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Home My WebLink AboutPR16-1163I D OND B�1R CITY OF DIAMOND BA -11 DEPARTMENT OF COMMUNITY & DE'VELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 PRESS (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 FIRMLY BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@diamondbarca.gov JOB SITE ADDRESS AP D ' T TRACT OWN R ' 9 4"Z? ADDRESS ?D CITY4;2a,rt i 1i15"rIP TEL. APPLICANT TEL. _Z�Zny,2 [L�tkAl CONTRACTOR ADDRESS 0 • ' CITY ZIP - 7`—TEL. ARCH/ENG/ DESIGNER C ADDRESS CITY ZIP TEL. OWNER- ILDER 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 Gode: Any city or county that requires a permit to construct, alter, 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 U 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 3;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.). U 1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractuls' 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.). , / 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.ca.gov/calaw.htmi. LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. LICENSE CLASS: FJ LIC. NO.: DATE: I J CONTRACTOR: �' (� l 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 Compensation, as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is 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: CARRIER POLICY NUMBER (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS). I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation Laws of California. And agree that if I should become subject to the Worker's Compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. DATE: • APPLICANT: WARNING: Failure to secure Worker's Compensation verage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousarfd dollars ($100,000), in addition to the cost of the compensation, damages as provided for in section 3708 of the labor code, interest, and attorney's fees. 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 that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes. PERMITTEE NAME (PRINT)'�',�� SIGNATURE OF PERMITTEE _ DATE ' X— APPLICATION DATE: S// L� P/C# ISSUE DATE://JJ' PJERRMIIT# : TYPE CONST. /✓O 1/4/1`. — !O /9 OCC GROUP: AS Scope of Work addiho-ns OX 7 i;- # DWEL. UNITS If STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SF D REM 2�O%/31b, ' Garage/Carport LO Patio/Deck W LL Pool/Spa ZRe -Roof Commercial m Valuation: Adj. Area: QUANTITY DESCRIPTION FEE U. 2 U w J W z m a L1 U Z a x U CONSTRUCTION: S O O PLAN REVIEW: y�Z' ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: -I 1 • a SMIP: O i ENERGY P/C: ENERGY PERMIT: RETENTION FEE: 6i�j^_ 00 PRE -ALT FEE: BASF: O� PLOT PLAN: ZONING CLEARANCE: �r 2 TOTAL FEES Ses A/ COMMENTS: P/C: _ PAID BY: ^ VALIDATION: RECEIPT # Jr 7 PAID BY: I/a I VALIDATION: WHITE — Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy CITY ,OF'DIAI�id-ND 9VAR, I,NSSPE,CTI'ON R9CORD INSPECTION f.-f�, SETBACK/ LETTER _F9 M'711— FOOTINGS FORMS SLAB O. UG. PLUMBING UG. ELECTRICAL LIFER GROUND SEWER LATERAL MAIN WATER LINE SEWER CLEANOUT ROOF SHEATHING Z FLOOR SHEATHING SHEAR WALLS EXTERIOR SHEAR WALLS INTERIOR FRAMINGNENTING 1,007 ROUGH MECHANICAL ROUGH ELECTRICAL W( ) C ( ) ROUGH PLUMBING INSULATION WALL INSULATION CEILING DRYWALL / LATH (PRE) LATH EXTERIOR —WA LATH INTERIOR GAS TEST SCRATCH COAT ELECTRIC METER RELEASE GAS METER RELEASE SPECIAL INSPECTION FINAL BUILDING FINAL MECHANICAL FINAL ELECTRICAL FINAL PLUMBING T.C. of OCCUPANCY CERT. of OCCUPANCY COMMENTS: TRACT AND LEDGER SWITCH GEAR COMMERCIAL HOOD T -BAR INTERCEPTER HOT MOP/SHOWERPAN SEPTIC/CESSPOOL HERS REPORT RECEIVED DEMOLITION ROOF DRAINS ROUGH CONDUIT POOUSPA ROUGH PLUMBING ROUGH ELECTRICAL ROUGH MECHANICAL GAS TEST PRE GUNITE POOL PRE DECK BONDING P -TRAP FENCE / GATE/ ALARM FINAL POOL WALLS: WALL FOOTING/STEEL WALL STEEL 1ST( ) 2N°( ) LIFT WALL BOND BEAM WALL DRAIN/ SEAL WALL FINAL R0. FRAMING PLANNING APPROVAL ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT FINAL PLANNING FINAL ENGINEERING/ PW FINAL COMMUNITY SERVICES FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE .4 County of Los Angeles 4 waucw°I:Ks DEPARTMENT OF PUBLIC WORKS BUILDING .& SAFETY DIVISION Field Office Address: STRUCTURAL OBSERVATION REPORT FORM STRUCTURAL OBSERVATION means the visual observation of the structural system, for general conformance to the approved plans and specifications, at significant construction stages and at completion of the structural system. Structural observation does not include or waive the responsibility for the inspections required by Sections 108, 1701 or other sections of the Los Angeles County Building Code. (Sections 106.4.5, 1702) Report No. This report includes all construction work through / I day of ��cQy , 20_ /.(., Paae No. f of / Project Address: �?/6`0 fir. �i`arno,rd e.A Structural Observer of Record (SOR): SOR Phone No.: ar PORTION OBSERVED, IF NOT WHOLE Footing, Stem Walls, Building Permit No.: Structural Observation performed by. Observer Professional UcJReg. No.: Observer Phone No.: L6 _ h an. - e 6 3z - d 0000-KVCU,1 KUG1 UKAL.ELEMENTS ANn THFIR CnpitinCTInWC FOUNDATION WALL FRAMES FLOOR PORTION OBSERVED, IF NOT WHOLE Footing, Stem Walls, ❑ Concrete ❑ Steel Moment Frame ❑ Concrete ❑ Mat Foundation ❑ Masonry ❑ Steel Braced Frame ❑ Steel Deck ❑ Caisson, Plies, Grade Beams ❑ Wood ❑ Concrete Moment Frame ❑ Wood ❑ Retaining Foundation Hillside Special Anchors ❑ Other: ❑ Masonry wall Frame ❑ Others: ❑ Others: ❑ Others: NOTES: OBSERVED DEFICIENCIES: I DECLARE THAT THE FOLLOWING STATEMENTS ARE TRUE TO THE BEST OF MY KNOWLEDGE: 1. 1 AM THE ENGINEER OR ARCHITECT RETAINED BY THE OWNER TO BE IN RESPONSIBLE CHARGE FOR THE STRUCTURI L OBSERVATION IN ACCORDANCE WITH THE REQUIREMENTS OF THE CITY/ -9F Pn ;,,,, ,m d A; r 2. - I, OR ANOTHER ENGINEER OR ARCHITECT WHO 1 HAVE DESIGNATED ABOVE AND IS UNDER MY RESPONSIBLE CHARGE, HAS PERFORMED THE REQUIRED SITE VISITS AT EACH SIGNIFICANT CONSTRUCTION STAGE TO VERIFY IF THE STRUCTURE IS IN GENERAL CONFORMANCE NTH APPROVED PLANS AND SPECIFICATIONS; 3. ALL DEFICIENCIES WHICH REMAIN TO BE CORRECTED HAVE BEEN INDICATED ABOVE; 4. 1 RECOMMEND THAT ACCEPTANCE OF THE STRUCTURAL SYSTEMS BY THE CITY/COUNTY OF BE WITHHELD UNTIL ALL OBSERVED DEFICIENCIES ARE CORRECTED. DATE C 65432 �v f STAMP OF STRUCTURAL OBSERVER OF RECORD sorf.doc - LARUCP Structural Observation Report Form (V1.0 - Sr2000) Page 1 of 1 County of Los Angeles DEPARTMENT OF PUBLIC WORKS BUILDING & SAFETY DIVISION Field Office Address: Address: LAR UCII STRUCTURAL OBSERVATION REPORT FORM STRUCTURAL OBSERVATION means the visual observation of the structural system, far general conformance to the approved plans and specifications, at significant construction stages and at completion of the structural system. Structural observation does not include or waive the responsibility for the inspections required by Sections 108, 1701 or other sections of the Los Angeles County Building Code. (Sections 106.4.5, 1702) Report No. This report includes all construction work through � day of Project Address: , 20_Z.Clz Page No. of 171 Building Permit No.: / Structural Observaon perftrmed by. PR/6-//63 Ak'ai, 14411,N""o AB3ERVED STRu[_TURe1 F �enourTe sun Tuan nf1.■..c�.w.... FOUNDATION -- - - - -- WALL - - - - — -- _ FRAMES ■.. FLOOR ■ wn%P j PORTION OBSERVED, IF NOT WHOLE ❑ FootMg, Siem Wails, O Concrete 0 Steel Moment Frame 0 Concrete ❑ Mat FoundaNn 0 Masonry 13 Stoel Braced Frame 0 Stsel Dock 0 Calseon. Plfe% Grade Beams Wood O Concrete Moment Frame 0 Wood 0 Retaining Foundatfan Hlliside Special Anchors 0 Other: 0 Masonry Wall Frams 0 Others: 0 Others: 0 Others: NOTES: OBSERVED DEFICIENCIES: I DECLARE THAT THE FOLLOWING STATEMENTS ARE TRUE TO THE BEST OF luny KNnWt-PnaF- t. I AM THE ENGINEER OR ARCHITECT RETAINED BY THE OWNER TO BE IN RESPONSIBLE CHARGE FOR THE STRUCTURAL OBSERVATION IN ACCORDANCE WITH THE REQUIREMENTS OF THE CITY/COUNTY OF 2. I, OR ANOTHER ENGINEER OR ARCHITECT WHO 1 HAVE DENGNATED ABOVE AND IS UNDER MY RESPONSIBLE CHARGE, HAS PERFORMED THE REQUIRED SITE VISITS AT EACH SIGNIFICANT CONSTRUCTION STAGE TO VERIFY IF THE STRUCTURE IS IN GENERAL CONFORMANCE WITH APPROVED PLANS AND SPECIFICATIONS; 3. ALL DEFICIENCIES WHICH REMAIN TO BE CORRECTED HAVE BEEN INDICATED ABOVE; 4. i RECOMMEND THAT ACCEPTANCE OF THE STRUCTURAL SYSTEMS BY THE CITY/COUNTY OF BE WITHHELD LWMALL OBSERVED DEFICIENCIES ARE CORRECTED. Z/ DATE STAMP OF STRUCTURAL OBSERVER OF RECORD coif doc - LARUCP Structural Observation Report Form (V1.0 - 52000) - Page 1 of 1 City of Los Angeles Uniform Code Program Uniform Procedure I-7: Special Inspections Special Inspection Report DISCREPANCY • CONFORMANCE _ ' All discrepancies shall be brought to the immediate attention oTbMe conforms to approved design the Contractor for correction, if corrections are not made in aport to Building Departrneand copies to Coontracto Eng neer/ timely manrer, this report shag be used as a discrepancy I Submit the original to Building Department and ctes ro�Of Word and Cvner no tater than tre business day fallowing D clusion of the special Inspection, For inspections greater than 5 Contracts En neeflArchW of record and Owner. uration subnn a conformance report at least once every week- ------------ This eekThis Is a: • • Progress Report • Final Re rt Re rt No. 1 Protea addrPa a No. 1 of 1 ess: Desafpdw of Project: Pernrntt Number: r •-1 [� — ��v '-3 Owner. AmlIjb3ct(Enprneer of Record: rCorttraCOor. Full Name or Special rnspectlorrS ~ Uty RegEstratlon Number: Company: Phone Number. ---' F!uan Van Sul P013049 VanBul Inspection 714345-8266 type of Inspectlon: _ a Reinforced Concrete o Structural Masonry o Piling, •Piers & Caissons o Smoke Control o Restressed/Post-tensloned o Bolts in Cdna te./Masonry a Excavaticn and Fills o Energy Compliance a Shotcrete/Gunite a Sbvcbu-W Welding o Spray-Appiled Flre,Prooft ng o Insulating Concrete/Gypa�e a High Strength Boling crCther o Testing Reports Time Time Date Arrived Departed Description and Location of Work Inspected Remairkst 9/ - I HEREBY DECLARE THAT THE FOLLOWWNG IS TRUE TO THE BEST OF PAY KNOWLEDGE. - 1 - NOWLEDGE.- 1- : AM, OR MY COMPANY IS, RETAINED BY THE OWNER OR THE ARCHRECTIENGINEER OF RECORD TO PROVIDE SPECIAL INSPECTION FOR THE WORK COVERED IN THIS REPORT. ;- I HAVE PERFORMED THE REQUIRED INSPECTION DURING THE TiME PERIOD AS STATED ABOVE 3. THE WORK COVERED IN THIS REPORTIS IN CONFORJAA14CE TO THE APPROVED PIANS, SPECIFICATIONS AND APPLICA?1CV WORKMANSHIP PROVISIONS OF THE CODI~ EXCEPT AS INDICATED OTHERWISE. Signature: Huan Van Bui, Deputy Inspector