HomeMy WebLinkAbout1370 VALLEY VISTA DR (23) (2)� -��;*�� C1TY OT DIAMOND BAR
_...
{ ( DEPARTMEI�3T OF COMMUNITY&DEVELOPMGNT SERVICES �
.�
��`v � '' 2181Q Copley Drivc,Diamond Sar,CA 91765 PRESS
}u►;n,:
���� ��� (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(N09)839-7027 F�RM�Y
' `'y`LP°� BUILDING PER141T APPLICATION
� � ��O �T /C.(? APPLICATION DATE: � Z� L r P/Ck r
w JOB SITE ADDAESS � ISSUE DATE: 7�Z J��� PERMIT#�� I�- �'Z�"�
I �
o ppN LOT TRACT
TYPE CONST. OCC GROUP:
o OWNER -7
y ADDRESS��/���� � � ZONING SEfBACKS
� CITY� �F�� �.�7� Z�P��--TEL._ FRONT RW �
¢ APPIIGANT TEL. REAR �
o _.�y� ,,-,n n SIDE/SIDE STREET `�=RW �
Q CONTR,4CTOR !�� ������C��C /�/tr �/7�(� SIDE �
oro ADDRESS�/�/���+ "'�" �Nv� ��� PROPOSED USE
o CITY�U�Y�/�N ZIP TEL / ""'� �
�-�-
" ARCH/ENG/DESIGNER
0
o ADDRESS t1 DWEL.UNITS #STORIES #BEDROOMS
a C�-ry Z�p TEL. DESCRIPTION SQ.FT. FACTOR PSF . ADJ.AGtEANALUATION
� owra�-am�n�ueciannnoN
� I hereby amrm under penatty of perjury that 1 am exempt hom the ConGac[or's State License law Por ihe reason�s) SFR/ADD/REM
� fndicated below by the checkmark(s),I have placed next to the aDDlipble item(s)[Section 7031b,Buslness and Garage/Carport
0
w Professfons Code:Any city or county that requires a pertnit to co�Wct,alter,improve,demolish,or repatr,any
z structure,prior to its issuance,also requires ihe applicant fm the pertnit to file a slgne0 statement that he or she w Patio/Deck
a is licertsed pursuaM to the provislons of the CaMractor's State LJcertsa Law(Chapter 9)Commencing with Section W .
N 7D00 of DWision 3 of lhe Business and Professions CodeJ or that he w she is ezempt hom Ilcensure and the basis for � P�USpa
�
� Ne alleged exemption,My violaGon ol Section 7031.5 by any applfcant for a permR subjects the appllcant to a civil penalty Z R�Root
N of rrot more than fiv2 huntlred dollars(55001.
�
o (_]I,as owner at the qnperty,or my employees wlth wages as thelr sole compensation,will do(�all of or(_]poNons � �mmercial
0 ot the work,and ihe strucWre b not Intended or ottered Por sale(Section 7044,Business and Protessb�Cade:Tne �
m
� Contractnrs'State License Law dces nat aDDh ro an awner of Droperiy vfio,through employees'or personal ettort,truilOs
w or improves ttie properly,providtd Ihat ihe Improvements are not intended or offered for sale.If however,ihe building or
� improvement is sold within one year of completion,the OvmervBullder will have the buNen of proving that it was nut 6uiit
pa imprwed for Ne Durpose of sale.).
V 1 8s oW ner ot tl18 fo e �
� U� p P rty,am exclusively cantracting with 1lcensed CanVactors[o consWct the pr ct(SecLon ValuatiOn: Adj.Area:
0 7pqq,Business and Professiorts Code:The CoMractors'Sqte License Law daes not appN to an owner ot properry who
z buildsorimDj�sNereon,ar+dwtwcbntractsforthepro�eclswithalicensedConhactorpursuanttolhaCon\ractors'State QUAf�ff'ITY DESCRIPTION FEE
�
Y ucense�aw.). p (j G C
p (�I am exempt hom licensure under Ihe ConVactor's Staie llcense law tor ihe following reason(s): �
� ¢
LL By my signaWre below I acknowleUge that,except for my personal residence in which I must have resided for at lea5t one �
z year prlor to completion of the improvements covered 6y this pertnit,l txnnot legally sell a sWcture that I have built as an ,y
0
� owner-builder If it has�rot been consWcted In its entirety by licensed contractors.I undershand that a copy of ihe applicabla
law,Sectlon 704A of ihe Business and Professirns Code is available upon reduest when this applica6on is submitled or at
� ihe follovnng Web stte:http/www.leginto.ca.gov/qlaw.html. z
DATE: SIGN: �
� LICENSFD CONTRACTOH'S DECtARATION
a
U
w I hereby affirm under penatty oi perjury thal I am licensed untler prwisbns of Ghapter 9(commencing with Section 700D)
� 'ol Divlsion 3 of the Business and Professions Code,and my I�ense is in fWl iwce and eflect. � �A/ '
� ucEr,sE ciass: u o.: ' `.��' 2 � / ^f T. �//�'I
� DATE: �7 ,� �S CONTRACTOR: � L/ �G
Z f ! �i� w
¢ WORKER'S CAMPENSATION DE N �
� I HFAEBY AFFIRM UNDER PENALTY OF PERJURY DNE OF THE FOLLOWING DEGJ�MMTIONS:
¢ I have ane wiu maintain a Certificate ol Consent ro Seu-tnsure Im worker's Compensation,as providetl by CONSTRUCTION:
� SecGon 3700 of the Labor Code,for Ne performance of the wwk for which this permit is issued. p�1N REVIEW:
�
� I have and will mainfain Waker's Compensa6on Insurance,as requlred by Section 3700 0l the Labor Code,tor ELECTRIC: �
o ihe performance oi the vrork tor which thrs permit is issued.My Worker's Compensatlon Insurance Cartier and �
¢ Po�i�yNumberare: �. PLUMBING:
a �qqp�Fp MECHANICAL: l� • �
w
� POLICYNL'uacoCD�C(/�R C � q INSPECTION FEE:
� (T}nS SECTION NEED NOT BE COMPLEfED IFTHE PERMR IS FOR ONE HUNDRED OOLLARS(g10(I)OR LESSI. ISSUANC E: �O�
oI ceAiry that in the pertortnance ot the vmrk tor which N's pem�it's issueu,�st+an rot emplay anY persm�arry mannu so u ro SM I P:
o become s�ib)ect to the Worker�Compeiva6on Laws ol Calllomi�.Md agree that II I shadtl be suDject to theWakers
u� Compen�sa,tim�°���°Section 3700 01 the shan� "' mp wilh se visia�s. ENERGY PlC:
LL DATE:1��-/JnaPUCaNT: � ENERGY PERMff:
� WARNING:FaiNre to secure workers CompensaUon c s unlawlul,antl shal ub an empbyer to crlminal RETENTION FEE: �a
� penallles and civil fines up ro o�e hunAred thousan ars($100,000),in addifion e cost of ihe compensation,
d damages as provided tor in sectim 3708 of the labor code,interest,arM attomey's tees. PRE-ALT FEE:
0
d CANSSRUCTIO!!4.ENDING AGENCY BSAF:
�j I hereby affum under penalry of per�ury thal Nere is a Construction Lending Agency fa Ne peAomiance ol the work for
= wNcti ihis D�mR is{ssuetl(Sec.3097,Gv.C.�.
3 LENDER'S NAME
� LENDER'SAD�RESS: /j�1�
� I certify that I have read thfs appliption and state that ihe above information is cortect I agree ro compty with all ciry and TQTAL FEES ��
� counry wdinances and state Yaws relating ro building construction,antl hereby authonze represeniatives ot this wunty ro COMMENTS:
z
o enter upon the above-mentioned property for inspection pu^rposes.
J {�� � —v ,/
m
¢ PERMf17EE
� -2 - 3
N RECEIPT k PAID BY: VALIDATION:
= SIGNATURE F PERM4TfEE �ATE
�
WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—Fle Copy,GREEN—ApplicanYs Copy
�
CITY OF DIAMOIVD BAR
INSPECTION RECORD
. � � . � - • � � • '
SETBACK/;tETTER � � " TRACTAND LEDGER
FOOTINGS"FORMS ' °° = SWITCH GEAR
S�g.;" ��,, i ���� ��� COMMERCIAL HOOD
UG.PLUMBING ;�r `� ' � " ���� ' � � �"s � T-BAR
�,,
UG:ECECTRICAL- ° ` � INTERCEPTER
UFER���GROUND�� �`,,, , ��.�. f,.. '" � - : HOT MOP/SHOWERPAN
_ . .
SEWER IATERAL SEPTIC/CESSPOOL
MAIN WATER UNE HERS REPORT RECEIVED
SEWER CLEANOUT DEMOLITION
ROOF SHEATHING ROOF DRAINS
SHEATHING ROUGH CONDUIT
FL
. :< ; . > , _ , ,.. ,,. ROOL/SPA-': . „ ;" � .., "='�` ' >':
SHEAR WACLS`E5(?ERIOR`��, : ' � 4 '
c,
SHEAR WALLS�INTERIOR �:_ ' ' " ROUGH•BLI:iMBING : �� ..1 - �' � k ��,3 `°
FRAMINGNE�ITING =_ __ _"' ROUGH ELECTRICAL`' y ` �` { fi ` � '' y
ROUGH MECHAN.ICAL 3 �� � - " ` �: t' �ROUGH MECHANICAL�: - ��` �. ��- �: �- �'"�- �
� << t � - �` GASTEST �� :�r �> �, �L � �- , � r�� �
ROUGH`EL�CTRICAL W( `S C( ) '� '"_.� ���, _ '" � �
ROUGH PL'UMBING ` 4 " �' PRE GUNITE'� ; �` } � ,'� " Y� �"
r ... ,., , , ,
._.. . .
INSULATION WALL p_�:�P :� -� ' ., ._ � ,.� ��,� � ���
, .��.� '�:. .:�r. : I� iF ��
POOL P,RE D,ECK BONDING ,r, � , �
INSULATION CEILING }
DRYWALL FENCE I�GATE/ALARM ' ' ': �
LATH(PRE) ,FINAL POOL, `;'� -• { � 3 ' `-� -
LATH EXTERIOR WALLS:
LATH INTERIOR WALL FOOTING/STEEL
GAS TEST W,4�L STEEL 1�( )2"D( )LIFf
SCRATCH CQAT WALL BOND BEAM
ELECTRIC METER RELEASE WALL DRAIN/SEAL
GAS METER RELEASE WALL FINAL
SPECIAL INSPECTION RD.FiiAMING PlJWNINGAPP,ROVAL ;t , ``}
, � :�;� �.. . � _ _, � : ROUGH FIREAPPROVAL "``` � ' �� '`_ �„�; a s ' r�';�,
FINAL BUILDING n
FINAL�MECHANICAL � l ': _ . FINAL�FIRE DEPARTPAENT ` ` ' `
FINAI`�ELECTRIGAL � � " ' � �"�. �, � �;:� F.INAL P.4ANNING �;:' _ : �` ' ' f` " :
FINAL;PtUMBING :,ti�; .`,, ; ;� .� . ` '' ; `.-,:: �':.�`�. � . =� FINAC ENGINEERING/PW , � ^ , Fr, ` -� '' ��`„
T.C:of;OCCUPANCY �` ` `� x F,INi4LCOMRAUNIFY;SERVIGES �, � �* � 7 � ,
CERT.°of OCCUPANCY +. ` ,..�� _ . ;'' ,- f FINAC HF�4LTH'DEPT `: �� k �
,-� , ,. ,�. . . °
FINAL IN� � , ' �� � ` Y
� �:
DUSTRIAL�WASTE_'':. ._._ � �:, �= � a �-__
COMMENTS:
�
r� .i 'i
. . . .. -}, .�... �. .- "-�'H ,L� , ..� . .,4�-_. `�aP...' ' • ."'I"" .--- _�w�t�. iv„ .'����� . ..=•�.:�:.. �f� -�'�'�1T�„- '�
, �S . • � . ,r'�.. ,5` � � , . . . . • � .
k ,�i
I F"r� �' � ;,�.?;. C1TY OF DIAMOND BAR J'
� � I' I DEPARTN�ENT OF COMMUNITY&DEVELOPMENT�SERVICES � v �
r � =J� " 2 1 8 1 0 C o p l e y D r i v e,D i a m o n d Bar,cA 9i��s ' PRESS
� = m,,;;:-
, � ' „_� (909)839-7020�Fax:(909)861=3117 Suilding L�spec6on Hotline(909)839-7027 , FIRMLY
. � • ' ��"��''. BUILDING PERMIT APPLICATION
I'aa��� / ��/� I/ p J �
� JOB SITE ADDRESS / �"� i �" !" N�J P� �r�� APPLICATION DATE: � Z� a/ P� � `a
w ISSUE DATE: ! a'`b' �J PERMIT# ` �✓~ /�`� '
a .
zo APN LOT TRACT
o OWNER TYPE CONST. OCC GROUP:
' j N ADDRESS I ' � � � ZONING 5ETBACKS
N CITY n• -_ �� ZIP �S TEL. FRONT �RW • D
a APPLICANT ' TEL. REAR • �
o n SIDEJSIDE STREEf �' "`RW ❑
� CONTRACTO �� r���G1��G /y�� �A�,` SIDE �
� z� � v �_
o� ADDRE�S^S � � PROPOSED USE �
� CITY !'�'V 'J � ZIP � TEL���
0
`� ARCH/ENG/DESIGNER
0
o ADDRESS � tl DWEL.UNITS #STORIES k BEDROOMS
Q CITY ZIP. TEL. DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANA�UATION
� ownen-euao�ofcwunoN
� I hereby atlirm under penatty of Deriury that I am erzempt hom the ConUacta's State License Law for the reason(s) SFR/ADD/REM
� intlicated below by th¢checkmark(s),I have placed next to the apDikxble item(s)[Section 7031.5,Buslrtass and �
o Garage/Carport
w Professfons Code:My ary m county that requires a permit to construct,alter,improv&demolish,or repair,any
zstrucWre,prtor W ifs Issuance,also requires ihe applMant for Ihe permil to file a signed statement that he or she w Patb/Deck '
a is licensed pursuant to iha provFslons at ihe Contractor's Sfate llcense Law(Chapter 9)Commencing witli Section � P�USpa
� 7000 of Divlsfon 3 of the Busfness and Pratessio�Code]w that he a she is exempt from Ilcensure and the basis fw
� �
� th¢atleged exemplion.Any violation ol Section 7031.5 by any appllcaM for a permit subjects the apDlicant ro a civil penalry Z Ra-Roof -
�� of rroi more than five huntlred dWlars(E500).
�
o (,I,as owner of the property,a my employees wlth wages as thelr sole compensatlon,wlll do(�all of or(.]poNo� d Commercial �
0 of the work,and ttie strucNre is not intended or oRered 1or sale(SeCtlon 7044,Business and Profess(ons Code:The � .
� Contracinrs'State License Law does not appty to an owner ot property wfw,through empioyees'or personal eflort,6utlds m
u�7 w imprmes 11re property,Drovided that the(mprmements are rrot intended w ottared fa sale.If however,the builtling or '
� improvement Is soltl within one year of canple8on,Ne Owner-BUIlOe[will have the burden oi proving that it was not�uitt
pa improved for the purpose ol sale.). ��.�.� �
� I.as ow�r of the Y 9� �
� u property,am ezclusivel contractln with ItcenseA Contractors to conshuct the pro ect(Section ValuatiOn: Adj.Area:
. o �pqq,Biisiness and Professions Code:TAe Conhap�rsi St?te License Law tloes rtat appty to an owner ol Droperry wtro .
z buifAsorimprovesthereon,andwhocontrxtsiqrthe�projectswithallcensedContractorpursuamtotheContracrors'State QUANTI7Y DESCRIpTIOSJ FEE
u�
Y License Law,). � � � �j L'')'/ / G C/ .
o .U���empl hom Iicensure under tha ConVactor's Staie Llcense law tor ihe following reason(5): � . �� �
� �
�—` By my signature below 1 acknowledge that,except for my persa�al residence in which I mus[have resided for at least one w . �
Z year prior to comptetlon ot the improvemenfs cmered by this permlt,l cannat lepally sell a swcture that 1 have built as an ��,, . . � �
o .
. Q owner-builaer if it has not been consiructed in iis entirety by licensed contractas.I undersfand that a copy of Me applic�6le . .
pC law,Section 7044 0l ihe Business and Professlons Code Is availabla upon request when�his applicatlon is submitted or at r�
a �the idlowing Web site:htlp/www.leginfo.ca.gov/calaw.html.� z ' . .
w °�
DATE: SIGN: �
� �� � LICENSED CONTHACTOH'S DECLARATION a .
v '
. w I hereby affimi untler penalty ot perjury that i am licensed untler provisions of Chapter 9(commencing wilh Section 7000)
� of Division 3 af the Business and Professions Code,and my Ifcense is tn full imce and eHect. J � �Q�/J � � ��-
� . � ��� ' , ✓ .
� ������: c'20 ���: : 3 2 = -
o DATE: ' CONTRACTOR: I-! �� ��P �-� .�.• �Q�• •' � �� . � . .
zd WORI�R'S COMPENSATION UEGIARATION � � � '
� f HEREBY AFFIRM t1NDER PENAL7Y OF PERJUHY ONE OF THE FOLLOWING DECIARATIONS . � � ,. � �
¢ I have end will malntain a Cert�cate ot Cansent to Sen-Insure ror Worieer's Comvensation,as provided by CONSTRUCTION:
� �Section 3700 0l the Labor Cade,tor Ne perfamance af the wmk tor which this permit is issued. pl_qN REVIEW:
�
j I have and will maintain WorkePs Compensation Insurance,as repuiretl by Section 3700 of Ne Labor Code,for ELECTRIC: �� �
o 'ihe peAortnance ot lhe worle far which this permit is issued.My Worker's Compensaflon Insurance Carrier eM . �
a PdicyNumberare: � f� PLUMBING:
n CARRIFA R� ��-`� MECHANICAL� � � ,
� PouCv t�uMBFA �F INSPECTION FEE: �,::,,y,;`�
� SEC�IDN�ED NOT BE COMPLEIED IF T}��PQ?Mf�IS FOR ONE HUNDRED OOLViRS(510�OR LESS). . � . „� .. .�
(� ISSUANCE: ,,d;;�`,,
o �I certitY ihat ln ihe DQAormance at ihe wak tor which th45 P�ut is(ssued,I shatl rot emP�Y�Y Pefs�n in am/manner so as to ' � � � •
Ueoome subject to the Workers Compensalion Laws ol Calilania.�Md e that if I should e subject in fhe Workefs . SMIP:
� can uon sectian37000t �iwtt�r�c�om orisi«rs. EPfERGYPlC: ''
J 'oATE���nPPUCnr+r. ENERGY PERMIT:
LL . ,
� WARNING Failure to secure.Workets Compensation covera is w�awlul,and shall sub an emptoyer to criminal RETENTION FEE: �
„� penaflies and civil fines up ta one�hundred thousand��rs(5100,0001,in addition�t6 ihe cost of ihe compensation, . . .
a damages as provided for in section 3706 of the labor code,interes[,and attomey's tees. ' PRE-ALT FEE: .
o �
d - , GONSiRUCT10N LENDING AGENCY � ' BSAF: � .
' w I hereby affirm under penaity oi perjury that Urere is a CortsUuction Lending Agency lor the pertormance ol the xrork lor � � - .
� which ihis permit is issue0�Sec.3097,Civ.C.). . � � � � '
� LENOER'S NAME ' � ' �
� LENDER'S ADDRESS: � �
" � 1 certiry Nat I have read this appl'uxtion and state that the above iniormabon is correct I agree tn compy with all city and TQTAL FEES ' � � �i�
���� county wdinances and state laws reiatlng to buildi�consWcfion,and hereby auNorize represenfatives of this county lo COM MENTS: � � . �
Z enter upolSthe abave-mentioned property far inspection purposes. � ' � - � � � �
r
�= G-L-,,�`N J J9 u?(3
a PERMfTTEE NAME'(Pfll � ' ' ' � � . � • I //7 �
'` � .�,�.��' , _/ "����� . � ,
� RECEIPTtt � d� PAID�BY:�� VALJDATION:
� SIGNATURE OF PFAMfTTEE � j DATE � . - � .
. - v . � . . � . . . � . .
. \, . , . . . ' ' , ' , ' . . , . . . ' ' . . . . .. �
- � WHITE—Department Copy,YELLOW—Finance�Copy,PINK—Assessor Copy,.GOLDENROD=�FIe'Copy,GREEN—ApplicanYs Copy ' � , �
. � � _ .... � . . .. , yi, :� • , � .. �l;'
, . . : � . '���'•_. . ...,•�.�.. ' � ' '
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. �..,�:�.aw}'.�stfA�c_ . . . . ,. ,. ... ,.. ..:.. .. . ,i �.. ,.. :..,�,.,�_� �...,,r
CITY OF DIAMOND BAR �
INSPECTION RECORD
. � � , , o . � � , . � .
SETBACKf IET�TER ,. � t '" ",^4�?' ,: ` ' '� " �`'`-'? TRACT ANO LEDGER
f00TiNGS FORMS , ;����� -- ��� SWITCH GEAR
�S�qg°� �� � , ;, � ' .� COMMERCIAL HOOD
'UG.PLUMBING,. ` , - � , ` - = T-BAR
,
-UG.ELECTRICA� „���- - INTERCEPTER
�. . ,
� �` '= .' HOT MOP/SHOWERPAN
UFER�,GROUND � � � �,
SEWER LATERAL SEPTIC/CESSPOOL
fNAIN WATER LINE HERS REPORT RECENEd
SEWER CLEANOUT DEMOLITION
ROOF SHEATHING ROOF DRAINS
FLOOR SHEATHING ROUGH CONDUIT
SHEAR WALLS EXTERIOR��_� _, t ��`�� � t ; POOVSPA�,, ' � � � ����
� 3r = .. .-, i u _ ta tia.
SHEAR WALLS INTERIOR�� ' � ` �-- R-_OUGH PLUMBING �` �_ ti � '�
FRAMINGNENTING �� � r ' � '` v �f - '� °'�: � ', � ROUGHELECTRICAL=�'`` '�� j � ? �
" " ` ° ; � z F `:; :, ROUGH"AAECHAN1GAt' *`f ' +` �r
.ROUGH NIECHANICAL , ,�; � '�� � - - , 4
ROUGH ELECTRICAL W(�,�)C(,) ��- r"� �,�:� . � .GAS TEST� �' ' - ` � �' � '� �
ROUGH PLUMBING � - � ' �. ,- ` ._'� `'� FRE GUNITE , _ _ '' �` f"
INSULATION WALL ��POOL PRE DECK BQNDING '+< .,Y'� , y ` r��`
INSULATION CEILING p�T�p '��, � ��� ��� i ��� �� ��
DRYVJALL FENCE/.GATE/ALARM , - �� t`
' .M1. 1?.�,Y y 3:
LATH(PRE) FINAL POOL. .�,; . . , ,.�,-`.
LATH EXTERIOR WALLS:
LATH INTERIOR WALL FOOTING/STEEL
GAS TEST WALL STEEL 1�T( )2N0( )L1FT
SCRATCH COAT WALL BOND BEAM
ELECTRIC METER RELEASE WALL DRAIN/SEAL
GAS METER RELEASE WALL FINAL
;RO.FRAMIN6 PLANMNGAPPROUAL - ;;` ` �
SPECIAL INSPECTION ' �,
FINALBUILUING `� - - � ROUGH�FIREAPPROVAL >� � 't � ,� Y�
�FINAI-MECHANiCAL '° h FINAL,FIR,E DEPARTMENT-.� '� ��"' � •' ` �`
'FINAL ELECTRICAL " FINAL.PL'ANNING� ' - � ` � 5''��':`� `� �=� ` }_
FINAL'PLUMBING r�. t � `� 7- t FINAL ENGINEERING/PW :'. r r� : t-t ; .
2C.,:of OCCUPANCY. ,� � � FINAL"COMMUNITV SERVICES �' � ",,` � ,r�'�� , �
' - _ ,
� �, v ' t,r - 7r = ,
� „ „�� � � �
' ... .,� � � �i
CERT.of OCCUPANCY;; . .,. ;. ' � EINAL HF�4LTH DEET . . �: � : -° z '- �:�:
, :
._.:_ . .�.,..- ,,. - ..
. .;-.,_. Y ,,.. ., , F
'fINAI'INDUSTfl1AL WASTE; °' r` '� � y �
�
� ,. o- ._,
COMMENTS:
�.. ..,r �...,_ .
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�. y � �' . i:,_;�,�r+ y. ..� h Eit gr-»":�3,F�r,'�i�'���� , n
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� �' "`' �^�.�'''�� �� CITY OF DIAMOND BAR � � � � � � � �
7 ' �I � � � PARTIVIENT OF,COMMUNITY&DEVELOPMCNT SERVICES �'� � ��
-.�� r,,���j;,�:�- 21810 Copley Drivc,Diamond Bar,cA 9i��s PRESS .
� \�, ,,��'� (909)$39-7020,� Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 FIRMLY
, � •_ �" ." BUILDING PERMIT APPLICATION � r •
r^"g �'/�'��J '���-�,Qi t, , j �J APPLICATION DATE: � � � P/C#
� JOB SITE ADDRESS A' �I 5+�� � �`� x ��� � r
, a: � . � I
z APN LOT TRACT ' ISSUE DATE: � � S r � PERMIT# � � � +�t I��
0
o 'OWNER . , ,, TYPE CONST. OCC GROUP:
�, 'ADDRESS � .a+, IF�-':' L'��'1�..'�/' �r (/!t S I:'� !�t;
,� '1} /.r� t f � G t ZONWG SETBACKS
N CITY.,:. P�. � � ZIP /rl �J TEL.
FRONT RW ❑
�. APPLICANT TEL. REAR ❑ �
0 .�y�
> 1 I !� : ;':•`���..FJ``A�, Y Cti •�[ !�)i E'; SIDE/SIDESTREET 7 RW ❑
a
CONTR,4CTOR SIDE ❑
� � ADDRESS'?�t'�'% I� �:.�('''�-,'rI:'`i� ,�;1 G't� .
ac CITY i�.7! �=F�i EJ f/. ZIP �1'r�-�%� {-��L I t'" ' 'r:�j f-/,� PROPOSED USE , /�I./�ifl n
o TEL. ,1�.�.a:i �r P ��
o ARCH/ENG/DESIGNER �
w ' .
o ADDRESS ti DWEL:UNITS #STORIES #BEDROOMS
a- CITY. ZIP. TEL.
� • , avvH�-sm�nm oecwwnor+. .
DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
; o I heretry attirm under penatty of perjury ihat I am exempt hom�the Contractor's State Ucense Law tor the reasai(s) SFR/ADD/REM � � - ,
�p .intlicated below by the checkmark(s),I have�placed next�Po the�applicaWe ilem(s)[Section 70315,Business and Garage/Carport � � �
. o Professions Code:Any city or caunty that�requires a permlt to construcl,alter,improve,demolish,a repair,any . �
. z structure,prior to its iswance,also repuires lhe applicant for the permit to fila a signed statement that he or she � Patio/Deck � �
, .N is licensed pursuanl to the provfsions of the Contractor's Slate Ucense Law(Chapter 9)Commencing with Sectfon W � � . ��
, � ,7000 of Uivlsiom3 0l the Business and Prolesslore CodeJ or ihat he or she is exempt from Ilcensure and the basis tw . LL Pool/Spa � .
'� the alleged e:empfion.Any viWation of Section 7037.5 by any applicant iw a permfl subjects the apDlfcant to a civil perqlty C7
� ��of not more than frve�hundred dollars(y500). -. - � � � Z Re-Roof ' . . � � ' ��
.. � , . . , . • .
' o� (��,��ner of ihe property,a my employees wlth wages as thelr sole compensation,will do O all of or(,portlons � Commercial � � �
�� of the�work;and the strucWre Is not Intended or oflered for sale(Seclion 7044.Buslness and Protesslons Code:The � �
�� � �Contractnrs'State Licerise Law dces not a � � m � � � ' � �
. z ppty,to an owner of property vfio,through employees'or personal eBort,builds � � �
- �.w or improves the property,proJided ihat iho Improvements are not intonded or offered lor sale.H however,ihe building or � �I
�� g improvemen[is sold vnthin one year of compleUon,ihe Owner-Biiilder will have the burden of proving tha[It was,not bull[ � � �
� �o� a Improved for ihe.purpose of sale.). � ' �. ,,.� � .
(�I,as owner of the property;am exclusivety contractlng with I ertsed Contractors to�constmct the project(Secllon . � .
.,��o�� 7044,�Business and Prolessions Code:The COMraetas'Stale License Law does rwt a � ValuatiOn`. ' � �Ad�.Area: ' �
z. . . DPN to an avmer of pmperty who � � . 1 �
� N �builds or improves t�ereon,and who conVacts for`the projecls wiN e Ilcensed ConVactor pursuant to Uie Contrac[ors'State QUANTITY ' DESCRIPTION FEE�
.Y �Ucense Law.): . • .� ' ,'� - . . . .Y• J.`.f' � ^d' -' �S!1 ���.+J r/
� �^<- ..t� �I�"•� ►., •,+ �`"�! �.r��i�•
.� � .�j I am exempt hom Ilcensure unde�the ConVactofs State llceiue law io�ihe tollowing reason(s): .. . ' �
�, , �
' `i' B m si nature below 1 acknowled e that,exce t tw m � � . � � � �
Y Y 9 g p y personal reslde�e in which I must hava residetl lor at least one
�, .o year prior to compleUon oi the Imprwemen4 covered by this permit,l canrrot legalty.sell a structure mat 1 have built as an w � � .
a owner-builder if lt has rwt been constructetl in iLs entirety by licensed contractms.I wdershand that a wpy of the applicable. • � � '
• � law,Sectim 7044 0l the Business and Professlons Code is available upon request when this applipUon is submttted or at � . � .
�� X �Ne tolrowing Web stte:httphwrw.leginfo.ca.gov/calaw.hhnl. . � Z � �
w �ATE: ' SlGN: � . . , � m , , . � .
O g
�� �� � . �• . LICENSEO CONTRACTOfl'S DECLARATION ' , � � � �
a
� I hereby affirm under�penalty of perjury that I am licertsed untler prwisior�s ot Chapter 9(commer�cing with Section 7W0�• � . � . �
m oi Dhrison 3 of the Business and Professions Code,aiM my Ocense is in tull torce and effecL � � �,.�16 t �l.���j�J�,� �!.(
� � . . iA• �.., .
N ucer,sEaass: .�'�� uc.No;: � l��J�.�- _ � �,a7` ,}�,.%'7;..�
" ' /`y'�-.
Z DATE: ?T'��.:1� ""I_'i CONTRACTOH: �' �•-'r•�..�+-,� .u .rr,:.--C' � _ `��, 1�I�f G f� . � .
� Q WONNEH'S COMPENSATION DECLAFlATION f � ���-�� g � �
�, .� I HEREBY AFRRA7 UN�ER PENALTY_OF PERJURY DNE OF TNE FOLLOWING DECLARATIONS:
o � I have aird will malntain a Cerlinnte ot Consent to SeH-Ins�ire tor Worker's Compensation,as provided hy � CONSTRUCTION: � �
� � Seclbn 3700 of Ihe�Labor Cade,for the perfamance nf the work fa whfcli this permit is issued. PLAN RE1/IEW:
.��� I have and will maintain Worker's CompensaUm liuurance,as reqWretl by Section 3700 oi ihe Labor Cade,for ELECTRIC: �
u
Z the peAamance of ihe.work for which this permit is issued My Waker's Compensation I�uurance Carrier and � . � �
iu
a PolicyNumbera2: .�.:�- �y •� PLUMBWG: �
� CARRIER lr7a i a����'1'�V . . ._ . .
z �a ,r !r c� MECHANICAL: � '.<
�. . POLICY NUMBER- ��C � - � f��
INSPECTION FEE:
� . (TH6 SECTION NffD NOT BE COMPLEfED IF.1HE PERMIT IS f-0R ONE HUNDRED DOLLARS(S10Q!OR LESS�. - . . ''��-f` - ¢f'.. �
'o I certify,thal in tlie perlorrr4vice ot tlie�wrk la which this permit's issued,t shafl rrot em ISSUANCE: ' �. _
PbY�Y De�����Y rtianrcer so as to SM IP: �
o hewme subjecl to Ihe Waker's Compe�uatian LaxS of Calilomia.Md agree Ihat If�shmikl becbme subject t�the workets � - .
� Campensation prorisions'of Sechon 3700 ot the Labor Code;I shaA IaUm�Ni compry wilh those piovisias. � 'ENERGY P/C: � �
J oa�: /"��'`.1,✓nrvucrwr. (�'-' �"'D`C'-CCr"•',--.� �'',r�'`'`y,"r
" ENERGY PERMIT:
� WARNING Failure to secure Worker's Compensatlm coverage a unlawlW;and shall ubjecf an employer to criminal � � � ,
w penattles and civil fines uD to ona;hundred thousand'doliars($100,000),in atldiGai to the cost of ihe wmpensation,. �RETEN710N FEE: � �
o damages as provided tar in sectlon 3708 0l the labw code,interest,antl attomey's,tees. PRE-ALT FEE:
a � . � � CONSTRUCTION LENDING AGENCY ,� . - ' � ' � BSAF.. � � � ' �
� I here0y amrm under penalty ot perjury ihat there is a Constructiai Lending Agency for the perlormance of the work lor � . � � - . .
which this permit is issued(Sec.3097,Civ.C.): �
� LENDER'S NAME � � � � � � �
�� LENDER'SADDRESS: � ' � � �
��a I certity ihat I have read this application ane state ihat me above intorma6ai is cortectJ agree to compry with all city and TOTAL FEES � � • • � . % �
dr�
� �Z counry ordinances and sFate laws relating N huitding constructlon,end hereby authorize representatives of this county to . COMMENTS � � �
�p �enter upon the.abave-mentloned property for inspectbn purposes. - � � . � . . . �
J � � �� . . . . . , , ' .
' m ��-�-�--�-/�f , J/�'���l�, �s '
a� PERMfTTEE NAME(PRINn%^7 • �^. .g ' • � � . ! /
N if�" /j.�,..�*-�. �,�i'�i�'r�� �-r�-J�� �i ' ' ,I /J,/� y /f�
� SIGNATURE OF PEAMfTTEE � '" - G'' DATE � � � � RECEIPT#f' " �?�`$�` � PAID BY:�i� � VALIDATION: �!-'"��
. ...r� . . . , . �
,, WHITE—Department Copy,YELLOW=Fnance Copy,PINK—Assessor Copy,GOLDENROD-Fle Copy,GREEN=�ApplicanYs Copy- ' '
CtTY OF D(AMOND BAR
iNSPECTION RECORD
� � , • - � • � � - • -
SETBACK/LETT�R ;' '` ' TRACT AND LEDGER
FOOTiNG$FORMS '�- � � f;,`._,' " SWffCH GEAR
S�B "- y�l " � , �' -` COMMERCIAL HOOD
UG.PLt1M81NG �, ° T-SAR
llG:�ELECTRIGAL �'s �`, � .��_ `��� � s ` INTERCEPTER
'UFER GROUND _ � y`Y � ",`�M� ;'tit . t,��: HOT MOP/SHOWERPAN
SEWER LATERAL SEPTIC/CESSPOOL
MAIN WATER UNE HERS REPORT RECENED
SEWER CLEANOUT DEMOLITION
ROOF SHEATHING ROOF DRAINS
FLOOR SHEATHING ROUGN CONDUIT
SHEAR WALLS EXl'6RIOR , `'' �. ';��� "r �POQUSPA ,`r r,"` r`; '� _ ;;��
SMEAR WAGCS•INTERIOA . =' "" - `: ROUGH PLUMBING ' �_
>, ., ._
. ..
.. . .
U=S.��s
FRAMINGZVENTING� '�'� �; °- ROUGH.EL�CTRIGAL ^' �y'--.
- �•=`?
ROUGHMECHANICAL=� =�` �F'� - ROUGHMECHP,NIGAL ,,'i.-` `�;:,, r r. x- r`r�':
ROUGH ELECTRICAL�NI( ,).0(°') - ' - - ;GAS'TEST �- • ;" =:� �`:
. , _
. _.
.. � - - � -
_ � ,., ,�.,. � .: .
. _. `.
.. �.-. ,-z• � < ,. .
� .,_
HOIJGH PLUMBING �_: - � _.'3�.,,� `',, ; - ;PRE,GUNITE - L ,;;�., ,', _ :�v!
INSULATION WALL PODL PRE DEGK.BONDING.�. _ �" �' '��
r=� � .�.
INSULATION CEILING �P=TflAP�� . �` '� �"
, _ _. . _ __;�
DRYWALL FENCE/GATFJ AtARM r' ' ;" ' > .
LATH(PR� `FlNAL POOL '; ;- ;i;:_ - �`�`
LATH EXTERlOA WALLS:
LATH INTERIOR WALL FOOTING/STEEL
BAS TEST WALL STEEL 1sr� �2eo� )LIFT
SCRATCH COAT WALL BOND BEAM
ELECTRIC METER RELEASE WALL DRAIN/SEAL
GAS METER RELEASE WALL FINAL
... :.
SPECIAL INSPECT(ON �RO,FRMAiNG�PLNVNtNGAJ?PRQVAL " '� " ' -�
J�, � , �
F(NAL BUILQtNG i � ` � � ��' >ROUGk FfREAt'PROVAL' ' ` " � '�" '' ' -�=f
FINAL MECHANICAL:',;: � . . : " 'k#y ,,. . � .•.- � FINAl.FIRE DEPARTMENT ; �' ,M
_ ,: t� � �
,x. ,�. , - -� ..� -
FINAL ELECiHICAL, - _ _- ' ` - FINAL PLANfdING� - , �.�.,,,`
� _. . : _ _
FINAL PLUMBING, .,�' � <'� - FINAC ENGINEERIN6/RW ' - `'�
PANCY= . `; .,�; , _ _ _ -
�
, ,,- t :- , _ , FINAL COMMUNIiY SERVICES . ' c `:
T.G::of OCCU ' `� .
CERT.of OCGUPt1NCY � �` _ ' ° '� �>-
� ,., °� a��� �-.��� FINALHEALTH.DEPT., � ,,s��. �, �,�;�-�
FINAL'INDUSTRIAL WA5TE ` , �`,� r : ''. t �;.;-
. �.. _ .
COMMENTS:
- —_--_ rt. _ .,;.,. - ..rl, .a� K _-_ . �_ .., " . . . " , .d�l�L _ ...1 y .
,.. .,,.,,, _, _ ...,, -..-.�,.r . : �;� � � , j
- r = � '' i i.
. � � '1 t.-h: " . .. ._, ..9, . . , . . • . ..
�-� ,,�'�5� C1TY OF DIAMOND BAR �
;•' ' ,.,. .
'� ' �� ; I I 1 { ' � DEPARTMENT OF COMMUNTTY&DEVELOPMENT SERYICES � � E
, � .,�g�„�:y- �� ' 21810 Coplcy Drive,Diamond Bar,cA 9��fis PRESS
;r u,,,� (9p9)839-7020r. Fax:(909)861-3T17 Building Inspection Hotline(909)839-702T F�RMLY
� . � '���'��°'� BUILDING PERiVIlT APPLICATION � �
� q,-•? � ;r
�'� J� • � ' '� APPLICATION DATE: � � � P�C�
¢ JOB SITE ADDRESS � ` �� #��� � L��'f �� ���� � ��� !
w � ISSUE DATE: ��� �'e � � PERMIT# t�r� ��� �����
oAPN LOT TRACT
o OWNER • 1YPE CONST. OCC GROUP:
,.,� . :_� „
N ADDRESS ! _� di �: '<''""' . '• ,• .` �'ti ZONING SETBACKS
J CI7Y�.� •,,'"�° t .`1" ''�+! 7r"� RW ❑
� Z1P � TEL. FRONT
a APPLICANT TEL.
REAR �
� RW ❑
o ^,. � � , SIDFJSIDE STFiEET
> CONTRACTOR � � ° ` " � �-^ � " , '�r � � , SIDE �
c� ADDRESS.: .�+�i'_ :: "e ` •> • ''�' ' T t.{�Q ' „
, PRQPOSED USE r�'
cc CITY ;!�-'iw� ' • ZIP ,�/- •i TEL��� ' � ��� ` {�' p�n�" �
o �
" ARCH/ENG/DESIGNER
0
' o ADDRESS #DWEL.UNITS #STORIES #BEDROOMS
a CITY ZIP TEL. DESCRIPTION SQ.�. FACTOFi PSF ADJ.AREANALUATION
� DWNFA-BUIIDEA DECLAAATON
� SFR/ADD/REM
0 1 hereby amrm untler penatty of perjurY that I am exempt hom the Contracta's State�cense Law for the reason(s)
o indicatetl below by the checkmark(s),1 have place0 ne#to the apDlipble item(s)[Section 7031.5,Buslness end Garage/Carport'
'-'-' Protessions Code:My ciry or couMy thal requires a permit to consWct,alter,improve,demolish,a repalr,any
. z structure,prior W its issuance,also requires Ue applicant fa the permtt to file a signed statement Mat he or she t� .Patio/Deck .
' a is licensed pursuant to the provislons ot the CoMraclor's State License Law(Chapter 9)Commencing with Section W
� N 70W of DiNsion 3 of the Business a�M Professions Code]or that he or she is ezempt from Iicensure arM fhe basis for � P�Spa �
� �
. � Me alleged ezemD����Y�olation of Section 7031.5 by any applicant for a permit subjecLS the aDDlicant to a civil penalry Z Ra-Root
� of imt more tlian five hunareA tlollars�$500).
tc � Commercial
o (J I,as owner oi the property.a my employees with wages as their sole crompensation,will do U��o�a L1 PoNons �
� ol the work,and ihe strucNre Is not Intended or oRered for sale(Sectlon 7044.Business and Professions Code:The m
�� Contracturs'State License Law dces not appty to�an awner of property vfio,through employees'or personal ettort,builds
w .or improves tl�e property,provided ihat the Imprwemert[s are not intended or oNered lor sale.If however,the building or ' .
� Improvement is soid within one year oi canple6on,the Owner-Builder will have the burden of proving that it was not huilt
� or Imprmed fw ihe pur(pse of sale.). i. �' �
o i '
� I,as owner ot the ro e !y contractln wiN Ilcensed Gantracrors to canswct the project(Section
u p p rry,am exCusNe H Valuation: Adj.Area:
0 7044,Business and Prolessions Cotle:The Coritractors'Stale License I.w does rtot appy to an mvner of Droperty who
Z buildsorimprave5thereon,antlwhoconVactstortheprojectswittialicensesedContractorpwsuanttatheContraclors'State Ql1ANTfTY DESCRIPTION FEE
YLicense Law.).� � . � � � �i., "1 . ..;� (`. . �
o U I am exempt hom licensure untler ihe ConVacinr's State License law for the lollowfng reason�s): �
� �
`i By my signature below I acknowledge tha[,except for my personal residence in which I must have residetl lor ai least one w �
Z year prlor to compleBon of the fmprovements covered by ihis permit,l cannot legalry sell a sWcture that I have twill as an „�, �
0
� � owner-bullder if A has rrot been construc[ed in its enCuety by Ircensed contractors.I undershand ihat a copy of the applicable .
law,Section 7044 of the Business and Protessiais Code ls available upon repuest when this application is submitted or at
X the tollowing Web site:hilphw�nv.leginfo.p.gov/calaw.htrnl. • m
w DATE: SIGN: ?
� . LICENSED CONTfiACTOR'S DECLAHATION a
U
w 1 hereby afFum untler penatty ot perjury that l am licensed wder provisions of Chapter 9(commencing wilh Section 7000)
� of Dlvision 3 01 the Business and PrMessiorts Code,and my license is in full torce and eBect. r� :t '!
� � UCENSE CLASS' 4.. .��'�� LIC.NO.: � t�`'��+✓��J';,�. � j ,•'-f. ';`�'.. . . �'�+., i
Zo DATE: ��i "'..c. '��_ 1 • CONTMCTOR: � ' � . ' . - w l:' '�'' i,..* I
. ¢ WOHI(ER'S COMPENSATION OECLAHATIUN � �
� I HERFBY AFFlRM UNDER PENAL7Y OF PEflJURY ONE OF THE FOLLOWING DEp1aF1ATI0N5:
¢ 1 have and will malntain a Certifirate o(Consent to Self-Insure tw Worker's CompensaGon,as provided by CONSTRUCTION:
� � SecUon 370D ot lhe LaDor Cade,for Ihe peAormance of the work fa which this permit is issued. �- - �
� PLAN REVIEW:
� j - I have and will mainiain Waker's Compensatfon Insurance,as repuired by Section 3700 oi the Labor Cade,for ELECTRIC: ��� ��
�o� me pertormance of the work fa which ihis permit Is issued.My Worker's Compensafion liuurance Carrier anA -
.�. ¢ Policy Number are: ....-C,,, � , PLUMBING:
� - CAftPoER .n�r� �' ��"t;�;.�"�%V � MECHANICAL: � {�'�• �� .
� roucvpUMB�"��.:�' - ��.' ��f•= -' �� INSPECTIONFEE: ,p
N (TFflS SECf10N N�D N0T BE CAMPL£fED IFTF�PEFiR11T 5 FOH ONE NUt�RED DOLLMS(570�OR LESS�. � ISSUANCE: *p`����6y �
� 1 cerli(y that in the peRormancfl ot�he wak tor whiCh Ihks permit is tssued,I shall mt empby arry persm in anY man�rer so as M SM I P: .
0 6ecome subject in Na WakerS CompensaGon Laws of Califomla.And agree ihat if I shoukl becnrne subject Oo the Worker's
Compensation{swisions at Section 3700 ot ihe I�or Cais,I sh�ll tMhwith canpH vritn thase urovisias. ENERGY P/C:
`�` . _ rH . �,', : c _ • _.'1
LL ;oaTE: �`�` ° nPruGwr.-�` � � -` ,- '� �,�`` ENERGY PERMIT: ,�a�
� WARNING Failure to secure Worker's CompensaUon coverago is un�awlul,and snall sub�ect an employer to criminal RETENTION FEE: � Q�g"r
w penatties end chril lines up to onethundred thousand�dollars(5100,W01,in addition'to the cost oi the compensation,
a tlamages as provided for In Section 3708 ot the labor code,interest,and attomey's fees. PRE-ALT FEE:
� C�NSTRUCTION IENDING AGENCY BSAF: �
Z I hereby amrm urMer penalry of perlury Nal there is a Construction Lending A9ency tw Ihe pedormance o11he work tar �
w �
� whic�ihis permit is issued(Sec.3097,Gv.C.). '
� LENDER'S NAME ,
� LENDER'S ADDRESS: �
. a I certify that I have read this application and state that the above iniormation is correcL I agree ro compry with a11 ciry and TOTAL FEES . ��•�
� counry adinances and state laws relatlng lo building cons6uctlon,and hereby authorize representatives of this county to COMMENTS:
Z enter upon ihe.above-mentioned property for inspection purposes. �
,p
; . f�,�•�„��.+� �y"�' °�'`�'a,!' , '
E' . .�
Q PERMfTTEE NAME(PR1Nn � „�. A± tf Y � '� j �[r *`�,,
� RECEIPTk f�01'� 9 PAIDBY� T �� VALIDATION: �' �^*`
�
= SIGNATURE OF PEHMITIEE 4� �A� ,
�
� WHII"E—Department Copy,YELLOW—Finance Copy,PINK-Assessor Copy.GOLDENROD—Fle Copy,GREEN—ApplicanYs Copy
CITY OF DIAMOND BAR
� INSPECTION RECORD
. � � . � . . � � , . � .
'SETBACK!LETTER " TRACTAND LEDGER
FOOTINGS FORMS = � SWITCH GEAR
• : �- : ; -. . >' C
g�qg OMMERCIAL H000
UG:PLUMBING - - — �-`' T-BAR
UG.ELECTRICAL INTERCEPTER
UFER GROUND '`'�- HOT MOP/SHOWERPAN
SEWER LATER,4L SEPTIC/CESSPOOL
MAIN WATER UNE HERS REPORT RECENED
SEWER CLEANOUT DEMOLITION
ROOF SHEATHING ROOF DRAINS
FLOOR SHEATHING
ROUGH CONDU
�SHEARWALLS'EXTERIOR; _ � POOUSPA_� . ; _ � � k
,SHEAR WALLS INTERIOR;,� �1 � ROUGH PLUfVIBING �_ �� �� 5 ` � F � �' �� y=
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COMMENTS: