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Home My WebLink About16-0663 � ' � CITY OF DIAMOND BAR • ��D ' � � � I DEPARTMENT OF COMMUNITY�D�V"�,LOPMENT SERVICES 1� ` 21810 Copley Drive,Diamond Bar,CA 91765 ~ PRESS (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 FIRMLY ' ��`�s', BUILDING PERM TAPPLICATION www.cityofdiamondbar.com building@diamondbarca.gov � � P/C# w � s y-�j �1A� APPLICATION DATE� � � -� �� a JOB SITE ADDRESS .i Z ISSUE DATE: � � PERMIT#: � APN LOT TRACT `t'-' OWNER IJ� TYPE CONST. OCC GROUP: � ADDRESSZ'b Y'S a CITY �1��___�EL. • Scope of Work ¢ � APPLICANT ^R-T�1- T L. N a CONTRACTOR 0 �s `, � ADDR,EA� J' v #DWEL.UNITS #STORIES #BEDROOMS � CITY V`� s �� ZIP ( TEL. 0 o ARCH/ENG/ � z DESIGNER DESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREANALUATION ZADDRESS SFR/ADD/REM m CITY ZIP TEL. Garage/Carport ¢ � Patio/Deck � OWNER-BUILDEH DECLARATION w � o I hereby affirm under penalry of perjury that I am exempt from the Conhactor's State License Law for the reason(s) LL PooVSpa W indicated below by the checkmark(s�,I have placed next to the applicable item(s)(SecGon 7031.5,Busineu and Z Re-Roof z Prafessions Code:My city ar county that requires a permit to construc[,alter,improve,demolish,ar repair,any � a structure,prior ta its issuance,also requires the applicaM for the pertnit Uo file a signed statement that he or she � Commercial � is licensed pursuaM ta the provisions of the CantractnPs Sfate License Law(Chapfer 9)Commencing with Section m N 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.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 huntlred dollars($500). e (1 I,as owner af the property,or my employees with wages as iheir sole compensation,will do(J all of or(,portians Z of the work,and the s[ructure is not intended or offered for sale(Section 7044,Business and Professions Code:The V8luation: Adj.Area: � Contractors'St2te License Law does not apply to an owner of property who,through employees'or personal ettort,builds � or improves the property,provided that the improvements are not intended or offered for sale.If however,the building or QUANTITY DESCRIPTI N FEE p 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.). � � �,(1 ZI,as owner ot me ro e �' (1 .�O- U p p rty,am exclusively contracting with licensed Contractors ta construct the project(Section ¢ N 7044,Business and Professions Code:The Contractors'State License Law does not apply to an owner of property who � Y builds or improves thereon,and who conVacTs for ihe projects with a licensed ConVacTnr pursuant to the ConVactors'State � O IC 8 W.). w . � am ezempt from licensure under the ConVactor's Stffie License law for the following reason(s): � � �i � Z Z m � By my signature below I acknowledge mat,except for my personal residence in which I must have resided for at leas[one � � year prior to complefion of the improvements covered by this permit,l cannot legally sell a structure that I have built as an aJ. a owner-builder if it has not been constructed in it5 entirety by licensetl conVactors.I undersfand that a copy of the � applicable law,Section 7044 of the Business and Professions Code is available upon request when this application is � o submitted or at the following Web site:http/www.leginfo.ca.gov/calaw.html. � V LICENSED CONfMCTON'S DECLAHATION � II x � 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 antl Professions Code,and my license is in full force and effect. � o LICENSE CLASS LIC.NO.: � CONSTRUCTIONt Q DAlE: CONTRACTOR: p WOflKER'SCOMPEN TIONDECU111ATION P�NREVIEW: QI HEREBY AFFIRM UNDER PENAL7Y OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: ELECTRIC: " o I have and will maintain a Certificate oi Cansent to Self-Insure for Worker's Compensation,as provided by PLUMBING: � Section 3700 of the Labor Code,for the peAormance of the work for which this permit is issued. MECHANICAL: p I have and will maintain Worker's Compensation Insurance,as required by Section 3700 of the Labor Cotle,for a the periormance of ine work for which this permit is issued.My Worker's Compensation Insurance Carrier and INSPECTION FEE: Policy Number are: Z CnRRIER ISSUANCE: � POLICYNUMBER SMIP: � _ (IHISSEC�IONNEEDN0T8ECOM D iHEPERMR FO ONEHUN DDO 1000RLESS). ENERGYP/C: p I cerrti yfy ihat in me pert ance of the work tor ich rmit is iss ,I hall not mploy any pe n in y manner so�to EN ERGY PERM IT: o become sub t lo me orker's Compensation o I'rfo '.M agr e that� I should beco�e s '� t to the Worker's J Compen ' p visio Section 3700 oi ih h� e,I s II to wi comp with those visi s. RETENTION FEE: � DA1E: APPLICAHT: PRE-ALT FEE: � WARNING: ilure to secure Worker' ompensation coverage is u lawful,and shall subject an employer to criminal gASF: � penalties and civil fines up to one hundred thousand tlollars($100,00�,in adtlition to the cost of the compensation, p damages as provided for in sectlon 3708 of the labor code,interest,and attorney's tees. PLOT PLAN: Q a CONSTHUCTION LENDING AGENCY ZONING CLEARANCE: = I hereby affirm under penalty oi perjury that there is a ConsVuction Lending Agency for the performance oi the work for � which this permit is issued(Sec.3097,Civ.C.). H LENDER'S NAME: � LENDEfl'S ADDRESS: TOTAL FEES 9�- w a I certify that I have read mis application and siate that the above information is correct.I agree to comply with all city and Z county ordinances nd sfate laws rela'g to bu'ding construction,and hereby authorize represenTatives af this county to COMMENTS: p enter upon the abo - ention d pro or in ection purposes. _ � � m � PERMITTEE NA E RIN � I f� P/C: PAID BY: VALIDATION: � RECEIPT N �4—1�I�- PAID BY:+j �� VALIDATION:�_ � SIGNATUR PEfl EE DATE � � / ��8/�� WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy G�../� j t.b� ��"'�� I S ECTI.��! RECO DR � � � � . � � , � . . � � , � - SETBACK/LETTER TRACT AND LEDGER ' FOOTINGS FORMS SWITCH GEAR g�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 PLUMBIN6 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-TRAP DRYWALL � FENCE/GATE/ALARM LATH(PRE) FINAL POOL LATH EXTERIOR WALLS: LATH INTERIOR WALL FOOTING/STEEL GAS TEST ' � WALL STEEL 1 sr� \2ND� �LIFT 1 SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELEASE ,�//,,f'y 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 PLANNING FINAL PLUMBING FINAL ENGINEERING/PW T.C.of OCCUPANCY FINAL COMMUNITY SERVICES CERT.of OCCUPANCY FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE ' . COMMENTS: �Q�'l. `�'''QJ"�0'�'l'� R��l� rn�'PBGt,�On - ��/�.��6 ��