HomeMy WebLinkAbout16-0255 _ ' CITY OF DIAMOND BAR
I �� I1�"I�� i ' DEPARTMENT OF COi\'IMUN[TY& DEVELOPMENT SERViCES
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i"Di � BUILDINGPERMITAPPLICATION www.cityofdiamondbaccom building@diamondbarca.gov
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� APId� LOT . 7RACT ISSUE DATE:_J��S./�4. PERMITM� /'/�I�1' ' L'•X� �
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m AD�RESS 'Z�i'1i� L`7 F-CA/L.A'D�� � 1�G�' ' p DWEL.UNITS k STORIES p BEDROOMS
� CITY .�" .�� ' -. ; '� ZIP ��=�j J/'�135� --_
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o ARCH ENG/ �
z DESIGNER DESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREA/VALUATION
o ADDRESS SFR/nDo/REnn
m CIN ZIP TEL. Garage/Carport
¢ OWNER-BWLOEN�ECLAPATION w Patio/Deck
� I hereby eRlim untler penelTy o�perJury thet I am erempt�mm fhe Conhectors S�a�e Gcenee Lew for the reason(s) � Pool/Spe
ointllcetetl below by the checkmerk(s�,I heve plecetl neM to Ne eppllcable I�em�s)LSection]031.5,Business an0 Z Re-Roof
z Pmfessions Cotle:Any ciry or caunty ihat requires a permit[a consWct,alt¢r,impmve,tlemolish,or repair,any
d structure,pnortoiBissuance,alsor¢quir¢5@eapplicantfarMepermiFMfileasignetlsUiementNa�M1eo�she � Commercial
� islicenseOpursuanttolFieprovisionsMM¢Contractor'sSlaieLicenaeLaw(Chapler9�CommencingwiNSecfian �
N ]OOOofUivisian3oiMeBusinessantlPmt¢ssionsCOGe]oribalnearsneiseeemptimmiicensureantlthebasisior m
� theallegetlexemption.Anyvlola6ano(Setlion�WiSbyanyapPlicanifora0ermttsubjecisipeappficanttoaclvllpenelry
� oinotmoathanfiveM1untlretltloliars(5500�-
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� U I,as owner of the O�opeM1y,or my employees with waqes as iM1eir sole campensation,will tlo U all of a U Portions
ot�he work,antl ihe sfmciure is noi intentletl or oHeretl tor sale(Section]044.Business antl Pmtessians Cotle�.The Valuation: Adj.Area:
w Conhac�ors'StatelJcenseLewtloesno�appyNenownero�pmpertywho,thmughemployeesbrpe�ponelaflor[builtls �
� orimpmvesmepmperry.Provitletlmatmeimpmvemen4arenotintentletlorofleretlforsaleJihowever,mebuildingor QUANTITV DESCRIPTION FEE
oimpmvementissoltlwithinoneyearo�campletlan,ihe0wner-Butltlerwillhavetheburtlenofpmvingihatitwasnotbuilt
� orlmpmvetl�or�hepurposeofsele,).
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o Ul,asowneroitne0mperty,amexclusivelyconiractinqwRM1licensetlCOMracrorstoconstmeithepmjec[�Section —
z ]W4,Business antl Pmfesslons CoUe:IDe Contactors'State G�znse Law tloes nol epply lo an owner of pmperly who �
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y buil4sorimpmvesNereon,antlwhoconirac�s�orthepmle��swithalicensetlContractarpursuant�otheConVactors'Sta[e
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� (_�Iamexempthomlicensureuntler�heGonhactor's5ta�eGcenselawfor�hetollowingreason(s): ��
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� BymysignaN�ebelowlacknowletlge�ha4exceptforniypersonalresitlencelnwfticltlmusthave�esltletl(oretleastone �
Q yearpriortocompletiono�theimpmvementscovere4byNispermi�,lcanno�legallysellasimc[ure�hatlhavebuiltasan a
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p; OWfIBFI11111tlBf If I(h39 00[bOBfl COII6h11C12tl Ifl 1�8 B11(fBly by IICBf19Bd CpfIV9CN[8-I IIIIQBf8�8f1(I�h3�2 CQpY 0(IhB
� epplicable law,Section]044 alipe Buainess en0 Pmfessians CaOe is aveilable upon raqueelwhen ibls appGcation is �
o submitletloratNefollowingWebsife:�tlp/www.leginto.ca.gov/calawbtmL �
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� LICENSEO CONTHACTOR'S OECLAPATION s
� Iherebyafllimuntlerpenaltyofperjury��a�lamlicensetluntle�pmvleionSofChepterB(commencingwlth5eetlon]000) �
� of�ivision3o�Ne8usinessantlPmfessionSCotle,andmylicenseisin�ullfomean4eRec1.
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� LIGENSECLASS��G LIC_NO.�. d��2- �
o CONSTRUCTION:
Q oATE '=' ..�'>, CaNTFACroB�. PIAN REVIEW:
p., WONKER'S COMPENSATION OECIABATI4N
�' IHEREBYAFFlFMUN�EflPENHLTVOfPEflJUFY0NE0FTHEFOLLOWINGOECIAFATIONS ELECTRIC:
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I have antl will maintain a Ce�tificaie of Consent lo Self-Insure for WOBer's Compensation,as pmvitletl by PLUMBING: ��.5/
Q! Sec�ion 3]00 of the labor Cotle,for Ihe performance ot the woB for which Ihis permi�is issued.
� IhaveantlwillmaintainWorker'sCompensationlnsurance,asrequiretlbySection3�0ootineLaborCotle,for MECHANICAC
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Q �hepertormanceo��hewoBforwhichthispermitisissuetl.MyWoM1er'sCompensa�ionlnsu2nceCarrierantl INSPECTIONFEE:
Policy Number are'.
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� '� POLICYNUMBEF SMIP:
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��, (IHISSEC110NNEE�NOTBECOMPtAE01FiHEPENMRISFOFONEHUNOFE�DOLLAF5�5100�OFlESS). ENERGYP/C:
p �Icertirymatinthepedomianceoliheworutorwhicninispermilisissuetl,isnallnotemployanyoersoninanymannersa�ro ENERGYPERMIT:
o become subject�me WOBeYs Compensa�ion laws of CalAomia.Antl agree mat rf I shoultl become subl�t tu Ne WOMer's �
� CompensaronpmvisionsofSection3]OOoimeLaborGotle,IshallfoMwimcomplywimmosepmvisions. RETENTIONFEE: .�,G�4
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LL oATE�. APPUCANT: PRE-ALT FEE:
� WAFNING�.FaiWre to secure Worket's Compens'ation coveage is unlawlul.antl ffiall subject an employerN criminal gqSF'
W pEflTl�l26 8[IQ flVll If006 Up t0 0118 hOfIQfB4 1f10083fid AOIIBf6($1�0,���f,III BQdIIIOfI 10�h0 COAI Of�h2 COrtIpBfI68I�OR
o tlainagesaspmvidetlfor�nsectlon3�OBoiNeleborcotle,intereat,an�enomeys�ees. PLOTPLAN:
d CONSTPIICTION LENOING AGENCY ZONING CLEARANCE:
uzi I hereby ettlrm untlerpenelTy otpeQury�hatthem ia a Consimctlon Lentling rAqency tort�e pedormance ot the woM�or
s whfch�hlsperml�lelseuetl�5ec.3�8],CIv.C.J.
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� LEN�ERS NAMF.
� LENOER'SA�oR[55: TOTAL FEES ����.'�-3
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d Icertlrythatlhavereetlthlsappllcanoneo0statethauheabovelmormatloniscorrectlegaemcomplywlinellcityann COMMENTS:
� counry oNinences antl state laws relatln9 to builtling construcfion,antl hereby authorize representatives of INs munry to
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p en�erupontheabove-mentionetlpmpertyfo�inspec[ionpurposes.
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N PEBMITTEE ME flIN� % P/C: PAIDBV: �J ___VALIDATION:__,___q_-_
� � REGEIPT#���� �� PAI�BV: �-���// � VALI�ATION: /'/�.
i SIGNATOFEOFPEFMITTEE OAiE �i� ^
W HITE—Department Copy,VELLOW—Finance Copy,PINK—Assessor Copy
CITY OF DIAMOND BAR
- Communiry and Dcvclopmeut Services Department
I ���I i � ' 27 810 E.Copley Drive• Diamond Bar, CA 91765
�
��:� � �J��� Building Inspection Request Hotline
�`::,. � (909) 839-7027
IN;'
_� 13uilding Planning 6ngineering
(909)839-7020 • (909)839-7030 • (909) 839-7040
CORRECTION NOTICE
PERMIT NO. �II'�c�Y:al DATE: � � TIME: ���p,,,.
CONTRACTOR/
OWNER BUILDER
ADDRESS (Project Site) ��d� ��y'La �� ���
CD P�'c�a� �en�.r �-p� P �rh,r�a ��c��l
i� � 1, � �,� J! r.Tr h�9'-�--r'P,� t � L�
�(' l CG�'�r� rao�, f �e � cGdN
❑PLEASE CONTACT THE UNDERSIGNED
�"PLEASE MAKE CORRECTIONS AND CALL FOR REINSPECTION
❑REINSPECTION FEE REQUIRED
❑ PLEASE MAKE CORRECTLONS AND PROCEED W ITH WORK
INSPECTOR: �L�� ��L
(pnn[vame)
SLGNATURE OF 1NSPECTOR: IJYL IJ���
CITY OF DIA,A�SO�C-BAR
INSPECTION RECORD
� � • • • • � � • -
SETBACK/LE'fTER TR,QCT AND LEDGER
FOOTINGS FORMS SWITCH GEAR
SLAB COMMERCIAL HOOD
UG PLUMBING T-BAR
UG ELECTRICAL INTERCEPTER
UFERGROUNO HOT MOP/SHOWERPAN
SEVJER LATERAL SEPTIC/CESSPOOL
MAIN WATER LINE HEHS REPORT RECEIVEO
SEWER CLFANOUT DEMOLRION
ROOF SHEATHING ROOF DRAINS
FLOOR SHEATHING ROUGH CONOUIT
SHEAR WALLS IXTERIOR POOUSPA
SHEAR WALLS INTERIOR ROUGH PLUMBING
FRAMINGNENTING ROUGH ELECTRICAL
ROUGH MECHANICAL ROUGH MECHANICAL
ROUGN ELECTRICAL W( )C( ) GAS TEST
ROUGH PLUMBING � PRE GUNITE
INSULATION WALL POOL PRE DECK BONDING
INSULATION CEILING P-TRAP
�RYWALL FENCE/GATE/ALARM
LATH(PRE� FINAL POOL
LATH FXTERIOR WALLS
LATH INTERIOR WALL FOOTING/STEEL
GAS TEST WALL STEEL 1�'( )2N°( )LIFf
SCRATCH COAT WALL BOND BEAM
ELECTRIC MEfER RELEASE WALL DRAIN/SEAL
GAS MEfER RELEASE WALL FINAL
SPECIAL INSPEC110N RO Fi1AMING PLANNWG APPROVAL
FINAL BUILDING HOUGH FIRE APPflOVAL
FINAL MECHANICAL FINAL FIHE DEPAflTMENT
FINAL ELECTRICAL FINAL PLANNING
FINAL PLUMBING FINAL ENGINEEHING/PW
T C of OCCUPANCY FINAL COMMUNITY SEHVICES
CERT.ol OCCUPANCY FINAL HEALTH DEPT
FINAL INOUSTIIIAL WASTE
COMMENTS �EQdcJ CD l��V ��rl� �VaV lnAJ'��'/'.I' �/d�//fi r�¢.T