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Home My WebLink About15-2380 _ ' _ CITY OF D[AMOND BAR �V��1� I ' �- � I i I DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES --- 21810 Copley Drive,Diamond Bar,CA 91765 PRESS (909)839-7020 Fax:(909)861-3ll7 Building Inspection Hotline(909)839-7027 FIRMLY � '�""� BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@diamondbarca.gov � 1 � G a JOB SITE ADDRESS lS � � (�� APPLICATION DATE: IO'�O ' I� P/C# a o APN LOT TRACT ISSUE DATE:��+��S PERMIT#: I S� Z� o� � OWNER K N TYPE CONST. OCC GROUP: � ADD SS I1 � e �-•� � � CITY ZIP (�S TEL. G2 ' ' � 2 Scope of Work �� v Q�!� Q o APPLICANT � W TEL. q L( 30 p O�I G$ o CONTRACTOR � ;M N�tr n ' � S � ADDRESS #DWEL.UNITS #STORIES � #BEDROOMS o CITY Q�QrS.C��ZIP LSo'frEL. Od � `� ARCH/ENG/ z DESIGNER DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION ZADDRESS SFR/ADD/REM m CITY ZIP TEL. Garage/Carport o� OWNEH-BUILDEH DECIAHATION w Patio/Deck � I hereby affirm under penalty of perjury that I am ezempt from the Contractor's Sfate License Law for the reason(s) LL Pool/Spa oindicated beiow by the checkmark(s�,I have placed next to the applicable item(s)[Section 70315,Business and Z pe-Roof w Professions Code:My city or couMy that requires a permit to conshuct,alfer,imprave,demolish,or repair,any 0 a s6uc4ire,prior tn ifs issuance,also requires ihe applicant for the pertnit to file a signed sfaffiment that he or sAe � Commercial � is lice�sed pursuant lo ttie prorisions af the CoMractar's STate License Law(Chapter 9)Commencing with Section � N 7000 of Division 3 of the Business and Professions Code]or that he or she is exempt from licensure and the basis for m � the alleged ezemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty 0 of not more than five hundred dollars($500). � (J I,as owner of the property,or my employees with wages as their sole compensation,will do(�all of or(,portions Z of the work,and the structure is not intended or offered for sale(Section 7044,Business anA Professions Code:The Valuation: Adj.Area: � Contractors'State License Law does not apply to an owner ot property who,through employees'or personal effort,builds � or improves the property,provided that the improvements are not intended or oftered tor sale.If however,the building or QUANTITY DESCRIPTION FEE p 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.). � Z (..)I,as owner of the property,am exclusively conVacting with licensed ConVactors to construct the project(Section � y 7044,Business and Professions Code:The ConVactors'State License Law does not apply to an owner of property who � — builds or improves thereon,and who conVacts for the projects with a licensed ConUactor pursuant to the Contractors'State � oLicense Law.). "' � (�I am ezempt hom licensure under Me CoMractor's State License law tor the following reason(s): � z a m � By my signature below I acknowledge mat,except for my personal residence in which I must have resided for at leas[one � � year prior ro completion ot the improvements covered by this permit,l cannat legally sell a sWcture that I have built as an a X owner-builder if it has not been cons[ruc[ed in iLs entirety by licensed conVactors.I undersfand that a copy of Ne w applicable law,Section 7044 of the Business and Professions Code is available upon reques[when tt�is application is � o submitted or at the following Web site:http/www.leginfo.ca.gov/calaw.html. � v LICENSED CONTRACTOfl'S OECLAHATION � _ . mI hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9(commencing with Section 7000) � N of Division 3 of the Business and Professions Code,and my license is in full force and effect. � � N LICENSE CLASS: v�� LIC.NO.: 1 • CONSTRUCTION: q 2.p� Q DATE: 'd�H'I � CONTRACTOR: p�p,N REVIEW: �� p WORKEN'S CO ENSATION DECLARATION . QI HEREBY AFFIRM UNDER PENALIY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: ELECTRIC: S�•S o I have and will maintain a Certificate ot Consent to Self-Insure for Worker's Co rovided by PLUMBING: � Section 3700 of the Labor Code,for the performance of the work for which this Dermit is issued. _ I p � I have and will maintain Worker's Compensation Insurance,as required by Section 3700 of the Labor Code,for MECHl�NICAL: , ¢ the performance of the work for which this permit is issued.My Worker's Compensation Insurance Carrier and INSPECTION FEE: 0 Policy Numbe ar: ' Z CARRIER S�a Ca.Mp ISSUANCE: ��Za � POLICY NUMBER 90T D�� SMIP: J. S L � � (THIS SECIION NEED NOT BE COMPLElED IF 1HE PERMfT IS FOR ONE HUNDRED DOLUlRS($100)OR LESS�. EN ERGY P/C: p I certity that in ihe performance of ine work for which mis permit is issued,I shall not employ any person in any manner so�to ENERGY PERM IT: 0 6ecome subjecl ro the Worker's Compensation Laws ot fal'rfomia.Md agree that if I should become subject to the Worker's p J Compensation pmvisions of Section 3700 �r Cotle,I shall firthwilh comply with ihose provisions. RETENTION FEE:__ � O,1?� � DATE: I ' '� APPLICANT: PRE-ALT FEE: � WARNING:Failure to secure Worker's ompensation coverage is unlawful,and shall subject ploye to criminal gASF: �•� w� penalties antl civil fines up to one hundred thousand tlollars($100,000),in addition to t ost af the pensation, p damages as provided for in section 3708 of the labor code,interest,antl attomey's fees. PLOT PLAN: ¢ a CONSTflUCTION LENDIN6 AGENCY ZONING CLEARANCE: = I hereby affirm under penalty of perjury that there is a Conshuction LenAing Agency for the performance of the work for � which this permit is issued(Sec.3097,Civ.C.). � LENDER'S NAME: � LENDER'SADDRESS: TOTAL FEES SOv w a I certify that I have read Mis application antl state that the above iniormation is correct.I agree to comply with all city antl Z county ordinances and state laws relating to builtling construction,and hereby authorize representatives of this counry to COMMENTS: o enter u on the above-mentioned property for inspection purposes. � � m a ME(PRINi� r P/C: PAID BY: VALIDATION: N ' O �� '�✓ RECEIPT�� pAID BY: �� 3� VALIDATION:� � S TURE F PERMITTEE DATE WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy CITY OF DIAMOND BAR INSPECTION RECORD . _ _ • � � . � . . � � , . � . 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 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 1ST( )2"0( )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 L ROUGH FIRE APPROVAL FINAL MECHANICAL FINAL FIRE DEPARTMENT FINAL ELECTRICAL p FINAL PLANNING FINAL PLUMBING FINAL ENGINEERING/PW T.C.of OCCUPANCY FINAL COMMUNITY SERVICES CERT.of OCCUPANCY FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE COMMENTS: