HomeMy WebLinkAbout1180 DIAMOND BAR BL (2) � . „_��, :�,���„_ C1TY OF DIAMOND BAR
( I � DEPARTMENT OF COMMUNITY&DEVELOPMCNT SERYICES �
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�� - =� ' 21810 Co Ic Drive Diamond Bar CA 917fi5
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�,,� ,,,,� (909)839-7020 Cax:(909)861-3ll7 Building Inspection Hotline(909)839-7027 F�RMLY
`•JN°' BUILDING PERMIT APPLICATION � 's'dn�
� APPLICATION DATE: P�C� ��- �3 �-��
w JOB SITE ADDRESS +��� � P-�f ISSUE DATE: +�/ �/d�/�7 PERMIT#i
z APN��I'�'�'aj�OT TRAC7 /u� � G�
o r'L�L TYPE CONST. OCG GROUP:
o OWNER
� ADDRESS d� �N "J �t• �V ZONING SETBACKS
J C�Ty �j�l N DI�yC @ ZIP��L TEL. •' �S�� �� FRONT RW ❑
a APPLICANT TEL. REAR �
o �7�. SIDE/SIDE STREET RW �
Q CONTRACTOR ���"� �NST��'���� SIDE �
oro ADDRESS .S�C� �TV�ZN S 1 PROPOSED USE C1e�l �S�L�h '� ��b
� CITY S'd ZIP�TEL'� ' ��/ t�7� OGnr��\�-�r�ov'� 'Fo�' -
� �-IZ ��l',H I�IZ-T'/}'�� �/✓L- 'T \
"- ARCH/ENG/DESIGNER
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z ADDRESS � 1.1 d NTk�L{./ r ���l� �� q DWEL.UNITS It STORIES #BEDROOMS
a CITY��,�1L1� ZIP �� TEL. ��.0 U yd�� DESCRIPTION SQ.Ft FACTOR PSF ADJ.AREANALUATION
� OWNER-BUILDER DECWIATION
¢ I hereby amrm under penalry of Derjury that I am exempl from the Contracta's State Liceiue Law tor the reason(s) SFR/ADD/REM
� indicatetl below by the checkmark(s),I have placed ne#to the aDPlicable item(s)[Section 70315,Buslness and
o Garaga/Carpwt
w Protesslons Cade:Any dty ar county that requires a permit to consWct,alter,improve,demollsh,or repair,any
z struchire,prtor W its iswance,also requires the applicant for the permit to file a signed sfatertrent thal Ae or she w Patio/Deck
a is licensed pursuant to the provislons of tlre Co�rtractor's S[ate llcemse Law(Chapter 9)Commencing with Sedion LL P��jSpa
� 7000 ot Oivisfon 3 of ihe Business and Prafessions CodeJ or that he a she is exemD�Nom licensure and the basis tor
�
N Ne atlegetl exemption.My vidation of Section 7031.5 by any appficant lor a pemtit subjects the apDlicant M a civil pereity
N Z Re-Root
ot not more than frve hurbreA dollars(3500). p
o U I,as owner of ihe property,or my employees wilh wages as their sole compensatim,will do U��o�a l-1 W�o� _� Commercial
� 01 the work,and fhe structure is not Intended w oftered for sale(Sectlon 7044.Business and Proiessions Code:The m
c"'�.� Contractors'Stata License Law does not appty ro an owner oi property who,through employees'or personal ettort,�uilds
w a improves the D�oPerhS P�detl Nat the imprmements are not intended w ottered 1or sale.If however,the buAding or
� imprmement Is sold wfthin one year of completion,ihe Owner-Builder will have t�e burden of proNng inat it was not�Uitt
por Imprmed for Ne purpose of sale.�.
� (�I,as owner ot the propertY,am exclusHely cAnVacOng with licansed Gantractors to canstrUcl Ute 4roject(Sectan
0 7044,Busmess and Professions Code:Tlie Contractors'State License Law does rwt appty to an owner ot properry who ValuatiOn: Adj.Area:
z bulldsatmprrnesUerean,andwhocontractstathep�ojeclswithalicensedGontracturpur.�anttutheContractors'State QUANTIIY DESCRIPTION FEE
�
Y LJCBfi58 LBW.). J
o (�1 am pa�empt trom licensure under the ConVactur's State License law tor the totlowfng reason(s): �
� ¢
� By my signature below I acknowledge that except for my personal residence ln which I must have residod iw at least one �
z year prior to comple8m of the ImprovemenLS covered by�his permit,l cannot legally sell a strucNre ttiat I have buil�as an �„
0
� owner-builder it it has rwt been consiructed in lis entirery by licertsed contractors.I u�ershand tha[a copy ol ihe applipble
law,Section 7044 of the Business and Professions Code is available upon reques[when this aDDlication is suhmitled or at
� the following Web site:http/wxay.leglnio.q.gov/calaw.html. z
DATE: SIGN: �
1�— UCENSEO CONTRACTOH'S DECLARATION �
a
U
w I hereby affirm untler peoaYty of perjury that V am licertsed under provisio�s ot Chapter 9(crommencirre Ni1h Section 7000)
� of Divlsion 3 of tbe Business a�Professions Code,and my license is in NII force and eflect.
�7('^ c�
� UCENSE CLASS: � LIC.NO.: (J I 13 L� � .
o DAr�: cw�TRacrOR:l�lZ-� G�NSSd"vLTt� w
7"d WORNER'S CUMPENSATION UECWIATIUN �
� I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: � .
w •
o _�I have and will maintain e CeAiltcate of Consent to Setl-Insure 1or WorVicers Compemation,as provided 6y CONSTRUCTION:
Seclion 3700 0l the Labor Code,for Ihe perTormance o�the work for whiCh ihis pertnit is issuetl. p�QN REVIEW: �� • ��
j �'� I have a�will maintain WorkePs Comoensation Insurance,as required by Section 3700 of the Labor Cade,fw ELECTRIC:
o' the perfortnance ot the work fpr which ihis permfl is issued.MV Worker's Compensatlon Insurance Carrier antl
¢ Poli�yNumbe�are: •-� PLUMBING:
o �iEq �I�urv' �� y~.�'✓�C.�3 —__— MECHANICAL:
� POLIGY NUMBER G L✓O�3�I �V INSPECTION FEE:
� (htlSSECfIONNffDN0T8ECOMflFfEDIFTFfrPfAMRISfORONEHUNDRFDDOLLARS�^10DjORlfSS�. ISSUANCE:
oI ces6ty tliat i�me pertormance ol Uie wodc(or which lhis pertnit is issued.I shatl r.ol empby arry person in anY��4�ru�e�s�as to SM IP:
o heame subjecl to the Waker's ComDer�sation La�'rs at Callfomia.Mtl agree that If I should become subjeci tn the Worker's
� Gompe�aGo rovisb ot Sectia�370o ot the Cod t taUxriui cnmvN�N�v�'�a� ENERGY P1C:
J DAiE: -r nvPLlCar+r: ��� C�ta/Z1���(? ENERGY PERMIT:
LL
� WARNING:Failure to seare Workers Compensatlm cmerage Is unlawlul,arM shall sub�ect an employer to criminal REfENTION FEE:
� penaflles and civil tines uD to one hundred thousand dollars($100,000�,In adtli�an to the cost of the compensatlon,
w PRE-A�T FEE:
a darnages as provided for in section 3708 of the labw cade,interest,and attomey's fees.
0
� CaNSTRUCTION LENDING AGENCY BSAF:
��j I hereby affum under penalty of per�ury Ihat there is a ConsWclion Lertding Agenq tw the perlormance of the work far
= which this permfl is issued(Sec.3097,Gv.C.).
� LENDER'S NAME:
� LENDER'S AD�RESS:
a 1 certiy that I have read Nis applicalion and state that Ne above intormabon is conect I agree to wmpty with all city and TOTAL FEES
� counry ordinances and state laws relating to building Conswctlon,and hereby authorize represen�tives of Nis county to COMMENTS:
Z enter u n Me above-mentioned ro e ior ins
p Po P P hY P�ibn purpases.
J
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¢ PERMITTEE ME(PRI
N �i� �'i �Z'i//s� /�
= SIGNATURE OF PERMITCEE OATE RECEIPT N�I���v PAID BY: � VAUDATION:
f-
WHITE—Department Copy,VELLOW—Finance Copy,PINK—F�ssessor Copy.GOLDENROD—File Copy,GREEN—AppllcanYs Copy
CITY OF DIAMOND BAR . , ,;
INSPECTION REC�RD
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SETBACK/LETTER ` = " TRACT AND LEDGEfl
�F0071NGS'FORMS � - ��;:�„ ;��� SWffCH GEAR
S�qg = •' ' _ ` COMMERCIAL HOOD
UG.RLUMBIN6���, � �'�� , .�:� � T-BAR
UG.ELECTRICAL - `� INTERCEPTER
UFER`�iROUND�� ��� � , �;':;�� � "�:k F�+ ' '� HOT MOP/SHOWERPAN
SEWER LATERAL SEPTIC/CESSPOOL
MAIN WATER LINE HERS REPORT RECEIVED
SEWER CLEANOUT DEMOLITION
ROOF SHEATHING ROOF DRAINS
FLOOR SHEATHING ROUGH CONOUIT
SHEAR WALLS:EXTERIOR,. � �' POOUSPA'� � r , r `
,- r,.
SHEAR WALLS INTERIOR ` ROUGH PLUMB�NG .`: t.- ' ' ' � +
FRAMIN6NENTING �:� ' ' 3 �`` , ROUGH ELECTRICAL� � �_ ' � � �
ROUGH MECHANICAL ; ' r,� � ,„ �� ROUGH�MEGHANICAL�� r �•` ' � f r ' � r::' qt �':
ROUGN ELECTRICAL Wf ,)C( ) �' ` "� GAS TEST.- � = ' `` ^ � `F
- �PRE GUNITE ����` d ���� .�. � .� � ��'� n `�:`
ROUGH PLUMBING ` ��, ' ,>`' ' '
INSULATION WALL � P,OOL�PRE DECK BOfdDING �- � , ` x�� : �� .�� � � ��
INSULATION CEILING �� �� � �:`° �� ��� �
�Pi.fRF1P � :7 v
DRYWALL FENCE/GATE!AIARM ' � � '�' �:
. ,
LATH(PR� FIPJAL POOL- _ - �; a;. � � =A -
LATH EXTERIOR WALLS:
LATH INTERIOR WALL FOOTING/STEEL
GAS TEST WALL STEEL 1�T( )2MD( )LIFT
SCRATCH COAT WALL BOND BEAM
ELECTRIC METER RELEASE WALL ORAIW SEAL
GAS METER RE�EASE WALL FINAL
SPECIAL INSPECTION . RO fRAMING PElWNINGAPPROVAL - } <� '* � '
FINAL BUILDING � `` 'ROUGH FIREAPPRQVAL"' � � ��� -� � r'�'� ° '
FINAL MECHANICAL �� '� '; � � , FINAL FIRE OEPARTMENT :� ' � yh `=t j ` ' ''�
``' " �fINAL:PLAMNIN6 ' ` h �`r; r , _ "' ;}
FINAL ELECTRICAL `�� 1 - -� �� '" �' t �' `�
� , ,. _
'" FINAL ENGINEERING/PW `, ' r �F r y �.
FINAL PLUMBING � �s ` '"
`- z `, 'FINALCUMMUNITN_SERVICES r '`' ` ` �;F �� ° 3 '*-�
T.C.bf OCCURANCY. -��". � . �. ` .'_`. �� ��° � �
CERT.of OCCUPANCY' , `� FINAL HEALTH DEPT - � �
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�FINAL_INDUSTRIAL"��_WASTE,;_,� s:'�_'�. �` ��" } �" � ' ``�� � �
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COMMENTS: