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Home My WebLink About16-0787 (9) , �r'n�.'�. CITY OF DIAMOND BAR . I� � I � � � � DEPARTMENT OF COMMUNITY& DEVELOPMENT SERVICES II�- ` 21810 Copley Drive,Diamond Bar,CA 91765 PRESS `� il� (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 FIRMLY � �,'""°� BUILDINC PERMITAPPLICATION www.cityofdiamondbar.com building@diamondbarca.gov � w � 3 ,� �TI /]�� ( APPLICATION DATE• P/C# a JOB SITE ADDRESS `Cj S /�_ r^,��` � APN OT T CT ISSUE DATE: I ��_PERMIT#: V � 0 N OWNER �P � TYPE CONST. OCC GROUP: � ADDRESS � - ¢ CITY IP TEL. �'"�� ' Scope of Work o APPLICANT L7'� TEL. S� N o CONTRACTOR p P � ADDRESS � �—� � � CITY Z�p #DWEL.UNITS #STORIES BEDROOMS o , TEL._ o ARCH/ENG/ z DESIGNER DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION o ADDRESS ' SFR/ADD/REM z ¢ CITY ZIP TEL. Garage/Carport � OWNEH-BUILDER DECLAHATION w Patio/Deck oI hereby a�rm untler penalty of perjury that I am exempt from the Contractor's State License Law for the reason(s) LL PooVSpa o intlicated below by the checkmark(s),I have placed neM to the applicable item(s)[Section 7031.5,Business and � iz Professions Code:Any ciry or cawrty that requires a permit to construct,alter,improve,tlemolish,or repair,any ? Re-Roof a sWcture,prior to iTs issuance,also reQuires the applica�rt for the pertnk M file a signed statement that he or she � Commercial � is licensed pursuant to the provisions of the Contractor's State License Law(Chapter 9)Commencing with Section � N 70�of Division 3 of the Business antl Profeuions Code]or that he or she is exempt from licensure and the basis for m N the alleged exemption.My violation of Section 7037.5 by any applicant for a permit subjects the applicant to a civil penalty o of not more than five hundretl dollars($500). � (�I,as owner of the property,or my employees with wages as their sole compensation,will do(J all of or(J poRians � of the work,and the structure is not intentled or offeretl for sale(Section 7044,Business and Professions Cotle:The Va/uat/on: Adj.Area: � Contractors'State License Law does not apply 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 QUANTITY DESCRIPTION FEE o improvement is sold 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 (�I,as owner o(the property,am exclusively contracting wdh licensed Contractors to construct the project(Section " � 7044,Business antl Professions Code:The Contractors'State License Law does not apply to an owner ot property who � U Y builds or improves thereon,and who conVacts for the projects with a licensetl Contractor pursuant to the Contractors'State � o License Law.). � w � ()I am exempt from licensure under the Comractor's State License law for the following reason(s): � � z z o m � By my signature below I acknowledge that,except for my personal residence in which I must have resitled for at least one � � year prior to completion of the improvements coveretl by this Dermit,l cannot legally sell a sWcture that I have built as an a � owner-builder if it has not been constructed in its entirety by licensed contractors.I understand that a copy of the applicable law,Section 7044 of the Business and Professions Code is available upon request when this application is o submitted or at the following Web site:http/www.leginfo.ca.gov/calaw.html. � � c~j LICENSED CONTRACTOfl'S DECLAflATION � x � I hereby affirm under penalry of perjury that I am licensed under provisions of Chapter 9(commencing with Section 7000) � � of Division 3 of the Business a/nd Professions Cotle,and my license nis in full force antl effect. o LICENSE CLASS:� " Y LIC.NO.: "'� �� U� CONSTRUCTION: a DATE: � ` ��CONTRACTOR: e��,. P � p WORKEfl'S COMPENSA ION D LA ION PLAN REVIEW: ¢ I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: ELECTRIC: o I have and will maintain a Certificate of Consent to Self-Insure for Worker's Compensation,as provided by PLUMBING: �/�/ � �Sec6on 3700 of the Labor Code,for the performance of the work for which this permit is issued. <<— p �_I have and will maintain Worker's Compensation Insurance,as required by ction 3700 of the Labor Code,for MECHANICAL: - ¢ me peAormance of the work for whic Nis permit is issued orker's mpensation Insurance Carrier and INSPECTION FEE: o Policy Number are: "' CARRIER � r � ISSUANCE: rL� z � POLICY NUMBER SMIP: y � � (THIS SECIION NEED NOT BE MPLEfED IF 1HE PERMf!IS FOR ONE HUNDRED DOLLARS($100)OR LESS). EN ERGY P/C: p I certify that in the performance of ihe work for which this rmit is issued,I shall not employ any person in any manner so as to ENERGY PERMIT: � o become suhject to e Worker's Compensation laws of 'rfomia.Md ag2e that if I should become subjecl to the Worker's J Compensati p i o of Section 3700 of the Lab shall foMwith comply with those provisions. RETENTION FEE: .►�--- � DATE: APPLICANT: PRE-ALT FEE: � � WARNING: ailure secure Worker's Compensatio overage is unlawful,antl shall subject an employer to criminal gASF: � penalties and civil fines up to one hundred thousand tlollars($100,000),in addition to the cost of the compensation, p damages as provided for in section 3708 of the la6or code,interest,antl attomey's fees. PLOT PLAN: ¢ a CONSTflUCTION LENDING AGENCY ZONING CLEARANCE: = I hereby affirm under penalty of perjury that lhere is a Construction Lending Agency for the pertormance of the work for � which this permit is issued(Sec.3097,Civ.C.�. � LENDER'S NAME: � LENDER'S ADDRESS: TOTAL FEES ! � S w � I certify that I have read this application and state that the above information is correct.I agree to comply with all city antl Z county ordinances and state laws relating to building construction,and hereby authorize representatives of this counry to COMMENTS: p enter upon the above-mention pr perty for inspection purposes. � m a P RMfTTEE NAME(PRIN P/C: AID BY: VALIDATION: � y RECEIPT k �_ PAID BY ' VALIDATION� � SIGNAiURE OF PERMITfE DATE WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy �� CITY OF DIAMOND. BAR INSPECTION RECORD � ' • � � • - • � . � - SETBACfU LETTER TRACT AND LEDGER FOOTINGS FORMS SWITCH GEAR S�6 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 SF �G+ PRE GUNITE INSULATION WALL POOL PRE DECK BONDING INSULATION CEILING P-TRAP DRl'WALL FENCE/GATE/ALARM LATH(PRE) FINAL POOL LATH EXTERIOR WALLS: LATH 1NTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL 1 sr� �2No� �LIFT SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELEASE WALL DRAIN/SEAL GAS METER RELEASE WALL FINAL SPECIAL INSPECTION R0.FRAMWG PLANNING APPROVAL FINAL BUILDING ROUGH FIRE APPROVAL FINAL MECHANICAL FINAL FIRE DEPARTMEN7 FINAL ELECTRICAL F1NAL PLANNING FINAL PLUMBING (i �4� FINAL ENGINEERING/PW T.C.of OCCUPANCY FINAL COMMUNITY SERVICES CERT.of OCCUPANCY FINAL HEALTH UEPT. FINAL INDUSTRIAL WASTE COMMENTS: �� td..f .f+�G l;�Q.� f' C � i�+},�'¢'ftib B� `//��lb A.�