HomeMy WebLinkAboutPR15-2438• CITY OF DIAMOND BAR
DEPARTMENT OF COMMUNITY & 66ELOPMENT SERVICES
21810 Copley Drive, Diamond Bar, CA 91765 PRESS
` V . (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027
BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@diamondbarca.gov FIRMLY
JOB SITE ADDRESS I (.ic � C �XC&- 1_ .
APIN LOT�� TRACT
OWNER
ADDRESS
CITY ZIP TEL.
APPLICANT �7Y`� V yF0.-
CONTRACTOR h VAb.N1 L A &Wt^ Ili
ADDRESS
CITY \\ i p a • ZIP t TEL.
ARCH/ENG/
DESIGNER
ADDRESS
CITY ZIP TEL.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the reason(s)
indicated below by the checkmark(s), I have placed next to the applicable item(s) [Section 7031.5, Business and
Professions Code: Any city or county that requires a permit to construct, atter, improve, demolish, or repair, any
structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she
is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9) Commencing with Section
7000 of Division 3 of the Business and Professions Code] or that he or she is exempt from licensure and the basis for
the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty
of not more than five hundred dollars ($500).
U I, as owner of the property, or my employees with wages as their sole compensation, will do LJ all of or U portions
of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The
Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds
or improves the property, provided that the improvements are not intended or offered for sale. If however, the building or
improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built
or improved for the purpose of sale.).
L) I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who
builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State
License Law.).
L) I am exempt from licensure under the Contractor's State License law for the following reason(s):
By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one
year prior to completion of the improvements covered by this permit,l cannot legally sell a structure that I have built as an
owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the
applicable law, Section 7044 of the Business and Professions Code is available upon request when this application is
submitted or at the following Web site: http/www.leginfo.Ga.gov/calaw.html.
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commenc w Section 7000)
of Division 3 of the Bu ss and Professions Code, and my license is in full force and effect.
LICENSE CLASS: LIC. NO.:
DATE: CONTRACTOR: V
WORKER'S COMPENSATION DECLARATION
I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS:
I have and will maintain a Certificate of Consent to Self -Insure for Worker's Compen anon, as provided by
Section 3700 of the Labor Code, for the performance of the work for which this permit issued.
I have and will maintain Worker's Compensation Insurance, as required by Section 3700 of the Labor Code, for
the performance of the work for which this permit is issued. My Worker's Compensation Insurance Carrier and
Policy Number are: < f
CARRIER r
POLICY NUMBER
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HD DOLLARS ($100) OR LESS).
1 certify that in the performance of the work for which this permit is issued, I shall not oy any person in any manner so as to
become subject to the Worker's Compensation Laws of California. And agree that i I s uld become subject to the Worker's
Compensation provisions Section 3700 of the Labor Code, I shall forthwith comply ose provisions.
DATE: \O'' APPLICANT:
WARNING: Failure to secure Worker's Compensation coverage is unlawful, an h I subject an employer to criminal
penalties and civil fines up to one hundred thousand dollars ($100,000), in a i to the cost of the compensation,
damages as provided for in section 3708 of the labor code, interest, and attorney's e .
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a Construction Lending Agency for the performance of the work for
which this permit is issued (Sec. 3097, Civ. C.).
LENDER'S NAME:
LENDER'S ADDRESS:
I certify that I have read this application and state th t the above information is correct. I agree to comply with all city and
county ordinances and state laws relating to buil n construction, and hereby authorize representatives of this county to
enter upon the above -me ion d property for insp c n purposes.
PERMITTEE NAME (PRINT) VHH
SIGNATURE OF PERMITTEE DATE
APPLICATION DATE:
io..-21)— �� P/C# /:� 0;,7__)0ISSUE DATE: )0/0 /C PERMIT# : N 9 Id- --elr4
TYPE CONST. OCC GROUP:
Scope of WorkN^ 11W/J�.'� r n(�
C ,v—
N
If DWEL. UNITS # STORIES # BEDROOMS
DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION
SFR/ADD/REM
Garage/Carport
w
Patio/Deck
W
LL
Pool/Spa
ZRe
-Roof
Commercial
co
m
Valuation: 0Adj. Area:
QUANTITY DESCRIPTION FEE
\2 1 H
U
2
U
J
w
z
m
-J00 f
1 Si
rL
IFA r�
U_
zd
U
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CONSTRUCTION: Jim r 69
PLAN REVIEW: i 6 /. ,a 4
ELECTRIC: SJ • I(-
/U/+
PLUMBING: k] ,
MECHANICAL: 60 •`t i
INSPECTION FEE:
ISSUANCE:
SMTP: f . 0
ENERGY P/C:
ENERGY PERMIT:
RETENTION FEE:
PRE -ALT FEE:
BASF:
PLOT PLAN:
ZONING CLEARANCE:
TOTAL FEES 47 / I rJj-
COMMENTS:
P/C: PAID BY: VALIDATION:
RECEIPT # 4"7W- PAID BY: VALIDATION:
WHITE — Department Copy, YELLOW — Finance Copy, PINK —Assessor Copy
CITY OF DIAMOND BAR
INSPECT IOfd=RECORD
INSPECTION DATE
INSPECTOR
INSPECTION DATE
INSPECTOR
SETBACK/ LETTER
TRACT AND LEDGER
FOOTINGS FORMS
SWITCH GEAR
SLAB
COMMERCIAL HOOD
UG. PLUMBING
T -BAR
UG. ELECTRICAL
INTERCEPTER
UFER GROUND
HOT MOP/SHOWERPAN p • 'j- fs
SEWER LATERAL
SEPTIC/CESSPOOL
MAIN WATER LINE
HERS REPORT RECEIVED
SEWER CLEANOUT
DEMOLITION
ROOF SHEATHING
ROOF DRAINS
FLOOR SHEATHING
ROUGH CONDUIT
SHEAR WALLS EXTERIOR
POOUSPA
SHEAR WALLS INTERIOR
FRAMINGNENTING
Q
ROUGH PLUMBING
ROUGH ELECTRICAL
ROUGH MECHANICAL N
ROUGH MECHANICAL
ROUGH ELECTRICAL W( ) C ()
IV -Z7,1
GAS TEST
ROUGH PLUMBING
p ..27.1 i
PRE GUNITE
INSULATION WALL
I D ••Z7.1
►
POOL PRE DECK BONDING
INSULATION CEILING
P -TRAP
DRYWALL
FENCE/GATE/ALARM
LATH (PRE)
FINAL POOL
LATH EXTERIOR
LATH INTERIOR
GAS TEST
WALLS:
WALL FOOTING/STEEL
WALL STEEL 1-( ) 2ND( ) LIFT
SCRATCH COAT
WALL BOND BEAM
ELECTRIC METER RELEASE
WALL DRAIN/ SEAL
GAS METER RELEASE
WALL FINAL
SPECIAL INSPECTION
RO. FRAMING PLANNING APPROVAL
FINAL BUILDING
ROUGH FIRE APPROVAL
FINAL MECHANICAL
FINAL ELECTRICAL
FINAL FIRE DEPARTMENT
FINAL PLANNING
FINAL PLUMBING
T.C. of OCCUPANCY
FINAL ENGINEERING/ PW
FINAL COMMUNITY SERVICES
CERT. of OCCUPANCY
FINAL HEALTH DEPT.
COMMENTS: Rq
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FINAL INDUSTRIAL WASTE
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ARCHITECTS Inc.
9u'hject: GIL & BARBARA SMITH
address: 1120 SENECA PLACE
DIAMOND BAR, CA 91765
date: 1152015
sheet #: 1 of: 1
4"
SIZE OF HOLE
fV
3
REPAIR DETAIL FOR
1
AN OPENING IN
LOCATION OF 18' WOOD
SCREWS FOR ATTACHING
REPAIR WOOD TO (E)A
AN EXISTING SHEAR WALL
(E) 2X @ 16" O.C.
(E) PLYWOOD
(N) 2X SOLID BACKER
LUMBER
(N) 2" STR. 1
PLYWOOD, OR OSB
3 SECTION THROUGH
PATCHED WALL
• k/ •
1 REPAIR DETAIL
FOR AN
OPENING IN
AN EXISTING
SHEAR WALL
12756 MITCHELL AVENUE LOS ANGELES, CA 90066 Tel: 310 430 2326; Fax: 310 476 8601 michaelmillerarchitectcom