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Home My WebLink About15-0666Uld,�lO�D BAPI CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 BUILDING PERMIT APPLICATION I PRESS FIRMLY APPLICATION DATEr V P/C# ISSUE DATE: PERMIT# 4r 0 TYPE CONST. OCC GROUP: ZONING SETBACKS FRONT RW ❑ REAR ❑ SIDE/SIDE STREET RW ❑ SIDE ❑ JOB SITE ADDRESS APN ? LOT TRACT OWNER L GNU e Cwt / l' I .0 ADDRESS 0 G 7 CITY ftZIP TEL. l r�F� 4Yf APPLICANT TEL. c / 1 O +l I l a CONTRACTOR V O CLu Pool/Spa ADDRESS S G 4 a -i CITY CO I'VA D- ftJ?1 ZIP q"//`/1 TEL. 10 — ARCH/ENG/DESI NER 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, Businessand 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 L) all of or L) 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 Cade: 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 cannotJogally sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contra ors I understan t a copy of the applicable law, Section 7044 of the Business and Professions Code is available upon q hen this app cation is submitted or at the fallowing Web site: http/www.leginfo.ca.gov/calaw.html. �i DATE:-..r/Zv 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 rand efeffect, LICENSE CLASS: G/ �i�•7 "/� LIC.F.: !i' GJ DATE: ONTRACTOR: LU WORKER'S COMPENSATION DECLARATION I HEREP�GAFARM 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 the performance of the work for which this permit is issued. My Worker's Compensation Insurance Carrier and Policy Number are: C� CARRIER -/ c/ POLICY NUMBER (THIS SECTION NEED NOT BE COMPLETED IF THE P MR IS FOR ONE HUNDRED DOLLARS ($100) OR LESS). I certify that in the performance of the work for which this permitis issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation Laws of California. And agree that if I should become subject m the Workert Compensation provis'ons of Section 3700 of the Lab JCode, I shall forthwith comply wd those provisions. DAT APPLICANT: '(� / -C�-� `/ — E` No WARN[ : Failure to secure Worker's Compensation coverage is unl wfu[, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,000), in addition to the cost of the compensation, damages as provided for in section 3708 of the labor code, interest, and attorney's fees. 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. PERMITTEE NAME (PRIM) SIGNATURE OF PERMITTEE �- DATE I PRESS FIRMLY APPLICATION DATEr V P/C# ISSUE DATE: PERMIT# 4r 0 TYPE CONST. OCC GROUP: ZONING SETBACKS FRONT RW ❑ REAR ❑ SIDE/SIDE STREET RW ❑ SIDE ❑ PROPOSED USE # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM �j Q Garage/Carport w Patio/Deck LL Pool/Spa C7 Z n�,.r Re -Roof .e I//�"V O J Commercial m Valuation: Adj. Area: '7 I QUANTITY I DESCRIPTION FEE e U f! e 41,1O cc ceras I'c n.s-f-cl 0 oEt�00 C" cv n SIO � v I rL a eu✓ " s. Yl f L K I ¢ orf. ; U x w CONSTRUCTION: f �q PLAN REVIEW: ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMIP: ,' ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: BSAF: TOTAL FEES n COMMENTS: !i RECEIPT # 3,<l PAID BY: \ �n5 VALIDATION: WHITE — Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy, GOLDENROD — File Copy, GREEN — Applicant's Copy SETBACK/ LETTER " TRACT AND LEDGER FOOTINGS'�ORMS§ w `' " SWITCH GEAR ,SLAB,COMMERCIAL „ x COMMERCIAL HOOD b� BING � , i T -BAR 'I G. ELECTRICAL INTERCEPTER 'UF Rim.„,��. ,; HOT MOPISHOWERPAN SEWER LATERAL SEPTIC/CESSPOOL MAIN WATER LINE HERS REPORT RECEIVED SEWER CLEANOUT DEMOLITION ROOF SHEATHING FLOOR SHEATHING DRAINS ROUGH CONDUIT SHEAR WALE=S EXTERIOR' I, JPOOL/SPA SHEAR WALLS INTER16R ROUGH PLUMBING FRA MINGNEWING 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 -TRAP DRYWALL FENCE / GATE/ ALARM LATH (PRE) FINAL POOL LATH EXTERIOR WALLS: LATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL 1S'( ) 2ND( ) LIFT SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELEASE WALL DRAIN/ SEAL GAS METER RELEASE WALL FINAL SPECIAL INSPECTION FINAL BUILDING*,, FINAL MECHANICAL, aimi7i n ;:(-mri COMMENTS: R0. FRAMING PLANNING APPROVAL d (' ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT FINAL PLANNING FINAL ENGINEERING/ PW- . m _ FINAL COMMUNITY SERVICES xiw FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE