HomeMy WebLinkAbout1050 GRAND AV (28) -=.. �2�MT:�
�.'„�_ CITY OF DIAMOND BAR -
!� I � I I i ' I DEPARTMENT OF COMMUNITY&DEVELOPMGNT SERVICES
� ,�Ill��i?� �� " 2181U Copley Drive,Diamond Bar,CA 917fi5 PRESS
� (909)839-7020 Fax: (909)861-3117 Building Inspection Hotline(909)839-7027 � FIRMLY
'�" . BUILDING PERNIIT APPLICATION
g ���,�,J / �a , S APPLICATION DAT : �7 P/Ck I
w JOB SITt ADDRESS - � / �� '
a ISSUE DATE: � PERMIT#
z APN T TRACT �w
oOWNEFi � S TYPE CONST. w OCC GROUP: I
y ADDRES
� CITY�1���,Cl ZIP �o Z 7EL. •"? .� ZONING F ONTCKS RW ❑
� APPLICANT TEL. HEAR ❑
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¢ CONTRACTO/R ,� / 8/C ��r SIDE ❑
� ADDRcESS 11��O��7 l'i�I�1'/'�/lq V� / PROPOSED USE �t/�i - -
o CITY -T�l1�Zt"� /Li�. ZIP RZ7GS TEL. 7��'�Im y�7Y'� `--
o ARCH/ENG/DESIGNER
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o ADDRESS
o #DWEL.UNITS k STORIES p BEDROOMS
zd CITY ZIP TEL.
� OWNFA-BUILDER DECLAHATION DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
o I heretry aflirm under penatty o(perjury that I am exempt tmm the Contractor's State License Law for the reason(s) SFR/ADD/REM
p intlicated below by the checkmark�s�,I have placed ne�rt�o the applicable ilem(s)[Sectbn 7031.5,Buslness and Garage/Carport
o Professions Code:My city w county that requires a permlt to construct,alter,improve,demolish,a repatr,airy
z structure,prior to its issuance,also requires the applicant for the pertnit to file a Signed statement tha�he or she � Patio/Deck
� Is licensed pursuant to ihe praWsions of the ConUacla's State Llcense Law(Chapter 9)Commencing wllh Section w
� 70D0 of Division 3 of the Business and Professions CodeJ or that he or she is exempt hom licensure and the basis fw � P�I/S a
�
N the alleged ezemption.Any violation of Section 7031.5 by any applicant for a pertnit sub�ects ihe apDlicant to a civil penalty C7
� of not mwe than five huntlred dollars(5500�. Re-R �G
¢
o (,�I,as owner of the property,or my employees wlth wages as thelr sole compensaUon,wlll do O all of or(_,)portiorts -� Commercial
� al ihe work,and the strucLue Is not intended a ottered for sale(Section 7044.Business and Protessans Code:The �
� Contractors'State License Law dces rwt a to an ovmer of r who,throu em o es'or m
Z PDN P WQrtY gh W Ye personal eflort,builds
w w improves ihe property,pmvldetl that ihe improvements are not intended or oftered tor sale.If however,Ne building or
� lmprovament is sold within one year af completlon,�he Owner-BullOer will have Ne burden ot proving that it was rqt buitt
p w imDrwed for the purpose of sale.).
� I,es owner oi lhe ro
r l� p perty,am exdusivety contractlng with licensed Contractors to construct the project(Section
0 7044,Business and Prolessions Cale:The Contractors'Stale License Law does not appry to an owner ol Droperty wtro Valuation: Adj.Area:
Z builds a imprwes tnereon,and who contrxts far the projects wim a iicer�sed Contractor pursuant to the Contracmrs'State QUANTIIY DESCRIPTION FEE
I N
Y License Law.).
o U I am exempt from licensure under the Coniractor's Stete License law lor iha tollowing reason(s): �
� �
`l By my signature below I aclmowledge that,except fw my personal residence in wh(ch I must have resided tor at least me �
o year prior to completion of the imprwemenfs covered by this permit,l carinot leqalry sell a strucNre that I have built as an �
¢ owner-builder if it has rrot been constructed in ifs entirety by licensed contraclors.I understand tliat a copy of ihe applipble
� law,Sectim 7044 of the Business and Professiorts Code is avallable upon request when this application is submitted or at
X the following Web site:httpAmay.leginto.p.gav/calaw.htrnl. _
� �ATE: SIGN: �
~ LICENSED CONTRACTON'S DECLAHATION �
U d
w �I hereby affirm untler penalty of perjury thal I am licensed under provisions of Chapter 9(commencing with Section 7000)
m W Dlvison 3 of the Business and PrMessions Code,and my licer�se is in full force and effecL
� ������a�s G 3 4 ��.No.: ������9 a
� oa�: ��/�� corrraacron: D/'/a►li-n, /�%'i%�1 S2/1�� �
WORKEF1'S COMPENSATION OECIARATION � �
� I HEREBY AFFlRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS:
oI h a�will maintaln a CertlFlcate ol Consent to Self-insure fw Worker's Compensation,as providetl by CONSTRUCTION:
� clion 370D ot Ihe Labw Cotle,(or the pertormance ol the work tor which thls permit is issued. p�qN REVIEW:
> I have and will maintain Waker's Compensation Insurance,as repuired by Section 3700 of the Labor Code,for
Z ihe DeAormance o1 ihe wwk lor which thfs permR is issued.My Wwker's Compensation Insurance Carrier anA ELECTRIC:
a PolicyNumbera /� f �� PLUMBING:
� CARRIEA�✓� G �//G/1 L�I'�t :LO'J G • MECHANICAL:
� POLJCY NUMBER �r ��L���.��ZZ/ INSPECTION FEE:
N (�H5 SECfION NEED N07 BE COMPLEfED IF hIE PEFVdR 5 FOR ONE HUNDRED DOLLNH$�510�OR LESS�.
ISSUANCE: Z
o I ceRiry tliat in ihe perfortnance ot Ihe vrork for which this permit's issued,I shall rol empby eny perso�n arry manner so as to �
o become subject to the Worker5 Compensa�of Cal' .Md agree that I�I stwuld beco e subject to the Warker's SMIP: �
� Compe7�tion ot Sectian 3700 0� Cad y��or�hwNi ry with t ENERGY P/C:
„ DA7E:J'�AppLIC1WT: � �/ ENERGY PERMIT:
� WARNING:faiiure to secure Worker's Compensation cwerage is unlavAul,and shall subjecl an employer to criminal REfENTION FEE: .�
w penatlies and civil fines up to one hundred ihousand dollars(5700,000),in atldition to the cost of the compensation,
o darnages as provided for in sectlon 3706 0l me laborcode,interest,and attomey's tees. PRE-ALT FEE:
a CONSTRUCTION LENDING AGENCY BSAF: �
� I hereby aKrm under penalry of perju al there is a Construction Lending Agenq fm Ne pedorn�ar�ce of the work Im
� which this permit is Issuetl(Sec. ,Gv.C.�.
r LENDER'S NAME
� LENDER'SADOR �
a I certiry that I have read this appliqtlon and state mat the above intormatlon is correcL I a ree to com TOTAL FEES . /�.�
g pty with all ciry and
Z counry ortlinances and state laws relating to building constructlon,and hereby authorize representatives of this county to COMM ENTS:
p enter upon e above-m tioned pmperty(o inspectbn pur
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_ � �
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a PER w� n
� 3• �/
� SIGNATURE OF PFAMITTEE DATE RECEIPT 71 PAID BY: VALIDATION:
WHITE—Department Copy,YELLOW—Fnance Copy,PINK—Assessor Copy.GOLDENROD—Fle Copy,GREEN—ApplicanYs Copy
CITY OF DIA�VIOND BAR - , �
INSPECTION RECORD , � °�
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SETBAGKf LETTER �;��� " ' �.� �..,. ��-, �� TRACTAND LEDGER
FOOTiNGS FORMS - " - _ : SWITCH GEAR
S�g=;:, , ,r�. '� COMMERCIAL HOOD
UG.PL'UMBING,;' �'� �'� ` T-BAR
UG.ELECTRICAI, - - ''`;`` - INTERCEPTER
UFER�GROUND" �'� "'° '� � �'�' HOT MOP/SHOWERPAN
r
SEWER LATERAL SEPTIC/CESSPOOL
`'°e.4_IN WATER LINE "''Y HERS REPORT RECENED
SEWER ClEANOUT DEMOLITION
fl00F SHEATHING •t ROOF DRAINS
FLOOR SHEATHING ROUGH CONDUIT
SHEAR WALLS EXTERIOR` � s PQOUSPA= - - ' �
.
SHEARVdALLS'INTERIO�T4; � ��° RQUC�H�PLU,MBING _ � ` W �' � ����>>
� �. �
FRAMINGNEMING = � RpUGH`ELE_CTRICAL;� ' � � � '� _ ;
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ROUGIi�MECHANICAL � ��� `�ry {.';} ` " .ROUGH�MECNANICAI �r , x" � : r r��` ° ' { r `'
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ROUGH'ELECTRICAL W( .)C( :) �, - _ �;--' ` GAS TEST-: - � r� t
ROU�H'PLUMBING � PRE GUNITE _" � �� `� - '
•- �. ; . , .
INSULATION WALL POOL PRE DECK BONDING .� �'�._`- �, {��'����„ �� �� ' ��`
INSUIIITION CEIIING P-T�P ` ' . F
r:
DRYWALL FENCE�/GATE/ALARNI � _h ' " ' '� `4 = '
LATH(PR� FINAC POOL = ' � " �`
E.<:
LATH EXTERIOR ' WALLS:
IATH INTERIOR WALL FOOTING/STEEL
GAS TEST WA�L STEEL 1�( )2ND( )LIFT
SCRATCH COAT WALL BOND BEAM
ELECTRIC METER RELEASE WALL DRAIN/SEAL
GAS METER RELEASE WALL FINAL
SPECIAL INSPECTION R0.FRAMING PLANNINGAPPR011AL ` 4 r�' r'�:" �£'
fINAL'',BUILDING } `,:I" � +° + '� ' � ' F " ROUGH FI$EAPPROVAL ` �' } ir �; ;
FINAL MECHANICAL _ EINAL FIRE DEPARiMENT `.
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FINAL ELECTRICAL `., � 1-; ; .' ; � - -
�,FINAL:PLANNING �:' .; � '��� '
� , , ��;, ' ` ' ;.
FINAL'PLUMBING '" ` ' :� FINAC ENGINEERING/,PW_'': �= F
T.C.of OCCUBANCY � '� fINAL COMMUNITI';'SERY(CES ��* - °� r�
d : 4 / �
'CERT.�of OCCUPANCY ; - '� -' -" `EINAL.HEALTH DEP;,T {; � ' �_° ��
a.
F-INAL INDUSTRIAL=WASTE`'� -- ` �~.
COMMENTS: �� �
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