HomeMy WebLinkAbout25548CITY OF DIAMOND BAR t?•`,`,;,
DEPARTMENT OF COMMUNITY&llEVELOPMENT SERVICES
21825 Copley Drive,Diamond Bar,CA 91765
909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 - ' PRESS
BUILDING PERMIT APPLICATION FIRMLY
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cn DESCRIPTION S.FT. FACTOR PSF ADJ.AREANALUATION
p OWNER-BUILDER DECLARATION
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p HEREBY AFFIRM UNDER PENALTV OF PERIURY THAT I AM E%EMPT FROM THE CANTRAC70HS LI GalegB/CefPOffWCENSEUWFORTHEFOLLOWINGREASON(SEC.7037.SBUSINESSANDPROFESSIONSCODE:PNVCITVOR (nUCpUN1yWHICHREOUIRESAPERMITTOCONSTRUCT,ALTER.IMPROVE,DEMOLISH,ORREPAIRANY57RUC- W Patio/DeckwTURE,PRIOfl TO ITS ISSUANCE,ALSO RE UIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED wSTATEMENTTHATHEORSHEISLICENSEDPURSUANTTOTHEPROVISIONSOFTHECONTRAC70RSLI-
CENSE UW(CFiAPTER 9(COMMENCING WI7H SECTION 700a)OF DIVISION 3 OF THE BUSINE55 AND PRO- POOVSp2
FESSIONS COOE)OR h1AT HE OR SHE IS EXEMPT THEREFROM AND THE BA515 FOR 7HE ALLEGED EXEMP- (
TION.MlVV10LATIONOFSECTION7031.5BVANVAPPLICANTFORAPERMITSU&lECTSTHEAPPLICANTTO Z Re-RoofACIVILPENALTVOFNOTMOREhiANFIVEHUNDREDDOLURS(f5a0).):
ZOI,ASOWNEROF7HEPROPERTV,ORMVEMPLOVEESWITHWAGESASTHEIRSOLECOMPENSATION, 0 COrt1f110fCi81WILLDOTHEWORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SAIE(SEC.70/,BUSI- J
NESS AND PROFESSIONS CODE:THE CANTRACTORS IICENSE LAW DOES NOT APPLY TO AN OWNER OF
PROPERTY WHO BUILDS OR IMPROVES THEfiEON,AND Vrt70 DOES SUCH WORK HIMSELF OR HERSELF OR
CC THROUGH HIS OR HER ONM EMPLOVEES,PROVIDED THAT SUCH IMPFiOVEMENTS ARE NOT INTENDED ON m
Q OFFEREDFORSALEIF,HOWEVER711EBUILDINGORIMPROVEMENTISSOLDWITHINONEYEAROFCAMPLE-
Z TION,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR
IMPROVE FOR THE PURPOSE OF SALE).
w OI,ASOWNEROFTHEPROPERTY,AMEXCLUSNELYCONTRACTINGWITHUCENSEDCONTRACTOHS'
Q TO CANSTRUCT THE PR0.1EC7(SEC.701/,BUSINESS AN PROFESSIONS CODE:THE CONTRACTORS LI- V21UflIlOf1 ADJ.AREAWCENSEUWDOESNO7APPLVTOANONMEROFA7ROPER7YWHOBUILDSORIMPROVES7HEREON,AND
NMOCONTRACTSFORSUCHPROJEC75WITHACONTRACTOR(S LICENSEDPURSUPNTTOTHECANTRAC- QUANTITY DESCRIPTION FEE
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LICENSED CONTAACTORS DECLARATION W
I HEREBY AFFIRM UNDER PENALTV OF PEFiJURV 7HAT I AM LICENSED UNDER PROVISIONS OF CHAP7ER
d Y(COMMENCING WITH SECTION 7000)OF DIVISION J Of THE BUSINESS AND PROFESSIONS CODE,AND ZXMYLICENSEISINFULFORCEANDEFFECT. mLLI
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LICENSE CpIASS G bR/ LIC.NO, a b O
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WORKERS'COMPENSATION DECLARATION Q
1 HEREBV AFFIRM UNDER PENALTV OF PERIURV ONE OF THE FOLLOWING DECURA710NS:
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IHAVEANDWILLMAINTAINACERTIFICATEOFCONSENT70SELF-INSUqEFORWORKERS'
Q CAMPENSATION,AS PROVIDED BY SECTION 3700 OF THE LABOR CODE,FOR THE PERFORMANCE W
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OF THE WORN FOR WHICH THIS PERMIT IS ISSUED.
W _I HAVE ANO WILL MAINTAIN WORKERS'COMPENSATION INSURANCE.AS REOUIRED BV SECTION
Q 370o OF THE LABOH CODE,FOR THE PERFORMANCE OF 7HE WORK FOA WHICH THIS PERMI715
ISSUED.MV WORKERS'CAMPENSATION INSURANCE CARRIER AND POLICV NUMBER ARE: CONSTRUCTION
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iHI55ECiK7NNE NOT8E00MR.EfEDOFTHEPEPAYTISFORONEFNI OREDDOL1AiLS S100)ORLESS PLUMBING
WZ I CERTIFY 7HA71N 7HE PERFORMANCE OF THE WORN FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL C
SHAIL NOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBJECT TO THE
N WORNERS'COMPENSATION LAWS Of CALIFORNIA,AND AGREE THAT IF I SHOULD BECOME INSPECTION FEE
SU&IECT TO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 3700 OF THE LABOFi
CADE,I SHALL FORTHWITH COMPLY WITH THOSE PROVISIONS. ISSUANCE 7.O
SMIPpDATE:APPLICANT:
J WARNING:FAILURE 70 SECURE WORNERS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALLBE ENERGY P/C
SU&IECTANEMPLOVERTOCRIMINALPENALTIESANDCIVILFINESUPTOONEHUNDREDTHOUSAND ENERGYPERMITDOLLARS(f100,000).IN ADDITION TO THE COST OF CAMPENSATION,DAMAGES AS PHOVIDED FOR IN
SECTION 37oe OF THE LABOR CODE.IN7EREST,AND ATTORNEV'S FEES. RETENTION FEE: 1•
OCONSTRUCTION LENDING AGENCY PRE•ALT FEE:
1 HEREBY AFFIf1M UNDER PENALN OF PE0.IURV THAT THERE IS A CONSTRUCTION LENDING AGENCY
FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMI7 IS ISSUED(SEC.3087,CIV.C.).
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LENOER'S NAME
LENDER'SADDRE55
TOTAL FEES p•oICERTIFVTHATIHAVEREADTHISAPPLICATIONANDSTATETHATTHEABOVEINFORMATIONISCAHRECT.w 1 AGREE 70 CAMPLV WITH ALL CIiY AND COUNN ORDINANCES AND STATE LAWS REU7ING TO BUIL ING
CANSTRUCTION,ANDHEREBYAUTHORREREPRESENTATIVESOFTHISCOUNN70ENTERUPON7HE
ZABOVE MENTIONED PROPERTV FOR INSPECTION PURPOSES.
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COMMENTS
VN cliTSK'(
VERMITTEE P 6 6 D
sic OF PER DATE
RECPT.N0. PAID BY 2 VALIDATION2
WHITE—Department Copy,YELLOW inence Copy,PINK—Assessor Copy,GOLDENROD--File Copy,GREEN—Applicant's Copy
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OG9 pC C 400a DG14L Oa pf C 40a GyJ pC C 400W DLa4f Oa pI C 40a
SET BACK FLOOR JOIST
FTGS/FORMS/STEEL FHA REQMTS
ELECTRIC GROUND UNDER FLOOR DUCT
GROUND PLUMBING UNDER FLOOR CONDUIT
SLAB GRADE FIREPLACE FOUNDATION
TEMP POWER FIREPLACE BOND BEAM
WATER SERVICE MID HT. BOND BEAM
ROOF SHEATHING 8 FT. BOND BEAM
FRAMINGNENTILATION FINAL BOND BEAM
ROOF COVER PRE-GRADING
ROUGH HEATING BENCHING
ROUGH ELECTRIC ROUGH GRADING
ROUGH PLUMBING FINISH GRADING
SHOWER/TUB TEST POOL ELECTRIC
EXT. LATH/SIDING POOL FENCING
WALL INSULATION POOL FINAL
CEILING INSULATION OFF SITE IMPS.
DRYWALL NAILING DEDICATIONS
SEWER FINAL ENG.
SEPTIC TANK LANDSCAPE/IRRIG.
SEEP PIT/L.L. ON SITE IMPS.
GAS AIR TEST FINAL ZONING
FINAL CONST. FIRE DEPT. FINAL
FINAL HEATING HEALTH DEPT. FINAL
FINAL ELECTRIC DEV. FEES PAID
FINAL PLUMBING ENERGY
C o c
COMMENTS
SEPTIC TANK SIZE
SEEP PIT/U SIZE
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