HomeMy WebLinkAbout1050 GRAND AV (25) _M�'�,'�'�.•�_ Cl'CY OF DIAMOND BAR �"I� /vl G/�'( �/
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� � DEPARTMENT OF COMMUNITY&DEVELOPMGNT SERVICES � �
�— ��-��� , � ' 218'10 Co
� ,��111��i`-.=' � plcy Drivc,Diamond Bar,ca 9���5 PRESS
,�,,� (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 F�RMLY
�4�'L"°�- BUILDING PERMIT APPLICAT[ON
� JOB SITE ADDRESS �� �✓ �✓ /h, APPLICATION DATE� p/Cq I
z APN T TRACT �jj� �pM./+
ISSUE DATE: � PERMIT# /� I�'�d
o OWNER / � TYPE CONST. /�Yi"/�w/� OCC GROUP:
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� ADDRESS l Z ✓P/.
¢ CITY�/'171/7�� Gq ZIP 2 � TEL. q� •(,'7 t{ ZONING F ONTCKS RW ❑
� APPLICANT TEL. REAR ❑
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� � SIDE/SIDE STREEf RW ❑
a CONTRACTOR O V�A / S � C SIDE
� ADDRESS L � 13o/�ha� V ❑
o CITY , ZIP�Z 70S"TEL.��' �G7�7%f'I PROPOSED USE $ G7i '� 1.f� �9Go N'`' G
o ARCH/ENG/DESIGNER
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o ADDRESS
H DWEL.UNITS #STORIES #BEDROOMS
z CITY ZIP TEL.
� DESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION
owN�t-euuo�oecuu�nnoN
o I I�ereby amrm under penatty of perjury that I am exempt hom the Coniracta's State License Law(or the reason(s) SFR/ADD/REM .
1p (ntlicated below by the checkmark(s),1 have placed nezt to the apD�icable item�s)(Section 70315,Business and Gerage/Carport
o Professiom Cade:My dty m county that requires a permit to ca�xWct,alter,improve,demolish,w repafr,any
w structure,priw to fts issuance,also requires the applicant for the permit to file a signed stalement that he m she � Patio/Deck
N Is Ikensed pursuant to llre provisions of the CoMractols Sfate Liceme Law(Chapter 9)Commencing with Section W
� 7000 of Dfvlsion 3 of the Business anA Prolessions Cotle]or that he w she is exempt hom licer�sure and the basis for LL P
N the atleged exemption,My violafion of Section 7031.5 by any applicant lor a permft sub�ects Me applicant to a civil penatty C� �
� 01 rot more than(rve huntlretl tlollar5($500). Re-Roo
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o U����er of ihe property,a my employees with weges es their sole compensatlon,wlll do(J all ot w U portlorts � ommercial
I � ol the work,arM the struc4�re is not intended a otfered tor sale(Section 7044,Business and Prolessions Cade:rne �
� Contractnrs'State Llcense Law dces not appry to an owner of o m
z pr perty who,through employees'or personal eflort,builds
w or imprrnes ihe property,D�'�ded ihat ihe improvemerrts are not inten0etl or ottered for sale.11 however,the builtling or
� tmprovement Is sold within one year ol compleUon,the Owner-Builder will have Ne burden o1 proving ttiat it was rqt�uitt
� p a imprmed fw the purpose of sale.).
� I,es owner ot the ro
r U p perty,am exclusivery contracting with Ilcensed Contractors to canstnict the proJect(Section
0 7044,Bislness and Professions Code:The CoMractors'Stale License law daes not appty to an owner of properry wlro Valuation: Adj.Area:
Z buHds a improves mereon,and who contracts(or the projecls with a licensed Contractor pursuant to the Coniracrors'State QUANTIII' DESCRIPTION FEE
�
Y ucense Law.).
o U���empt hom licertsure untler lhe ConVactor's State Ucense law for Ue lollowing reason(s): �
� By my signature below I aclmowledge Uiat except for my personal residence in which I must have reslded lar at least one �
� o year prior ro canpletlon oi the improvements covered by ths permit,l canrrot legalry sell a structure ihat I hare buill as an �
w
� owner-bullder Ii it has rrot been consWcted ln its entirety by licensed contractors.l understand that a copy of tlie applicable
� law,Section 7044 ot ihe Business and Professtons Code is available upon request when ihis applicatbn Is submitted w at
� me following Web site:httpAvxtiv.leginfo.ca.gov/calaw.html. �
z
o DATE: SIGN: �
� LJCENSED CONlRACTOfl'S�ECLAHATION �
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„� I hereby affirm under penatty of per�ury Mat I am licensed untler prwfsions of Chapter 9(commencing witti Secfion 7000)
� ot Divlsion 3 of ine Business and Professons Code,and my license is in full tarce and ett}}}e��Jct. �
0 DATE: 3��.a.1 �� COMRACTOfl• ur'N!'�`oV/6 21'B` 1�C YJ� 4x
� w
WORNEp'S COMPENSATION OECLAHATION g
� I HEREBYAFFlRM UNDER PENALTY OF PERJURY ONE OFTHE FOLLOWING DECLARATIONS: '
0 1 ave and will maintain a Cert�cate ot Consent to Self-Insure tw Worker's Compensation,as provided by CONSTRUCTION:
� SeCtion 370D ol the La�or Code,for Ihe pertmmance af the wwk for which this permit is issued. p�qN REVIEW:
� I have am1 will maintain Worker's Compensation Insurance,as requiretl by Section 3700 of the Labor Code,fw
Z me peAormance of the work fw which this Dermd is issued.My Worker's Compensation liuurance Carrier entl ELECTRIC:
a PoliqNumbera : � /� / X PLUMBING:
w CARHIER ��G� /`'/�lG��� �r�,/J�. ��'}G, MECHANICA�:
� PouCY NUMB��/�CGLDGZ�I Z'L INSPECTION FEE:
N (THIS SECIION NFED NOT BE COMRFTED IF T}fr pEpMfT 6 Fpq ONE Ht1NDRED DOWiFiS($10Dj OR L6S7. ISSUAN CE:
H
p I certi(y fhat in the pertormarice of the work lor which ihis permit� issued.I shatl irot empbY anY person in manner so as to
.o becane subject to tha W«ker�Comperaation of Calil �a.Md agree that il I should become su' m me Wakers SMIP: �
� Compe�a--�on�Sec6on 3700 or cod snal�� wim trrose v ' ENERGY P/C:
`i �Ah`s � APPIICANT' ENERGY PERMIT:
� WARNING:Failure to secure Worker's Compensatlon coverage is unlawlul,and shall subject an emproyer to criminal RETENTION FEE: Z ,�
w permtlles and civil fines uD to one hundred thousand tlollars(3700,Opp),in atltlition ro the cost of the compensation,
o damages as prwided fa in sectbn 3708 0l the labor code,interest,and atlomey's tees. PRE-ALT FEE:
a CONSTRUCTION LENDING AGENCY BSAF: / �
= I hereby affum under penalry of per�ury that Ihere is a Construction Lending Agency for the perlormance ol the vrork tm
� which ihis permA is tssue0(S .3097,Gv.C.�.
� LENDER'S NAME
� LENDER'SADDRES :
a I certify that I have read this application and state that the above information is corzect.I agree to compry vnm all ciry and TOTAL FEES /���1
Z county adinances and sfate laws relatlng to buildi�construcBon,and hereby authorize represerdatives of this county to COMMENTS: �
p enter upo �e abave-mg/tioned properry tor inspection pu ses�
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m LJ ✓' ��
¢ FEHM E( �
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F SIGNATURE OF PFAMITTEE DATE RECEIPT N PqID BY: VALIDATION: �
WHITE—Department Copy,YELLOW—Fnance Copy,PINK—Assessor Copy.GOLDENROD—Fle Copy,GREEN—Applicant's Copy �
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CITY OF DIAMOiVD BAR ,
INSPECTION RECORD
• o � � • ' • � ' � '
SET,BACKI,LETTER , - TRACT AND LEDGER
FDOTINGS FORMS - SWffCH GEAR
SL`AB � -' " � ' s, i °`` - COMMERCIAL HOOD
UG:PLUMBING � - T-BAR
UG:'ELECTRICAL�,�„ ��: � �` " � � � INTERCEPTER
UFER��GROUN���`'' � � .�„� � ��� j��:` " �'>°�������� HOT MOPISHOWERPAN
SEWER LATERNL SEPTIC/CESSPOOL
MAIN WATER LINE HERS REPORT RECEIVED
SEWER CLEANOUT DEMOLITION
ROOF SHEATHING g t L ROOF DRAINS
fL00R SHEATHING ROUGH CONDUIT
� , �; :�,° - r=
SHEAR WALLS fXTERIOR' � z �" > POOUSPA
SHEA'R WALLS�INTERIOR;��,� -�� " � - ROUGH PLUMBIN6 �' _ _
:. ,
e
FftA�iHINGNENTING - �� � _ flOUGH ELECTRICAL'-� '�� �� '�°
ROUGH MECHANICAL ' ` ' F �f �' ROU�iH'MECHANICAL?r. ?' , :' '1 " ` e
;� � <
ROUGH�ELECTRICAL'Wt�-)C,( ,) � �GAS TEST.' � `
ROUGN`PLUMBWG+ ' _ :,-,� . PRE GUN17E •v '� ' A
, a , <. .
_ _ . , ;. _
INSULATION WALL POdL PRE DECK�BONDING �� ��', + ' '
INSULATION CEILING `P`�P "` ° ' v'�
DRYWALL FENCE/,GATE/ALARM � :
LATH(PR� FINAL:�POOL �� ;' - � �` �� -
LATH EXTERIOR WALLS:
LATH INTERIOR ' WALL FOOT�NG/STEEL
GAS TEST WALL STEEL 1sT( )2"0( )LIFf
SCRATCH COAT WALL BOND BEAM
ELECTRIC METER RELEASE WALL DRAIN/SEAL
GAS METER RELEASE WALL FINAL
`R0.`FBAMING PL'A(JMNGAPPROVAL ` '���, ` `�'�
SPECIAL INSPECTION ' �
FINAL BUILDING � �- : �'a � � ROUGH F1RE APPROVAL , _ � _
, b,
FiNAL�MECHANICAL = �� � ��� � - �FINAL_FIRE DEPARTMENT �`� - [� � �
FINAL ELECTRICAL I - ' _ FINAL{PlAP1NING , ; t� t �y� `�� ;
FINAL'PWMBING - �.:�r. _ - FINAL ENGINEERING/PW "r '+` { :<' � ^.-
T.C.�of OCGUPANCY ,;� � ;�., .,���„, �FINACCOMMUNITY���SERV(CES - � ��" �-
-' FINAL HEALTIi-DEPT a.��;' " ` " ' �7 : � 4>
CERT,of�OCCUPANCY `
' 'FINAL:INDUSTRIALWASTE:� - = � � v` --
COMMENTS: