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Home My WebLink AboutPR11-1575DLLIOJ'DMAK CITY OF DIAMOND BAR DEPARTMENT OF COAENJUNITY & DEVELOPMENT SERVICES 21825 Copley Drive, Diamond Bar, CA 91765 (57 (909) 839-7020 Fax (909) 861-3117 Building Inspection Hotline (909) 839-70n BUILDING PERIMIT APPLICATION !!CC JOBSITE ADDRESS Z% 4 Z.O fJ&%IK !/Np fIK APN LOT TRACT OWNER 4a Lj If A3 J rwwrL, ADDRESS 2 t 2Ao F it=l.JttJb l.!-� CITY ZIP"% t 7G 5 TEL�i APPLICANT TEL. CONTRACTOR ADDRESS CITY ZIP TEL. ARCFVENG/ DESIGNER ADDRESS CITY ZIP TEL OWNER -BUILDER DECLARATION I HEnEBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM EXEMPT FROM THE CONTRACTORS U• CENSE LAW FOR THE FO! .OWLNG REASON (SEC. 7031.5 BUSINESS AND PROFESSIONS COD- ANY CIYOR CWNrYW.4!CHREOUIRESAPEFW..ITMCANS nUCT,ALTER e!PROVG.DEMOU?LOR R--PAIRANI'STRUO TUBE. PRIOR TO ITS ISSUANCE. ALSO RECUIRES THE APPLICANT FOR SUCH PERMITTO FILE A SIGNED STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS L4 CENSE LAW (CHAPTER 9 (COMMENCING WITH SECTION 7063) OF DIVISION 3 O THE BUSINESS AND PRO- FESSIONS CODE) OR THAT HE OR SHE IS EXEMPTMEREFROM AND THE BASIS FOR THE ALLEGED EXEMP- TION. ANY YAW.TION OF SECTION 7031.5 BY ANY APPLICANT FOR A PERMIT SUBJECT S THE APPLICANT, TO A CML ENMITY OF NOT MORE 711A.N FIVE HUNDRED DOLLARS (SSW)): AS OW'lNER OF THE PROPERTY.OR MY EMPLOYEES WITH WAGESAS THEIR SOLE COMPENSATION, W LL THE WORK AND THE STRUCTURE 15 NOT INTENDED OR OFFERED FOR SALE (SEC. 70". BUST. NESS AND PROFESSIONS CODE: THE CONTRACTORS LICENSE LAZY DOES NOT APPLY TO AN OWNER OF PROPERTY WHO BUILDS OR IMPROVES THEREON, AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR THROUGH HIS OR HER OWN EMPLOYEES. PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR OFFERED FOR SALE IF. HOWEYERTHE BUILDING OR WPROVEMLENT IS SOLD WffHLNO.NEYEAROFCOMPLE- TION. THE OWNER -BUILDER DER WALL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALEM 01, AS OWNER OFTHE PROPERTY. AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEC. 7044, BUSINESS AVO PROFESSIONS COD= THE CONTRACTORS U - CENSE LAW DOES NOT APPLY TORN OWNER OF APROPERTY WHO BUILDS OR IMPROVES THEREON, AND VMO CONTRACTS FOR SUCH PROJECTS WITHAOONTRACTOR(S) LICENSED PURSUANTTO THECONTRAO- TORS LICENSE LAW). x `3IAM EXEMPT UNDER SEC 7�q`T a, i P.0 FORTHS REASON DATE I _ �j - 792 I 1 O._-RL LICENSED CONTRACTORS DECLARATION - lie 1 HEREBYAFFIRN UNDER PENALTY OF PERJURY THAT IAM LICENSED UNDER PROVISICNS OF CHAPTER 9 (COMMENCING Y/RH SECTION 70DD) OF OFASION 3 OF THE BUSINESS AND PROFESSIONS CODE. AVD LrYUCFNSE S IN FULLFO iCEAND EFFECT. LICENSEE CLASS LIC. NO. DATE C014TPAC70R WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWAN:G DECLARATIONS: I HAVE AND W IL L M.ANTAN A CERTIFICATE OF CONSENT TO SELFNSURE FOR WORK -ERS COMPENSATION. AS PROVIDED BY SECTION 37113 OF THE LABOR CODE, FOR THE FERFORMIMCE OF THE WORK FOR WHICH THIS PERMIT 13 ISSUED 1 HAVE AND WILL MAINTAIN WOPJLERSCOMPENSATION INSURANCE AS REOUIRED BY SECTION 3740 OF THE LAEOR CODE, FOR THE PE'RFORV.INCE OF THE WORK FOR WHICH THIS PERMIT 15 ISSUED IAYY.VRKERa COMPEIJSATIONINSURA:CECARRLRA:DPOLICYNUALBERARE CARRIER POLICY NUM -E TiiSECiu7NEED N77 EERJNF--LEmOF D=_ Pe'AT G FOR ua 1Rr'.Ti.'REO mUqsrS1ml OR LESS) I CERTIFY THAT IN THE PERFORMA:CE OF THE W\VRI FOR Y.WCH THIS PERWT IS ISSUED, 1 SMALL NOT EMPLOY A7 PERSON IN A!iY UAbL'ER SOAS TO BECCYS SUBJECT TO THE WORKERS' COMPENSATION LAWVS OF CALIFORt:IA AND AGREE THAT IF 1 SHOULD EECOME SUBJECT TO THE WORKERS' COMPENSATION PROVISIONS OF SECTgN 3703 OF THE LABOR CODE.1 SHALL FORTHVATH CO!APLY WITHTHOSE PROVISIONS. DATE: APFLICANT: WARNING: FAILURE TO SECURE WORKERS COMPE14SATIO-1 COVERAGE 15 UNLAWFUL AND SHALL BE SUBJECT AM EMPLOYER TO CRIILN•AL PENALTIES AND CIVP FO: -ES UP TO ONE HUNDRED THOUSAN DOLLARS 0100.00-211 11 ADOmO.170 THE COST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE INTEREST ANDATTORNEYS FEES. CONSTRUCTION LENDING AGENCY 1 HERESY AFFIR)J UN:OER PENALTY OF PERJURY THAT THERE S ACONSTRUCTION LNDL`7G AGENCY FORTHEEPEERFORMANCE OF THE WVORKFOR WHICH THIS PERMIT IS ISSUED ISEC, 3037 CIV.Ca. LENDERS NAME L7:DEPS ADDRESS I CERTIFY THAT I HAVE READ THIS APPLICATION A:O STATS THAT THE ABOVE INFORMATION IS CORRECT. 1 AGREE TO COMPLY VATH ALL CT' 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 I.N5PEECTION PURPOSES TERM a NAME (PRINT) zO G TURE P RU E DATE WHITE—Department Copy. YELLOW—inane Copy. PIN PRESS I:IRAAI V APPLICATION PERMIT/ DATE NUMBER 9 5 15' P/C ISSUE TYPE � J)a OCC �G DATE CONST / /C /(CFS ROUP ZONING S ACKS FRONT RW ❑ REAR L-1 SIDE/SIDE STREET RW SIDE PROPOSED USE NO. DWEL. NO.n NO. t UNITS STORIES BEDROOMS _ DESCRIPTION SO. FT FACTOR PSF ADJ. AREA/VALUATION SFR/AOD/REM Garage/Carport WPalio(Deck .•. LL PooVSpa Z Re -Roof — 0 Commercial M Valuatlon ADJ.AREA QUANTITY DESCRIPTION FEE 1 P C9PG'�. E Cr U `I DO 0- 0- _J Q _U 2 2 ' U W CONSTRUCTION PLAN REVIEW ELECTRIC C. PLUMBING ke MECHANICAL 7 INSPECTION FEE ISSUANCE 3d SMIP ENERGY P/C ENERGY PERMIT RETENTION FEE: W PRE -ALT FEE-- EETOTAL TOTALFEES 35 f COMMENTS RECPT. NO. PAID BY VALIDATION wyr. �Gpy, UKC=r—Appecanl'a L;opy PROJECT ADDR SS 1 O �%� �G�//�D �l PROPERTY OWNER f/ U-TYOPE T /4% ZV �/�3CY�f PR//.- /.5;;!; ISSUED SIGNATURE DATE INSPECTION SIGNATURE DATE INSPECTION I SIGNATURt DATE BUILDING MECHANICAL PLUMBING 1. SETBACKS/LOT CERTIFICATION 1. VENTS & SUPPORTS 1. UNDERGROUND PLUMBING 2. FOOTINGS & FORMS 2. ROUGH DUCTS & SUPPORTS 2. ROUGH PLUMBING 3. STEM WALL FLOOR JOIST 3. CHASE & DRAFT STOPS 3. ROUGH GAS 4. STEEL & HOLD DOWNS 4. FURNACE 4. SEWER SERVICE CONNECTION 5. ROOF SHEATHING NAILING 5. COMMERCIAL HOOD 5. SEWER DEMOLITION 6. FLOOR SHEATHING NAILING 6. ANSEL SYSTEM 6. SEPTIC TANK 7. EXTERIOR SHEAR 7. FIRE DAMPERS 7. CESSPOLUSEPTIC DEMOLITION 8. INTERIOR SHEAR 8. SMOKE DETECTOR 8. WATER HEATER 9. FRAMING 9. COMBUSTION AIR 9. HOT MOP/SHOWER PAN LINER 10. DRAFT STOPS 10. AC CONDENSER 10. WATER SERVICE 11. WINDOW FLASHING 11. AC DISCONNECT 11. BACKFLOW DEVICE 12. EXTERIOR LATH 12. CONDENSATE LINE 12. ROOF DRAINS/SCUPPERS x 13. INSULATION 13. DRIP PAN 13. VENTS AND SUPPORTS f 14. INTERIOR LATH 14. AIR BALANCE REPORT 14. GRAY WATER SYSTEM 15. T-BAR CEILING GRID 15. SERVICE PANEL BREAKER 15. INTERCEPTOR 16. DRYWALL Z 16. FINAL MECHANICAL 16. CLEAN OUTS 17. BROWN COAT 17. SEWER LATERAL 18. LEDGER ANCHORS 18. FINAL GAS TEST 19. ATTIC VENTS 19. PLUMBING FINAL 20. CERTIFICATE OF COMPLIANCE MISCELLANEOUS INSPECTIONS 21. ROOF FINAL 1. 22. PATIO FINAL 2. POOL 23. BUILDING FINAL 3. 1. SETBACKS 24. SIGN FINAL 4. 2. STEEL 25. SPECIAL INSPECTION REPORT 5. 3. ROUGH PLUMBING 6. 4. EQUIPOTENTIAL BONDING GRID MASONRY WALLS 5. LIGHT SHELL & BONDING 1. SETBACKS 6. ROUGH ELECTRICAL 2. DRAINAGE ELECTRICAL 7. GAS LINE TEST 3. FOOTINGS AND STEEL 1. UNDERGROUND CONDUIT 8. UNDERGROUND CONDUIT 4. LOW BOND BEAM 2. ROUGH ELECTRICAL 9. FENCE & GATE 5. GROUT MID BOND 3. SERVICE 10. DOOR ALARMS 6. TOP BOND BEAM 4. LIFER BOND 11. P-TRAP 7. WEATHER PROOFING 5. TORQUE LUGS 12. FINAL ELECTRICAL 8. BACK FILL COMPACTION 6. TEMPORARY POWER POLE 13. FINAL PLUMBING 9. BLOCK WALL FINAL 7. UTILITY RELEASE. 14. FINAL POOL 8. SOLAR FINAL 9. FINAL ELECTRICAL ALL FINAL & CLEARANCE INSPECTIONS MUST BE COMPLETED BEFORE FINAL RELEASE OF UTILITIES ENGINEERING SIGNATURE DATE FIRE DEPARTMENT SIGNATURE DATE PLANNING & BUILDING SIGNATURE DATE GRADING FINAL SPRINKLERS/FIRE ALARMS ELECTRICAL FINAL GAS FINAL