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Home My WebLink About15-2657 �/��/r�. '�- CITY OF DIAMOND BAR i � � � DEPARTMENT OF COMMUN[TY�&DEVELOPMENT SERVICES F�NALIZE� �- 21810 Copley Drive,Diamond Bar,CA 91765 PRESS � �' (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 � �'"', BUILDING PERMITAPPLICATION www.cityofdiamondbar.com building@diamondbarca.gov FIRMLY � w APPLICATION DATE: P/C# a JOB SITE ADDRESS / ) o APN LOT TRACT ISSUE DATE: <<f �I��.�- PERMIT#: �� N OWNER TYPE CONST. OCC GROUP: _� ADDRESS S4�p �S�� ,r W o � CITY ZIP TEL. Scope of Work 1, o APPLICANT TEL. cn C o CONTRACTOR c� =�7 w ADDRESS � #DWEL.UNITS #STORIES #BEDROOMS � CITY ZIP4��TEL. o ARCH/ENG/ � � y� z DESIGNER � f- " DESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREANALUATION ZADDRESS SFR/ADD/REM m CITY ZIP TEL. Garage/Carport ¢ � Patio/Deck ac OWNER-BUILDEfl DECLAHATION w oI hereby affirm under penalty of perjury that I am exempt trom the Contractor's State License Law for the reason(s� LL PooVSpa W indicated below by the checkmark(s),I have placed ne#to the applicable item(s)[Section 7031.5,Business and � z Professions Code:My city ar county that requires a permit to construct,aRer,improve,demolish,ar repair,any Z Re-Roof a sWcture,prior to its issuance,also requires the applicant for 1he permit to file a signed statement that he ar she � Commercial � is licensed pursuairt to the provisions of the Contractur's State License Law(Chapter 9)Cammencing with Section m � 7000 of Oivision 3 af the Business and Professions Code]or that he or she is ezempt from licensure and Ne 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 � o of not more than five huntlred dollars($500). , e �1 I,as owner af the property,or my employees with wages as their sole compensation,will do�1 all of or(J poRions Z of the work,and the structure is not intended or offered for sale(Section 7044,Business and Professions Code:The VBluatfon: �� dj.Area: . C � Conhactors'State License law does not apply to an owner of property who,through employees'or personal effort,huilds por improves the property,provitled that the improvements are not intended or otfered for sale.If however,the building or QUANTIIY DESCRIPTION FEE improvement is sold vnthin 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.). � Z (�I,as owner of the property,am ezclusively cortUacting with licensed Contractors to construct the project(Sec[ion � � 7044,Business antl Professions Code:The ConVactors'State License Law does not apply to an owner of property who � Y builds or improves thereon,and who contracts for the projects with a licensed Contractor pursuant to the ConVactors'State � o License Law.). `�' LL (J I am exempt from licensure under the Corrtractor's State License law for the following reason(s): � z Z m � By my signature below I acknowletlge mat,except for my personal residence in which I mus[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 a � X owner-builder if it has not been consVucted in ifs entirety by licensed contracNrs.I undersian0 that a copy ot the '� w applicable law,Section 7044 of the Business and Professions Code is availahle upon request when this application is � I o submitted or at the following Web site:http/www.leginfo.ca.gov/calaw.hUnl. � H Q V LICENSED CONTflACTOR'S DECLAflATION = mI hereby atfirm under penalty oi perjury that I am licensetl under provisions of Chapter 9(commencing with Section 7000) � N of Division 3 of the Business and Professions Code,antl my license is in full force and effect. N LICENSE CLASS: ` �� LIC.NO.:__ (�_��I O T a DATE:�� CONTRACTOR: G�(��—C i� CONSTRUCTION: p WORKEp'S COMPENSATION DECLAflATION PLAN REVIEW: aI HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: ELECTRIC: 0 1 have and will maintain a Certificate of Consent to Self-Insure for Worker's Compensation,as provided by PLUMBING: � Sec[ion 3700 of the Labor Code,for the pertormance ot the work for which ihis permit is issued. MECHANICAL: p I have and will maintain Worker's Compensation Insurance,as required by Sedion 3700 of the Labor Code,for Q the perfortnance of the work for which this permit is issuetl.My Worker's Compensation Insurance Carrier antl INSPECTION FEE: Policy Number are:2 � ) ' Z CARRIER T✓'V�� C�� ISSUANCE: 7��3� � POLICYNUMBER �� C(�1t��, SMIP: � ,� N _ (IHIS SECTION NEED NOT BE COMRFfED IF THE PFNMf!IS FOR ONE HUNDRED DOWIRS($100)OR LESS�. EN ERGY P/C: p I cer�ty ihat in the pertormance of the workfor which this permtt is issued,I shall not employ any person in any manner so�to ENERGY PERMIT: 0 6ecome subject ro Ne Worker's Compensation Laws of Califomia.Md agree that if I should become subject tn the Workers J Compensalio provisi s oi Sectlon 3700 of ine'Lab^�I shall forth�mply wilh�isions. REfENTION FEE: � � DAIE: PPLICANT: H � PRE-ALT FEE: � WARNING: adur ro secure WorkePs Compensation coverage is unla I,an shall subject an employer ro cnminal gASF: f Q� � penalties and civil fines up to one hundred thousand dollars($100,000),in addition to the cost of the compensation, �,_ p damages as provided for in section 3708 of the labor code,interest,and attorneys fees. PLOT PLAN: s 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 issuetl(Sec.3097,Civ.C.). � LENDER'S NAME: � LENDER'SADDRESS: TOTAL FEES �� /J'I{� w y� d I certify that I have read this application antl state that the above information is correct.I agree to comply with all city and Z county ordinances and state laws relatinq to building construction,and hereby authorize representatives of this county to COMMENTS: p enter upon the above-mentioned property for inspecti purposes. � �� m � PERMIITEE NAME(PRIN� v P/C: PAID BV: VALIDATION: N ` � � RECEIPT#•�7�7 M PAID BY: � 7 N VALIDATION:�__ F SIGNA7URE OF PERMITTEE DAlE WNITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy :_ CITY OF DIAMOND BAR �k(� {��y j�q��/,(.�� INSPECTPON �ECORD . `T'A�'1BPCTP�OU�r>!y�ryAl q�w. � � � � � . � , � � • � I SETBACK/LETTER TRACT AND LEDGER ' FOOTINGS FORMS SWITCH GEAR ' g�qg COMMERCIAL HOOD UG.PLUMBING T-BAR UG.ELECTRICAL INTERCEPTER , UFER GROUND HOT MOP/SHOWERPAN ' SEWER LATERAL SEPTIC/CESSPOOL II MAIN WATER LINE HERS REPORT RECEIVED SEWER CLEANOUT DEMOLITION ROOF SHEATHING ROOF DRAINS FLOOR SHEATHING ROUGH GONDUIT 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'T�P DRYWALL FENCE/GATE/ALARM LATH(PRE) FINAL POOL LATH EXTERIOR WALLS: LATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL 1sr� �2r+o� �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 FINAL PLUMBING FINAL ENGINEERING/PW T.C.of OCCUPANCY FINAL COMMUNITY SERVICES CERT.of OCCUPANCY FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE COMMENTS: