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Home My WebLink About15-0346DIAMOND BAR CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 BUILDING PERMIT APPLICATION JOB SITE ADDRESS 2 3% APN LOT TRACT OWNERI IA 1--j1--j^ S, � N n%Cv EO X� ADDRESS2 3f -- ✓ �i n L d pi Zj2r./ CITY S % 7 ZIP APPLICANT TEL. CONTRACTOR G J YAC v b t�1 \ c1 ti ADDRESS CITY ZIP TEL. ARCH/ENG/DESIGNER ADDRES ZIP TEL. OWNER -BUILDER DECLARATION 1 r "'.penalty of perjury that I am exempt from the Contractor's State License Law for the reason(s) indicated elow the checkmark(s), I have placed next to the applicable item(s) [Section 7031.5, Business and Professi Co e: Any city or county that requires a permit to construct, alter, improve, demolish, or repair, any structure, prio to Its issuance, also requires the applicant for the permit to Tile a signed statement that he or she is licensed pu ant 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 1, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U 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 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' 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.). () 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 r , ca t legally se a a built as an owner -builder if it has not been raa mtstrtlire ractors. I ers at a cop he applicable law, Section 7044 of the Business and Professions Code is vai ab p request s plic n is submitted or at the folio eb si : http/ w.leginfc.ca.gov/calaw.htis ATE: SIGN: L]Lit:NbtUt;uNiKAuiOR'SEIrCLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (col n7iwithSection 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. LICENSE CLASS: LIC. NO.: DATE: CONTRACTOR: WORKER'S COMPENSATION DECLARATION 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 Worker's Compensation, as provided by Section 3700 of the Labor Cade, for the performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as required by Section 3700 of the Labor Code, 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 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 Worker's Compensation Laws of California. And agree that'rf I should become subject to the Worker's Compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. DATE: APPLICANT: WARNING: Failure to secure Worker's 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 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 certity 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 building construction, and hereby authorize representatives of this county to enter upon tit mentioned propp for inspection purposes. NAME7PRI I / NATURE OF PE DATE am PRESS FIRMLY APPLICATION DATE: "_� ) I C 1% S P/C# V-Xv, \S^-34, 1 ISSUE DATE: ,?/"Q/ aZO%(_ PERMIT# /%r- 101 7 6 TYPE CONST. OCC GROUP: ZONING SETBACKS FRONT REAR SIDE/SIDE STREET SIDE RW ❑ ❑ RW ❑ ❑ PROPOSED USE # DWEL. UNITS # STORIES DESCRIPTION MKIIIIIII64OCIArUATION SFFVADD/REM #BED O rn U, Garage/Carport Patio/Deck LL Pool/Spa ZRe m -Roof Commercial Valuation: �o les Adj. Area: QUANTITY DESCRIPTION FEE J U cc H U w CD J d J U Z U w CONSTRUCTION: PLAN REVIEW: O lv S 9 V- C ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMTP: a 64 ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: BSAF: TOTAL FEES a®1 aeil,. COMMENTS: �7 'tF oV k cora?\c IT= LoI� RECEIPT # �-� � PAID BY: V 7f VALIDATION: WHITE — Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy, GOLDENROD — File Copy, GREEN —Applicant's Copy ,UFER GROUND ' SEWER LATERAL MAIN WATER LINE A- A SEWER CLEANOUT ROOF SHEATHING , FLOOR SHEAT SFIEAR,W I SHEAR WALLS INTEN101 t ,FRAMINGNEN' •'" ,:a RQUGH MECH` . x ROUGHELECRIGAL�W(. ).0 (& flt CITY OF DIAMOND BAR INSPECTION RECORD Rf l lf;H PI I.IMfW%AWWAk J611MM INSULATION INSULATION DRYWALL LATH (PRE) LATH EXTERIOR LATH INTERIOR GAS TEST SCRATCH COAT ELECTRIC METER RELEASE GAS METER RELEASE SPECIAL INSPECTION �� FINN BUIL'D'ING '1� ' It f. � 7 .� COMMENTS TRACTAND LEDGER SWITCH GEAR COMMERCIAL HOOD T -BAR INTERCEPTER HOT MOP/SHOWERPAN SEPTIC/CESSPOOL HERS REPORT RECEIVED DEMOLITION ROOF DRAINS ROUGH CONDUIT POOUSPA ROUGH PLUMBING F ROUGH ELECTRICAL r . ROUGH MECHANICAL GAS TEST PRE GUNITE POOL PRE DECK BONDING �E P -TRAP FENCE / GATE/ ALARM FINAL POOL WALLS: WALL FOOTING/STEEL WALL STEEL 1sT( ) 2NO( ) LIFT WALL BOND BEAM WALL DRAIN/ SEAL WALL FINAL N0. FRAMING PLANNING APPROVAL - v ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT FINAL PLANNING FINAL ENGINEERING/ PW 1 FINAL COMMUNITY SERVICES FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE ,