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Home My WebLink About16-0791 . ., � "'''� CITY OF DIAMOND BAR '� j I I i ii DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES / � , �� ` c � � PRESS " 21810 Copley Drive,Diamond Bar,CA 91765 ��„��N; (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 F�RMLY � BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@diamondbarca.gov � Z�� tl, w APPLICATION DATE: /�// f � �/ /C# a JOB SITE ADDRESS � APN OT TRACT ISSUE DATE: I PERMIT#: I `� 0 � OWNER TYPE CONST. OCC GROUP: _� ADDRFiSS�. � ¢ cirv�"l/ ZIP • TEL. � � � Scope of Work o APPLICANT ,p I TEL. � a CONTRACTOR _ �vi � /L 7 0 � ADDR S � � #DWEL.UNITS #STORIES_� #BEDROOMS o CI � ZIP ' A TEL. �!� o ARCH/ENG/ z DESIGNER DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION Z ADDRESS SFR/ADD/REM m CITY ZIP TEL. Garage/Carport a Patio/Deck x OWNEH-BUILDEH DECWiATION w oI hereby aifirm under penalty of perjury that I am exempt from the Contrac[or's State License Law for the reason(s) LL PooVSpa w indicated below by the checkmaAys),I have placed next to the applicable item(s)�Sec6on 7031.5,Business and Z Re-Roof zP�essions Code:Any ciry ar county that requires a permit to construcT,alffir,improre,demolish,or repair,any � � structure,prior tn iTs issuance,also requires ttie applicant for the pertnit to file a signed statement that he or she � Commercial � is licensed pursuantto the pravisions of the CaMractor's STate License Law(ChapTer 9)Commencing with Section � � 7000 of Division 3 af the Business and Professions Code]or that he or she is ezempt from licensure and the basis for m � the allegetl exemption.My 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). � ()I,as owner of the property,ar my employees with wages as fheir sole compensation,will do(,all of or�1 portions Z of the work,and the sVucture is not intended or offered for sale(Section 7044,Business and Professions Code:The Valuation: Adj.Area: w Contractors'State License Law does not apply to an owner of property who,through employees'or personal effort,builAs p� or improves the property,provided that the improvements are not intended or offered for sale.If however,the builtling or QUANTITY DESCRIPTION FEE improvement is sold within one year of completion,the Owner-Builtler will have the burden ot proving that it was not built � or improved for the purpose of sale.). � Z ()I,as owner of the proDerty,am exclusively conVacting with licensed Co�actors ta conshuct the project(Section � N 7044,Business and Protessions Cotle:The Contractors'State License Law does not apply to an owner of property who � Y builds or improves therean,and who contracLs for the projects with a licensetl Contractor pursuant to the ConVactors'State � o License Law.). w � (�I am exempt from licensure under the ConVactor's State License law for the following reazon(s): � z � - 0 � By my signature below I acknowledqe that,except for my personal residence in which I mus[have resitled for at least one � year prior to completion of the improvements covered by This permit,l cannot legally sell a struc[ure that I have built as an a X owner-builder if it has not been constructed in ils entirety by licensed conhactors.I understand that a copy of the w applicable law,Section 7044 of the Business antl Professions Code is available upon request when this application is � o submittetl or at the following Web site:http/www.leginfo.ca.gov/calaw.html. �, �"j LICENSED CONiRACTOR'S DECLAHATION � mI hereby affirm untler penalry of perjury mat I am licensetl untler 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 eftect. N LICENS,';}�� LIC.NO.: �J Z DATE: �' � CONrruCTOR: CONSTRUCTION: a �'t PLAN REVIEW: p WOflKER'S COMPENSATION DECLAHATION H I HERE AFFIRM UNDER PENALIY 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: � Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. / i p I have and will maintain Worker's Compensation Insurance,as required by Sectlon 3700 of the labor Code,for MECHANICAL: , z the performance of the work for which this permit is issued.My Worker's Compensation Insurance Carrier and INSPECTION FEE: ¢ Policy Number are: �-y�� w CARRIER � �/� � ISSUANCE: _ ` ` z � POLICYNUMBER SMIP: N � (THIS SECTION NEED NOT BE CA PLEfED IF 1HE P IS FOR ONE HU RED DO S(3�oo)OR LESS�. ENERGY P/C: p I certify that in the per(ormance of the work for which this permit is issued,l shall n employ erson in any manner so�Tn ENERGY PERMIT: o become su'ect to the Worker's CompensaU d agree that if I sh become subject to Ne Worker's J Compen np isians of Section 3700 of the r Cade,I forthwith comp those provisicy�s. REfENTION FEE:_ , ��• � Dat�: ' " ruCnNr: PRE-ALT FEE: � WARNING:Failure to secure Worker's Compensation coverage is unlawful,an0 shall subject an employer to criminal gASF: � penalties and civil fines up to one hundred thousand dollars($100,000�,in addition to the cost ot the compensation, p damages as provided for in section 3708 af the labor code,interest,and attorney's fees. PLOT PLAN: ¢ CONSTRUCiION LENDING AGENCY ZONING CLEARANCE: = I hereby aKrm under penalty of perjury that there is a ConsWction Lending Agency for the peRormance of the work far � which this permit is issued(Sec.3097,Civ.C.). C LENDER'S NAME: Q LENDER'S ADDRESS: TOTAL FEES /O w d I cerUty that I have read this a lication and sta e mat the above information is correct.I agree to comply with all ciry and Z county ordinances and state I ws relating to b Iding con ctlon,and hereby autho'e representatives oi this county to COMMENTS: p enter u on above-men' d property for'spection os � m a� �,j� / a PER EE (PRINn � ` � P/C: PAID BY: VALIDATION: y N RECEIPT# PAID BY: VALIDATION: � SIGNA F PEfl pp� WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy CITY OF DIAMOND �BAR . INSPECTION RECORD . . � � , . � . . � � . . � . SETBACW LETTER TRACT AND LEDGER FOOTINGS FORMS SWITCH GEAR S�qg . 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( )C( ) 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� \ZND� �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 PLANNIN6 FINAL PLUMBING � FINAL ENGINEERING/PW T.C.of OCCUPANCY FINAL COMMUNITY SERVICES CERT.of OCCUPANCY FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE � COMMENTS: