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Home My WebLink AboutPR17-17227CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 PRESS i (909) 839-7020 Fax: (909) 841-3117 Building Inspection Hotline (909) 839-7027 FIRMLY BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@diamondbarca.gov JOB SITE ADDRESS " n `l APN LOT TRACT OWNER E ADDRESS CITY ZIP TEL. APPLICANT + r TEL. CONTRACTOR ADDRESS CITY ZIPTEL. ARCH/ENG/ DESIGNER ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the reasons) indicated below by the checkmark(s), I have placed next to the applicable items) [Section 7031.5, Business and Professions Cade: Any city or county that requires a permit to construct, alter, improve, demolish, or repair, any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law {Chapter 9) Commencing with Section 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. 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). U I, as owner of the property, or my employees with wages as their sale compensation, will do U all otor U pardons of the work, and the structure Is not intended or offered for sale (Section 7044, Business and Professions Code, The 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 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.). (_) I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' Stale License Law does nut apply in an owner of property who builds or Improves thereon, and who contracts for the projects wilh a licensed Contractor pursuant to the Contractors' Stale License Law.). Q I am exemptfrom licensure under the Contractor's State License law for the following reasoni Date,_ Sign: By my signature below I acknowledge that, exceptlor my personal residence In which! must have resided for at least one year prier to completion of the Improvements covered by this perni cannot legally sell a structure that I have built as an owner -bulkier if 11 has not been constructed In its entirety by llcensed contractors I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code Is available upon request when this application is submitted or at the following Web site: htp/www.leglnfo.ca.gavlcalaw.html. LICENSED CONTRACTOR'S DECLARATION I hereby afflrm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sect€on 7000) of Division 3 of the Business and Protesslons Code, and my,, license Is In full farce and effect. 21 LICENSE CLASS: t— LIC. INC.: C1 EXP. DATE: CONTRACTOR: kA WORKER'S COMPENSATION DECLARATION ` 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: I have and will maintain a Cartificate of Consent to Self -insure for Worker`s Compensation, as provided by Section 3700 of the Labor Code, for the performance ofthe work for which this permit is issued. have and will maintain Worker's Compensation Insurance, as required by Section 3700 of the Labor Cade, for the performance of the work for which this permit is issued My Worker's Compensation Insurance Carrier and Policy Number are: CARRIER POLICY NUMBER (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS $100 OR LESS), I certifythat in the performance of She work forwhlch this permit Is issued, I shall not employ any person In any manner so as to become subject to the Worker's Compensation Laws of California. And agree that If I should became subject to the Worker's Compensation provisions of Section 370C of the Labor Code, I shall folhwlth complywith those provisions, DATE: APPLICANT: WARNING: Failure to secure Worker's Compensation coverage is unlawful, and shall subject an employer to crlminal penalties and olv11 fines up to one hundred thousand dollars ($100,000), in addition to the cast of the compensation, damages as provided for In section 3708 of the labor code, Interest, and attorney's fees CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a Construction 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 city and county ordinances and state laws relating to bullding construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspectlom purposes. PERMITTEE NAME { IN SIGNATURE OE PER ATE APPLICATION DATE: •Z r/_IJ P/C# ISSUE DATE: If ig ZI PERMIT# : i _ ' Z TYPE CONST. OCC GROUP: Scope of Work # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport Lo Patio/Deck Lu LL Poof/Spa zRe -Roof Commercial m Valuation: Adj. Area: QUANTITY DESCRIPTION FEE ca v J w z a z x U CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMTP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: 9 PRE -ALT FEE: BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES 263.31 COMMENTS: P/C: PAID BY: VALIDATION: RECEIPTA 3 68, PAIDBY:,"'2 VALIDATION: WHITE— Department Copy, YELLOW -- Finance Copy, PINK— Assessor Copy CITY OF DIAMOND BAR INSPECTION FINAL INNSTRIAL WASTE COMMENIVI a 000 TRACT ANI) LLDGI_R SWITCH GEAR G OMMEACIAL I IOOD M311MUMM SETBACK/ LEITER FOOTINGS FORMS SLAB UG. PLUMBING T -BAR IN IERCEP I kR 1101 MOPISHOWERPAN SI"i'T ICICFSSPOOL HERS RUPOTIT RECEIVED DE-MOUTION ROOF F)RAINS UG. ELECTRICAL UFER GROUND - - - - .._...... _ F - ... .... _..._...._._._ SEWFFR I ATERAL MAIN WATER LINE SF.WFR CLEANOUT ROOFS SHEATHING FLOOR SHEATHING ROUGI I CONDUIT SHEAR WALLS EXTERIOR SHEAR WALLS INTERIORHOUGH POOL/SPA PLUMBING - ROUGH ELECTRICAL - FRAMINGNENTING ROUGH MECHANICAL ROUGH MECHANICAL GAS TEST ROUGH ELECTRICAL W( }C ) ROUGH PLUMBING INSULATION WALL INSULATION CEILINGP-TRAP DRYWALL LATH (PRE) LATH EXTERICR PRE GUNITE POOL PRE DECK BONDING FENCE / GATE/ ALARM FINAL POOL WALLS: LATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL is-'( ) 2`0( ) LIFT SCRATCH GOAI WALL BOND BEAM ELECTRIL: MFIEll RELEASE WALL DRAIN/SEAL WALL FINAL GAS MFT1:F1 I ISLE ASE SPL( IAL INSPECTION RO. FRAMING PLANNINGAPPROVAL FINAL BUILDING ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT FINAL MECHANICAL FINAL ELECTRICAL FINAL PLUMBING FINAL PLANNING FINAL ENGINEERING/ RING/ PW T,C. 4T OCCUPANCY CERT, of OCCUPANCY FiNAT COI 9MUNITY SERVICES FINAL HEALTH DEPT, FINAL INNSTRIAL WASTE COMMENIVI a