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Home My WebLink About14976 (880)CITY OF DIAMOND BAR COMMUNITY DEVELOPMENT DEPARTMENT 21660 E. Copley Drive Suite 190 (909) 860-3195 Fax (909) 661-3117 BUILDING PERMIT APPLICATION JOBSITE ADDRESS 2893 VISTA COURT APN LOT 19 TRACT 47850 OWNER DIAMOND BAR WEST, LLC ADDRESSS 80 TORRANCE BLVD., SUITE 30 CITY TORRANCE zip 90503 TEL. APPLICANT TEL, CONTRACTOR JCC CONSTRUCTION ADDRESS same as above CITY ZIP TEL. ARCFVENG/ DESIGNER ADDRESS CITY ZIP TEL. OWNER-BLALDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM EXEMPT FROM THE CONTRACTORS LH CENSE LAW FOR THE FOLLOWING REASON (SEC. 7031.5 BUSINESSAND PROFESSIONS CODE: ANY CrrYOR COUNTY WHICH REQUIRESAPERMITTO CONSTRUCT,ALTEFL IMPROVE, DEMOLISH, OR REPAIRANY STRUC- TURE. PRIOR TO ITS ISSUANCE, ALSO REWIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED STATEMENT THAT HE OR SHE IS LICENSED PURSUANT 70 THE PROVISIONS OF THE CONTRACTORS LI- CENSE LAW (CHAPTER B (COMMENCING WITH SECTION IWC) OF DIVISION 3 O THE BUSINESS AND PRO- FESSIONS CODE) OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED EXEMP. TION. 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).): ❑ 1. AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (SEC. 7044, BUSI- NESS AND PROFESSIONS OOOE: THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF PROPERTY WHO BUILDS OR IMPROVES THEREON, AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR THROUGH HIS OR HEROWN EMPLOYEES. PROVIDED THATSUCH IMPROVEMENTS ARE NOT INTENDEDOR OFFERED FOR SALE. IF, HOWEVER THE BUILDING OR IMPROVEMENT IS SOLD WITHIN ONE YEAR OFCOMPLE- TIXN, THE OWNER -BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE). ❑ 1. AS OWNER OF THE PROPERTY. AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEC. 7044, BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS LI- CENSE LAW DOES NOT APPLY TO AN OWNER OF A PROPERTY WHO BUILDS OR IMPROVES THEREON, AND WHO CONTRACTS FOR SUCH PROJECTS WITH A CONTRACTORIS) LICENSED PURSUANT TO THE CONTRAC- TORS LICENSE LAW.). 111 AM EXEMPT UNDER SEC. B. & D.C. FOR THIS REASON DATE OWNER LICENSED CONTRACTORS DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER B (COMMENCING WITH SECTION 70W) OF DIVISION 3 O THE BUSINESS AND PROFESSIONS CODE, AND MY LICENSE IS IN FULL FORCE AND EFFECT. LICENSE CLASS B LIC.No. 671982 DATE CONTRACTOR JCC CONSTRUCTT WORKERS' COMPENSATION DECLARATION' 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: I HAVE AND WILL MAINTAIN CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS' COMPENSATION. AS PROVIDED BY SECTION 37M OF THE LABOR CODE. FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT 15 ISSUED. _I HAVE AND WILL MAINTAIN WORKERS' COMPENSATION INSURANCE. AS REQUIRED BY SECTION 5700 OF THE LABOR CODE. FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. MY WORKERS' COMPENSATION INSURANCE CARRIER AND POLICY NUMBER ARE: QA,R,ER SUPERIOR NATIONAL INSURANCE COMP W POLICYNUMBER DN 60738A (RIB SECTION NE® NOTBE COMPLETED OFTHE PER ITISFORONE HUNDRED DOLLARS(SIM)OR LESS) 1 CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT 13 ISSUED, I SHALL NOT EMPLOY ANY PERSON IN ANY MANNER BOAS TO BECOME SUBJECT TO THE WORKERS' COMPENSATION LAWS OF CALIFORNIA, AND AGREE THAT IF I SHOULD BECOME SUBJECT TO THE WORKERS' COMPENSATION PROVISIONS OF SECTION 37000E THE LABOR CODE. I SHALL FORTHWITH COMPLY WITH THOSE PROVISIONS. DATE: APPLICANT. WARNING: FALURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL BE SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100.000). IN ADDITION TO THE COST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS ACONSTRUCTION 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 CIN 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. i NDR.r-/ fi 1VASN`-,;rPw77CIPI P TTEE mMilv- -5 I ZoG•ZJ '914NATURE OF PERMITTEE DATE O PRESS FIRMLY 4 APPLICAT 3 PERMIT P/C a DATE NUMBER # ISSUE TYPE OCC DATE CONST. GROUP ZONING SETBACKS . FRONT RW REAR 0- SIDE/SIDE STREET RW ❑ SIDE ❑ PROPOSED USE NEW SINGLE FAMILY RESIDENCE NO. DWEL. 1 NO. 2 NO. UNITS STORIES BEDROOMS _ DESCRIPTION SO. FT. FACTOR PSF ADJ. AREA&ALUATION SFR/ADD/REM 4.591 If Garage/Carport 700.5 s f W Patic/Deck 144 f .Gd LL. Poovspa 0 Z Re -Roos 0 Comrmrcial PORCH 142 If Q Valuation ADJ.AREA QUANTITY DE CRIPTION ar FEE J Q U FIL U W W Z Z_ m tiff CITY OF Dl _j r Bt ILD]N U_ Z Q 2 U LU a a -5p CONSTRUCTION , PLAN REVIEW ELECTRIC 3 PLUMBING soa - C/o MECHANICAL INSPECTION FEE ISSUANCE SMIP If 1 / 60 ENERGY PIC six ENERGY PERMIT RETENTION FEE: PRE -ALT FEE: TOTAL FEES r1 COMMENTS RECPT. NO. PAID BY 1 f VALIDATION Turn 1 e epanment copy, TeLL-uvv—rinanCe t;opy, VINK—Assessor Copy, GOLDENROD—File Copy, GREEN—Applicant's Copy