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Home My WebLink AboutPR 16-463CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY&DEVELOPMENT SE iVICES U` - c 21810 Copley Drive,Diamond Bar,CA 91765 PRESS 909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 FIRMLYBUILDINGPERMITAPPLICATIONwww.cityofdiamondbar.com building@diamondbarca.gov w G l APPLICATION DATE: a 5 e P/C# P (o 4Fc J a JOB SITE ADDRESS i.' I . • • o APN TR ISSUE DATE: a I I,SuPERMIT#: PCZ o - 4 03 N OWNER TYPE CONST. OCC GROUP: ADQ a CITY ZI TE A C o APPLICANT TEL. Scope of Work r . o CONTRACTOR ADDRE DWEL.UNITS STORIES BEDROOMS o CITY P C'TEL o ARCH/ENG/ z DESIGNER DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION ADDRESS SFR/ADD/REM m CITY ZIP TEL. Garage/Carport a Patio/DeckccOWNEN-BUILDER DECLAl1ATI0N w oI hereby affirm untler penalty of perjury that am ezempt from the Contractor's State License Law for the reason(s) LL PooVSpa o indicated below by the checkmark(s,I have placed next to the applicable item(s)[Section 7031.5,Business and w Professions Code:Any city or county that requires a permit to construct,alter,improve,demolish,or repair,any Z Re-Roof N structure,prior to its issuance,also requires the applicant for the pertnit to file a signetl statement that he or she Commercial is licensed pursuant W the provisions of the CanVactar's State License Law(Chapter 9)Cammencing with Section N 7000 of Oivision 3 of the Business and Professions Cade]or that he or she is exempt from licensure and the basis for m N the alleged exemption.My violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalry 0 of not more than five huntlred dollars($500. I,as owner of the property,ar my employees with wages as their sole compensatian,wili do(J all of or(J portions Z of the wark,antl the structure is not intentled or offeretl tor sale(Section 7044,Business and Professions Code:The Va/Yafion:U Adj.Area: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 QUANTITY D SCRIPTJON FEEpimprovementissoldwithinoneyearofcompletion,the Owner-Builder will have the burden ot proving that it was not built or improvetl for the purpose of sale.. Z (I,as owner of the properry,am exclusively contracting with licensed Contractors to construct the project(Section ` N 7044,Business and Professions Code:The Contractors'State License Law does not apply to an owner of property who obuiltls or improves Nereon,and who contracts for the projects with a licensed Contractor pursuant to the Contractors'Sfate License Law.). w I am exempt 6om licensure under the Comractor's State License law tor the following reason(s):LL zIZm O By my signature below I acknowledge that,ezcept 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 a I a owner-builder if it has not been constructed in its entirery by licensed contractors.I understand that a copy of the i w applicable law,Section 7044 of the Business and Professions Code is available upon request when this application is o submittetl or at the following Web site:http/www.leginfo.ca.gov/calaw.html. c~j LICENSED CONTRACTOR'S OECLAflATION x m 1 hereby affirm under penalty of perjury that I am licensetl under provisions of Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code,antl my license is in full force and effect. wV} Q LICENSE C LIC.NO.:_(]_ CONSTRUCTION:__ p , j 'DATE:CONTRACTOR:/ ,X__ p , C WOHKEN'S COMPENSATION DECLARATION P N REVIEW:_g I HEREBY AFFIRM UNDER PENAL7Y OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: ELECTRIC: __ g o I have and will maintain a Certificate of Consent to Self-Insure for Worker's Compensation,as provided by PLUMBING:Section 3700 of the Labor Code,for the pertormance of the work for which this permit is issued. MECHANICAL:p I have antl will maintain Worker's Compensation Insurance,as required by Section 3700 of the Labor Code,for a the pertormance ot the work for which this permit is is d.My Worker' Compensation Insurance Carrier antl INSPECTION FEE: o Policy Number are: 1 w CnRRIER O. ISSUANCE:1\, a$z POLICYNUMBER SMIP: S L' $ N TFiIS SECiION NEED NOT BE COMPLE ED IF THE PERMR IS FOR ONE HUNDRED DOIlARS($100)OR LESS. ENERGY P/C: p I certify that in me perfortnance of ihe work for which this rmit is issuetl,I shall notpe ployanypersoninanymannerso to ENERGYPERMIT:o become subj to th Worker's Compe lifomia.M gree that i I ould become subject to the Worker's J Compensatio i of Section 37 of ihe Labor Code, I fo ith co ply 't those provisions. RET'ENTION FEE:o. O'O DnTE: APPLICnNr: PRE-ALT FEE: WARNING:Failure to secure Worker's Compensation coverage is un avrful,and shall subject an employer to criminal gASF:a. penalties and civil fines up to one huntlred thousantl dollars($100,000),in addition to the cost of the compensation, p damages as provitled for in section 3708 of the labor code,interest,antl attorney's fees. PLOT PLAN: CONSTRUCTION LENDING AGENCY ZONING CLEARANCE:w I hereby affirm under penalty af perjury that there is a Construction Lending Agency for the performance of the work for which ihis permit is issued(Sec.3097,Civ.C..3 LEN ER'S NAME: wLENDER'SADDRESS: TOTAL FEES S, a, a o I certity that I have reatl this application and state that the above information is correct.I agree to compty with all city andZcountyordinancesandstatelawsrelatingtobuiltlingconstruction,antl hereby authorize representatives of this county to COMMENTS: p enter upon the abo E-men'Dned operty t fips ection purposes. m N `ERMITfEE NAM (PRI P/C: PAID BY: VALIDATION: N V RECEIPT# 1 /0 PAIDBY: VALIDATION:_ F SIGNATURE OF PERMITTEE DATE WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy C1iT'Y GF G,h9+ntdD BAR iNSFECTION REGORD 4 ; i i y SETBACK/LETTER TRACT AND LEDGER FOOTINGS FORMS SWITCN GEAR SEAB GOMMERC(AL HOOD UG.PLUMBIN T-BAR UG.ELEGTRIGAL lNTERGEPTER UFER GROUND HOT MOP/SHOWERPAN SEWER LATERAL SEPTIC/CES5POOL MAIN WATER LINE HERS REPORT RECEIVED SEWER CLEANOUT DEMOLITION ROOF SHEATHING R00 DRAiNS FLOOR SHEATH{NG ROUGH CQNDt11T SHEAR WALLS EXTEREOR PQOUSPA SHEAR WAL S INTERIOR RQUGN PLUMBING FRAMlNG/VENTING ROUGH ELECTRICAL ROUGH MECHANICAL ROUGH MECHANICAL ROUGH ELFCTRICAL W( )CO GAS TEST ROUGH PLUMBING PRE GUNITE INSULATION WALL POdL PRE DECK SONDING INSULATION CEItiNG P-7RAP d- fENGE t GATEI ALARM LATH(PRE}FINAI P00 t LATH EXTERIQR WALIS: lATH lNTERlOR WALL FOOTING/STEEL GAS TEST WALL STEEL 1sT( )2"0( )LIFf SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELEASE n / / WALL DRAIN/SEAL GAS METER RELEASE WALL FINAL SPECIAL INSPECTION R0.FRAMIN PLANNING APPROVAL F1NAL BUILDiNG L ,`r R0t1GH FIRE RPPROVAL FINAL MECNANICAL FINAL FlRE DEPARTMENT FINAL ELEGTRIGAL FINAL PLANNlNG FINAL PWMBlNG FINAL ENGINEERING/PW T.C.of OCCUPANCY FINAL COMMUNITY SERVICES CERT.pf OGCUPANCY FINAL HEAI.TH DEPT. FtNAL INDUSTRIAL WASTE COMMENTS: