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HomeMy WebLinkAboutPR16-0321Z CD rt a X LU CD U LUm 0 z ¢ 0 EU D Z 0 w z CD ti CITY OF DIAMOND BAR• DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES Illrr ` 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.cityofdiamondbarcom building@diamondbarca.gov 7L 72 J�1 JOB SITE ADDRESS 1 t c � Q APN © OTTRACT OWNER ADDRESS f Y CITY (� ZIP TEL. APPLICANT k� TEL. (QZErD.( CONTRACTOR ADDRESS ZZ ('1'e MIA_ CITY ZIP TEL. ARCH/ENG/ DESIGNER ADDRESS t CITY t ZIP TEL. OWNER -BUILDER DECLARATION (/p� 2" L� ��jJ'`/'t� I hereby affirm under penalty of perjury that I am exempt from the Contractor's State Licenselaw 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, after, 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 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 Code is available upon request when this application is submitted or at the following Web site: http/wvvw.leginfo.ca.gov/calaw.htmi. LICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of p rjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) st Division 3 of the Business and Professions Code, and my license is in fuulli rce and effect. LICENSE CLASS: LIC. NO.: l ✓ n DATE: _ CONTRACTOR:' ' •iAA- 'L2 WORKER'S COMP SATION 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 �57, to q� POLICY NUMBER '1r; — _ (THIS SEC11ON NEED NOT BE COMPLETED IF THE PERM- 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 became 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 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 cast 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 enteWpon the above-mentioned property for inspectio purposes. cwj PERMITTE INT) , w Z.Z — ' aAAAA SIGNATURL F ERMITTEE DATE APPLICATION DATE: Z^ 45 PP/C# J ] / ISSUE DATE: 42.a PERMIT# : A / (i - 10-31 / TYPE CONST. OCC GROUP: Ad Scope of Work o i cie So a tcy, PI if s %Kfew,_ 5 # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport rJ) LU Patio/Deck LL Pool/Spa ZRe -Roof Commercial m Valuation: Adj. Area: QUANTITYT DESCRIPTION FEE U U W J W CD z a CJ CJm x CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: S1cj i (D SMIP: lyi1 -A— ENERGY P/C: ENERGY PERMIT: A RETENTION FEE: PRE -ALT FEE: BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES u aX% 2 ? COMMENTS: r 7`J PIC: 2VA711I PAID BY: VALIDATION: RECEIPT # dfW PAID aaa y VALIDATION: WHITE — Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy CITY OF DIAMOND BAR INSPECTION RECORD INSPECTION DATE INSPECTOR SETBACK/ LETTER FOOTINGS FORMS ifb /S SLAB /1 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 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( ) 2ND( ) LIFT WALL BOND BEAM WALL DRAIN/ SEAL i WALL FINAL R0. FRAMING PLANNING APPROVAL ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT FINAL PLANNING .ANAL ENGINEERING/ PW 01/1) G FINAL COMMUNITY SERVICES FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE County of Los Angeles DEPARTMENT OF PUBLIC WORKS BUILDING & SAFETY DIVISION Los Angeles Regional Uniform Code Program STRUCTURAL OBSERVATION. REPART 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 Section 108, 1704 or other sections of the Los Angeles County Building Code. (Sections 106.4.5, 1709) Report No. This report includes all construction work through qday of M,20/(Page No. of Project Address:Structural Observer of Record (SOR): SOR Phone No.: (C 6e Of JOHAJ C . L'f &J (02(0— 26-056 Building Permit No.: Structural Obgervation Observr Professional Lic./Reg. No.: Observer Phone No.: 1Z — 0!3(-4 performed by: J00Q CHB& S 5 111 626-2L-4 L6 d5-6% OBSERVED STRUCTURAL ELEMENTS AND THEIR CONNECTIONS FOUNDATION WALL FRAMES FLOOR ELEMENTS/CONNECTION OBSERVATION LOCATION ❑ Footing, Stem Walls ❑ Concrete ❑ Steel Moment Frame ❑ Concrete ❑ Mat Foundation ❑ Masonry ❑ Steel Braced Frame ❑ Steel Deck kt�ali > ❑ Wood ❑ Concrete Moment ❑ Wood Grade Beams Frame ❑ Retaining Foundation ❑ Others: ❑ Masonry Wall ❑ Others: Hillside Special Anchors Frame ❑ Others: ❑ Others: NOTED DEFICIENCIES with the proposed corresponding corrective actions with respect to general conformance with the approved plans or in the load path: (A final report by the structural observer which states that all observed deficiencies have been resolved is required before acceptance of the work by the building officials.) - Idi i d eg a� mayd- ec% Gr% i ft2 daarz%)d P41i I DECLARE THAT THE FOLLOWING STATEMENTS ARE TRUE TO THE BEST OFAY KNOWLEDGE: 1. 1 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 COUNTY OF LOS ANGELES. 2. I, OR ANOTHER ENGINEER OR ARCHITECT WHO I HAVE DESIGNATED ABOVE AND IS UNDER MY RESPONSIBLE CHARGE, HAS PERFORMED THE REQUIRED SITE VISITS AT EACH SIGNIFICANT CONSTRUCTION STAGE TO VERITY IF THE STRUCTURE IS IN GENERAL CONFORMANCE WITH APPROVED PLANS AND SPECIFICATIONS; 3. ALL NOTED DEFICIENCIES WHICH REMAIN TO BE CORRECTED HAVE BEEN INDICATED ABOVE; 4. 1 RECOMMEND THAT ACCEPTANCE OF THE STRUCTURAL SYSTEMS BY THE COUNTY OF LOS ANGELES BE WITHHELD UNTIL ALL OBSERVED DEFICIENCIES ARE CORRECTED. �OFCH ESc�Q^� 6CO 7 Z 1� LL O EX?: C:/-1/7�ct 7� 9�OF CAS\�O (STAMP OF STRUCTURAL OBSERVER) SIGNATLKE OF STRUCTURAL OBSERVER DATE Version 1.0 (2008 LACBC) Jan. 10 2008 'ANY nental Time: L.V. Office: Arr.Office: Job No: Z / Date: Attn: Phone No: Fax No: Site Address: Q' �jC yI Lot Tract a, r- (Ti�C ! County ❑ Structural Footings ❑ Fill Key/Bottom No exception taken ❑ , Retaining Wall Footing El Grading Inspection ❑ Exception taken �.DriPiles/Piers El Moisture Content of Subgrade Soil El Recommend review by Engineering Geologist llecl ther ❑ Call this office reobservation Comment and/or recommended actions Clean and/loose/wet/cracked-soil br debri$ from excavations prior7to pouring canprete- (� Notify Building and Safety Inspector or others for project required inspections prior to covering work. /BGIC Observation is for general conformance with the design concept of the project and the recommendations mad in i T.I.N. Engineering Company. Any Action shown is subject to the requirements of the plans specifications, other En i --in Geolo ists and re ulator authorities 9 9 9 9 Y Observer: T.I.N. ENGINEERING COMPANY Title roject Engineers, County of Los Angeles DEPARTMENT OF PUBLIC WORKS BUILDING & SAFETY DIVISION Los Angeles Regional Uniform Code Program 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 Section 108, 1704 or other sections of the Los Angeles County Building Code. (Sections 106.4.5, 1709) Report No. This report includes all construction work through day of ,20Page No. —1—of > Project Adreskdk1'!2:q 22 34 hO'V5 e. of FRAMES Structural Observer of Recor (SOR): 61-(A) e CYE SOR Phone No.: -eTK Building Permit No z t%— 8 l Structural Observation performed by: �1�N —626-y2?, Observr Professional Lic./Reg. No.: -3111 Observer Phone No.: rra2 —�2(o QS� OBSERVED STRUCTURAL ELEMENTS AND THEIR CONNECTIONS FOUNDATION WALL FRAMES FLOOR ELEMENTS/CONNECTION OBSERVATION LOCATION ❑ Footing, Stem Walls ❑ Concrete ❑ Steel Moment Frame ❑ Concrete ❑ Mat Foundation ❑ Masonry ❑ Steel Braced Frame ❑ Steel Deck Caisson Piles, ❑ Wood ❑ Concrete Moment ❑ Wood Grade Beams Frame ❑ Retaining Foundation ❑ Others: ❑ Masonry Wall ❑ Others: Hillside Special Anchors Frame ❑Others: ❑ Others: NOTED DEFICIENCIES with the proposed corresponding corrective actions with respect to general conformance with the approved plans or in the load path: (A final report by the structural observer which states that all observed deficiencies have been resolved is required before acceptance of the work by the building officials.) 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 1N RESPONSIBLE CHARGE FOR THE STRUCTURAL OBSERVATION IN ACCORDANCE WITH THE REQUIREMENTS OF THE COUNTY OF LOS ANGELES. k 2. I, OR ANOTHER ENGINEER OR ARCHITECT WHO I HAVE DESIGNATED ABOVE AND I UNDER MY RESPONSIBLE CHARGE, HAS PERFORMED THE REQUIRED SITE VISITSIM EACH SIGNIFICANT CONSTRUCTION STAGE TO VERITY IF THE STRUCTURE IS 1 0 No.: x3111 Z GENERAL CONFORMANCE WITH APPROVED PLANS AND SPECIFICATIONS; EXP: 03/31/ZoIj Y 7� 3. ALL NOTED DEFICIENCIES WHICH REMAIN TO BE CORRECTED HAVE BEEN INDICATED�j►� �I ABOVE; 1J 4. . 4. 1 RECOMMEND THAT ACCEPTANCE OF THE STRUCTURAL SYSTEMS BY THE COUNTY �FCA1aF OF LOS ANGELES BE WITHHELD UNTIL ALL OBSERVED DEFICIENCIES ARE CORRECTED. ' (STAMP OF STRUCTURAL OBSERVERS ... SIGNATUf 'OF STRUCTURAL OBSERVER DATE Version 1.0 (2008 LACBC) Jan. 10 2008 Southwest Inspection and Testing, Inc. 441 Commercial Way, La Habra, Ca 90631 (562) 941-2990 e (714) 526-8441 e Fax (562) 946-0026 REGISTERED INSPECTOR'S DAILY REPORT SWIT Job No. MISC Date 5-17-16 TYPE`..OFReinforced Concrete ❑ Structural Steel Assembly ❑ Quality Control INSPECTION:...;.`::.:::;` ::::.::..........' El Post;Tensioned, Concrete ❑ Fire Proofing ❑ Wood Framing FffrCUIRED ❑:Reinforcedi,Masonry.:.; ` ❑. Asphalt El Other JobiA... �.....::::........:::.:.:...:::::::....::..::..:::;,,...............:..;...:.::..:....., . . dd e- 22380`Kicking Horse Dr.. city Diamond Bar 'Job Name Slien Zhon Min Residence 6 Permlt.N°. PR16-0321 Issued By Diamond Bar Type of Structure, I I r piles for proposed drivewa Architect M t r ri e, wade, rce §T X�� T1Rd� grade 806 r6ar #5 and #8 Engineer g John Chin -Chan Chen T4000 psi concrete, mix desi n#EC620T31 ype II/V, g Contractor g. C&W Construction En Ineeers Inspectors Name Emmanuel Morales Subcontractor — ---- TESTS PERFORMED TYPE OF SAMPLE SLUMP QUANTITY IN SET ADDITIONAL REMARKS ON SAMPLE 4" X 8" cylinders 4.5" 4 Sampled from load#1, ticket#1692578 INSPECTION SUMMARY — LOCATIONS OF WORK INSPECTED, TEST SAMPLES TAKEN, WORK REJECTED, JOB PROBLEMS, PROGRESS, REMARKS, ETC. INCLUDES INFORMATION ABOUT - AMOUNTS OF MATERIAL PLACED OR WORK PERFORMED, NUMBER, TYPE & IDENT. NO'S OF TEST SAMPLES TAKEN: STRUCT. CONNECTIONS (WELD MADE H.T. BOLTS TORQUED) CHECKED, ETC. _ 1. Monitored the placement and consolidation of 72 cu yds of concrete, supplied by Robertson's, using mix design# E13620T31 (4000 psi) along the (15) 30" by 30' soldier piles located at therear of the residence for the proposed driveway. 2. One set of 4" x 8"= 4 test cylinders were cast from load#1 and load was placed at piles 1 and 2. Slump test results= 5" and concrete temp= 75 F. 3. Work monitored is in accordance with the approved construction documents. CERTIFICATION OF COMPLIANCE I HEREBY CERTIFY THAT I HAVE OBSERVED TO THE BEST O MY KNOWLEDGE ALL OF THE ABOVE fjEPORTED WORK �N9LESS THER NOTED. I HAVE FOUND THIS WORK COMPLY WITH T /APP EDP S, SPECIFICATION, ANDAPPLICABLE TIONOFTHEGO E NIN UILDI WS. SIGNATURE OF REGISTERED INSPECTOR RC 5289845 ICC SPECIALTY NO. AGENCY CONTINUED ON NEXT PAGE ❑ PAGE 1 OF TIME IN TIME OUT SAMPLES 8:00 am 2:30 pm 4^ Approved By -w6ject-3apertntea ent White — Office Copy • Canary — Accounting Copy 9 Pink — tnspectoes Copy • Goldenrod — Jobsite Copy Southwest Inspection and Testing, Inc: 441 Commercial Way, La Habra, Ca 90631 (562) 941-2990 • (714) 526-8441 • Fax (562) 946-0026 REGISTERED IN PECTORIS DAILY REPORT SW IT Job No. Date 15-261 TYPE OF Reinforced Concrete ❑ Welding INSPECTION ❑ Post Tensioned Concrete ❑ Fireproofing REQUIRED ❑ Reinforced Masonry E:1 Asphalt ❑ DIA/Epoxy ❑ Wood Framing ❑ Other Job A6J �C�/A/G Tract No. Lot No. Job Name k/m'/'va //6eSE Permit NAVA, , D321 Issued B� Type of Structure U///G& � � Architect Material Description (type, grade, sou(e) Engineer ,V C11111e'/11,'.v6 30rx1 S/ t'qtlCA'.cTE �,/x 95.3cv1-)y/ Contractor/ & CGWSTiPUCT/Orf/ Inspec or's Name Sow EClfE.'esav Subcontractor lz__�vG TESTS PERFORMED SET# TRUCK # TICKET # SAMPLE LOCATION SLUMP AIR CONC TEMP TEMP WATER ADDED TIME CAST MIX # REMARKS / AM /697871/ 10-07-1.,V& S YZ 7Y 15 5?W# AS300/>V/ INSPECTION SUMMARY -LOCATIONS OF WORK INSPECTED, TEST SAMPLES TAKEN, WORK REJECTED, JOB PROBLEMS, PROGRESS, REMARKS, ETC. INCLUDES INFORMATION ABOUT - AMOUNTS OF MATERIAL PLACED OR WORK PERFORMED, NUMBER, TYPE & IDENT. NO'S OF TEST SAMPLES TAKEN: STRUCT. CONNECTIONS WELD MADE H.T. BOLTS TORQUED CHECKED, ETC. LOCN710V Os' " �OC/� �•PCi G.�sI�%' 6E�sy 1ZW7/iv6 ®&-A'VCd 7-110 //JrE��.vT .f%vcl l�.Wso/l/.,7-A,:W Cbz- 3O CU&C (0!/ _;d O/' 'navC.Pf7E,Su >//C C!ZY1 R0&e7-50NS ,%Ve-1 PI,7Cez/ V1,9.� 8 � 6-7.5 7- 4/ ,Cr0-63) //X6 TES? f ,Vlw✓c/F.QS /4�e fiSTi"!' S7i2".-IrlS• yir wO'?/r 06.seeved ,S 4V ?O CO3V7;ei,r7- CIS U�9E.VTS CERTIFICATION OF COMPLIANCE I. HEREBY CERTIFY THAT I HAVE OBSERVED TO THE BEST OF MY KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS, SPECIFICATION, AND APPLICABLE SECTION `rO� F THE GOVERNING BUILDING LAWS. SIGNATURE OF REGISTERED INSPECTOR /L 8/S2/2Y ler SPECIALTY NO. I. AGENCY Y CONTINUED ON NEXT PAGE ❑ PAGE OF Approved By J '' -• • _ �,. "Projectbupe�'ehdent White - Office Copy • Canary - Accounting Copy . Pink - Inspector's Copy • Goldenrod - Jobsite Copy SITI F-049 ©Southwest Inspection & Testing, Inc. SAMPLES 0