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Home My WebLink About15-1912 , ' � -� CITY OF DIAMOND BAR � a ��/� ? I I i 1. DEPARTMENT OF COMMli�1TY&'DEVELOPMENT SERVICES 21810 Copley Drive,Diamond Bar,CA 91765 PRESS ' ,.� (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 FIRMLY ��'�"'� BUiLDING PERMiT APPLICATION www.cityofdiamondbar.com building@diamondbarca.gov C w JOB SITE ADDRESS I�� l./� APPIICATION DATE: $�13�1 S P/C# �S-i 9�a o APN LOT TRACT ISSUE DATE: C�� •I S PERMIT#: �S�' I G I�,. N OWNER �j�jRQlfj��IC TYPE CONST. OCC GROUP: � ADDRESS 1 a CITY�r',��I TEL. ��" L "�1 3�� p ,r� o APPLICANT M �b..1 �+%S�O/JTEL. G—E: I " `'�1 —'7 d� (� Scope of Work ��T n!l.�U 1�6V `�� cn 1 2.� �'��/L�S , l� , �s �l� ¢ CONTRACTOR E "N E � —� 0 �m ADDRESS 2I �► � Ei G d�f+/J T�I�N�� CITY��Ti�GLA�I�T+�- ZIP9�•3 s'� TEL.C 6 i ��f!y �'7CSC O #DWEL.UNITS #STORIES #BEDROOMS 0 " ARCH/ENG/ z DESIGNER DESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREANALUATION � SFR/ADD/REM o ADDRESS m CITY ZIP TEL. Garage/Carport ¢ OWNEN-BUILDEH DECLAHATION w Patio/Deck � I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the reason(s) � Pool/Spa w indicated below by the checkmark(s),I have placed ne#to lhe applicable item(s)[Section 7031.5,Business and � wProfessions Code:My city ar couMy that requires a permit tn construct,alter,improve,demolish,or repair,any o Re-Roof a sWclure,prior to its iuuance,also requires the applicant for the permit to file a signed statemeM that he or she � Commercial = is licensed pursuantto the prorisions of the Contractor's STate License Law(Chapter 9)Commencing with Secfian � N 7000 of Division 3 of the Business and Professions Code]or that he or she is ezempt from licensure antl me basis for m N the alleged exemption.Any violation ot Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty 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(1 all of or(J portions Z of the work,and the sWcture is not intendetl or offered for sale(Section 7044,Business and Professions Code:The Va/uation: Adj.Area: � Contrac[ors'State License Law does not apply to an owner oi property who,through employees'or personal effort,builds � or improves the property,provitled that the improvements are not intended or offered for sale.If however,the building or (]UANTIIY DESCRIPTION FEE p improvement is sold within one year of completion,the Owner-Builder will have the burtlen of proving that it was not built � or improved for the purpose of sale.). ¢ 0 Z (,I,as owner of the praperty,am exclusively cortVacting with licensed Contractors to construct Me project(Section Q q q,�..� N 7044,Business and Professions Code:The ConVactors'STate License Law does not apply to an owner oi property who � — builds or improves thereon,and who contracts for the projects with a licensed Contractor pursuant to the ConUactors'Sfate � Y w o License law.). � (_J 1 am exempt from licensure under the Contrac[or's State License law for the following reason(s): � LL Z Z m � By my signature below I acknowledge that,except for my personal resitlence in which I must have resided for at least one � � year prior to completion of the improvements covered by this permit,l cannot legally sell a structure that I have built as an a X owner-builder if it has not been consVucted in its entirery by licensed contractors.I untlerstand that a copy of ihe w applicable law,Section 7044 of the Business and Prafessions Code is available upon reques[when this application is � o submitted or at the following Web site:http/vnvw.leginfo.ca.gov/calaw.html. � V LICENSED CONTHACTOfl'S DECLAHATION � mI hereby affirtn under penalty of perjury that I am licensed under provisions ot Chapter 9(commencing with Section 7000) w N of Division 3 of the Business and Professions Code,and my license is in full force and effect. � a`n uCENSE CLASS:�C 1 � LJC.NO.:�_�� T' CONSTRUCTION: �� DATE: �" ' ,—1 , CONTRACTOR: �_�-��C�N L:E� p�,qN REVIEW: q7` , p WORKEH'S COMPENSATION DECLA11AT10N aI HEREBY AfFIRM UNDER PENALiY OF PEflJURY ONE OF THE FOLLOWING DECLARATIONS: ELECTRIC: o I have and will maintain a Certificate of Consent to Selt-Insure for Worker's Compensation,as provided by pLUMBING: Q Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. MECHANICAL: o ,�I have and will maintain Worker's Compensation Insurance,as required by Section 3700 of the Labor Code,for Q the performance of the work(or which this permit is issued.My Worker's Compensation Insurance Carrier and INSPECTION FEE: o Policy Number are: w CARRIER r� �� ciA��ry i�vS. �o ISSUANCE: ��.as Z �w r `7 y't� qi� Z � POLICYNUMBER SMIP: p~.j� N F (lFIIS SECTION NEED NOT BE COMRFTED IF THE PERMR IS FOR ONE HUNDRED DOLLARS($100)OR LESS). EN ERGY P/C: p I certify that in the pertormance of ine vrork for which this 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 Lavrs of Cal'rfomia.Md agree that if 1 should become subjec[in the Worker's J Compensa5on rovisio of on 3700 of the Labor sh I formvrim compty w ose pmvisions. RETENTION FEE: p�g,�» � DATE: � APPUCANT: �� /'7 PRE-ALT FEE: � WARNING: ailure to secure Worker's Compensation covera is unlawf , nd shall subject an employer to criminal gASF:_ '�� penalties antl civil fines up to one hundretl thousand tlollars($100,000),in addition to me cost of the compensation, p damages as provided for in section 3708 oi the labor code,interest,and attorney's fees. PLOT PLAN: � CONSTflUCTION LENDING AGENCY � ZONING CLEARANCE: w I hereby atflrm under penalty of perjury that there is a Conshuction Lentling Agency tor the performance of the work for = which this permit is issueA(Sec.3097,Civ.C.�. � C LENDER'S NAME: � LENDER'S ADDRESS: TOTAL FEES �0� ' W w � I certi(y that I have read this application and sfate that the above intormation is correct.I agree to comply with all city and Z counry ordinances antl siate laws relating to builtling construction,and hereby authorize representatives oi this counry ro COMMENTS: o enter upon the above-mentioned property for inspection purposes. m !t,� �.,.5 a P RMITf E(P INn P/C: PAID BY: VALIDATION: � ' RECEIPT#��Q�� PAID BY:� yS I V VALIDATION:� � SIGNATU OF PERM EE DATE . WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy i . CITY OF DIAMOND BAR , INSPECTIONrRE�.�RD � � � � • - • � � � • - SETBACK/LETTER TRACT AND LEDGER FOOTINGS FORMS SWITCH GEAR I g�qg COMMERCIAL HOOD I UG.PLUMBING T-BAR UG.ELECTRICAL INTERCEPTER UFER 6ROUND HOT MOP/SHOWERPAN SEWER LATERAL SEPTIC/CESSPOOL MAIN WATER LINE HERS REPORT RECEIVED SEWER CLEANOUT DEMOLITION ROOF SHEATHING ROOF DRAINS i FLOOR SHEATHING ROUGH CONDUIT I SHEAR WALLS EXTERIOR POOUSPA SHEAR WALLS INTERIOR ROUGH PLUMBING FRAMINGNENTING ROUGH ELECTRICAL ROUGH MECHANICAL ROUGH MECHANICAL ROUGH ELECTRICAL W( )CO GAS TEST ROUGH PLUMBING PRE GUNITE INSULATION WALL POOL PRE DECK BONDING INSULATION CEILING P-TRAP DRYWALL FENCE/GATE/ALARM , LATH(PRE) FINAL POOL LATH EXTERIOR WALLS: LATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL 1sr� �2r+o� )LIFf SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELEASE WALL DRAIN/SEAL GAS METER RELEASE WALL FINAL SPECIAL INSPECTION R0.FRAMING PLANNING APPROVAL FINAL BUILDING / ROUGH FIRE APPROVAL FINAL MECHANICAL FINAL FIRE DEPARTMENT FINAL ELECTRICAL 2 l� FINAL PLANNING FINAL PLUMBING FINAL ENGINEERING/PW T.C.of OCCUPANCY FINAL COMMUNITY SERVICES CERT.of OCCUPANCY FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE COMMENTS: