HomeMy WebLinkAboutPR17-8850 (7)CITY OF DIAMOND BAR
f I i DEPARTMENT OF COMMUNITY &. DEVELOPMENT SERVICES
21810 Copley Drive, Diamond BGr, CA 91765
PRESS
(909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 FIRMLY
BUILDING PERMIT APPLICATION wvvw.cityofdiamondbar.com building@diamondbarca.gov
JOB SITE ADDRESS
Al LOT TRACT
OWNER
ADDRESS
r
CITY 8 ZIP TEL,
APPLICANT Ti �P?'
CONTRACTOR
ADDRESS
CITY ZIP TEL.
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 reason(s)
indicated below by the checkmark(s). I have placed next to the applicable itemts) [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 tot the permitto file a signed statementthal 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 exampdon. Any violation of Section 7031.5 by any applicant for a permit sub)ectsthe applicant to a civil penalty
of not more than five hundred dollars (S500).
O1, as owner of the property, or my employees with wages as their sole compensation, will do () all of or U portions
of the work, and the structure Is not intended or offered for sale (Section 7044, Business and Professions Cade; The
Contractors' State license Law does not apply to an owner of property who, through employees' ar personal effort, bunds
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,},
U I, as owner of the property, am exclusively contracting with 11censed 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 licensure under the Contractor's State License law for the following reason(s):
Date: Sign:
By my signature below I acknowledge that, except far my personal residence 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 1 have built as an
owner -builder [f 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 appllcallon is
submitted or at the following Web site: http/www.leginfo,ca.gov/ca€aw.html.
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 Dlvlsion 3 of the Business and
Professions Code, and my licenseis in full force and effect
LICENSE CLASS: f� TO, NO, MI /® all
EXP. DATE; CONTRACTOR:
WORKER'S COMPENSATION DECLARATION
I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS:
1 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 ofthe workfor which this permit is issued. My Worker's Compensation Insurance Carrier and
Policy Number are:
CARRIER /
POLICY NUMBER ® D
(THIS SECTION NEED NOT BE COMPLETED IFTHE PERMIT IS FOR ONE HUNDRED DOLLARS $100 OR LESS).
I certifythat in the padormance of the work forwhich 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 Nifamia. And agree that it I should become subject to the Worker's
Compensatlon 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 ceftify 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 the above -needed proper[yfor inion purposes.
PERMITTEE NAME (PRrN
SIGNATURE OF PERMITTEE-' DATE
APPLICATION DATE:
ISSUE DATE: PERMIT#
TYPE CONST. OCC GROUP:
Scope of Work Z001 QY,4 SA S-041
# DWEL. UNITS # STORIES # BEDROOMS
DESCRIPTION SQ. FT. FACTOR PSF AD,- AREA/VALUATION
SFR/ADWREMI
Garage/Carport
W
Patio/Deck
Jul
LL
Pool/Spa
ZRe
-Roof
O
Commercial
Va![�atfort: Adj. Area:
QUANTITY DESCRIPTION FEE
a
i7oo 148
ca
s
V
u..l
w
ca
Co
J
d
J
Q
U_
Z
4
T
V
CONSTRUCTION:
PLAN REVIEW:
ELECTRIC:
PLUMBING:
MECHANICAL:
INSPECTION FEE:
ISSUANCE:
SMTP:
ENERGY I
ENERGY PERMIT:
RETENTION FEE:
PRE -ALT FEE:
BASF:
PLOT PLAN:
ZONING CLEARANCE:
TOTAL FEES
COMMENTS:
PIC: 15 PAID BY:ryVALIDATION: 140
RECEIPT it PAID BY; VALIDATION:
WHITE — Department Copy, YELLOW — Finance Copy, PINK— Assessor Copy
CITY OF DIAMOND
INSPECTION
SETBACK/ LETTER
TRACT AND LEDGER
ROUGH MECHANICAL
FOOTINGS FORMS
SWITCH GEAR
HOUGH ELECTRICAL W( } C O
SLAB
COMMERCIAL HOOD
UG. PLUMBING
T -BAR
UG, ELECTRICAL
LIFER GROUND
PRE GUNITE
INTERCEPTER
INSUI AiION WALL
HOT MOP/SHOWERPAN
POOL PRE DECK BONDING
SEWER LATERAL.
MAIN WATER IMF
SEWER Cll ANOU I
ROOF SHFATIZING
FLOOR SHF'ATHIN[,
SHEAR WALLS EXTERIOR
INSULATION CEILING
SEPTIC/CESSPOOL
P -TRAP
HERS REPORT RECEIVED
DEMOLITION
ROOF DRAINS
ROUGH CONDUIT
POOL/SPA
ROUGH PLUMBING
ROUGH ELECTRICAL
DRYWALL
-.
1
SHEAR WALLS INTERIOR
FRAMING/VENTING
LATH (PRE)
ROUMI MECHANECAL
ROUGH MECHANICAL
HOUGH ELECTRICAL W( } C O
GAS TEST
ROUGH PLUMBING
PRE GUNITE
INSUI AiION WALL
POOL PRE DECK BONDING
INSULATION CEILING
P -TRAP
DRYWALL
-.
FENCE / GATE/ALARM
_... ...
LATH (PRE)
FINAL. POOL
LATH EXTERIOR
WALLS'
LATH INTERIOR
WALL F00TING/STEEL
GAS TEST
WALL STEEL 'IST( )2 [AD( ) LIFT
SCRATCH COAT
-
WALL BOND BEAM
ELECTRIC METER RELEASE
��
WALL DRAIN/ SEAL
GAS METER RELEASE
WALL FINAL
SPECAL INSHFCIION
R0. FRAMING PLANNING APPROVAL
FINAL BUILDING
ROUGH FIRE APPROVAL
FINAL MECHANICAL
FI __ —
FINAL FIRE DEPARTMENT
F1NAL. ELECTRICAL
d
FINAL PLANNING
FINAL PLUMBING
FINAL ENGINEERINGI PW
T.C. of OCCUPANCY
FINAL COMMUNITY SERVICES
CERT. of OCCUPANCY
............................
FINAL HEALTH DEPT,
FINAL INDUSTRIAL WASTE
COMMENTS:
CITY OF DIAMOND BAR
BUILDEVG & SAF 27DIVISION
21810 Copley Drive
Diamond &7n CA 91765
(909) 839-7020
i i •
In order to help assure the life and safety within existing dwellings, the 2013 California Residential Code (CRC) Section
R314 and R315, along with the California Building Code Section 420,5 and 420.6 requires existing dwellings to have
smoke alarms and carbon monoxide alarms installed within the upper 12" of the ceiling when a building permit is issued
for, worked on, or in a building that is valued at $1,000 or more. Alarms may be solely battery operated where repairs or
alterations do not result in the removal of wall and ceiling finishes or there is no access by means of attic, basement or
crawl space.
Starting July 1, 2014 all smoke alarms including combination smoke alarms, that are solely battery powered
shall contain a non -replaceable, non -removable battery that is capable of powering the smoke alarm for at least
10 years.
'REQUIRED IN EXISTING DWELLINGS:
• Where a permit is required for alterations, repairs or additions exceeding $1,000.
• Existing dwellings or sleeping units that have attached garages or fuel burning appliances.
Carbon monoxide alarms shall be installed:
• Outside of each separate dwelling unit sleeping area in the immediate vicinity of the bedroom(s).
® On every level of a dwelling unit including basements.
REQUIRED IN NEW D'W'ELLINGS:
Carbon monoxide alarms shall be installed:
• Outside of each separate dwelling unit sleeping area in the immediate vicinity of the bedrooms(s).
• On every level of a dwelling unit including basements.
Alarms shall receive their primary power from the permanent building wiring without a disconnecting switch other than as
required for overcurrent protection. Battery backup is required.
NOTE;
Multiple purpose alarms.
• Listed and labeled combination carbon monoxide /smoke alarms are acceptable in new and existing
dwellings.
Carbon Monoxide Alarms is a requirement that is in addition to required Smoke Alarms.
The alarms are required to be installed in the following locations:
�.+ Smoke alarms in all sleeping rooms.
CO alarms in all sleeping rooms where fuel burning appliances are installed.
+ Smoke alarm and CO alarm in hallways preceding sleeping rooms.
+4+ Smoke alarm and CO alarms on each dwelling level including basements and habitable attic rooms.
The smoke and CO alarms are required to comply with the above when requesting a final inspection. Please make sure
an adult is present to allow the Inspector access to the home to verify compliance with the above requirements. If no one
will be available, you may opt to complete the Installation Certification below and leave it with the job card.
(Please fill out and tear off this portion to leave with the ,fob card ff no one will be available to
allow the inspector inside the house.)
INSTALLATION CERTIFICATION
For the property located at '11 71 S (- k^cc k
smoke alarms and carbon monoxide alarms have been installed as listed above.
X.
_'7^
Signature Print Name
I hereby certify that the required
Relationship to project (please check one):
o Owner ❑ Agent for Owner ❑ Licensed Contractor o Agent for Licensed Contractor
f 1
Date
If "Licensed Contractor" or "Agent for Licensed Contractor" is checked, please complete the following:
Contractor Contractor's State License Number