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Home My WebLink About15-0763DIVIO 'D. BAR CITY OF DIAMOND BAR 0 OS/,Z4 /l S-- DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 PRESS (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 FIRMLY PERMIT APPLICATION 1 JOB SITE ADDRESS ��C� I 1 WaV cQ /Ia l APN LOT TRACT OWNER 1�D�7aiA2 ADDRESS/ CITY ZIP TEL. S I ZiZ O �S�i APPLICANT J / f TEL. CONTRACTOR ADDRESS �i CITY .�1Gi D ZIPA� TEL. �'7 ARCH/ENG/DESIGNER ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the reason(s) indicated below by the checkmark(s), I have placed next to the applicable item(s) [Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair, any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9) Commencing with Section 7000 of Division 3 of the Business and Professions Code] or that he or she is exempt from licensure and the basis for the alleged exemption. Any 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). U I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The 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 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.). U I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law.). U I am exempt from licensure under the Contractor's State License law for the following reason(s): 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 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 submitted or at the following Web site: httpAvww.leginfo.ca.gov/calaw.html. DATE: SIGN: LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect.. LICENSE C S: LIC. NO.: DATE: CONTRACTOR: WORKER'S COMPENSATION DECLAMATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: I have and will maintain a Certificate of Consent to Self -Insure for Worker's Compensation, as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as required by Section 3700 of the Labor Code, for 7 the performance of the work for which this permit is issued. My Worker's Compensation Insurance Carrier and Policy Number are: CARRIER POLICY NUMBER Lola 0 00" -Lazz4_ (THIS SECTION NEED NOT BE COMPLETEPERMIT IS D IFTHE PEFOR ONE HUNDRED LLARS ($100) OR LESS). I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become sub'ed tothe Worker's Compensation Laws of California. And agree that 'rf I should become subject to the Worker's Compen ti n pro isio s Section 3700 of the Labor Code shall fodhwith comply with those pro�an DATE: �. APPLICANT: WARNI : Failure to secure Worker's Camp on coverage is unlawful, and sh ubjecrto criminal penaltiesand civil fines up to one hundred thousand dollars($10000in addi' the ompensation, damages as provided for in section "" of the labor code, interest, and attorney's lees. CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a Construction Lending Agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). LENDER'S NAME: LENDER'S ADDRESS: I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes. uh/ � P ITTEE NAME (P INT) " r SI6'N_ATNe1OrFERMiTrEE DATE APPLICATION DA�T/E':` , n 1 ISSUE DATE: `i /� �D'fl tC TYPE CONST. P/C# �f� �/�J PERMIT# 14-- D7 b.? OCC GROUP: ZONING SETBACKS FRONT REAR SIDE/SIDE STREET SIDE RW ❑ ❑ RW ❑ ❑ PROPOSED USE If DWEL. UNITS # STORIES / # BEDROOMS DESCRIPTION SQ. FT FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport rn w Patio/Deck LL PooVSpa ZRe -Roof 0 w Commercial m Valuation: / Adj. Area: QUANTITY DESCRIPTION FEE J U Q U J w c� cc m a a U a_ w CONSTRUCTION: PLAN REVIEW: / • -r ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: '71,14 SMTP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: BSAF: TOTAL FEES COMMENTS: RECEIPT # .�;�11.�� PAID B s VALIDATION:-_ WHITE — Department Copy, YELLOW — Finance Copy, PINK 1- Assessor Copy, GOLDENROD — File Copy, GREEN — Applicant's Copy CITY OF DIAMOND BAR INSPECTION RECORD SETBACKrLITTER ,_ §°, •;. 4�. � TRACT AND LEDGER FOOTINGS FORMS SWITCH GEAR COMMERCIAL HOOD UG4PLUMBING T -BAR UG, ELECTRICAL INTERCEPTER `UFER GROUNDS HOT MOP/SHOWERPAN SEWER LATERAL SEPTIC/CESSPOOL MAIN WATER LINE HERS REPORT RECEIVED SEWER CLEANOUT DEMOLITION ROOF SHEATHING FLOOR SHEATHING ow ROOF DRAINS ROUGH CONDUIT -SHEAR WALLS EXTERIOR "' POOL/SPA ` 10R SHEAR WALLS INTER ROUGH PLUMBING FRAMINGNENTING ° ROUGH ELECTRICAL ROUGH MECHANICAL - ROUGH MECHANICAL ROUGH'ELECTRICAL ?W( ) C ') ROUGHjPLUMBING, GAS TEST PRE GUNITE INSULATION WALL POOL PRE DECK BONDING INSULATION CEILING P -TRAP DRYWALL_ FENCE / GATE/ ALARM LATH (PRE) _ FINAL POOL LATH EXTERIOR WALLS: LATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL 1s'( )2 ND( ) LIFT SCRATCH COAT _ WALL BOND BEAM ELECTRIC METER RELEASE WALL DRAIN/ SEAL GAS METER RELEASE WALL FINAL SPECIAL INSPECTION R0. FRAMING PLANNING APPROVAL FINAL MECHANICAL _ .. ,FINAL.ELECTRICAL -t44 FINAL PPLUMBING -4 .. - 'T. t", of.00CURANCY CEkT. Of OCCUPANCY `' 6 s COMMENTS: '' ' g _ lilt f evv q i ROUGH FIRE APPROVAL _ FINAL FIRE DEPARTMENT FINAL PLANNING FINAL ENGINEERING/ PW FINAL COMMUNITY SERVICES FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE