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Home My WebLink About15-0660CITY OF DIAMOND BAR �. DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 ,r (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 >.. RI IILDING PERMIT APPLICATION JOB SITE ADDRESSOG.�G F i Ki �OI�II I� V APN M _ L T TRACT OWN\ADDCITYZI TEL. APPLICANT Ake TEL. WW46 CONTRACTOR�� ADDRESS��\�.�C Y.��,Qti� CITY 2)�(i3O U ZIP q� TEL. b . 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 mason(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 facensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to acivil 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 CJ all of or U portions of the work, and the stricture 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 1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' Stale 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 it 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: hitpWww.loginfo.ca.gov/calaw.htmi. r 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) J r of Division 3 of the Business and Professions Code, and my license is in full force and effect. LICENSE �t�–�� 1c+ ic. Na.: L (� [� a DATE: w `ti CONTRACTOR: i; WORKER'S COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: C I have and will maintain a Certificate of Consent to Self -Insure for Worker's Compensation, as provided by 3 lion 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 the performance of the work for which this permit is issued. My Worker's Compensation Insurance Carrier and [ Policy Number ar ' CJ CARRIEA 7 POLICY WMBER !� r` (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS (3700) 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 subject to the Workers Compensation Laws of California. And agree that if I should become subject to the Worker's y Compensab pro of Section 3700 of the Laypr,fale, ailltsh forthwith comply with those provisions. DATE:. APPLICANT: 7 WARNING:Qure t Failsecure Worker's Compensation coverage is unlawful, and shall subject an employer to criminal cpenalties and civil fines up to one hundred thousand dollars ($100,000), in addition to the cost of the compensation, U L damages as provided for in section 3708 of the labor code, interest, and attorney's tees. C CONSTRUCTION LENDING AGENCY L 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: L I certify that !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. a_ = PERM ME (� .--�- __ n = SIGNATU PERMITTEE DA� FINALIZE&SS FIRMLY APPLICATION DATE: P/C# p- _ ISSUE DATE: ✓,/o d I/qir PERMIT# 1 J ' 01 �/ jj TYPE CONST OCC GROUP: ZONING SETBACKS FRONT RW 171 REAR d— SIDE/SIDE STREET RW CL SIDE ❑ PROPOSED USE # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADDIREM Garage/Carport u) Patio/Deck W LL Pool/spa ZRe Roof -� Commercial CO CO Valuation: Adj. Area: QUANTITY DESCRIPTION FEE U 2 U w Z m ii a U Z a x CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: 6 r7` Q2 MECHANICAL: INSPECTION FEE: ISSUANCE: SMTP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: a_ PRE -ALT FEE: BSAF: TOTAL FEES - J' COMMENTS: RECEIPT # PAID E4Y:�/i�r-'� -VALIDATION:_ WHITE — Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy, GOLDENROD — File Copy, GREEN — Applicant's Copy CITY OF DIAMOWD INSPECTION BAR .P.�6CORD INSPECTION DATE INSPECTOR INSPECTION'. DATE INSPECTOR SETBACK/ LETTER TRACT AND LEDGER FOOTINGS FORMS SWITCH GEAR SLAB COMMERCIAL HOOD UG: PLUMBING T -BAR ,UG. ELECTRICAL `... ::'.. INTERCEPTER LIFER 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 EXfiERIOR : POOL/SPA SHEAR WALLS. INTERIOR : ROUGH PLUMBING FRAMINENTING '. .;', GN ROUGH'ELECTRICAL. " ROUGH MECHANICAL.", ,, ROUGH MECHANICAL ROUGH ELECTRiCAL'W( ) C ( ) . TEST - GAS . ROUGH PLUMBING ', . 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 1-( ) 2ND( ) LIFT SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELEASE WALL DRAIN/ SEAL GAS METER RELEASE WALL FINAL SPECIAL INSPECTION RO. FRAMING PLANNING APPROVAL fINAL f3UICOiNG = ROUGH FIRE APPROVAL FINAL.MECHANICAL - FINAL FIRE DEPARTMENT FINAL. ELECTRICAL.'' FINAL PLANNING .FINAL PLUMBING : T.0 of OCCUPANCY . FINAL ENGINEERING/ PW FINAL COMMUNITY SERVICES CERT. of bCCUPANCY . FINAL HEALTH DEPT: FINAL INDUSTRIAL WASTE