Loading...
HomeMy WebLinkAboutPR15-579CITY QF DIAMOND BAR + rll JA�iYTi� DEPARTMENT'OF COMMUNITY & DEVELOPMENT 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 JOB SITE ADDRESS)(S 1 APN LOT TRAC OWNER ADDRESS CITY TEL. Ill APPLICANT TEL. 41 CONTRACT ADDRESS _} !�1Wnr_N4_i'h D— CITY ZIP 6 C�1T-EL. ARCH/ENG/DESIGNER T1 yam, ell S VLA_ ADDRESS !�litA4A I 6W 051" W 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, 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 (-) all of or (, 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.). U 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.). (J 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.ca.gov/calaw.html. DATE: SIGN: 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. CENSE CLASS:: LIC. NO.: ATE: CONTRACTOR: ( �J 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 Cade, 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 IFTHE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS). I certify that in the performance of the work far 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 Comp en ion ro Bions of Section 3700 of the Labor e, I shall forthwith comp) w' those provisions. DATE: APPLICANT: V"'O'k �/ WARNING: F ilure to secure Worker's Compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand 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 andstate laws relating to building construction, and hereby authorize representatives of this county to enter upon the above- . 'oned property for inspection p oses. PERMITTEE NAME (PRINT) y A N IGNATURE OF PERMITTEE DATE b APPLICATION DATE: �� f� P/C# ISSUE DATE: $ \ S PERMIT# TYPE CONST. OCC GROUP: ZONING SETBACKS FRONT REAR SIDE/SIDE STREET SIDE RW ❑ ❑ RW ❑ ❑ PROPOSED USE .Q p # DWEL. UNITS # STORIE3a(�6 #BEDROOMS % �! DESCRIPTION SQ. FT FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport 0) w Patio/Deck LL Pool/Spa ZRe -Roof Commercial m Valuation: Adj. Area: j QUANTITY DESCRIPTION FEE a U Q I U J w 'O co ,17AA A,11 z m J � CL I i � I CONSTRUCTION: PLAN REVIEW:_ \4v cQ.n _ a D6 I \610 . i4- LX ELECTRIC: PLUMBING: (off . Off_ MECHANICAL: loo INSPECTION FEE: ISSUANCE: S M I P: 3k A&r . OS ENERGY P/C: k ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: to l L 1Sa t>>o BSAF: 00 TOTAL FEES \'1 �b� , a 4 COMMENTS: ,tVIfe \o F/G g13s4s d -into e, RECEIPT # A \ �� PAID BY: J 11.5 VALIDATION: WHITE — Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy, GOLDENROD — File Copy, GREEN — Applicant's Copy a� NG, IGAI SEWER LATERAL MAIN WATER LINE SEWER CLEANOUT ROOF SHEATHING FLOOR SHEATHING SHEARWA_I LS INTERIOR x FRAMING/V NTIN.G ;ROUGH MECHANICAL' k ,ROUGH ELECTRICALW( ) C ( ) ROUGH PLUMBING-� INSULATION WALL INSULATION CEILING DRYWALL LATH (PRE) LATH EXTERIOR LATH INTERIOR GAS TEST SCRATCH COAT ELECTRIC METER RELEASE GAS METER RELEASE SPECIAL INSPECTION FINAL BUILDINV7 FINAL MECHANICAL , `FINAL ELECTRICAL; FINAL PLUMBING; ;e CERT of DCCUPQNCY COMMENTS: CITY OF 11I0AMOND BAR r INSPECTION RECORD •".- - TRACT AND LEDGER _ SWITCH GEAR COMMERCIAL HOOD T -BAR ._ INTERCEPTER -�a„, , , , '�`'” HOT MOP/SHOWERPAN SEPTIC/CESSPOOL HERS REPORT RECEIVED _ DEMOLITION ROOF DRAINS ROUGH CONDUIT POOL/SPA �s �. ROUGHiELECTRiCAL ROUGH¢:. MECHANICAL GAS',TEST (. PRE GUNITE y; POOL" PRE DECK BONDING.` P,TRAP,:'� FEN GE,',J,GATE/ ALARMlaw.- FINALPOOL �2=. WALLS: WALL FOOTING/STEEL WALL STEEL 1 S'( )2N['( ) LIFT WALL BOND BEAM WALL DRAIN/ SEAL -------- ---------- ---- WALL FINAL RO�FRAMING�RANNING APPROVAL �d � s �r ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT FINALPLANNING FINAL ENGINEERING/ PW ` FINAL,COMMUNITY SERVICES ... ��, ..a FINAL HEALTH DEPT. __... FINAL INDUSTRIAL WASTE � r�:_ . , ��.r%' W (IND BAR CITYlJF DIAMOND BAR DEPARTMENT'OF COMMUNITY & DEVELOPMENT 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 JOB SITE ADDRESS APN LOT TRACT OWNER, ADDRESS CITY ZIP TEL. APPLICANT TEL. CONTRACTOR )44" SIAAALA� ADDRESS C CITY14 ZIP ARCH/ENG/DESIGNER ?,LL 1W CO V�AAn� k.jA, ADDRESS <AJA. n �z �o 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, 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 fora 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 (J all of or (J 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.). U 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.). U 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 Cade is available upon request when this application is submitted or at the following Web site: http/www.leginfo.ca.goy/calaw.html. DATE: SIGN: 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: J 0 ( v JlIC. NO.: DATE: �_J� �L CONTRACTOR:(1014&M 41A A44q= T// } WORKER'S COMPE SN ATION DECLARATION I HER Y 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 SEC11ON NEED NOT BE COMPLETED IFTHE 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 Compen 'on ro ions of Section 3700 of La hor Code, shall forth7)ri comply with those provisions. - DATE:_ -i APPLICANT: _(�7,_ WARNING: Failure o secure Worker's Compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand 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 1 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 roating to building constru ion, and hereby authorize representatives of this county to enter upon the above-mentioned operty for inspection pur s W 12K^V PERMITTEE NAME (PRINT) SIGNATURE OF PERMITTEE DATE to APPLICATION DATE: �) �S I\S P/C# o_ -- ISSUE DATE: PERMIT# f�P, \S — X371_1 TYPE CONST. OCC GROUP: ZONING SETBACKS FRONT REAR REAR SIDE/SIDE STREET SIDE RW [I— ❑ RW ❑ ❑ PROPOSED USE # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport u) LU Patio/Deck LL Pool/Spa ZRe -Roof Commercial m Valuation: Adj. Area: QUANTITY r DESCRIPTION FEE L) U J w m z m m J d U Q U CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: 3S S�- SMIP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: BSAF: TOTAL FEES COMMENTS: i RECEIPT# ��' b �9 PAID BY:1_J1 VALIDATION: Gln WHITE — Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy, GOLDENROD — File Copy, GREEN — Applicant's Copy UG. ELECTRICAL ;LIFER GROUND SEWER LATERAL MAIN WATER LINE SEWER CLEANOUT ROOF SHEATHING FLOOR SHEATHING INSULATION WALL INSULATION CEILING DRYWALL LATH (PRE) _— LATH EXTERIOR LATH INTERIOR GAS TEST SCRATCH COAT ELECTRIC METER RELEASE GAS METER RELEASE SPECIAL INSPECTION CITY OF, C "AIVIOND BAR h. INSPECTION RECORD "r nuiuuva- ROUGH FIRE APPROVAL e_ - ��__ MECHANICAL r.; PLUMBING. fOCCUPANCY tea. of 66CUPANCY _ COMMENTS: FINAL ENGINEERING/ PWS ` FINAL COMMUNITY SERVICES FINAL HEALTH DEPT. Kilo -itiniRTRIAI WACTF . max.. �A...:.Y... w `A ON 2- TRACT AND LEDGER I I SWITCH GEAR ! 1 r COMMERCIAL HOOD T —BAR -- INTERCEPTER _ HOT MOP/SHOWERPAN SEPTIC/CESSPOOL _ HERS REPORT RECEIVED— DEMOLITION ROOF DRAINS ROUGH CONDUIT 7' r POOL/SP1 I ROUGH PLUMBING 7 ROUGH ELECTRICAL` z ROUGH MECHANICAL W—A ii GASTEST ° �a`L:• 'PREGUNITE POOL PRE DECK BONDING P—TRAP ®. FENCE / GATEI ALARM — _ _..__......... FINAL POOL WALLS: WALL FOOTING/STEEL WALL STEEL 1-( ) 2NO( ) LIFT WALL BOND BEAM WALL DRAIN/ SEAL _ WALL FINAL I RO.FRAMING PLANNINGAPPROVALXT nuiuuva- ROUGH FIRE APPROVAL e_ - ��__ MECHANICAL r.; PLUMBING. fOCCUPANCY tea. of 66CUPANCY _ COMMENTS: FINAL ENGINEERING/ PWS ` FINAL COMMUNITY SERVICES FINAL HEALTH DEPT. Kilo -itiniRTRIAI WACTF . max.. �A...:.Y... w `A ON 2- CITY OF DIAMOND BAR ••� rv� _ DEPARTMENT OF COMMUNITY & DEVELOPMENT 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 JOB SITE ADDRESS X Z I S;B r" - — v iAW.P"WUNw � toll APN LOTS TRACT OWNERY VPAAhh ADDRESS CITY ZIP TEL. APPLICANT A (� TEL. CONTRACTOR�� Y ��WfSVI / ADDRESS L' CITY W&Q,t `- ZIP �d TEL. ARCH/ENG/DESIGNER-71�'IJI� tl kj IkC�► 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, 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 (J all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Gode: 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.). (J 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.). U 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 Cade is available upon request when this application is submitted or at the following Web site: http/www.leginfo.ca.gov/calaw.htmi. DATE: SIGN: 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 LA S: k_ ('( LIC. rcanV" K? DATE: / �.0 /� CONTRACTOR: 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 (MIS SECTION NEED NOT BE COMPLETED IFTHE 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 Califom ia. d agree that if I should become subject to the Worker's Go mpe ti prov ions f Section 3700 of Labor Code, I h orthwith comply with those provisions. DATE: APPLICANT: A / WARNING: ailure o secure Worker's Cc pensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,000), in addition to the cost of the compensation, damages as provided for in section 3708 of the labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a Construction Lending Agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). LENDER'S NAME: LENDER'S ADDRESS: I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon the above -me Toned property for ins ion purposes. X PERMITTEE NAME (PRINTf SIGNATURE OF PERMITTEE DAT N APPLICATION DATE: V P/C# C S ISSUE DATE: �' I \3 PERMIT# TYPE CONST. OCC GROUP: ZONING SETBACKS FRONT RW ❑ REAR ❑ SIDE/SIDE STREET RW ❑ SIDE ❑ PROPOSED USE 5 # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SO. Fr. FACTOR PSF ADJ. AREAIVALUATION SFR/ADD/REM Garage/Carport w Patio/Deck LU Pool/Spa ZRe -Roof D � co Commercial m Valuation: Adj. Area: QUANTITY DESCRIPTION FEE Q U J w CD m J rL U Q w CONSTRUCTION: PLAN REVIEW: 9, 62> C? ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMTP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: BSAF: TOTAL FEES COMMENTS: RECEIPT # oAs a C PAID BY: I/ VALIDATION: a Y1 WHITE — Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy, GOLDENROD — File Copy, GREEN — Applicant's Copy CITY OF DIAMOND BAR INSPECTION RECORD ;SETBACK/;LETTER;TRACT AND LEDGER FOOTINGSEORMS.: SWITCH GEAR ,SLA$n .. ' COMMERCIAL HOOD i ,UG. PLUMBING- �� . ;� P T -BAR ,UG'. ELECTRICAL ��;:'� _ INTERCEPTER UFER GROUND ,,, -,,,,, HOT MOP/SHOWERPAN j SEWER LATERAL SEPTIC/CESSPOOL MAIN WATER LINE HERS REPORT RECEIVED SEWER CLEANOUT ( DEMOLITION ROOF SHEATHING ROOF DRAINS FLOOR SHEATHING _ ROUGH CONDUIT SHEAR-WALLSEXTERIOR "_''. # POOVSPA;°'` `SNEAR`WALLS INTERIORS W- , I ROUGH PLUMBING' FRAM(NGNENTING ROUGH ELECTRICAL ROUGH MECHANICAL , ,A � ' ' i R(iUGH MECHANICAL .A, r, , & ."v", f ,ROUGH LEGTRICAL W I C ) - -' �`„ A ' GAS TEST ROUGH PLUMBING �' a PRE.GUNITE INSULATION WALL POOL PRE DECK BONDING INSULATION CEILING P -TRAP DRYWALL / GATE! ALARM e LATH (PRE) -FENCE iFINAL POOL LATH EXTERIOR WALLS: I LATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL 1-( ) 2N°( ) LIFT SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELEASE WALL DRAIN/ SEAL GAS METER RELEASE WALL FINAL SPECIAL INSPECTION ,RO. FRAMING PLANNINGAPPROVAL,. FINAL BUILDING ROUGH FIRE APPROVAL .. .: FINAL,MECHANICAL .. Po. jfL AL FIRE DEPARTMENT ' FINAL PLANNING'°.36_ - ,�, Ora _,= FINAL ENGINEERING/ PW, "' FINAL COMMUNITY SERVICES" FINAL_ HEALTH DEPT, FINAL 1NDUSTRUIL WASTER COMMENTS: c� CITY OF DIAMOND BAR, I i DEPARTMENT OF COMMUNITY & DEVELOPMENT 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 APN LOT TRACT OWNER A/ ADDR SSI CITY 1 a liviv ZIPb. TEL. APPLICANT TEL. CONTRACTOR 1M ADDRESS ZIP Cl* TEL. / EM11 ff .5im p 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, 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 1, 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 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.). U I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' Stale 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.). U 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.ca.gov/calaw.html. 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 isiin'full force and effect. '/Ja`� 1 'V LICENSE CLASS: LIC. NO.: van 1 ( DATE: CONTRACTOR: yb46 A 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 COM THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS). I certify that in the performance of the work for whi s permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation Lafes if California. And agree that if I should become subject to the Worker's Compen.s�a4'�n__p,roviss/II'Io�nSS11--of Section 3700 of the e, Shall forthwith comply with those provisions. DATE: APPLICANT: WARNING: Failure lo secure Worker's Compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand 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 thi above-mentioniied p party for insp ctio purses. V PERMITTEE NhMt (PRINT) 1 452 -- SIGNATURE OF PERMITTEE DATE APPLICATION DATE:�// /�P/C# ISSUE DATE: ��Gi7/�%b PERMIT#: P12 TJ Or%9 TYPE CONST. OCC GROUP: Scope of Work 2 P "Y1 f # 1. f @ A~ t dF 'I'ed IOQrwt ,T_— # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport W Patio/Deck W tL Pool/Spa ZRe -Roof 0_ Commercial m Valuation: Adj. Area: QUANTITY DESCRIPTION FEE U U w w co z M J a ZU_ Q x U CONSTRUCTION: 7 PLAN REVIEW: ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMTP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES • �� COMMENTS: P/C: PAID BY: / r VALIDATION: RECEIPT # 1� Ll PAID BY: C G h VALIDATION: 4 WHITE — Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy CITY OF DIAM6ND' BAR INSPECTION RECORD INSPECTIONDATE INSPECTOR SETBACK/ LETTER FOOTINGS FORMS SLAB UG. PLUMBING UG. ELECTRICAL UFER GROUND SEWER LATERAL MAIN WATER LINE SEWER CLEANOUT ROOF SHEATHING FLOOR SHEATHING SHEAR WALLS EXTERIOR SHEAR WALLS INTERIOR FRAMINGNENTING ROUGH MECHANICAL ROUGH ELECTRICAL W( ) C ( ) ROUGH PLUMBING INSULATION WALL INSULATION CEILING DRYWALL LATH (PRE) LATH EXTERIOR 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: INSPECTIONDATE INSPECTOR 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( )2 ND( ) 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 e, -'f -;?, /_. �� �� 115 Q c..+ �--� � S w J � �-`v► I `^� �� (L )o i5 as fb A ?yt,-_ CITY OF DI01% Mki BAR �� ++ (, THESE PLANS AND ETAILS A BY TH AOOMVAl 63 fi499 PLA" Wt- - NOT BE (960TRWfly 9i; A PgRMlf fOR ANY IO IQN � @FAhY 99®g 6 MINA09 00 fH' U T11E9E ALANB 6c14; §j 0 TfIR FQRALLUQUUTEp INSPEU16hp r 'G� . ., \1 FOR ALL REQUESTED INSPECTION# a Yf- .� Mf MI NS, 1ti �/�4i FaMii'C n�. �. a.. I m ITHES'EPt j 3 f Q Irl � t � I l� PROVAL,@�M.�'v I 9R NSTR TO'BE A �' Ft 17 FOF� I e I I T` 810 Y COBE R 9►� CE �'PH ��� -�� _ I I >� At L1�3C�t7�'' 1 W41 STRUCTURAL INSPECTION CONSULTANTS ARCHULETA INSPECTIONS OFFICE/FAX: (626) 309-0055 CELL: (626) 235-8947 (24 HOURS) WEBSITE: ARCH ULETAINSPECTIONS.COM REGISTERED INSPECTOR'S DAILY REPORT Project Address �o�k (��� Permit ��15-57q City b/4Mn ON� 1�/9it Project # Engineer. Weather IL4 V Contractor - � � Temperature 0 Type of Inspection _ Reinforced Concrete Structural Steel - Fire Proofing 1a4 o pre -Stressed Concrete L-'-Drilled-In Anchors ✓Epoxy Required Reinforced Masonry _ Shotcrete/Gunite _ Other INSPECTIONDATEG9 J- 6 65c rUC •.✓I s 1a4 o v eo_L 0 1 0 r'C t .�e rU-IS o1 o e o. k NPJOA�o 0, gr,.aZ1- D SZ A ? yl r Do e- d E ✓1 I �)r. o � � � ov►�►�t �l-� a CERTIFICATE OF COMPLIANCE ALL WORK LISTED ABOVE WAS INSPECTED AS\REQUIERD BY H APPROVED LAN PEOFICATIONS, AND GOVERNING CODE rt .A SIGN TURE OF REGISTERED INSPECTOR TIME IN TIME OUT REG. HOURS O.T. HOURS SAMPLES 0 0 Cf ;.�?D - All inspections based on a minimum of4 hours and over 4 hours — 8 hours minimum. If the inspector is called to a project and no work is performed a two hour minimum charge will be applied. Approved by Project Superintendent - IDENTIFICATION NUMBER CC: ARCHITECT, ENGINEER, BUILDING OFFICIAL WHITE -OFFICE COf?Y—, CANARY -INSPECTOR'S COPY . PINK-.IOB.COPY FORM 9 AI -690 -R.CHULETA ' � 1 SINCE 1990 STRUCTURAL INSPECTION CONSULTANTS ARCHULETA INSPECTIONS OFFICE/FAX: (626) 309`0055 CELL: (626) 235-8947 (24 HOURS) WEBSITE: ARCHULETAINSPECTIONS.COM REGISTERED INSPECTOR'S DAILY REPORT Project Address 3 Permit # 5 • City Project # 04 n.t .e Proofing Fes Engineer Weather 41 _ Drilled -In Anchors Epoxy ' iAv I 0Jel) Reinforced Masonry Contractor ; t Temperature Type of INSPECTION SUMMARY DALE';. • Inspection Reinforced Concrete _ Structural Steel .e Proofing Fes Required Pre -Stressed Concrete _ Drilled -In Anchors Epoxy 3 a _. N/ e� 00 C J I Reinforced Masonry Shotcrete/Gunite Other _ _ CERTIFICATE OF COMPLIANCE - ALL WORK LISTED ABOVE WAS INSPECTED AS REQUIERD BY TIME IN TIME OUT REG. HOURS O.T. HOURS SAMPLES THE Fc PROVED PLAN, PE IPIC TIONS, AND GOVERNING CODE •r , 5v' All inspections based on a minimum of 4 hours and over 4 hours — 8 hours minimum. \ If the inspector is called to a project and no work is performed a two hour minimum SIGNA URE OF REGISTERED INSPECTOR charge will be applied. Approved by nasq! ?,tD Project Superintendent IDENTIFICATION NUMBER Ca AacyiTECT, ENGINEER, BUILDING OFFICIAL WHITE -OFFICE COPY CANARY -INSPECTOR'S COPY PINK -JOB COPY = FORM # Al - 90 INSPECTION SUMMARY DALE';. stfvv�U e v- ; 1A If -- tic 3 a _. N/ e� 00 C J I S fA CERTIFICATE OF COMPLIANCE - ALL WORK LISTED ABOVE WAS INSPECTED AS REQUIERD BY TIME IN TIME OUT REG. HOURS O.T. HOURS SAMPLES THE Fc PROVED PLAN, PE IPIC TIONS, AND GOVERNING CODE •r , 5v' All inspections based on a minimum of 4 hours and over 4 hours — 8 hours minimum. \ If the inspector is called to a project and no work is performed a two hour minimum SIGNA URE OF REGISTERED INSPECTOR charge will be applied. Approved by nasq! ?,tD Project Superintendent IDENTIFICATION NUMBER Ca AacyiTECT, ENGINEER, BUILDING OFFICIAL WHITE -OFFICE COPY CANARY -INSPECTOR'S COPY PINK -JOB COPY = FORM # Al - 90 CITY OF DIAMOND BAR DEPARTMENT OF BUILDING AND SAFETY STRUCTURAL OBSERVATION REPORT FORM THISBEPORT INCLUDES ALL CONSTRUCTION WORK THROUTH 4 DAY OF 28 �HGCLES RCCIq'f qCk,, ,LAR, JCi t 2015 REPORT NO. -1 OJEC ADDRESS: ROCKVIEW STRUCTRUAL OBSERVER DAVID LI STRUC. OBS. PHONE NO. (626)-288-1216 00 LIC. OR REGISTRATION NO. C58075 BUILDING PERMIT NO. OBSERVED STRUCTRUAL ELEMENTS AND THEIR CONNECTIONS LOCATION AND DATE PORTIONS OFF BLDG. `'G G PRESTRESSED CONCRETE SLABS ❑STEEL MOMENT -ORDINARY ❑_ ❑- Z ❑- ❑- ❑- ❑- ❑- ❑- OBSERVED DEFICIENCIES: 0 I--) -b- I DECLARE THAT THE FOLLOWING STATEMENTS ARE TRUE TO THE BEST OF MY KNOWLEDGE AND BELIEF: 1. 1 AM THE REGISTERED ENGINEER OR LICENSED ARCHITECT WHO HAS RESPONSIBLE CHARGE FOR THE STRUCTURAL OBSERVATION 2. I, OR ANOTHER REGISTERED ENGINEER OR LICENSED ARCHITECT WHO HAVE DESIGNATED 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 THE APPROVED PLANS AND SPECIFICATIONS; 3. ALL DEFICIENCIES WHICH I DOCUMENTED HAVE BEEN CORRECTED UNLESS OTHERWISE INDICATED ABOVE, 4. 1 UNDERSTAND THAT FINAL ACCEPTANCE OF THE STRUCTURAL SYSTEMS BY THE DEPARTMENT OF BULIDING AND SATETY CANNOT OCCUR WITHOUT THE CORRECTION OF ALL OBSERVED DEFICIENCIES; 5. 1 AM RESPONSIBLE FOR THE SUBMISSION OF THE ORIGINAL OF THIS REPORT TO THE DEPARTMENT OF BUILDING AND SAFETY, CITY OF LOS ANGELES. 6. 1 HAVE PROVIDED STRUCTURAL OBSERVATION ACCORDANCE WITH THE REQUIREMENTS OF THE CITY OF LOS ANGELES. ❑DEFICIENCIES CONTINUED ON ATTACHED FORM (B&S 261 ��FESSIONq� F� Q .. �FCHENG G'i No 6 3p 2 1!Y d ExP STATE OF�� WET SIGNAT,UREOR REGISTERED CIVILOR ST((UCTUF2AL',ENGINEERQRLICENSED,ARCHITEGT I STAMP OF ENGINEER OR ARCHITECT STRUCTURAL OBSERVATION DOES NOT WAIVE ANY OF THE REQUIREMENTS FOR BUILDING INSPE_ CTION BY AUTHORIZED EMPLOYEES OF THIS DEPARTMENT DISTRIBUTION: STRUCTURAL OBSERVER TO SEND ORIGINAL TO THE BUILDING INSPECTOR'S OFFICE, ATTACH THE FIRST COPY TO THE APPROVED PLANS, AND KEEP SECOND COPY FOR STRUCTURAL OBSERVER'S RECORD AND DISTRIBUTIONS.(B&S 261 R.12/95)