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Home My WebLink About15-1841 ::"�.. _ CITY OF DIAMOND BAR ' . `��. , ;� DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES FINAL�EO c 21810 Copley Drive,Diamond Bar,CA 92765 PRESS ,,� (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 ''�"'� BUILDING PERMIT APPLICATION 8'.- 3_� � FIRMLY � �/ � = JOB SITE ADDRESS I� OCa`� �� . APPLICATION DATE: � P/C# i ISSUEDATE: ��I:J PERMIT# I��7I z APN LOT . TRACT /�� OWNER I �- L TYPE CONST. �G�/1�JCif.ic I OCC GROUP: � AD $S � Q.S QCIT �W�O� ZIP��TEL. � ZONING F ONTCKS RW ❑ = APPLICANT V TEL. REAR ❑ � � SIDE/SIDE STREET RW ❑ ¢ CONTRACTOR V ? SIDE ❑ � ADDR �� 1 x CITY D C.� ZIP��TEL. a— � PROPOSEDUS G � 1 � G I � ARCH/ENG/DESIGNER �� ' �G � � = ADDRESS � #DWEL.UNITS #STORIES #BEDROOMS z CITY Z TEL. � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � OWNEfl-BUILDEH OECLAMTION = I hereby aftirm under penalty of perjury that I am ezempt from the Contractor's State License taw for the reason(s) SFR/ADD/REM I � indicated below by the checkmark(s�,I have placed next to the applicable item(s)[Section 7031.5,Business and Garage/Carport I � Professions Code:Any city ar county that requires a permit to conshuct,alter,improve,demolish,ar repair,any � z structure,prior to its iuuance,also requlres the applicant for the permit ta file a signed sfatement That he or she � Patio/Deck I i is licensed pursuant to the provisions of the Contradar's State License Law(Chapter 9)Commencing with Section W � 7000 of Division 3 of the Business and Professions Code]or that he or she is exempt fmm licensure and the basis for � Pool/Spa i � the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjecis the applicant to a civil penalty C7 I = of not more than five hundred dollars($500). ZQ Re-Roof � (�I,as owner of the property,ar my employees with wages as their sole compensation,will do(�all of or(J portions � Commercial y ot the work,and the structure is not intended or oftered for sale(Section 7044,Business and Professions Code:The m z Contractors'State License Law'does not appty to an owner of property who,through employees'or personal effort,builds � or improves the property,provided that the improvements are not intended or offered 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 buiR � � or improved for the purpose of sale.). I � - (J I,as owner of the propeRy,am exclusively contracting with licensed Contractors to construct the project(Section ValuOtion: Ad Area: z 7044,Business and Professions Code:The Contractors'State License Law does not apply to an owner of property who 1• I � buildsorimprovesthereon,andwho tractsfortheprojeciswithalicensedContradorpursuanttotheContractors'State QUANTITY DESCRIPTION FEE I License Law.). � (,1 am exempt from licensure under the C ractor's Siate License law for the following reason(s): � I � � I 1 By my signature below I acknowledge that,except my personal residence in which I must have resided for at least one � � year prior to completion of the improvements covered this permit,l cannot legally sell a structure that I have built as an w I owner-builder if it has not been constructed in it5 entirety icensed contractors.I understand that a copy of the applicable I � law,Section 7044 of the Business and Professions Code is a 'lable upon request when this application is submitted or at I X the following Web site:http/www.leginfo.ca.gov/calaw.html. � z_ I = DATE: SIGN: � � LICENSED CONTHACTOfl'S DECLANATION � I d I� 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. J /__ ^ I ;,� LJCENS SS V�� LIC.NO.: !—1�' � � >CR,.,�` Z �� I Z DAlE: 3 , CONTRACTO �� o � � � I ¢ WOHI�R'S COMPENSATION DECLAHATION g I � I HEREBY AFFIRM UNDER PENAL7Y OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: L � . I have and will maintain a Certificate of Consent to Self-Insure tor Worker's Compensation,as provided by CONSTRUCTION: � Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. PLAN REVIEW: > �I have and will maintain Worker's Compensation Insurance,as required by Section 3700 of the Labor Code,for � the performance of the work for which this permit is issued.My Worker's Compensation Insurance Carrier and ELECTRIC: z ¢ PolicyNumberare: �—. PLUMBING: y CARRIER Ifl MECHANICAL� �p�3 Z POLICYNUMBER (I.�C� INSPECTION FEE: :� n (THIS SECTION NEED NOT BE COMPLEfED IFhIE PERMfT IS F9R ONE HUNDRFD DOLLARS($100)OR LESS�. ISSUANCE:_ �� = I certify that in the pertortnance of the vrorh for which ihis pertnft is issued,I shall not employ any person in any manner so as to — � become subject to the Worker's Compensation Laws of Califomia.And e tl�at if I should become su6ject to the Worker� SMIP: � Comp tion rovfi,�,�s of Section 3700 of the Labor Coc�,I�iall fo wim ulhtGoco{uuy�sions. ENERGY P/C: i DAT: 1 J APPLICANi ��C ENERGY PERMIT: - � WARNING: ailu to secure Worker's Compensation coverage is unlawful,and shall subject an employer to criminal RETENTION FEE: �j y penalties and civil fines up to one hundred thousand dollars($100,000),in addition to t6e cost of the compensation, 1 damages as provided for in section 3708 of the labor code,interest,and attorney's fees. PRE-ALT FEE: � i CONSTHUCTION LENDING AGENCY BSAF: = I hereby attirm under penalty of perjury that ere is a Construction Lending Agency for the peRormance of the work for � which this permit is issued(Sec.309I,Civ.C.). LENDER'S NAME: � = LENDER'SADDRESS: � I certiTy that I have read this application and state that me a6ove information is correct.I agree to comply with all city and TOTAL FEES �/� C 7 fl Z county ordinances and state laws relating to building canstruction,and hereby authorize 2presentatives of this cnunly to COMMENTS: � enter upon the above-mentioned property for in ion purposes. J � � < PERMITTEE NA (P � = SIGNATURE OF PERMITTEE D E RECEIPT# ��V� PAID BY: �tS_��S�VALIDATION: WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy ��i.�ANI� CiVSPEC�ON RECO DR , � �, � o � � • � - • • r � . � . �_a��.,� _ _ SETBACfG'L€TTER�� TRACT AND LEDGER FODTINGS.FORMS SVJITCH 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 RQQF SHEATHING ' ROOF DRAINS FLOOR SNEATHING ROUGH CON�UIT SHEAR WALLS.EXTERIOR POOUSPA ,� : _ SH�AR,WALLSINTERIOR �ROUGH PLUMBING F�RAMfNGIVENTlNG ROUGH ELECTRICA� ROIJfN ME�HANIGAL ROUGH MECHANICAL __ RpUGH ELECTRICAL W( }C(4s) - GAS TE�T _ -= _ „�.; RO�JGH�PUJNIBING' �,,. _ � 'PREGUNiTE � INSULATION WALL POOL PRE DEGKBONDING ' INSULATIQN CEILING `P-TRAP � DRYWALL ��;��FENGEJ�GATEIALARM' � LATH(PRE) 'FINAL P�OL .- LATH EXTERIOR WALLS: LATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL 1 S�( )2NQ( )LIFT SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELEASE WALL DFAIN/SEAL GAS METER RELEASE WALL FINAL SPECIAL INSPECTION fl0.FRANlING PLANNINGAPPROVl�1 FINAL BUILDING ROUGH FIRE APPRdVAI ' FINAL MECHAN1�fiL / / FINAL FIRE DEPARTINENT � _� fINAL`°ELECtRIGAL,, FINAL PLANNING , ;�INAL PLUINBING�� FINAI ENGINEERING/PW �, �T.Cmof OCCUPANCY FINAE GOMMUNITY SERVICES GERT.of OCCUPANGY FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE COMMENTS: