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Home My WebLink AboutPR16-457CD 0 UJ LL LauJ 2 0 2 UJrZ z x 2 w LD 0 m W PLUIOND B CITY OF DIAN `DBAR DEPARTMENI %if COMMUNITY & DEVELOPMENT,. EE+RVI- )J_ 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 bvilding@diamondbarca.gov JOB SITE ADDRESS \ V9 le APN LOT TRACT OWNER' Ylcmras ADDRESS 0441 In.nn61 �/,�3 .,. .._ CITY ZIP TEL, q APPLICANT o�y1 - - A, , /b TEL. / 5I ` 7_7 o),? 3 � CONTRACTORX006d/ `Q✓gt ri/L,/H �y�i C ADDRESS �� J I ,7 # tk S7 CITY ZIP IA5109 TEL. 9 S I- 17 7 p1 3 3 ARCH/LNG/ d � �I DESIGNER /t yil C d /OL/� C�O4 f ADDRESS di H ✓e CITY N ZIP 0 TEL. (% OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the reason(s) indicated below by the checkmark(s), I have placed next to the applicable item(s) [Section 7031.5, 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 fife 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 pem ltsub]ecls the applicantto a civil penalty of not more than five hundred dollars ($500). U I, as owner of the properly, or my employees with wages as their sole compensation, will do (-) all of or L) 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 net intended or offered for sale. If however, the building or Improvement is sold within one year of completion, the Owner -Rudder 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.). U I am exempt from Ifcensure underthe Contractor's State License law for the following reason(s); Date: Sign: By my signature below I acknowledge that, exceptfor my personal residence in which I must have resided for at least one year prior to completion ofthe improvements covered by this permit,] cannot legally sell a structure that I have bulli as an owner-bulider it it has not teen 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 avallable upon request when this application Is submitted or at the following Web site: hUp/www-Ieglnfoca.gev/calaw.htrri - LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am flcensed antler provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Buslne^ss and Professions Code, and my llcense Is in full force and effect. LICENSE CLASS, G J LIC. NO.: rk 7 EXP. DATE: % CONTRACTOR: it/j��g�_ 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 Code, 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 u-, -es C ® ,,,9 /{�' �d'yL•l ,/4 POLICY NUMBER _/iVfAlG �S&y (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 whichthls permit Is issued, I shall not employ any person in any manner so as to became subject to the Worker's Compensation Laws of California, And agree that If I should become subject to the Worker's Compensallon 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 atlomey'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. 5097, Civ. C.). LENDER'S NAME: LENDER'S ADDRESS: I certify that I have read this appllcahor 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 the above-mentloned property for inspection purposes. ✓d/a PERMITTEE NAM INT) 813E OF PFRMI DATE APPLICATION DATE: a I ® l l PIC# ISSUE DATE: kQt +�T I I f ., PERMIT# : M e TYPE CONST. OCC GROUP: Scope of Work # DWLL. UNITS # STORIES if BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage7Carport LU Patio/Deck w L f Pool/Spa dCD z T Re- oof J Commercial m Valuation: O e) Adj. Area: QUANTITY I DESCRIPTION FEE rU j f9 Ub A'+1P' CC U J e C rf 9 f5 z Alas 1 .4 40 lvt & 4.13 &W LTJe 11l e., f &Jf Ja o Pr9 dd ? rrol U Q on 9 ReAfc CONSTRUCTION: — PLAN REVIEW: . ELECTRIC: ' PLUMBING: . SQ, MECHANICAL: INSPECTION FEE: ISSUANCE: SMTP: ENERGY PIC: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: —7 .ss®— �. BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: PIC: PAID BY: VALIDATION: RECEIPT# PAID BY: I/ VALIDATION: WHITE — Department Copy, YELLOW Finance Copy, PINK— Assessor Copy COMMENTS: - _— _-- City of Diamond Bar F Building & Safety Division r- �-j z, 21810 Copley Drive Diamond Bar, CA 91765 Building Division (909) 839-7020 / Inspection Request Hotline (909) 839-7027 PERMIT # p\ + t,,, - L, -z,. c3 -N DATE ISSUED: \'3 1) �Q ADDRESS: /A\ .r }� ��r��-y DESCRIPTION: --- POST IN SAFE, CONSPICUOUS PLACE AT FRONT OFJOB, PROVIDE PERMIT NUMBER WHEN CALLING FOR INSPECTION. HAVE APPROVED PLANS ON JOBSITE AT TIME OF INSPECTION. INSPECTION REQUESTS SHALL BE MADE 24 HOURS IN ADVANCE. YOU MAY CALLUS THE DAY OF YOUR INSPECTION AT 9:00 AM AT {9091 839-7020 TO OBTAIN AN APPROXIMATE TIMEFRAME. INSPECTION DATE: SIGN: INSPECTION DATE: SIGN: SETBACK/ LETTER TRACT AND LEDGER FOOTINGS FORMS SWITCH GEAR SLAB COMMERCIAL HOOD UG. PLUMBING T -BAR UG. ELECTRICAL INTERCEPTER UFER GROUND HOT MOP/SHOWERPAN SEWER L+ITERAL SEPTIC/CESSPOOL SEWER CLEANOUT HERS REPORT RECEIVED MAIN WATER LINE DEMOLITION ROOF SHEATHING ROOF DRAINS FLOOR SHEATHING ROUGH CONDUIT SHEAR WALLS EXTERIOR POOL SPA: SHEAR WALLS INTERIOR ROUGH PLUMBING FRAMING/VENTING ROUGH ELECTRICAL R0. MECHANICAL ROUGH MECHANICAL RO. ELECTRICAL W( ) C {) GAS TEST RO. PLUMBING PRE GUNITIE 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 1ST( ) 2ND( ) LIFT SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELEASE WALL DRAIN / SEAL GAS METER RELEASE WALL FINAL SPECIAL INSPECTION RO. FRAMING PLANNING APPROVAL FINAL BUILDING ROUGH FIREAPPROVAL FINAL MECHANICAL FINAL FIRE - 0 FINAL ELECTRICAL FINAL PLANNING FINAL PLUMBING FINAL ENGINEERING/ PW T.C. of OCCUPANCY FINAL COMMUNI7YSERVICES CERT.OF OCCUPANY FINAL HEALTH DEPT. INDUSTRIAL WASTE FINAL R City of Diamond Har Building & Safety Division SIC Al: 21810 Copley Drive � J SIGN: :� Ir-rw.rtaKF` Diamond Bay, CA 91765 Building Division (909) 839-7020 / Inspection Request Hotline (909) 839-7027 Ar PEIRMIT # 1.72 % DATE ISSUED: e O '-` 7-1 V ADDFiE5� i�r'G�_ ,r te CESCRIPT10N:co'o^Uee7- e -e,4 -,we POST IN SAFE, CONSPICUOUS PLACE AT FRONT OFJOR. PROV0E PERMIT NUMBER WHEN CALLING FOR INSPECTION, HAVE APPROVED PLANS ON JOBSITE AT TIME OF INSPECTION. INSPECTION REQUESTS SHALL BE MADE 24 HOURS IN ADVANCE. YOU MAY CALL US THE DAY OF YOUR INSPECTION AT 9;00 AM AT >,909) 839-7020 TO OBTAIN AN APPROXIMATE TIMEFRAME, INSPECTION DATE: SIC Al: !INSPECTIONDATE: SIGN: SETBACK / LETTER TRACT AND LEDGER F007INGS FORMS SWITCH GEAR SLAB COMMERCIAL HOOD F BAR UG. PLUMBING, UG. ELECTRICAL — INTERCEPTER LIFER GRDUNG — HOT MOP/SHOWERPAN -- SEWER LATERAL SEPTIC/CESSPOOL E1 ER CLEANOUT IN ERS REPORT RECEIVED MiV,,N WATER LINE IDEMOLITION �ROOF SHEL7HING ---ROUGH — ROOF DRAINS FbOOR SHEA-n-UNG CONDUIT SHEAR 'A',,% I..S UTEKOR SHEAR WALLS INTERIOR ; I-.OUGH PLUMBING FRAMINGIVEN ZING i?OLIGH ELECTRICAL RO. MECHANICAL�—Y 14i0UGH MECHANICAL RO. ELECTRICAL W( ) C O _ GAS TEST — RO. PLUMBING PRE GUNM.E �~ INSULATION WALL INSUUA TON (:E)LING w -- POOL PRE DECK BONDING P -TRAP �— DRYWALL FENCE / GATE / ALARM LATH (PIKE) FINAL POOL LATH EXTERIOR WAILS.' - LATH INTERIOR WALL F007LING/STEEL — GAS TEST WALL STEEL IST( ) 2ND(-) LIFT SCRATCH COAT WALL BOND BEAM ELECTrRIC METER RELEASF --- WALL DRAIN / SEAL GAS METER RELEASE WALL FINAL SPECIAL_ IN -SPEC -CION R0. FRAMING PLANNING APPROVAL FINAL BUILDING ROUGH I-7REAPPROVAL FINAL MECHANIC4L FINAL FIRE FINAL ELECTRICAL FINAL PLANNING FINAL ENG1,1VEERING/PW FINAL PLUMBING T.C, of OCCUPANCY INAL COP 7gUNITYSERVICES CERT.OF OCCUPANY - - — FINAL HEALTH DEPT. WDUSTRIAL WASTE FIAAL.