HomeMy WebLinkAbout14959 (13)CITY OF DIAMOND BAR
- DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES
w 21660 E. Copley Drive Suite 190
(909) 860-3195 Fax (909) 861-3117
BUILDING PERMIT APPLICATION _
ADDRESS o i r
APN 'LOT TRACT
OWNER
AD S lqox 15et'll"s W,
CITY ✓ Zt TEL.
APPLICANT TEL.
CONTRACTO 1.
ADDRE
CITY EL.
ARCWENG/
DESIGNER
ADDRESS
CITY ZIP TEL.
OWNER -BUILDER DECLARATION
I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM EXEMPT FROM THE CONTRACTORS LI-
CENSE LAW FORTHE FOLLOWING REASON (SEC. 7D31.5 BUSINESSAND PROFESSIONS CODE: ANY CITY OR
COUNTY WHICH REOUIHESA PERMITTO CONSTRUCT, ALTER, IMPROVE, DEMOLISH,OR REPAIRANY STRUC-
TURE, PRIOR TO ITS ISSUANCE, ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED
STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI-
CENSE LAW (CHAPTER B (COMMENCING WITH SECTION 7000) OF DIVISION 3 OF THE BUSINESS AND PRO-
FESSIONS CODE) OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED EXEMP-
TION. ANY VIOLATION OF SECTION 7031.5 BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO
A CIVIL PENALTY OFNOT MORE THAN FIVE HUNDRED DOLLARS (5500)):
❑ 1, AS OWNER OF THE PROPERTY, OR MV EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION,
WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (SEC. 7044, BUSI-
NESS AND PROFESSIONS CODE: THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF
PROPERTY WHO BULDS OR IMPROVES THEREON, AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR
THROUGH HIS OR HER OWN EMPLOYEES, PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR
OFFERED FORSALE IF, HOWEVER THE BUILDING OR IMPROVEMENT IS SOLD WITHIN ONE YEAR OFCOMPLE-
TK7N, THE OWNER -BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD 4R
IMPROVE FOR THE PURPOSE OF SALE).
❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS
TO CONSTRUCT THE PROJECT (SEC. 7044, BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS LI-
CENSE LAW DOES NOT APPLY TO AN OWNER OF A PROPERTY WHO BUILDS OR IMPROVES THEREON, AND
WHO CONTRACTS FOR SUCH PROJECTS WITH ACONTRACTOR(S) LICENSED PURSUANT70THE CONTRAC-
TORS UCENSE LAW.).
❑ IAM EXEMPT UNDER SEC. B. & P.C. FOR THIS REASON
DATE OWNER
LICENSED CONTRACTORS DECLARATION
1 HEREBY AFFIRM UNDER PE..".
PRESS
FIRMLY
APPLICATION5.� ��
PERMIT `'
P/C
DATE ✓
NUMBER
If
ISSUETYPE
OCC
DATE
CONST.
GROUP
ZONING SETBACKS
FRONT
RW
❑
REAR
❑
SIDE/SIDE STREET
RW
❑
SIDE
❑
PROPOSED USE
NO. DWEL. NO.
NO.
UNITS STORIES
BEDROOMS
DESCRIPTION SQ. FT.
FACTOR PSF
ADJ. AREA/VALUATION
SFR/ADD/REM
(1)
Garage/Carport
W
Patio/peck
UL
PaoUSpa
0
Z
Re -Roof
Commercial
5
fb
Valuation
ADJ.AREA
QUANTITY DESCRIPTION
FEE
J
Q
U
F
W
J
LU