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Home My WebLink About16-0811 "� �r�"� CITY OF DIAMOND BAR � v I I � IG DEPARTMENT OF COMMUNITY& DE�OPMENT SERVICES ��D I ;' - 21810 Copley Drive,Diamond Bar,CA 91765 PRESS (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 FIRMLY � �a"'� BUILDING PERMITAPPLICATION www.cityofdiamondbaccom building@diamondbarca.gov � /� w /� ��S ,/�' � �L� APPLICATION DATE: P/C# a JOB SITE ADDRESS �v 1 / �y�^ � APN LOT TRACT ISSUE DATE: �PERMIT#: I(n �CfC7/� 0 � OWNER TYPE CONST. OCC GROUP: _� ADDRESS c/ ¢ CITY .�iA mC711�f ' qi) �e�. D �a Scope of Work � 0 2 �� o APPLICANT T!✓Nl�M� '�OL7�FfNTEL. '7 U —�y0�I ¢ CONTRACTOR S j}} I•�£S( (� � ADDRESS Jr�7� I�I�EST f1J S/ C IL � �— #DWEL.UNITS #STORIES #BEDROOMS o CITY�/ �/��'��TEL 2— " ARCH/ENG/T p z DESIGNER�/�SS S J I�U��U�� IA�EC� � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION ZADDRESS 3 �W L SFR/ADD/REM m CITY CQZ��}m�Sj`F ZIP� e�. 29 Garage/Carport ¢ Patio/Deck � � OWNEH-BUILDEH DECLAHAiION � w oI hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the reason�s) � PooVSpa w intlicated below by the checkmark(s�,I have placed neM to the applicable item(s)[Section 7031.5,Business and � z Professions Code:Any city or county that requires a permit to conshuct,alter,improve,demolish,or repair,any Z Re-Roof � structure,prior to its issuance,also requires the applicant for the permit M file a signed statement that he or she � Commercial � is licensed pursuant to the provisions of the Contractor's State License Law(Chapter 9)Commencing with Section � N 7000 of Division 3 of the Business and Professions Cade]or that he or she is exempt from licensure and the basis for m � the allegetl exemption.My violation of Section 7037.5 by any applicant for a permit subjects the applicant to a civil penalry 0 of not more than five hundred dollars($500). � (J I,as owner of the property,or my employees with wages as their sole compensation,will do(J all of or(_J portions Z of the work,and the structure is not intended or offered for sale(Section 7044,Business and Professions Code:The Va/u�fiOn' Adj.Area: � � Contracrors'Sfate License Law does not appty to an owner of property who,through employees'or personal effort,builds por impraves the property,providetl that the improvements are not intended or offered for sale.If however,the builtling or QUANTIIY DESCRIPTION FEE improvement is sold within one year of completion,the Owner-Builder will have the burtlen of proving that it was not built For improved for the purpose of sale.). � Z as owner of the property,am exclusively contracting with licensed Cantractors to construct the project(Section � � 7 44,Business and Professions Code:The Contractors'State License Law does not apply to an owner ot property who � Y builds or improves thereon,antl who contracts for the projecis with a licensed Contracror pursuant to the ConVactors'State � o License Law.�. w � (�I am exempt from licensure under the Contractor's State License law for the following reason(s): LL � Z Z m � By my signature below I acknowledge that,except for my personal residence in which I must have resided for at least one = Q year prior to completion of the improvements covered by this permit,l cannot legally sell a structure that 1 have built as an a a owner-builder if it has not been constructed in its entirery by licensed contractors.I understantl that a copy of the W applirable law,Section 7044 of the Business and Professions Cotle 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 CONTFiACTOfl'S DECLAflATION � x � I hereby affirm under penalty of perjury that I am licensetl under provisions of Chapter 9(commencing with Section 7000) � Nof Division 3 of the Business and Professions Cotle,and my license is in tull force and effect. N LICENSE CLA�SS`�� V ��.No.: � Ufl4�6 7 � CONSTRUCTION: C17+��}- (p� ¢ DATE: G/�T� CONTRACTOR: �i�u?J��,�/�CT �r�IUSDLa-rU p � � WONKEH'S COMPENSATION DECUIRATION PLAN REVIEW: �`7 . S� Q I H �y,AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: ELECTRIC: � � �I have and will maintain a Certificate of Consent to Self-Insure for Worker's Compensation,as provided by PLUMBING: ��j� � Section 3700 of the Labor Cotle,for the performance of the work for which this permit is issued. MECHANICAL: Z I have and will maintain Worker's Compensation�nsurance,as required by Section 3700 oi the Labor Cade,for ¢ the performance of the work for which this permit is issuetl.My Worker's Compensation Insurance Carrier and INSPECTION FEE: Policy Number are: ' Z CARRIER �t��t� �U�v i ISSUANCE: � �a�, N POLICYNUMBER ��Z � Z ' SMIP: _� Q ,8 � (IHIS SECTION NEED NOT BE COMPLETED IF 7HE PE MfT IS FOR ONE HUNDRED DOLLARS($100)OR LESS). ENERGY P/C: p I certify that in Ne perfortnance of fhe work for whi is permit is issued,I shall not employ any person in any manner so�to ENERGY PERM IT: o become subject to the Worker's Compensation f Califomia. d agr that if I should become subject to the Worker's J Compensati pr i ions of Section 3700 of m otle,I all o ' mply with those provision ' REfENTION FEE: l+(a , d0 � oA7E. APPLICANT: PRE-ALT FEE: � WARNI .Fai re to secure Worker's C pens�ion coverage is unlawful,and shall subject an employer to criminal gASF: 1. �� w� penalties and civil fines up to one hund d tho and dollars($100,000),in addition to the cost of Ne compensation, p damages as provided for in section 3708 of the 1 or code,interest,and attomey's fees. PLOT PLAN: ¢ a CONS HUCTION LENOING AGENCY ZONING CLEARANCE: = I hereby affirm under penalty of perjury that there is a Construction Lentling Agency for the performance of the work for � which this permit is issued(Sec.3097,Civ.C.�. � LENDER'S NAME: � � LENDER'SADDRESS: TOTAL FEES �� w a I certify that I have reatl this application and state that the above information is correct.I agree to comply with all city and Z county ordinances antl state laws relating to building construction,and hereby authorize representatives of this county to COMMENTS: o enter upon the above-mentioned property for inspection purposes. m /Y1 a PERMITf AME(Pfll P/C: PAID BY: VALIDATION: N � _ RECEIPT ri � PAID B � VALIDATION: � SIGNATURE OF P ITTEE DATE WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy CtTY fJF DiA`�tJ10ND BAR u,: _, �l :. �-, �� INSP�iE�1T�N RECORD � . � � , � � � � i t « ! SETBACK/LETTER TRACT AND LEDGER FOOTlNGS FORMS SWITCN GEAR S�g GOMMERCIAL NOQD UG.PLUMBING T-BAR UG.ELECTRICAL INTEf3CEPTER UFER GR4UND HOT MOP/SHOWERPAN SEWER LATERAL SEPTIC/CESSPOOL MAIN WATER LINE HERS REPORT RECEIVED SEWER CLEANOUT DEMOliTION ROOF SHEATNIN6 ROOF DRAINS FLOOR SHEATHiNG ROUGH CaNDt11T SHEAR WALLS EXTERIOR POOUSPA SHFAR WALIS INTERIQR RQUGH PLUMBIN6 FRAMlNGNENTING ROUGH ELEGTRICAL RQUGH MECHANICAL ROUGH MEGHANICAL ROUGH ELECTRICAL W( )CO GAS TEST ROUGH PLUMBING PRE GUNITE INSULATION WALL POOL PRE DECK BONDING INSULATION CEILING P-TRAP DRYWALL FENCE 1 GATE/AIARM IATH(PRE) FINAL P00� tATN EXTERI4R WALLS: LATH INTERIOR WALL FQOTING/STEEL GAS TEST WALL STEEL 1ST( )2"0( )LI� SCRATCH COAT WALL BONQ BEAM ELECTRIC METER RELEASE / WALL DRAIN/SEAL GAS METER RElEASE WALL F1NAL SPECIAL INSPECTION R0.FRAMIN6 PL�WNING APFROVAL FINAL BUtLOtNG ROUGH FIRE APPROVAI. FINRI MECNANICAL FINAL FlRE DEPAR7MENT FINAL ELEC7RIGAL f FINAL PLANNING FINAL PLUMBING FlNAL ENGINEERING!PW T.C.•of pCCUPANCY FINAL COMMUNITY SERVICES CERT.of OCCUPANCY FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE COMMENTS: _ -. {P/ease fil! out anc� tear off this portian to le�ve with tite jola card if no one will be �vailable �o allov►r the inspecfor inside the house.) ., ; . ,,. INSTALLATION CERTlFICATION For the property located at �[�tU `}��('��(�� , i hereby certify that #he required smoke a{arms and carbon monoxide alarms have be mstalied as listed above. (/� � �ENNe.'fV► �UUa7� b I� I Cl _ Signature Print Nam Date Re{ationship to project(piease check one}: o Owner o Agent for Owner ❑ Licensed Contractor �Agent for Licensed Contractar (f"Licensed antractor" or"Agent far Licensed Contractor" is checked, please campiete the following: _�^._._ Ic��6`� Gontractor Contracta�s State License Number �