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Home My WebLink About16-0810 -"'� CITY OF DIAMOND BAR � � I�� I i i I DEPARTMENT OF COMMUNI7'Y&DEVELOPMENT SERVICES � �;,= - 21810 Copley Drive,Diamond Bar,cA9��6s � PRESS v� (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 FIRMLY r �'a"'� BUILDING PERMITAPPLICATION www.cityofdiamondbar.com building@diamondbarca.gov � w .�/` t L� u� 5 �,, � �� APPLICATION DATE: � P/C# ��/�7 a JOB SITE ADDRESS � APN LOT TRACT ISSUE DATE: PERMIT#: / 0 N OWNER G'� � (A.�� r li� (A� TYPE CONST. OCC GROUP: � ADDRESS ¢ CITY ZIP TEL. �'�� l7� �3 � g Scope of Work o APPLICANT '�J✓l �C�il 4 5 I G/t d TEL. 7( `( 3 I O'� R// ¢ CONTRACTOR 'e � y 0 � ADDRESS_L� �2- �' ��^�u rU � ( �2�7I #DWEL.UNITS #STORIES #BEDROOMS o CITY 'r Urz— lt/1 G ZIP l�3"6 TEL. �l fl 3 ��Z Z' �/2-7 o ARCH/ENG/ z DESIGNER DESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREANALUATION o ADDRESS SFR/ADD/REM z m CITY ZIP TEL. Garage/Carport ¢ Patio/Deck a� OWNEfl-BUILDEfl DECLAHATION w oI hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the reason(s) LL PooVSpa w intlicated below by the checkmark(s),I have placed ne#to the applicable item(s)[Section 7031.5,Business antl � z Professions Code:Any city or county that requires a pertnit to construct,aRer,improue,demolish,or repair,any Z Re-Root � strucNre,prior to its issuance,also requires the applicant far the permit to file a signed statement that he or she � Commercial � is licensed pursuant W the provisions of the CanVactor'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 N the alleged ezemption.My violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalTy �� of not more than five hundred dollars($500�. ' e (�I,as owner of the property,or my employees with wages as their sole compensation,will tlo(,all of or(,portions Z of the work,and the structure is not intentletl or offeretl for sale(Section 7044,Business and Professions Cotle:The Va/u8fion: Adj.Area: w Contractors'State License Law does not apply to an owner of property who,through employees'or personal effort,6uiltls � or improves the properry,provided that the improvements are not intentled or offered for sale.If however,the building or QUANTITY DESCRIPTION FEE p improvement is soltl within one year of completion,the Owner-Builtler will have the burden of proving that it was not built � or improved for the purpose of sale.). � Z (J I,as owner of the property,am exclusively contracting with licensed Contractors to canstruct the prqec[(Section �' �. � N 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 projects with a licensed Contractor pursuant to the Contractors'State � o License Law.�. w � ()I am exempt hom licensure under the CoMractor's State License law for the following reason(s): � � j � p � � Z Z � �X o °� � By my signature below I acknowledge 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 that I have built as an a r � u�� i � owner-builder if it has not been constructed in ifs entirety by licensed contractors.1 understantl that a copy of the � applirable law,Section 7044 of the Business and Professions Cotle is available upon request when this application is � o submitted or at the following Web site:http/www.leginfo.ra.gov/calaw.html. � �j LICENSEO CONTflACTON'S DECLAHATION � mI hereby affirm under penalty ot perjury fhat I am licensed under provisions of Chapter 9(commencing with Section 7000) � N oi Division 3 of the Business and Professions Cotle,and my license is in full force and effect. ' � LICENSE CLASS: ` ��1 LIC.NO.: Z—/ � / �" ¢ DATE: CONTRACTOR: F /J I y�.e,.1. CONSTRUCTION: p WORKEH'SCOMPENSATIO DECLAflATION PLAN REVIEW: ¢ I HEREBY AFFIRM UNDER PENALIY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: ELECTRIC: o I have antl will maintain a Certifirate of Consent to Self-Insure for Worker's Compensation,as provided by PLUMBING: O, � / Section 3700 of the Labor Code,for the peAormance of the work for which this permit is issued. MECHANICAL: � � I have antl 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 WorkePs Compensation Insurance Carrier and INSPECTION FEE: Policy Number are:��, �� U' ` f � � CARRIER � ISSUANCE: ' ! �1 � POLICYNUMBER_W � I `,TI�L(> 7 (� ��,� SMIP: � (1HIS SEC110N NEED NOT BE COMPLEfED IF 7HE PEAMfT IS FOR ONE HUNDRED DOIIMS($700)OR LESS). ENEFiGY P/C: p I certfy that in the performance ot ihe work for which this permit is issued,I shall not em lo an p y ypersoninanymannerso�to ENERGY PERMIT: o become subject to the Worker's Compensation Laws of Califomia.Mtl agree that if I should becrome subject to the Worker's J Compensation provisions of Section 3700 of the La/bor�Code,I shall torthwith comply with mose provisions. REfENTION FEE: � DATE: APPLICANT:__ �/__l�t �zJ PRE-ALT FEE: �i � WARNING Failure to secure Worker's Compens io8t n coverage is unlawful,and shall subject an employer to criminal gASF: � penalties and civil tines up to one hundred thousantl dollars($100,000�,in addition to the cost of the compensation, p damages as provided for in section 3708 of the labor cotle,interest,and attorney's fees. PLOT PLAN: ¢ � CONSTHUCTION LENDING A6ENCY ZONING CLEARANCE: = I hereby affirm under penalty o(perjury that there is a ConsWctian Lending Agency tor the pertormance of the work for � which this permit is issuetl(Sec.3097,Civ.C.). � LENDEfl'S NAME: wLENDER'S ADDRESS: TOTAL FEES �/� _�� I certity that I have read this application and state that the above information is correct.I agree ro comply with all city and Z county ordinances and state laws relating to building conshuction,and hereby authorize representatives of this counry to COMMENTS: p enter upon the above-mentioned properry for inspection puryoses. m "�"�n K, n a 5 l � a PERMITfE� ME(PRIN� �_� PAID B . VALIDAT�ON: � N �� RECEIPT# PAID BY. VALIDATION: F SIGNATU, PERMITTEE DATE WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy C 1 TY O F D�I AR,�"J►N•fi B A R � , INSPECTiOIV Rt��C;ORD r � � y i � � i , i * � SEfBACK!LETi'ER TRACT AND LEDGER FOOTINGS FORMS SWITCN GEI�R SLAB COMMERCIAL HOOD UG.PLUMBING T-BAR UG.ELECTRIGA� lNTERCEPTER UFER GROUND HOT MOPlSHOWERPAN SEWER LATERAL SEPTIG/CESSPOOL MAIN WATER LINE HERS REPORT RECEIVED SEWER CLEANOUT DEMO�iTIqN ROOF SHEATHING RdOF DRAiNS FLOOR SHEATNING RpUGN CONDUIT SHEAR WAl.t�S EXTERlOR POOUSPA SHEAR WALLS INTERIQR ROUGH PLUMBlNG FRAMINGNENTING ROUGH ELECTRIGAL ROUGN MECHANICAL ROUGN MECHAMCAL ROUGH ELECTRICAL W( )CO GAS TEST ROUGH PLUMBING (� PRE GUNITE INSULATION WALL POOL PRE DECK BONDING INSULATION CEILING P-TRAP DRYWALL FENGE/GATEt ALARM LATH(PRE} FINAL PO4L LATH EXTER{OR WALL5: LATH 1NTERIOR WALL FOOTlNG/STEEL GAS TEST WALL STEEL 1ST( )2ND( )LIFT SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELEASE WALL DRAIN/SEAL GAS METER RELEASE WALL FiNAL SPECiAL WSPECTION RQ.FRAMING PI,ANNING APPROVAL FiNAt BUtIDiNG � j� / ROUGN FiRE APFROVA� FINAL NIECNANtGA�� FINAL FIRE DEPARTMENT FENAL ELECTRICAL FINAt PLANNlN6 fINAI PLUMBING f J FlNAL ENGINEERING!PW T.C.of OCCUPANCY FINAL COMMUNITY SERVICES � CERT.af OCCUPANCY FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE COMMENTS:�,/1/��/� ' �'�'��d„� ,(� ►Nto1C� °lr � '' 1 � 1� ��G P l'� 1 ��_ (Please fi!!out and tear off this portion to /eave with the job card if no one will be avai/able ta allaw the inspector inside the house.) "� `"` INSTA�LATI(�N GERTIFICATlON For fhe properEy located at � r `' � , I hereby certify that the required oke alarms and carbon ma � ala have been i s#alled as iste above. r " �9n � rint Name at �� Re tianship to praject(piease check one}: - Owner ❑Agent for Owne� ❑Licensed Gontractor o Agent for Licensed Contractar if"Licensed Contractor"or"Agent for Licensed Contractor" is checked, please complete the following: Cantracto'r Contractor's State License Number