL COMMUNITY SERVICES CERT.of OCCUPANCY FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE COMMENTS: " 2 t / D �fd � � 0 S i .