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Home My WebLink About16-0521 % � , �/ad9�� 1anq�Jc ��n� "� CITY OF DIAMOND BAR � ' � � � � i DEPARTMENT OF COMMUN[T'1&DE`�ELOPMENT SERVICES ! II��' �`` 21810 Copley Drive,Diamond Bar,CA 91765 PRESS � (909)839-7020 Fax:(909)86l`3117 Building Inspection Hotline(909)839-7027 F�RMLY � �'D"', BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@diamondbarca.gov � °C l APPLICATION DATE: P/C# a JOB SITE ADDRESS �� Z-0 S �"' / /� /� Z • ISSUE DATE: �`��i��D PERMIT#: �v � D f�` � � APN LOT TRACT � OWNER �rL TYPE CONST. OCC GROUP: � ADDRESS � � ¢ CITY ZIP TEL. �'�1 -� �'�2_,/�. �j v�-�U�`_ o APPLICANT �" �TE ��—�� Scope of Work `- � � I a CONTRACTOR l7 o , � ADDRESS � � � � #DWEL.UNITS #STORIES #BEDROOMS � CITY � N ZIP�L�2c.tTEL. � • o ARCH/E / �� z DESIGNER DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION Z ADDRESS SFR/ADD/REM m CITY ZIP TEL. Garage/Carport I ¢ � Patio/Deck o OWNEH-BUIIDEfl DECLAHATION w i o I hereby affirm under penalty of peryury that I am exempt from the ConVactor's State License Law for the reason(s) � Pool/Spa w indicated below by the checkmark(s),I have placed next to the applicable item(s)[Section 7031.5,Business and Z Re-Roof wProfessions Code:My city or county that requires a permit ta canshuct,alter,improve,demolish,or repair,any � �� d structure,prior to its issuance,also requires the applicaM for the permit lo file a signed statemert[that he or she � Commercial � is licensed pursuant to the provisions of the ContracUor'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 antl ihe basis for m N the alleged exemption.My violation of Section 7031.5 by any applicant tor a permit subjecfs me applicant to a civil penalty - p of not more than five hundred dollars($500�. � (�I,as owner of the property,or my employees with wages as their sole compensaGon,will do(,all of or(�portions Z of the work,and the s[ructure is not intendetl or offered far sale(Section 7044,Business and Professions Code:The Valuafion: Adj.Area: � Contractors'State License Law does not apply to an owner of property who,through employees'or personal effort,builds por improves the property,provided that the improvements are not intended or offered for sale.If however,the building or QUANTITY DESCRI PTION 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.). ¢ O v Z (,I,as owner of the property,am exclusively conVacting with licensed ConVactors to construct the project(Sedion � � 7044,Business and Professions Code:The Contractors'State License Law does not apply to an owner of proDerty who � builds or improves thereon,and who conVacts for The projects with a licensed Contractor pursuant to the CanVactors'State � oLicense Law.). "' � (�I am exempt from licensure under the ConVactor's State�cense law tor the following reason(s): � z Z m � By my signature below I acknowledge that,except for my personal residence in which I must have resitletl for at least one � �� year prior to completion of ihe improvements covered by this permit,l cannot legally sell a structure that I have built as an a � X owner-builder if it has not been constructed in its entirety by licensetl contractors.I understand that a copy of the w applicable law,Section 7044 of the Business antl Professions Code is available upon request when this application is � o submitted or at ihe following Web site:http/www.leginfi.ca.gov/calaw.htmL � I � LICENSED CONTHACTOH'S DECLAHATION � j x � I hereby affirm under penalry of perjury that I am licensed under provisions of Chapter 9(commencing with Section 7000) � Nof Division 3 of the Business antl Professions Cotle,and my license is in full force and effect. N LICENSE CIASS: � uC.NO.: CONSTRUCTION: ,� ¢ DATE: CONTR.4CTOR� p � WOHKEH'SCOMP ION N REVIEW: QI HEREBY AFFI M UNDER PE ALTY OF PERJURY ONE 0 THE FOLLOWING DECLARATIONS: ELECTRIC: � I have antl will maintain a CeRificate of Consent to Self-Insure for Worker's Compensation,as provided by PLUMBING: � �eetiaR�O of the Labor Code,for the peAormance of the work for which this permit is issuetl. MECHANICAL: p �I have and will maintain Worker's Compensa5on Insurance,as required by Sectlon 3700 of the Labor Code,for a the perfortnance of the work far which ihis perm'' d.My Worker's Compensation Insurance Carrier and INSPECTION FEE: Policy Number are: �� u � CARRIER _ �� I�� ISSUANCE: _ � z r� � POUCYNUMBER 1 G� / � SMIP:_ I � �� _�—L 1 � (IFiIS SECIION NEED NOT BE COM�.t I tt1 IF THE PERMR IS FOR ON oDEUE DRONH wwS(S100)oR LESS�. EN ERGY P/C: p I cer�fy mat in the performance of ine work for which mis pertnit is issued,I shall not employ any person in any manner so�to ENERGY PERM IT: o become subjec[to the Worker's Compensation Laws of Califomia.Md agree that if I should become subjed tn the Worker's J Compensation provisions of Section 3700 of ihe Labor Code,I shall Torihwith comply wiUi ihose provisions. RETENTION FEE: �'D 0 � DA1E: APPLICANT: PRE-ALT FEE: � WARNING:Failure to secure Worker's Compensation coverage is unlawful,anA shall subject an employer to criminal gASF: / F �� penalties and civil fines up to one hundretl thousand tlollars($100,000),in addition to the cost of the compensation, o damages as provided for in secGon 3708 of the labor code,interest,antl attorney's fees. PLOT PLAN: a CONSTRUCTION LENOiNG AGENCY ZONING CLEARANCE: = I hereby aftirm under penalty of perjury that there is a Cons[ruction Lending Agency for the performance of the work for � which this permit is issued(Sec.3097,Civ.C.). � LENDER'S NAME: � LENDER'SADDRESS: TOTAL FEES �� 7 w a I certity that I have read this application and state that the a6ove information is correct.I agree to comply with all city and Z county ordinances and state laws relating to building construction, nd hereby authorize representatives of this county to COMMENTS: p enter u �pnbUve-mention d prope for inspection purpases.� _ � v/ m ¢ PERMI E (P INn� P/C: PAID BY: VA�IDATION: � N RECEIPT lt� PAID BY: VALIDATION:� � SIGNATURE PER EE - 3J�8�Ilo WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy � �, CITY OF Dl�h'�OP�D BAR ' INSPECTIC)N R�CORD � �6 � , � � � � . , 1 • • � 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 � /L ROOF DRAINS FLOOR SHEATHING ROUGH CONDUIT SHEAR WALLS EXTERIOR POOUSPA SHEAR WALLS INTERIOR ROUGH PLUMBING FRAMINGNENTING ROUGH ELECTRICAL ROUGH MECHANICAL ROUGH MECHANICAL ROUGH ELECTRICAL W( )CO 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 WALLS: LATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL 1sr/ \'2ND� �LIFT � , SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELEASE WALL DRAIN/SEAL GAS METER RELEASE WALL FINAL SPECIAL INSPECTION R0.FRAMING PLANNINGAPPROVAL FINAL BUILDING 7 6 ROUGH FIRE APPROVAL FINAL MECHANICAL FINAL FIRE OEPARTMENT FINAL ELECTRICAL FINAL PLANNING FINAL PLUMBING FINAL ENGINEERING/PW T.C.of OCCUPANCY FINAL COMMUNITY SERVICES CERT.of OCCUPANCY FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE COMMENTS: , ' (Piease fi1/ out and tear off this portion to /eave with #he job card if no ane wi//be available to allow the inspector inside #he house.) ` � �� INSTALLATION CERTIFICATION For the property located at {��/��i''7"'�r"7 5 ,Llf G tYl p�(',� �i�'� , I hereby certify that the required sm e s and carbon monaxide alarms have been installed as listed above. Ne�h r,- �rr�� L r -- Signature Print Name ate Relationship ta project(please che one): o Owner ❑Agent for Owner i��icensed Con#ractor o Agent for Licensed Contractor ff"�ice d C trac#or"ar"Agen far Licensed Cantracta�'is checked, please camplete the following: -- �� z�� Contractor Contractor's State License Number