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Home My WebLink About15-0380 � l.J�-�c ��,��- =��"--� �..._ CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES �'��:. -- 21810 Copley Drive,Diamond Bar,CA 91765 PRESS �,,,n�,,,,� (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 ,� �� BUILDING PERMIT APPLICATION FIRMLY s JOB SITE ADDRESS '� APPLICATION DATE: �� -7�\S P/C# � ISSUE DATE: a 1�1 �� S PERMIT# �� a a z APN LOT TRACT � � OWNER__G�� TYPE CONST. OCC GROUP: � ADDRESS �� J CITY 'C�•'P)• ZIP L.�S�— ��—"S> '� ZONING F ONT KS RW ❑ z APPLICANT TEL!'71 — REAR ❑ _ n j��`,��,�� v� SIDE/SIDE STREEf RW ❑ ¢ CONTRACTOR L.1 SIDE ❑ � ADDRESS �'V1� �J �'� PROPOSED USE = CITY OS'��_ZIP��T�EL!l�`�'�11�nb� !�1 i � = ARCH/ENG/DESIGNER � � ADDRESS � #DWEL.UNITS #STORIES #BEDROOMS z CITY ZIP TEL. a OWNEH-BUILDEN DECLAHATION DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � = I hereby affirm under penalty of perjury that I am ezempt fram the Contractur's State License Law for the reason(s) SFR/ADD/REM I � indicated below by the checkmark(s�,I have placed ne#to the applicable item(s�[Sectian 7031.5,Business and Garage/Carport I �-' Prolessions Code:Any city or couMy that requires a permit to construct,alter,improve,demolish,ar repair,any z structure,prior to its issuance,also requires the applicant for the pertnit to tile a signed statement that he ar she � Patio/Deck I �i is Ilcensed pursuant to ttie provisions of the Contractor's State License Law(Chapter 9)Commencing with Section w � 7000 of Division 3 of the Business and ProTessians Code]or that he or she is ezempt fmm licensure and the basis for � Pool/Spa I f' the alleged exemption.Any violation ot Section 7031.5 by any applicant for a permit su6jects the applicant to a civil penalty C7 ^ � ,n—Y of not more than five hundred dollars($500). ZQ Re-Roof �eJ Q e• I � ()I,as owner of the property,or my employees with wages as iheir sole compensation,will do(�all of or(]portians � Commercial I y of the work,and the structure is not intended or offered for sale(Section 7044,Business and Professions Code:The � m i'� Contractors'State License Law does not apply to an owner ot property who,through employees'or personal eftort,builds � or improves the pmperty,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 I � or improved for the purpose of sale J. I ' I,as owner of the ro e am exclusivel cont2ctin with licensed Contractors to construct the ro ect Section z 044,Business and Professions Code:The Contractors'State License Law does not apply ta an owner of property who ValUHtiOn: � �O� � Adj.Ar@a: I n buildsorimprovesthereon,andwhocontractsforiheprojectswithalicensedContractorpursuanttotheContractors'Shte QUANTITY DESCRIPTION FEE I Y License Law.). I � �I am ezempt from licensure under the Contractor's State License law for the following reason(s�: � � � �. , ^O I 1 By my signature below I acknowledge that,ezcept for my personal residence in which I must have 2sided for at least one � � = year prior to completion of the improvements covered by this permit,l cannot legally sell a strudure that I have built as an w �1 I I owner-builder it it has not been construded in its entirety by licensed contractors.I understand that a copy of the applicable �J I I � law,Section 7044 of the Business and Professions Code is available upon request when this application is submitted or at �•. % the following Web site:http/www.leginfo.ca.gov/calaw.html. Z � i i� � DATE: SIGN: � !, — LICENSED CONTHACTOH'S DECLAMTION � I I a I' 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 full force and effect. J I � " '12'1 l�3 � n LICENSE CLASS: G�� LIC.NO.: a I Z DATE: 1 � CONTRACTOR: � I ¢ WOHI�H'S COMPENSATION DECLAHATION � I y I HEREBYAFFIRM UNDER PENALTY OF PERJURY ONE OFTHE FOLLOWING DECLARATIONS: � I have and will maintain a CeRificate of Consent to Self-Insure for Worker's Compensation,as provided by CONSTRUCT�ON: �� z� � e ion 3700 of the Labor Code,for the performance of the work for which this permit is issued. p�qN REVI EW: � �I have and will maintain Worker's Compensation Insurance,as required by Section 3700 of the Labor Code,for z the performance of the work for which this permit is issued.My Worker's Compensation Insurance Carrier and ELECTRIC: ¢ PolicyNumberare:/^ (� � PLUMBING: y CARRIER C.f'��°�'O�t+(lti.��'y.3iY�°eGl' MECHANICAL: � POLICYNUMBER �1.� 1�� INSPECTION FEE: '� (fHIS SEC110N NEED NOT BE CAMPLEfED IF1HE PFAMfT IS FOR ONE HUNDRFD DOLLARS($100)OR LESS). ISSUANCE: `] j I ceitify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as m v-`��" � become subjed to the Worker's Compensation Laws of California.Md agree that if I should become subject to the Worker's SMIP: J CompensaVo�Section 3700 of the Labor Code,I shall forthvnm compty with those provisions. ENERGY P/C: i DATE:7^ APPLICANT: ENERGY PERMIT: � WARNING:Failure to secure Worker's Compensation coverage is unlawful,and hall subject an employer to criminal y penalties and civil fines up to one hundred thousand dollars($100,000�,in a ition to the cost of the compensation, RETENTION FEE: ai� � damages as provided for in section 3708 of the labor code,interest,and attorney's fees. PRE-ALT FEE: i CONSTHUCTIONLENDINGAGENCY BSAF: I.O� = I hereby aftirm under penalty of perjury that there is a Construction Lending Agenty for the performance of the work tor � which this permit is issued(Sec.3097,Civ.C.�. LENDER'S NAME: � s LENDER'SADDRESS: I i I certfy that I have read this application and state that the above information is correct.I agree to compty with all ciry and TOTAL FEES 3� • �� I =� county ordinances and state laws relating to building construction,and hereby authorize representatives of this county to COMMENTS: z � enterupon the above- entioned propertyf inspection purposes. J L _ � ¢ PERMITTEE ME(PRIfJn :n = SIGNATURE OF PERMITTEE DATE RECEIPT# a aa�3 PAID BY: �a�SaS VALIDATION:�_ I WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Applicant's Copy CITY OF DIAMOND BAR IiVSPECTION RECORD � • e � • � - • • r � • � . ,SEI�BAEK%LETTER R �: � �� '� � TRACTAND LEDGER < . , , . � , F40TINGS FORMS Y" ��` ' � , � ' �;� ��; ; - SWITCH GEAR ,,.�� . , ; :-� SLAB��,� �: ti�#�� ,` � . , � � COMMERCIAL HOOD s�-,s, UG:;PLtJMBINC� �'��. :- �:�� . � �__ _ , T-BAR , . UG.,:ELECTRIGAL ' ��. ��° � �°�� „ ��"�.�: d INTERCEPTER _ _ �� , � � � , ,� . � � - ,: , ��xw� ,UFER GROUN� . ;�n�� .'��• � � � � � HOT MOPISHOWERPAN • SEWER LATERAL SEPTICi"CESSPOOL MAIN WATER LINE HERS REPORT RECEIVED SEWER CLEANOUT DEMOLITION ROOF SHEATHING ROOF DRAINS FLOOR SHEATHING ROUGH CONDUIT ..a�� _ a . ;SHEARWALLS�EXTERIOR � � , �� . , ¢' ' :POOLISPA ��e �. ..�.. , .: �SHEAR WALLS'INTERIOR, �`�' , �R , ' � ` � " ° `" � � ��. - 4, a � � �, -ROUGH PLUMBING , ` ° : ` ` �, -` .� '�" _ . , ��, m � _ . .�t. _ �P��._. . FRAMINGN�NTING '"��° ��a `� &< < $ - , ~ ` ;ROUGN EL°ECTRICAL - g , > � � ' �� : �. , �. a�� . ._ , RO'�'J�H M�GMANIGA� �� ` ��HOUGH MECHANICAL � � � ` � � �� : �,a _ �. „ _. _ � >- . . s ROUGH ELECTRI�ALrW( )C°,i ,}�'� `-�� ` � � ;� �� ' ��AS TEST � � ` �ROUGH PL°UMBING ��, ��. : s �s: - �� ,. PHE GUNITE �� 6 " " INSULATION WALL POOL PRE DECK BONDING 0 ' ' INSULATION CEIUNG p-T�P DRYWALL FENCE!GATEI ALARM IATH jPREI FINAL PdOL ° LATH EXTERIOR WALLS: IATH INTERIOR WALL FOOTING/STEEL GAS TEST � WALL STEEL 1s'( )2Ne( )LIFT � SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELEASE WALL DRAIN/SEAL GAS METER RELEASE WALL FINAL ., --. ._ _ SP�CIAIINSPECTION RO.FFIAAMINGPLANNINGAPPFiOVAL ° ° �.; ��. . __. ��. _ _ _ Fit�AL BUILDING � ��^� , ?� �� _ ROU6H-FIRE APPROVAL `� . ' u_� . �; ; FINAL FIRE DEPARTMENT FINAL�MECHAN�AL�" , ' ,�� ;�� r�� . w _ ,EINAI�ELEC7RICAL,,� ��, ; `�� , °.� ° s; , ' FINAL PLANNING ' _ ` fINA'L�'PLUMBIN6`��-� �' �� '; �a' � ' �*�� ' �� FINAI ENGINEERING/PW �� _ . � - _ , � w, .. ,T G;�of•OGCUPANCY k� ��'h - ��' � ' " � ' �� FINAL COMMUNITY SERVICES � � � � � � � , �� . ��4. a �G FiT.of 0�_� � � � � �. , �- <� ` GC!lPAlilC�( ,��, ,`� a _�- ��'- , __ . -, 'FINAL NEALTH DEPL � ` FINAL.INDUSTRIAL WASTE � � � � � � � � ` COMMENTS: