HomeMy WebLinkAbout15-0450�I►t,l�ll}311 I��It
CITY OF DIAMOND BAR � ass I3 /1 S'-
DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES
21810 Copley Drive, Diamond Bar, CA 91765 PRESS
(909) &39-7020 Fax (909) 961-3117 Building Inspection Hotline (909) 839-7027 FIRMLY
BUILDING PERMIT APPLICATION
JOB SITE ADDRESS
API&ZlO�LY i6LT TRACT , 3 6-54 5
OWNER
ADDRE Y"c
GCiY ZIP TEL _
APPUCANT Y,, 1,. + TEL
CONTRACTOR ram, F'7 iL"
ADDRES/Si' -3 L S �r
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CITY C7 5yp, q —zip Y227-T TEL L+ ,.L=..... �J
ARCHIENG(DESIGNER
ADDRESS
CFTY AP—TEL.
OWNER BIIILOM DECLARATION
I hers" efnrm order penalty al perjury that I am exempt hum the Contractor's State Lunn taw Iw the reason(s)
Indicated brefaw by the ehectunarh(s) I have placed next to the appliraWe WSI, [I6Oon 7D3f 5, Butunesa wW
Froienlars t;pda Any city or eotmty that mclulres a permit fo earstruM elh r, Improeo, da mllalr, or repair, -V
Btruom, pemr to Its Issoance. also ra tubes Ore applicant for the permit to flle a elpned staternaM that he or dw
13 li d prrsuenttothe provisions of the Corrtracbrs State License Law Poplar B'I Cwffwm nC wlth SedOh
7000 of Dhdelon 3 at the Oussiness and Ralealon s Coda] or to he or she 13 exempt fmrn Ncerimm and the basis for
the alleged axerrpson Any wdalon of Section 7G31 5 by any appllrard by a permit subjects the applicant to* oW pdmtty
at not more am &re hundred dollars (SSODI
()I esownoratthepmperty,ormyemployeeswith wattesestheir sale companwhion,xrllido(j dlaforUpoNons
of the worts, and the structure Is not Intended Gr offered for sale jSecbon 7044 Susress and Professions Code The
Contractors' State License law does not apply to an owner of property who, through employees' ar perwW effort buyds
or impmvq the property provided that the Improvements are not landed or vtfered for us 0 hDmaver, the buldog or
Improvement Is sold wdhln one year d completion, the Owwar-Bulds whi have the burden of pmrltg drat R was mi owl
or Improved for the purpose of sale)
(,_)1, as owner at the property, am exclusiraly contracting w#h licensed CorMaclars to senstrt el the project (Secdw
7044, Business and Professions (.ode The Contractors' Sate License taw does nct apply to as ownaf W property who
WO or Improvesmemort, and who, cadracts for the projects withalcwmWCw1mctorpvnkMtrthe CorNt Stals
ucarea Low)
(.)1 am exempt horn acenso o under the Conhaclar's Stabs License taw for ire f WAving eagvoir
By my signature W:iw I acknnnrtadgethal, a7xapl fo my p€ mnal w$1Iol I rtnrst M Ak at A& tma
year prior to rampleberr d itre Immo rrto Guwmd Gf ttts Dam it 1 ¢Doctor y saN a a rt€ ttsal l stave brat as an
awrrar buldar dt has nalf tascn cor&trctod in bw0nely by%ansaf � f a ropy cf tlla a
law, Seddon 7044 at the kdneas aM Pmf mwm Code a af&" UW 004UW OV ft apft9bW It UAnkled oat
ttw fetlomng Web stfo htMNww Isp nfa ca WvAataw ktrrt
DATE Sidi
iiGF MCONTRACTOR'SDECiARATION
I hereby Om kmft peoft of Wpy that I am kanliest urn Dmsisionx of UmM 9lvot tp whh Section 7D001
of OwWw 3 of On t#=n= at Pmteswonx Coda and my tkww 15 ki W puce Scud offoct
—UCKD
DATE (a
r c' ,..4iaG tr C
WOAfsWSODMPDZATM DECLARATION
f ►lfY Ati�kf 1� PENfA,TY ftF Pi�tR1RY OFTHf tvLtowtr� AECtAHATtOFS
............— I iseye and wrs mebWt a Certfta% of Consent to Sal insure for Worker a Cornpensauen, as pamded by
Section 3+juts of t Law iAde �r tkta �tlSrtttaflc9 at the work fur Nilid 111s, �mXt 16 issued
�1 bw and wN maintain Wader's Carnpansafim Insurar ce as required by Section 37W of she tabor Cade, for
the perfomrance of"work fur wNdt ft pemxt Is issued Mvvkrker a Centpansatiar kusaxartee Cartier end
CFa'iRtE1t � }1,,
IYSticlf NLihIIf�3 �-?,
{IFAS SFL1101V N� it5f � CZtr�LEtEA tFTtfE P9i5�gT S FOR � ITJ� D011NtS fst001 GR LFSSy
i mirly Win pw periorrr atwe of the mrittor wN0 this pw O Isim d 100 rid employ arty penmn In any rrmnner so as to
b=m wbj 4 to the walkar'a t mpenWw Lam of Cardomla Arid agree Mat If I should become subject to the Worker's
ampe n p1 won 3700 for �Labtlr� i shall fomwm Comply wlh those "is*s
OATS i APFUCANT c I ,`rsr �LLrG
KARNW Fauna to soctre Wodrara CorrrcraOsabon 4awMe is wttavdul and shall subject an employer to rltrninW
pttna tW and civil foes up to one hundred cxsusand dollars ($100 000) In addition to the cost of the CCmpan"bon,
dwtwgoa as pavidrxi for+n section 37M of the labor owe Interest, and attOmeys fees
COMTRIICTION LENDING AGENCY
I hereby efflmt under penalty of ptaro that there Is a Consauctim Lendmp AgM for the performance of the work for
whtdt Mis pew ra tasued (Soc 3097 Crt C )
LENDEN S NAME
LENDER SAODAMS
I ccrdfy that I have read this app'Icaton Drat state tha4lira Strove Informhen is correct I agree to comp* wary all ttty and
musty ordinances and siala taws relating to building and oemily audcrtte mpr= mativesof =county to
0(ft " pP am metmoled property to clap Xwn purposes
PER IhR
Sr RE OF PERM Ow
APPLICATION DATE .+ PfC# 1f
/
ISSUE DATE 02 / Z�II S PERMIT4 �
TYPE CONST OCC GROUP
ZONING SETBACK$
FRONT
REAR --
SIDE,'SIDE STREET
SIDE
Rw
C3
RW 0
PROPOSED USE
q DWEL UNITS N STORIES
N BEDROOMS
DESCRIPTION
SO FT
FACTOR PSP
ADJ AREAAIALUATION #
SFRIAt9DMEM
'
3
GaragwDsivort
i
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Patkr+>aOck
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lSoa
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rta-p w
I
commemmi
I
Itatuat Adj Area
QUANTITY
DESCRIPTION
FEE
�
I
I
I
I
CONSTRUCTION
PLAN REVIEW
ELECTRIC
-
PLUMBING
MECHANICAL
INSPECTION FEE
ISSUANCE
At .
SMIP
ENERGYP/C
ENERGY PERMIT
RETENTION FIFE^
PRE-ALT FEE
BSAF
E
,QQ
TOTAL FEIES; q7,
COMMENTS
qoa .1 '
I
W1M — Aepartrnom Copty YELLLiW -- Finance Cam PWK — Anewor Cagy, GGOLDENADO-- Fite Dopy GREEN—Applkw M Gopy
CITY OF DIAMOND BAR
INSPECTION RECORD
SETBACK! LETTER
FOOTINGS FORMS
SLAB
UG PLUMBING
UG ELECTRICAL
UFER GROUND
SEWER LATERAL
MAIN WATER LINE
SEWER CLEANOUT
ROOF SHEATHING
FLOOR SHEATHING
SHEAR WALLS EXTERIOR
SHEAR WALLS INTERIOR
FRAMINGMNTING
ROUGH MECHANICAL, -
ROUGH ELECTRICAL W( )C
ROUGH PLUMBING
INSULATION WALL
INSULATION CEILING
DRYWALL
LATH (PRE)
LATH EXTERIOR
LATH INTERIOR
GAS TEST
SCRATCH COAT
ELECTRIC METER RELEASE
GAS METER RELEASE
SPECIAL INSPECTION
FINAL MECHANICAL
FINAL ELECTRICAL
FINAL PLUMBING
T C of OCCUPANCY
CERT. of OCCUPANCY
COMMENTS
f,
INSPECTO.R.,,
TRACT AND LEDGER
SWITCH GEAR
COMMERCIAL HOOD
T-BAR
INTERCEPTER
HOT MOP/SHOWERPAN
SEPTIC/CESSPOOL
HERS REPORT RECEIVED
OEMOLITIDN
ROOF DRAJNS
ROUGH CONDUIT
POOL/SPA
ROUGH PLUMBING
ROUGH ELECTRICAL
ROUGH MECHANICAL
GAS TEST
PRE GUNITE
POOL PRE DECK BONDING
P-TRAP
FENCE / GATE/ ALARM
FINAL POOL
WALLS
WALL FOOTINGISTEEL
WALE, STEEL 1ST( ) 2HD( ) LIFT
WALL BOND BEAM
WALL DRAIN/ SEAL
WALL FINAL
RO FRAMING PLANNING APPROVAL
ROUGH FIRE APPROVAL
FINAL FIRE DEPARTMENT
FINAL PLANNING
FINAL ENGINEERING/ PW
FINAL COMMUNITY SERVICES
FINAL HEALT4 DEPT
FINAL INDUSTRIAL WASTE