HomeMy WebLinkAboutPR20190000715PERMIT If: PR20190000715
CITY OF DIAMOND BAR
COMMUNITY DEVELOPMENT DEPARTMENT
21910 Copley Drive, Diamond Bar, CA 91765
(909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027
DIAMOND BAR BUILDING PERMIT APPLICATION www.citvofdlamandbar.com building@diamondbarca.gov
JOB SITE ADDRESS: 22055 RUNNING BRANCH RD, DIAMOND BAR, CA 91765
APN 8714019028 LOT#
OWNER NAME MEIDE SHI &IIANHUA LI
TRACT#
ADDRESS 21055 RUNNING BRANCH RD
CITY DIAMOND BAR ZIP 9176S
APPLICANT NAME
TEL <NO PRIMARY PHONE>
TEL
CONTRACTOR NAME Frisch & Sons Inc
ADDRESS 2546 N Orangehill Lane
CITY Orange STATE CA
ZIP 92867 TEL (714) 282-0643
ARCH/ENG/DES NAME
ADDRESS
CITY STATE CA
ZIP TEL
P/C DATE
P/C#
ISSUE DATE 01 May 2019
PR# PR20190000715
TYPE CONSTRUCTION
OCCGROUP
SCOPE OF WORK Pool & Spa Demolition
#DWELL UNITS 0 #STORIES
#BEDROOMS
BUILDING FEES
DESCRIPTION
SO. FT
FACTOR PSF
ADJ AREA/VALUATION
SFR/ADD/REM
GARAGE/CARPORT
PATIO/DECK
POOL/SPA
RE -ROOF
COMMERCIAL
TOTAL VALUATION.
TOTAL-,
PLAN CHECK FEES
PERMIT FEES
CONSTRUCTION
$195 S3
PLAN REVIEW
ELECTRICAL
PLUMBING
MECHANICAL
INSPECTION FEE
ISSUANCE
$45 02
SMIP
$0 72
ENERGY
RETENTION FEE
$9 78
PRE/ALT FEE
BASF
$1 00
PLOT PLAN
ZONING CLEARANCE
RECYCLING AND WASTE DEPOSIT
PERMIT SYSTEM REPLACMENT FEE
$7 82
TOTAL FEES:
$259 87
COMMENTS
P/C RECEIPT #
PAY METHOD VALIDATION
PERMIT RECEIPT # 44380
PAY METHOD Check # 1636 VALIDATION
PERMIT #: PR20190OV71S
rA � ,101 T
r r•�
INSPECTIONt
SETBAGitf LETTER
O`
- TRACK AND LEDGER
O`
FOOTINGS FORMS
T-BAR
.SLAB
POOL DEMOLITION
�lOj.ES
tr+ .f3�s
UG PLUMBING
ROOF DRAINS
L
UG ELECTRICAL
POtT
UFER GROUND
GASTEST, EL, PC ME
SEWER LATERAL
PREGUNITE
SEWER CLEANOUT
POOL PRE DECA RONDLNES
MAIN WATER LINE
P-TRAP
ROOF SHEATHING
FENCE/GATE/ALARM
FLOOR SHEATHING
FINAL POOL
SHEAR WAILS EXTERIOR
WALLS
SHEAR WALLS INTERIOR
WALL FOOTING/STEEL
FRAMLNG}VENTING
WALL STEEL 1ST(} IND(} LIFT
RO MECHANICAL
WALLDRAINfSEAL
RO ELECTRICALW() CO
WALLFINAL
RO PLUMBING
RO FRAMING PLANNING
APPROVAL
INSULATION WALL
ROUGH NREAPPROVAL
INSULATION CEILING
FINAL FIRE DEPARTMENT
HOT MOP(SHOWERPAN
FINAL PLANNING
DRYWALL
FINAL PIN ENGINEERING
LATH EXTERIOR
FINAL PW MAINTENANCE
LATH INTERIOR
FINAL HEALTH DEPT.
GAS TEST
FINAL INDUSTRIAL WASTE
SCRATCH COAT
PMAL BUILDING
112
J
ELECTRIC METER RELEASE
- FWAL MECHANICAL
GAS METER RELEASE
PANALELECTBR'AL
SPECIAL INSPECTION
FINAL PLUMBING
SMOKE IS, CARBON
MONOXIDE DETECTORS
T C OF OCCUPANCY
CERT OF OCCUPANCY
COMMENTS
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PERMIT It: PR201900D0715
OWNER UILDER DECLARATION
I hereby irm under penalty of perjury that I am exempt from the Contractor's State License Law for the reason(s) indicated
below by t e checkmark(s) I have placed next to the applicable item(s) [Section 70315, Business and Professions Code• 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
Contractors' 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 forthe alleged exemption Any violation of Section 70315 by any
applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500) )
(_) I as owner of the property, or my employees with wages as their sole compensation, will do (J all of or (_) portions 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 budding or improvement Is
sold within one year of completion, the Owner -Budder will have the burden of proving that it was not built or improved for
the purpose of sale )
(_)1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044,
Business and Professions Code The Contractors' State License Law does not apply to an owner of property who builds or
improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License
Law )
(_j I am exempt from licensure under the Contractor's State License law for the following reason(s)
By my signature below I acknowledge that, except 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, I cannot legally sell a structure that I have built as
owner -builder tf it has not been constructed in its entirety by licensed 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
fi wing Web srte* http/www leginfo ca gov/calaw html
SIGNATURE OF PROPERTY OWNER OR AUTHORIZED AGENT DATE
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, and my license is in full force and effect
LICENSE CLASS A, B LICENSE NUMBER 696810
EXPIRATION DATE CONTRACTOR SIGNATURE
WORKERS' COMPENSATION DECLARATION:
WARNING FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL 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 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES
I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS
I have and will maintain a certificate of consent to self -Insure for workers' compensation, issued by the
Director of industrial Relations as provided for by Section 3700 of the Labor Code, for the performance of the
work for which this permit is issued
I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for
the performance of the work for which this permit is issued My workers' compensation insurance carver and
policy number are
CARRIER State Compensation Insurance POLICY #* EXPIRATION DATE
Fund
NAME OF AGENT 9040338 PHONE #,
I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as 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 370D of the Labor Code, I shall forthwith comply with those provisions
SIGNATURE OF APPLICANT DATE
DECLARATION REGARDING 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 (Section 8172, Civil Code)
LENDER'S NAME
LENDER'S ADDRESS
By my signature below, I certify to each of the following
I am the property owner or authorized to act on the property owners behalf
I have read this application and the information I have provided is correct
I agree to comply with all applicable city and county ordinances and state laws relating to bw nstr n
I authorize representatives of the City of Diamond Bar to enter the above -identified prope f spec urp e
SIGNATUREOF ROP PITY OWNER OR AUTHORIZED AGENT Robert Frisch
DATE (jS O / i