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Home My WebLink About16-0600CITY OF DIAMOND BAR BUILDING PERMIT APPLICATII �` I DEPARTM ENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 PRESS (909) 839-7020 Fax (909) 861-3117 Budding Inspection Hotline (909) 839-7027 ol FIRMLY �'° ' cityofdiamandbarcom buddng@diamandbarca.gov JOB SITE ADDRESS. I V,�, .LlY.1,.�UE i i iu-lQ w D12 ANN LOT TRACT OWNER L �JS V}XN ADDRrrE��S�S -1() L ""1......... j. low 0 Fi- CItYI+f"VsM#rL Y';,.�yszssslyy?-- �17WS"TEL. 61 - fit C) APPLICANT—��a'C. ''eeaityao TEL IbU'Y�5 gL'5&1— CONTRAcTTO1Rh ADDRE )may rti�L''ST fC�n 0" r -C{$ cn ja __ZIPri1')2 TELyts S�i24ti ARCHANGy DESIGNER ADDRESS CRY ZIP TEL OWNER BUILDER DECLARATION I hereby affirm under, penalty of pedusy that I am exempt from the Contractor s State License Law for the reasm(si Indicated below, by the Owckmordo I harm plated next to the applicable Reath) tuctlon 70315 Business and Pmfrsdon4 Code My city or county that requires a Permit to construct alter criminal,demolish, or repair any structure prior to Its Issuancealso requires the applicant for the permit to file a signed statement than he or she Is Ikemed Pursuant to the provisions of the Commetofs State License Law (Chapter 9f Commencing wish Sector 7000 of Divides, 3 of the Business and No(essionf Code] or than he or she Is exempt from Reactive and the basis for the alleged exemFlen Any dolalon or Seders 70315 by any appllmm lir a permit sublectsthe applicant ma cmrpenaltyof pmt more drain five Wrsmed dollars ISSOM U Las ismer of the pop", ormymmismar s with wages as their aoiecmnpentaUon w 8do U allof orU pertbnv of Use work and Ne structure Is net Intended at offepmd for tale (Section 7!N,, B.I., and Premodern Code The Comractms SUN License Law does not apply to an owner of ixopeny who, through employees or persmul effect, bullets m FrImmes the Property, pmuWed that the Impmvmnents are lost ownded ce uttered for safe It however, the molding orImprovement Is mid within ane year Icrmpietmt the Qwpwr-Builder will have the burders ofpmWng that It was nor bulk m fr proed for lisp purpoac of sale ) U i as motor of the propeny,amexctusNeiy canpacUng with UcensMCanvacmn to+:orotruct the Proltxt o(pra.n 70Aa, Boshcess otd nfomay; tt Code incl who actors 5s IN prep¢ ects W sra sapphyman roccor Upropertywtm Wilds o bmpram theean and win contraett tec the projects with a licensed tmriractec punwnt tpthe Conisaetors Sta[e tkanselaw} U lam exempt from Ikemme uMer the Cecseractm !State Licenselaw for the Imans ng reason$) By my signature below t acknowlMge that, except for my personal ryYden ca in which i musthave resided fm ye at 1.9 Usear pro to completion of the ImprmemenM mwered by thn rot peony I carlegally NO a drmc.um that i have boat as an owner bulider if It has trot been mnstmcted In its emisery by Is msed contractors I untlotand that a copyol the applicable law Sectlmt Yo N, of the eusinest and ProfesslmsCede Is avallahie upon request when thls application d submiged or at the following Web we LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm under penalty of perjury that I am Ikansed under powipons of Chapter 9 (commencing wIM Secilon 7(1001 cll`Okollslon3�. doff Fire Business and N(reoyyrum''m Code,aand my license is In lull force and effect LICENSECIAS5 t�r^sLIC NO / I/I'} I �✓ DATE. a- I (D CONTRACTOR '°L.. C%Its E7G {.y WORKER S COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PENURY ONE OF THE FOLLOWING DECLARATIONS I ham and will maintain a Certificate of Convent to Sell Insure for Worker's Compensation, se prodded by Section 3700ofthe Labor Cade, forthm pedormenceofma, work For wNch this permit Issued have and will maintain Workers Commemoration Insurance, as required by Section 37x0 of the Labor Code, Airthemufmmarxm offankthe e work Toe which shb pemvi Is issuheh ed My Wo Compensatlan l rJ` Fs an and\e *N� W CARRiq T PIXICY NUMBER ((7 3 I - Q( (THIS SECTION NEED NOT BE COMPLETED IF THE PEW IS FOR ONE Ntl10REU D()i (SIOM OR LESS} Icmrp(y that to she p.fwnunce W the woh sec Which INT power Is lowed I shill not romeymg perzms In attt manner so as Is becmrc surest m Tho Wmkars Comper sa on Uws of Ca/om0 And agree that t 1 should become Whject to the Workers Compensationprmddms4 of SectorsJIOO of me Lab. Cody I shelf Forthwith cros�YTE.tgW1 APPLICANT s 1f'(4 e, GA CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there as Constructor) Lending Agency for she performance of the work lir which IN, port Is Ismed ISec Jews CN CI !ENDER S NAME LENDERS ADDRESS I cendy that l haveread thisappicatloniond state that the above information is comes lagme to comply with all city and county ordinances and state lawn mudh g so Wilding construction and hereby authmtre represenutrves of this county to enter upon the above mentioned property for Inspection purposes Pso n a- (wi/t L M 4,64 1 r "A PERM E INT /J L4 -1 SICdtATUAEOF EE DATE t SE' APPLICATION DATE iSSUEDATE I�o TYPE CONST PtCjy'��`. +�y�B f _�-} PERM P G/1Y�4/ '!.... OCC GROUP ....... SadpeMWm Tn tc tivLrron B DWEL UNITS r STORIES o S w If BEDROOMS .............. DESCRIPTION 54 FT FACTOR PST ADI AREANALUATION SFWAODAREM Gamge/Cmpos3 PatlaNetk ._ w Porr3pa ............... 8 Re Roof ^p Commercial Yalaaetllort Adj Area OLIANTI Y DESCRIPTION FEE w I"yldi t rt t r'rt? C n eJ LA �' as i CONSTRUCTION_ PLAN REVIEW ELECTRIC PLUMBING MECHANICAL INSPECTION FEE _ ISSUANCE SMTP ENERGY PK ENERGY PERMIT RETENTION FEE �ry • aF-+e PRE ALT FEE BASF Plot Plan Zoning Ckaranl TOTAL FEES COMMENTS PIC, PAID BY YAUDAT*N RECEIPTa.� W() YAUWTgN WHnE—Depanm CwYYEUOW—nm-eCopy, —Assessor Grip} GOLDENROD —File Copy; GREEN —Aptump sCopy CITY OF DIAMOND BAR INSPECTION RECORD �PN�yP� ■i i i DATE mum uum mI m ii INSPECTIONi• DATE INSPECTOR; '.SETBACK/LETTER TRACT AND LEDGER FOOTINGS FORMS SWITCH GEAR SLAB'' . ............. COMMERCIAL HOOD UG PLUMBING T•BAR'.. UG ELECTRICAL LIFER GROUND INTERCEPTER HOT MOPISHOWERPAN '.. SEWER LATERAL SEPTIC/CESSPOOL MAIN WATER LINE '.. SEWER CLEANOUT HERS REPORT RECEIVED DEMOLITION ROOF SHEATHING 1 ROOF DRAINS FLOOR SHEATHING ROUGH CONDUIT SHEAR WALLS EXTERIOR _ _ SHEAR WALLS INTERIOR POOUSPA ROUGH PLUMBING FRAMING/VENTING ROUGH ELECTRICAL ROUGH MECHANICAL ROUGH MECHANICAL ROUGH ELECTRICAL W( ) C (1 LASTEST ,.;ROUGH PLUMBING PRE GUNITE '.. INSULATION WALL POOL PRE DECK BONDING INSULATION CEILING P TRAP DRYWALL EENCEIGATEIALARM LATH (PRE) FINAL POOL LATH EXTERIOR WALLS' 'i LATH INTERIOR WALL FOOTING/STEEL LASTEST WALL STEEL 1sT( )2 ND( ) LIFT SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELEASE WALL DRAIN/ SEAL GAS METER RELEASE WALLFINAL RO,FRAMINGPLANNING APPR AL '.FINAL BUILDING J' .S ROUGH FIRE APPROVAL ''. FINAL MECHANICAL FINAL FIRE DEPARTMENT FINAL ELECTRICALry FINAL PLANNING 'FINALPLUMBING / ✓"" _ FINAL ENGINEERING/PW TC of OCCUPANCY FINAL COMMUNITY SERVICE _ CERT of OCCUPANCY FINAL HEALTH DEPT FINAL INDUSTRIAL WASTE COMMENTS