HomeMy WebLinkAbout15-2453 • „-�+� . .
, CITY{lF DIAMOND BAR � � +
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SPEGWLINSPECTION RO R�FU411NGf'I�WMAN"APPROVAI.
FINAL BUILDING � ROIJ6H FIRE APPR04AL
...................................
FINAI.MECHANICAL FINAL FIflE DEPARTMENT
...............................
FINAL ELECTR[CAL PINAL PLANNING '
.............................................
FINALPLUMBING ' PINALENG�NEERINGIPIN
T C of OCIXIPANCY �'� PINAL fAMN{UNITY SERYICES '
CENi.oI OCCUPAMCT '�� FINAL NEALTH QEPi �'
� FINAL fNDUSTflIAL WASTE '
COMMENTS
• 1 • . +ls ' +
Tany's .Deputy Insp►ectians
65�? Darcena 5t, Chino CA 91?]O
Fax: &8�-7&9-8988 Cell: sto-974-�515
www.TD Ins�ections.cc�m
Special In��ector Daily Re�vrt
Build�n De t C� of Diamon Bar Permrt # PR15-2453 Date: 12123/15
Pro ect Address 23716 E. Goldrush Dr, Diaman Bar, Califamia
Owner Erlinda{}rtabza Phone.
Address� 23716 E Goldrush Dr Diamon Bar Cal�fomia
General Cantractor: Gabnel Phane� (&18} 918-6076
Address:
Sub Contractor� Phone
Address•
En ineer. Gore Associates Phone. {$18) SQt}-2552
Address 22030 Ventura BLVD#A WdODtAND HIilS,CA 91364
Mason ❑ Concrete DIA Weldin Shatcrete ❑ Rebar F-I� Bolts�
Su tier: Slum Post Tenslan 1 Pre-Stress ❑
Mix-Desi n� C *hnders Panels Prisms Mortar
I hereby cen�fy that t have mspected W the best of my knowledge al!of the follocw�g wark at the above locatipn, uniess athenv�se
noted, and that the work campl�es wtth the appttcable pmviswns oE ttre Buildmg Codes and approved drawtngs ATT4RNEY'S
FEES-If any acuon at law ar m equtty is brought to enforce or to mtetptet the terms of tlus contract, Yhe prevatlmg party slsall be
enutled to reasonable attorney's fees, cost, and nec�ssary disbursements m addinon to any other rehef to whish such party may be
entttled
rrived on site as requested by client and absenred as foliows • -
Instaltaticsn of (23} #4 Dowels @ 16" d.0
�� ,� '=• ' �-� �`;� E:�
�th 8 embedment ar�i (5) 5/8 anchar bolts ���y-,�; � ,, , ; �
Hold daw�) to the exist�ng footin� per detail �;��,� � ;� � a
.:pr;.�... ,ii�
9 S1 ,Location of work performed took piace ��:.=�_ � ; . ;.
n the south perimeter of faundaUon framing pian �-==�"-'�- i�'li� '`���
�-,;��::=��:E �� ��+�'�;
*"`Da not apply load after cure tame 24 hrs"' ���=i F;��''i'u'�
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ote•Cond�tion at warked was wire brushed �,;;,._._.. _ ,, ��,,�r;a
d a�r blasted per manufacturer insteuctions.g ' ��_ �p�'!1��'
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Name Edwin Jimenez Registration # 82344467 TYP� tCC
Alt Inspcct�ans are cdarged on a 4hr and aver 4hes—an 8hr mmimum.A�r Inspecnons extendmg past noon wilt bc an 8 haur mimmum
Any Inspcct�aa canceted upon annvai w�ll be charged a 2hr mimmum
Monday Tuesday Wednesday ¢ Thursday Fnday S urday S�rnday
Approved by � 4 " i�~�� Inspector Szgnature ,(.}'J G/,t.����.-�
��
The alarms are reqwred ta 6e mstalled m the faliowmg locations
fi Smoke alarms�n ell sieeping rooms
°a CO atarms�n aI#sleep�ng rooms where fuel buming appl�ances are mstalled
•S Smake alaRn aad GQ alarm in hallways precedirrg steeping rooms
v Srrmice alerm and GC?alarms on each dwellmg level mciud�ag basements�nd habdable attic rooms
The smake arxi Gfl aiartns are requ�red to compiy w�th the abave when requesbng a finai mspection Please make sure
an adult is present to albw khe Inspector access to the ho�ne to venfy compl�ance+mth the atwve requ�rements If no one
wd!be avadable, you may opt to compiete the Installat�on Gert�icatwn below end 3eave it�nnth the�06 card
,
(Please iit!out and[ear off thfs partion to leave with the job card Jf no orre wfl!be avar`lable ta
allow the inspectar fnsfde the house.)
INSTALI.ATION GERTIFIGATI#}N
For the property tocated at � �'�7 t� �� ���'^"" +"" � , I hereby ceR�+ that the required
smoke alarms and carbon monoxide alarms have been mstalied as listed above
.��'��,,�k M�►� �,��jnd� �r �vl�'�
Signature �^'— Pnnt Name Date
Relationship to proaed{please check o�e)
a Owner ❑Agent fae Qwner ❑Li�ensed Gontractor o Agent for Licensed Gontractor
It"Licensed Contractor or"Agent for�icensed Conir�to�' is checked,please complete the following
Cantractor Contractor's 5tate l�t�nse Number
Pt}Mt}NA UNIFIEI? SCHI`�l`�L DISTRICT ��"� � �
CAPITAL FACILTTIEu PRUGItAM MANAGEMENT w�n t�cmmer
&40 50UTfi GABEY AS'EhllTE # POMC}NA f CAI.IFORNIA 917fiti
�ertifccatio� nf G'vrrsptiartce
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np��canes t�an��n�sat�
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Apulicam's SignaWre Oate of S�gnalu�e
ZY�e appttcant eeecu(ing thu dec(ar¢t�ort cernfiu vnder penoky of perjury thut (!J lhey are the Uwner and/or peve(oper er th¢y ur¢outhonzrd 7o s+gn an behnlf of rhe
Ownu and�or Developer, (2) �hat the wjormm�an prowded u true and utcurate fo fhe bvs!oJ 7he Gwncr s andlnr Deve7oper s knowledge, (3) �hc Owner andlor
pevelpper w�tt file un amended cert�cufron of mmphanre and pay Che mtdutona(amounu due�f Owner andlor Devvloper�ncreasu lhe number of dwelLng rue�b
cnrUor rquare(�ntage aflw rhe tiuJdirsg perm�i u rssued or cf+he�nitaal defermrnadan ojunArs andlor aquare faoiage is found to be�ncnmea and(4)rMey hnue read
artd futty understartd thu side ared tFe rererse s�de ofihu documenf u�c(ud�ng the 9Q-day profest pena!pas(ed on the revene s�de af ehu docvmenc
CY�mwPsrt)evetopers Nartre pwnef s/Develapar's Ptwtie Na
Um�etdDevelopei's Ma�hngAdtlress
pevelopment Type and Fee Schedule Ckerkapprvp.rarekos(es),fiti�n tXeJee per aq Jr o,rdc„cte rhe jee tevet m eJjecr
ICJ�.Residenbat S !sp A (level 1•level2-Level 3}
New Addibon_!S��la Fanxly_t Sir�gie Fam1ly aCached_t Mul6 Famiy_,__t CTi�er
❑ RlartuiacturedlMobde Hanes b tsq ft {levaE 1-Cevei 2-i.evel3}
❑ CortvnOroaUlndustnai � !sc ft �sent �t3hs; uspficatrat t notes
Ssn�Gt�n Housrng $ !sa ft {See reverse s�af st�eek} t`} � r
S -� ts9 ft. {Prov�de yusLftratt�t}
�8$�CU�8110fl8 Earh CxrtrJ+tnhors of Comphnrfceform es farfive(3)ProlerxT mGnmurn Ilse ptGt�#dna!jarms fPr grldumnat P+oleds
�c'��"11t.���,��,�R.�,,�h��� �R�tu�S-tsc�p�453 s �� �{�O � n a -B''�.
���'����},y N9 7 wt Ma t AC�ess Ptan CF�f�Fb Fee per sq fl. Area Fee
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Traq Mo t Lot No !A�r�s Plan Chad�Na Fes pet eq R Xuea Fee �
3 S sa e S
TrBCNo Jl.qiNo tAtN1re� P1anGhedcNo Feap&'eq fl Wea Fee
a a � �. a
Tred Na 1 lat No !Address P�an GhxK No Fee per sp R Mea Fes
5 S sa e S
T�uct No/lot No 1 AtlMass Plan Chedc No Fee p�er sp ft Area Fsa
TOTAL UNITS: 70TA1.FEES DUE S �
( rofm on1Y,1„ /`•' ....._ tTMs fan+cnty)
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isNCt/CFPM re mNJ PnMed e) L1ata
R8C6lpt af F085 Shu u m cemjy thai at1 jees dae m tLe Pomana Ua�ced Schaat L4suzct'radr.r a�pteca4lepmuum+v ojfhe Gouernmenr Code at+d rhe
F.�tucapon Cad4 as prerequcrue ro rhe Lmmmrtce of e Butldug Permrt by thc G}tytCwrtry.have b�n rer.e�ved Based on rhe r+y'ormauors
prerented atbve,rLu Cen�l+r�+�a�olComFhunce u l�reby ecmurd
Rece�pt Na Ct+a�G�Pb
D�str�cHFvscai Semces (S�faW�e aM FAnfed test Mamari�y Dsta
See reverse side f�r Generat tnfarmation.Senior Citizen Housine Pavment of Fees.Nat�ce-Pro�ss�Ferrnd axd Anpeats Prncess.
o�su�wm,o a cac� whrte•c+tyrccwnta: v�m,�r.�xa+r�cuc��. t�nc-o�i se�. cw�,�oa-o� Re.tssd o,ns
C,Lh�RAf.R+iFORMATT6N � , '
On Novtmtrer 4, 1946,SB 50 became effect�uo Thts bdl grenks Cahfomia school distncts Ihe authar�ty to(evy fees�n ezcess of[hose euthonzed by
Gavernment Code Seohon 65995 {Level 1 Fees), �P dta d�stnct m�ts certam speeified tesis and e�naues a Seh�l Factl�hes Nxds Anal;�s�s
Aitemat�ve Leve!2 fces may be levied w[ten spte bond Eunds are avatlable for uhool twnstruct�on pro}et1s,and AI[emat�ve L.evet 3 Cees a�y only be
Iev�ed when the State allocat�on Board certEfles thst u�s na ioetger a�covmg apportonscsams for aew eonstruchon dua to 3aci:of avadabie funds�g
'Ibc Ba�rd of EcSucat�on approved the Sch�[Faciltiaes Neeeis Analysu and adopted a reso3ut�on lev}nng the alteroative fees under SB 50 and has
approved t6e fees on commerc�sUmdustx�al deve2aprnent by sepatate rcsoluhon Cogies of the tesatuc�ons and the Scha�(FacA(ihes Needs Ana3ysis
aze avai(abtie for+newing tn the Cap�tat Fwil�ttes Pmgram Management office
SE2�iIQR CTTSZEN RdUSING
Per Govemment Code SecGon 65995 3(e},�f a semor auzen hovsmg prolect�s Iaser converted!a non-resiricttd use,!he applieantldeveloper who�s
seek�ng the change m use wd!have to p�y the difCarence betwcen the curtent rrsidendal fee and�tfiat was paid far the seniae cidzen housmg
PAYMENT OF FEES
State law proh�bits a ctry or county hom�ssumg x buddmg pertmt unless the local schoot d�sCnct has certtfied that the apphcahon is m compl�anee
with the Distnct's cotluhon program for fees assessed developers The procedure for obta+nmg the reqwred cartFicat�on follows
Pro��t Ptans-A set of�otect plans stsmped by the goremmg uty or county buddmg dapartmen4�d va(uahan receipt md�cazmg calcalated square
faotage and plan thesk number,mwst be revyewed by the D�stnct 17ie sddrrss Coliows
Capr`tat Faei&tter Progrum hfanagemen;Psneona iJn�ed Sckoo!Dwnd,&40 Saark Garey Avenue,Pomoxa, CA 91766
CaloulahnQ Area for Res�denhat Pro�ects-2he D�stnct levtes fees on ex�spng xes�donteal constr�tion oniy tf the resulttng mcrease m essassable
spsce exceeds 540 sqetare feet after deducttng acsy loss of assessabk space m the same residonhai st:ucture as a result of the�me reconstruU�on Alf
assessahle s�uare fflotage m new residenua�struatures�s subtect ro the fee Ievy "Assessable space"mesns atI squaze f�mge wnhen the penmater of
a msident�al structure,nat moludmg sny caz}wrc, waikway, gasage, overhang,pafio,eocloseti pat�o,detact�ed accessary shucture,or sumtar area
Restdenpat pro��atsa mc3ude the�mt�at location,installas�on a occu�ncy af a enacmfactuced home ar mo6tle ho�
Calculann¢Area for Cn�nnureiaVlndusinat Pm�ects-'[he chsrgea6k covered and enclased space af co�re�al or andustna!constn�cttan shall oot
be deemed to tnelixle 4he aqvare faatage aE any struckure axistmg on dx s�ta of that construchon as af the date the first buitdmg pemut�s usued for
any pomon of thet canspuetwn "C1�argeable covered and enclased space" r�at�s the covered and anclosed sgaee detenruned io be vnthin tha
prnmeter of a wmmcrmal or mdusmai struesure,no[mdudmg any starage areas mculertal to the pnncipa! use of the cans�ucnon,gacage,parking
shucture,unencloseA walkway,or uhhry er dtsposa!azea
Ava�tabk Hours for Ven6cahon-CFPM stall w�ll venfy pro�ect developme�t type and square fnataga snd eamplete the Cemfwtwn of Comphancc
�dunng avadable hmus Avazlable hours ate fram 8:30 A.M - 12:00 P.M. and 1:00 p.M. - 411� p.M, Monday theough Fnday, except Dis6nU
hal�ays Other pmes ace svatlable by appo�ntment by callmg(909)397-4800,ext 3920
� �
Avazlable Hours for Pavmant-Fees due are�d to the Ltismct dunng avwlabie hours Avwlable hours are hom 8:30 A ht - 12 00 P M and 1.00
F.hi -d•00 P.M., Mvnday thro�gh �r�day, e�ccept Distr�a hal�days Cap�cs ot the completed Com6cat+on of Compltance vnll be given ro the
appiEcank Cor use�n flbaunmg tfic buitdmg pertnit{s)and for thc applicant's rewcds
NQTSCE-PRQTEST FERI�ID
SecUon fi626 of the Gove�ament Geade cequtres d�at Pamona Unrfied SchooS L1iy9nct growde a wntten nat�a to the pro)ect appluant,at the tima�f
Paymeot of school develo�tment fees,�suhgahon pa}mtentc or oth�eacaeaans{"Fcec):of tha 94-day ponai to protest the impos�hon of thase F�es
Theref�re. m secprdance vnth Sc�tean 66020 of tha Cmvem�rent Code sexl other appl�cable taw,thu Not�ce sl�at!serve to adwse the spgiicasK tfiat
tbe 96day protest penat m regard ta such Fces or the valyd�ty thaeof,comme�fces wNh such gayttitnt ar petfomsance of any oiher requiret�ient as
desenbal m Seckon 654Z4 uf the Govcm�nt Ca3e
APPEALS PRUCL�S3
Any claim by an appLcant that their pro�ect should be exemEx&om asse&sntait of fees,or that the fees Iev�ed are mcorrect,must be t�da tn wnkng
and filed w�th the Pomona UniGed School D�stnc[ 'Che cla�m must spec�Fy the factuai and legai grvunds suppnttmg the clwrn In add�tiun,tha ciaim
must cantaui a statett�ent spetafymg the aature of the prqect and the date the pro�ect bmidtng pernut appl�cat�on was filed
'Che D�nd's Sa�renntenda�t,ar lus designee,sha{I respond m wntmg to a clwm vnth�n fourteen(ld)days Bom rece�pt of the clatm Tha response
shatl coatam tho St�peenatend�t's deu�s�an on the c{aun and a stntement of the rcasoas supportmg the deaswn.
Any ols�eiunnc who�s d�ssat�s#`�ed wrth ttre decuian msy request review by tha Discnet's Baard of Educanon A request for rewew must be wrrtten and
Eeted xnth tlte Supermtendart's or des�gnce's office not later than[en(14}deys from the data of khe decution 'R�e request must contwn a statament of
aI1 faowal and lega!grounds in wppo�t of t6e wnnnumg clum.
'Ihe Board of Educ�ca�shalk t�s�dcx and�t upa�a request for cev�ew at s publ�c rneenng emi}azer than thzrty(30}days Erom tho datc of Slsag oF
tbc request A slazmattt may appear and eddeess Ihe Board w regard to dte olatm'Lhe$aard shalt prov�de wntten nokce uf iCs decuswn,ta ba rsratled
w die cl�unsant,w�th�n fa�rteen{16}days after publzc�eung at which She Hoaxd acted upa�the da�m.
Camspondence shall6e addressed ta
Auesrant ta tke Superrntcrtdent,Businest Srrwees-Fadfereu,Pomaaa Unifred Schaat Distrut,&11Q So+�th Garey Auenue,Pomaea,CA 41?66
►�'� �r� �a- ���,
„�,
, CITY OF DIAMOND BAR �, I I � ' �
Depertment of Bullding and Safety
REQUEST FOR APPROVAL OF SPECIAL INSPECTOR
,,,,atlg..
SpeciallnspectorsName ��IW IN U�y`^QheZ PhoneNoC'�5!)YZ�O�yG
Address � 63� �Q1�.SYY88� City I.. OVOYIa Zip 9Z ��lZ
Type ot Inspection ❑ Continuous '� Periodic
JobSiteAddressz3 �' �G � ���(�Y(15Y1 UY �lGW10h Q� l A .
Job Name 1
Typeof PrQ;Pr.t uOWle lA I��OYI
Attach work expenence and educational qualifications to this application
The above named person will be employed to inspect and/ortest and will be responsible for the following inspections
(Please circle number and provide description of work)
1 Concrete Placement
2 Reinforcingand/orprestressedsteel
3 Structural Welding
4 High-StrengthBolting ���1C��s TNS ��n Ql'1 �PO
5 StructuralMasonry
6
7
Duties and responsibilrties of the Special Inspector
1 The special inspector shall observe the work assigned lor conformance with the approved design
drawings and specif�cations
2 Thespecialinspectorshallfurnishinspectionreportstothebutldingofficial,theengineerorarchitectof
record,andotherdesignatedpersons Alldiscrepanciesshallbebroughttotheimmediateattentionof
the contractor for correction, then, if uncorrected, to the proper design authority and to the building
offiaal
3 The speaal mspector shell submrt a final signed report stating whether the work requinng speael
inspection was, to the best of his knowledge, in conformance wrth the approved plans and
speaficatlons and the applicable workmenship provision of the codes
�� � ��
Defe Owner's S�pnefure Contrecfors Signature
Fee$ � � U � Approved ` � eudd�np o�r�c�e�
Receipt No �$ 3 � � Date I 1 s I��
DISTRIBUTION Wh�fe— Frle
Cenery—Inspecra
10012 BD P�nk— SOeuel Inspocfoi
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