HomeMy WebLinkAboutPR17-12924CITY OF DIAMOND BARS DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 (949) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@diamondbarea.gov j JOB SITE ADDRESS 1-eraj L) w APN LOT TRACT OWNER k\ ADDRESS -e- rr a C C CITY `'yafl'YW,'Vk.,._5�.a zIP�'fEL. �-79 il� APPLICANT ' ,ay -f_ L -i TEL.7tLi ADZ Ji s3 .- CONTRACTOR ADDRESS 1 L 14-1 CITY1y� ZIP_qTEL ARCH/ENG/ DESIGNER J7 V !' Of -ii ADDRESS U5 z_ 1tTA CITY ^ !s_ ZIP TEL. 7i' S OWNER -BUILDER DECLARATION I hereby affirm under penally of perjury that I am exempt from the Contractor's State License Law for the reason(s) Indicated below by the ahmkmark(s), I have placed next to the applicable items) {Section 70al.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 file 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 Ilcensufe 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}, (_)1, as owner of the property, or my employees with wages as their sole compensation, will do U all of or I 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 properly 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-Ruiider 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 exclus vely 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 forthe projects with a licensed Contractor pursuant tothe Contractors' State License Law.), L) 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 for my personal residence in which I must have resided for at least one year priorto completion of the improvements covered by this permll cannot Iegaily sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by llcensed 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 atthe following Web site: htfplwww.Ieginfo.ca.govlcalaw.html. LICENSED CONTRACTOR'S DECLARATION i hereby affirm under penally 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 Linn full�fyorce and effect. LICENSE CLASS: �-""d LIC, NO.: lot t q 46 �d EXP. DATE:L•-`--�y'^-%4i 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 Code, for the performance of the work for which this permit is issued, I have and wNl 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 N -ti_ POLICY NUMBER 017 E7 12_4�i (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS $100 OR LESS}. I cerhiy that in the performance of the work forwhich this permit is Issued, I shall not employany person In any manner so as to become subject to the Worker's Compensation Laws of Callfornla. And agree that if I should become suhJect 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, Clv. C.). LENDER'S NAME: LENDER'S ADDRESS. I cerdfy 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-mentioned pr arty for inspection purposes. ­- � - PERMITTEENAME(PRIN �- SIGNATURE OF PERMITT - DATE PRESS FIRMLY APPLICATION DATE:IS ISSUE DATE: If PERMIT# : TYPE CONST. P/C#^�' — I In l „" ! Z 1 OCC GROUP: s yds e Scope of Work ,,ZiT a il l: Gtr /I • y g _ # DWEL. UNITS # STORIE=S # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADDI Garage/Carport Patic/DeoK LL � Pool/Spa ZRe -Roof Commeroia€ m Valuation: kdj. Area: QUANT€TY DESCRIPTION FEE J d U x J W c� m J rL _U Z Q x U CONSTRUCTION: PLAN REVIEW: 2-1 ELECTRIC: 5q _3 6 PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: 17— 2-L4 SMIP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: P1C: � PAID BY: VALIDATION: RECEIPT#.4_51 4 PAID BY:'- 3 VALIDATION: WHITE — Department Copy, YELLOW --- Finance Copy, PINK — Assessor Copy CITY OF DIAMOND BAR INSPECTION D 71RACTANDGER COMMERCIAL HOOD T -BAR INTERCEPTHI HOT MOPISHOWERPAN SEPTIC/CESSPOOL HERS REPORT RECEIVED DEMOIP ION ROOF DRAINS ROUGH CONDUIT POOLISPA ROUGHPLUMBING ROUGH ELECTRICAL ROUGH MECHANICAL GAS TEST PRE GONITE POOL PRE DECK BONDING P TRAP FENCE 1 GATE/ ALARM FINAL POOL WALLS: WAI 1. I DOTING/STEEL. WAI I STEEL 1'T( ) 2N°( } LIFT ........... _. WALL. BOND BEAM WALL DRAIN/ SEAL WALL. FINAL RG FRAMING PLANNING APPROVAL ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT FINAL. PLANNING FINAL ENGINEERING/ PW FINAL COMMUNITY SERVICES FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE SETBACK/LETTER FOOTINGS FORMS SLAB UG. PLUMBING UG. ELECTRICAL LIFER GRCUND SEWER LATEHAL MAIN WATER LINE SEWER GL..FANOUT ROOF SHEATHING FLOOR iff ATHING SHEAR WALLS EXTERIOR SHEAR WALLS INTERIOR FRAMINGIVENTING ROUGH MLCHANICAL _ ......... ROUGH ELECTRICAL W( ) C ( ) ROUGH PLUMBING INSULATION WALL INSULMION CEILING DRYWAI 1. LATH (PRE) LATH EXTERIOR LATH INTERIOR -- GAS'.1 LST SC IAICH COAT ELECTRIC METER RELEASE CA5 METER RELEASE SPECIAL INSPECTION 00 FINAL BUILDING FINAL MECHANICAL FINAL ELECTRICAL FINAL PLUMBING 1C. of OCCUPANCY CERT. of OCCUPANCY 71RACTANDGER COMMERCIAL HOOD T -BAR INTERCEPTHI HOT MOPISHOWERPAN SEPTIC/CESSPOOL HERS REPORT RECEIVED DEMOIP ION ROOF DRAINS ROUGH CONDUIT POOLISPA ROUGHPLUMBING ROUGH ELECTRICAL ROUGH MECHANICAL GAS TEST PRE GONITE POOL PRE DECK BONDING P TRAP FENCE 1 GATE/ ALARM FINAL POOL WALLS: WAI 1. I DOTING/STEEL. WAI I STEEL 1'T( ) 2N°( } LIFT ........... _. WALL. BOND BEAM WALL DRAIN/ SEAL WALL. FINAL RG FRAMING PLANNING APPROVAL ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT FINAL. PLANNING FINAL ENGINEERING/ PW FINAL COMMUNITY SERVICES FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE F- CD 0 C3 J w Li CL 0 s a z z F - cc cc w rl CITY OF DIAMOND BAR DEPARTMENT OF CONIMUNITY & 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 vi'ww cityofdiamondbancom building(?,diamondbarea.gov JOB SITE ADDRESS I CA r 6e I- Al iAJ APN LOT TRACT OWNER i t s) ADDRESS Vi er4r ,. G CITY Prig _4r: ZIP e-TEL?�J, APPLICANT u L it— TEL. "7i'd-F 7 CONTRACTOR" Al I CITY �� L= �9 � '"'' ZIP '3: �iJTEL.:7dvf Iw' ' ARCH/ENG/ DESIGNER €i�tkfw rte° ADDRESS I �,') V4 t'&,. CITY ZIP A " TEL. s� l � .) OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the reasons) indicated below by the checkmark(s), I have placed next to the applicable items) [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 file a signed statementthat he or she is licensed pursuant to the provisions of the Contractors State License Law (Chapter 9) Commencing with Section 7GOO of Division 3 of the Business and Professions Code] or chat he or she is exempifrom 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 Cil penalty of not more than five hundred dollars (8500). (-) 1, as owner of the property, or my employees with wages as their sole compensation, will do (-) all of or ( j 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, hufids or Improves the property, provided that the improvements are not Intended or offered for sale. If however, the building or Improvement 1s sold within one year of complstion, the Owner-Rullder w1i have the burdor of proving that h was not built or improved for the purpose of sale,}, U I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Secticn 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves (hereon, and who contracts for the projects with a ilceneed Contractor pursuant to the Contractors' State License Law,}, (-) I am exemptfrom licensure under the Contractor's State License law for the fallowing reason(s): Date: Sigrr. By my signature below 1 acknowledge that, except for my personal residence in whioh 1 must have resided for at least one year prier to completion of the improvements covered by this permit,l cannot legally sell a structure that I have built as an owner-trullder if it has not been constructed in Its entirety by licensed contractors. I understand that a copy of the apphcabie law, Section 7044 of the Business and Professions Code is available upon request when this application is submitted or at the following Web site: httpMrvvw.leglnfocagov/calaw.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 Division 3 of the Business and Professions Code, and my license is in lull force and effect. LICENSE CLASS: EXP. DATE a_u'.r CONTRACTOR:���..r' WORKER'S COMPENSATION DECLARATION I HEHEBY 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 ofthe work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as required by Section 3700 ofthe Labor Code, ter the performance ori work for which this permit Is Issued My Worker's Compensation Insurance Carrier and Policy Number are: a y" CARRIER POLICY NUMBER.---L:�_ T2. (THIS SECTION NEED NOT BE COMPLETED IFTHE PERMIT IS FOR ONE HUNDRED DOLLARS 8100 OR LESS). I certifythat 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 subs to the Worker's Compensation Laws of California And agree ihai if 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 tines up to one hundred thousand dollars (S100,000), 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 certify that I have read this application and state that the above information Is correct. 1 agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county Is enter upon the abov -men Toned p party for inspection purposes. PERMITTEE,. ,RINT) a SIGNATUl PERINI DATE APPLICATION DATE: ISSUE DATE: TYPE CONST. d ' ') . `! I `HERMIT#: P/C# z 0.— 7 6 Ii �J - OCC GROUP: Scope of Worktjv # DWEL. UNITS ,V & i # STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport w Patio/Deck W LL Pool/Spa ZRe -Roof 0 Commercial in Valuation:3 Adj. Area: QUANTITY DESCRIPTION FEE a U s U LSJ m z m b 4 z LD CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMIP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: 0a Fee P/C: RECEIPT # PAID BY: PAID I VALIDATION: VALIDATION: WHITE— Department Copy, YELLOW — Finance Copy, PINK— Assessor Copy CITY OF DIAMOND BAR INSPECTION ,IIT SETBACK/ LETTER FOOTINGS FORMS SLAB UG. PLUMBING UG. ELECTRICAL LIFER GROUND SEWER LATERAL ROUGHMECHANICAL ..._._ ..... __. ROUGH ELECTRICAL W( ) C ( ) ROUGH PLUMBING ........ INSIRATION WALL INSUI ATION CEILING DRYWAI 1 LA -Ir{ (PRr:) I.AT[ i IXIENOR I ATI1 INTERIOR CAS .I Li I - SC RA I CH iI- SCRAICH COAT ELL(;IRIC METER RELEASE r(=ASI METER RELEASE SPLGIAL INSPECTION FINAL BUILDING FINAL MECHANICAL FINAL ELECTRICAL 'FINAL PLUMBING T.O, of OCCUPANCY CUT. of OCCUPANCY RACE AND LEDGER SWI I Cl I GEAR COMMI:HCIAL HOOD I fiRli IN i I IICEPTER HO -T MOWSHOWERPAN SEPTIC/CESSPOOL HERS REPORT RECEIVED DEMOLITION ROOF DRAINS ROUGH CONDUIT POOUSPA ROUGH PLUMBING ROUGH ELECTRICAL ROUGH MECHANICAL GAS TEST -- PRE GUNITE .- — POOL PRE DECK BONDING P -TRAP FENCE 1 GATE/ ALARM FINAL POOL WALLS: WALL FOOTING/STEFI WALL STEEL 18( ) 2"0( ) LIFT WALL BOND BEAM WALL DRAIN/ SEAL WALL FINAL RO. FRAMING PLANNING APPROVAL . ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT FINAL PLANNING FINAL ENGINEERING/ PW FINAL COMMUNITY S RVWES FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE CITY OF DIAMOND BAR BUILDING & SAFETY DIVISION 21810 Copley Drive Diamond Bar, CA 91765 (909) 839-7010 �a F F ' - ,•� i "' �_� «;f. � ��S E-,� y i i i!� l'.t �� � � g ms's "r '.! ' w � c - .'. y . i a�; r' , - ylr� '-r- # r-" <'""`� ��� S � � 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 4.20.5 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. CARBON MONOXIDE ALARMS 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: a 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 DWELLINGS: 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: 0 Listed and labeled combination carbon monoxide I 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, 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 job card if no one will be available to ailow the inspector inside the !souse.) INSTALLATION CERTIFICATION For the prop cated pt:LL r° I hereby certify that the required smoke alar 1116h monoxide alarms have been irAstalled as listed above. oo ignature Print Name ate Relationship to project (please check one): Owner n Agent for Owner ❑ Licensed Contractor Agent for Licensed Contractor If "Licensed Contractor' or "Agent for Licensed Contractor" is checked, please complete the following: Contractor Contractor's State License Number