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Home My WebLink AboutPR16-2884_ CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES it I I 21810 Copley Drive, Diamond Bar, CA 91765 PRESS (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 �'°�°•"�' � BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@diamondbarca.gov FIRMLY JOBSITEADDRESS 7-31Zb -� RIO "1305 RV PIAMOOD t5PAX q0 APN LOT TRACT OWNER S!ANJ(r7 J"NU M PA RK4 YN VI fV 6-7 SO_V PA lZI: ADDRESS Z1 1I Vt 'E ]21 0 L0 805 a D CITY DIAMOND- PAn. ZIP 0-A TEL. 0111� APPLICANT TEL. CONTRACTOR ADDRESS CITY ZIP 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, 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 70DO 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 L) all of or U portions of the work, and the stmcture 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.). L) I am exempt from licensure under the Contractor's State icense law for following reason(s): Date: (7— (_7 4 Sign: By my signature below I acknowledge that, except for my personal re a in which I must have re/havuilt one year prior to completion of the improvements covered by this permiLl canifot legally sell a structure ts an owner -builder if it has not been constructed in its entirety by licensed contractors. I understanthe applicable law, Section 7044 of the Business and Professions Code is available upon request whn 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 (com ncing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effec LICENSE CLASS: LIC. NO.: EXP. DATE CONTRACTOR: WORKER'S COMPENSATION DECLARAT I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING D TIONS: I have and will maintain a Certificate of Consent to Self -Ins for Worker's Compensation, as provided by Section 3700 of the Labor Code, for the performance of the ork for which this permit is issued. I have and will maintain Worker's Compensation Insuran , as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is i ed. My Worker's Compensation Insurance Carrier and Policy Number are: . CARRIER POLICY NUMBER (THIS SECTION NEED NOT BE COMPLETED IF E PERMIT IS FOR ONE HUNDRED DOLLARS $100 OR LESS). I certify that in the performance of the work for which is permit is issued. I shall not employ any person in any manner so a; to become subject to the Worker's Compensation La of California. And agree that if I should become subject to the Worker's Compensation provisions of Section 3700 of the her Code, I shall forthwith comply with those provisions. DATE: APPLICANT: WARNING: Failure V ker's C pensation coverage is unlawful, and shall subject an employer to criminal penalties and civil e hu redthousand dollars ($100,000), in addition to thecost of the compensation, damages as providn 8 of the labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY I hereby affirm underjury that there is a Construction Lending Agency for the performance of the work for which this permit is3097, Civ. C.). LENDER'S NAME: LENDER'S ADDRESS: I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter upon the above -mentioned property for inspection purposes. �NtJG7 5 "2� PERMITTEE NAME SIGNATURE OF PE C E DATE APPLICATION DATE: ISSUE DATE: t A PERMIT# : TYPE CONST. Prr/C# PR OCC GROUP: 1 �_A Scope of Work G17� V vM i # DWEL. UNITS # STORIES i Gti► # BEDROOMS DESCRIPTION SQ. FT. FACTOR SF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport w Patio/Deck w LL Pool/Spa ZRe -Roof Commercial m V uation: 0 — Adj. Area: QU TITY DESCRIPTION FEE U w z m a J Q ZU_ Q x U CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMIP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE-ALT FEE: `� c�a Vim+ BASF: AA r OG PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: °-% P/C: PAID BY: VALIDATION: RECEIPT # PAID BY: �'VALIDATION: WHITE — Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy CITY OF D&W011,JD BAR INSPECTION RECORD COMMENTS: F �\ BMW Building & Safety Division 21810 Copley Drive Diamond Bar, California 91765 (909) 839-7020 Fax (909) 861-3117 Job Address:10 W 05 2D . P)A M 0ND 1$A>z C,14- n 17 b� Dear Property Owner. An application for a building permit has been submitted in your name stating yourself as the builder of the property improvements specified. For your, protection, you should be aware that as "owner -builder° you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the City of County. They are also required by law to put their license number on all permits for which they apply. If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500.00 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers compensation insurance, disability insurance costs, and unemployment compensation contributions. There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers compensation insurance. For more specific information about your obligations under.the federal law, contact the Internal Review Service (and if you wish, the U.S. Small Business Administration). For more specific information about your obligations under State law, contact the Department of Benefit -Payments and the Division of Industrial Accidents. If the structure is intended for sale, the property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and materials personally. Building permits are not required to be signed by the property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors State License Board at 9821 Business Park Drive, Sacramento, CA 95827, www.esib.ca.gov or at (800) 321-CSLB (2752). Please complete and return the enclosed "Owner -Builder" verification form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. ,Building & Safety Division I 21825 Copley Drive Diamond Bar, California 91765 (909) 839-7020 Fax (909) 861-3117 Attention Property Owner. An "Owner -Builder'° building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building, permit will be issued until this verification is received by us. 1. I personally pla)r .tQ provide the major labor and materials for construction of the proposed property improvement yes or no).. 2. 1(havethave not) h o6J-c signed an application for a Ibuilding permit for the proposed work. 3. 1 have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone Contractors License No. I 4. 1 plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work: Name Address City Phone Contractors License No' 5. 1 will provide some of the work but I have,'contracted, (hired) the following persons to. provide the work indicated: Name Address 'Phone Type of Wont Signed /./ lj 1 �', rl ,}• � IJ,. ill .I � 1 ,. 1 f i,! �. �11 �: ( I i 'I ,.,. t NOTICE TO PROPERTY'OWNER Dear Property Owner - An. �applicabbn, fora building permit has,been. submitted in your name listing yourself as the builder of the property improvement specified at Z3I z b, r—, 2 i o w B n S i2D D 1 P M,0Nb 13 4tZ C44: -31'2br: We are providing you •with aniOwner-Builder AcknowledgmenUind information Verification Form to' make you aware of your'responsibllities and possible risk you may incur -by having this permit issued in your name as the Owner -Builder. 111�We will. -not issue a ,building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner'cannot execute this notice unless you, 'the.property,owner,, obtain the prior approval of the permitting authority. i� i • " IbWNER'S ACKNOWLEDGEMENT AND:VERIFICATION DIRECTIONS; Reait and initial each statement below.to signify you understand or verify this information. P, 5 1: `I understand+ a frequent practice of unlicensed persons'is to have 'the property owner obtain an "Owner= Builderr":ibuilding permit that erroneously implies that the property owner is providing his or her own labor ands material personally l;.as eamOwner-Builder,' may beheld liable and subject to serious financial risk for any injuries sustained by an, unlieens4 prson; and his or her employees while working w,my property'. My.;homeowner's insurance may not proyide,coverage, for those injuries. I; am, willfully acting 'as, ad Owner=Builder and am aware of the limits of my insurance coverage'fo'r injuries to workers on my property. 2. I understand'buildin building,permits are, not required to be signed by property owners unless they are responsible for the construction and ',are not hiring a licensed Contractor to assume this responsibility. S 3. tl understand as an "Owner -Builder") am the responsible partyof record on the permit. I understand that I, may protect myself -from potential financial riskby hiring.a licensed Contractor and having the permit filed in his or her name instead of my own. ' understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits,and contracts. ' 5 5. 1 understand, if i employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at least'five hundred dollars ($500), including labor and materials, i may be considered an "employer" understate and federal law. 1�' % 5 6. 1 understand if I am considered an, "employer' under state and federal law, I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for.each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. LL7. I understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential structures cannot legally build them -with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a Licensed general building. Contractor. 145 8. 1 understand as an Owner -Builder if I sell the' property for which'this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owners) that result from any latent construction defects in the workmanship or -materials. 8.. 1 understand I may obtain more information regarding' my obligations as an "employer' from the Internal Revenue Service, the, United States Small Business Administration, the California Department of Benefit Payments, and the. California Division of -industrial Accidents. I also understand I may contact the �Califomia Contractors' State LicenseBoard (CSLB)-at 1 80MV-CSLB (2752)'or www.cslb.ca.00yfor.more information about licensed contractors. t .: K `S 10. I am aware,of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the party legally and financially responsible for proposed construction activity at the following address: i I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner -Builders as well as employers. k`5 12. 1 agree to notify the issuer of this form immediately: of any additions, deletions, or changes to any of the information I have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in, civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner -Builder and wish to: hire Contractors; you will be responsible for.verifying whether or not those Contractors are properly licensed and the, status of their workers' compensation insurance coverage. Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Note: A copy of the property owner's driver's license, form notarization, or other verification acceptable to the agency is required to be presented when the permit'!is issued to verify the property owner's signature. i Signature of Property Owner: Date: Z/2f DON SOILS ENGINEERING, CO CONSULTING GEOTECHNICAL ENGINEERS 2225 S. LA BREA AVENUE LOS ANGELES, CA90016 TEL. (323) 936-6763 FAX. (323) 936-6581 January 17, 2017 Project No.: G-3051 Mr. Sung Bum Park 3359 Hawkwood Road Diamond Bar, CA 91765 Subject: COMPACTION REPORT (SECONDARY STRUCTURAL FILL) Proposed Swimming Pool Backfill 23126 Rio Lobos Road Diamond Bar, California (APN: 8717-029-037) INTRODUCTION Submitted herewith is a summary of the observation and testing services provided from January 5, 2017 through January 16, 2017 by Don Soils Engineering, Co., during grading operations. These observations and tests were required in order to comply with the City of Diamond Bar grading ordinances. The purpose of the grading was to provide landscape area after backfilling the existing swimming pool (Secondary Structural fill). SITE CONDITIONS The subject site is located on the south side of Rio Lobos Road in the City of Diamond Bar. The approximate location of field density tests and limits of certified fill is shown on Drawing B. ASTM D-1557 was used for the laboratory standard for maximum density and ASTM D-1556 for field density test method. GENERAL GRADING PROCEDURE The following is a discussion of the grading operations as they were performed on the subject site. 1. The gunite perimeter wall of existing swimming pool was removed to 2 feet from existing surface. Existing concrete shell is also remained. There were three two - foot diameter holes on the bottom of existing concrete shell for drainage. 2. Deleterious materials at the area to be graded, such as concrete debris, were removed and disposed of off -site prior to grading. 3. The depth of compacted fill was approximately 3.5 to 5.5 feet. 4. Fill, consisting of import materials, silty sand(SM) and sandy clay (CS), placed in lifts restricted to six inches in thickness, watered or air-dried as required to achieve adequate moisture conditions, compacted to a minimum relative compaction of 90 percent of the laboratory standard. The soils were compacted mechanically by construction equipment. 5. The approximate locations of all tests taken within the graded limits included in this , report and test results are shown on the enclosed Drawing A and Table II. Lab density test result is presented at the end of this report in Table I. CONCLUSION AND RECOMMENDATIONS The observations and test results indicate that the compaction was accomplished in accordance with the City of Diamond Bar grading ordinance. The conclusion and recommendations contained herein have been based upon our observation and testing as noted. Services performed by Don Soils Engineering Co. were prepared in accordance with generally accepted geotechnical engineering principals and practices. No other warranty, expressed or implied, is made as to the conclusions and professional advice included in this report. This report pertains only to the grading and compaction within specified site as described herein and is subject to review by the appropriate regulating agencies. Very truly yours, Donghyun Yim/Civil Engineer v2�OF E o�p�Q O�C�GtI Y Uh, c5 Nn.514739 ti ~' 'OF Ate TABLE I LABORATORY TEST SUMMARY Soil Classification Maximum Optimum Shear Type Dry Density Moisture lbs./cub.ft % Dry Wt Cohesion (psf) I Sand' silty, light red brown 119.5 9.3 (SM) (S 1 Clay, sandy, brown 108.7 12.3 TABLE II RELATIVE COMPACTION SUMMARY Shear Friction (deg) Test Date of Depth Soil Type Moisture Dry Unit Relative No. Test Below Fin. Content Weight Compaction Grade(ft.) (percent) (pounds per cubic foot) 1 1/16/17 4 II 13.8 98.3 90.4 2 1/16/17 2 I 10.2 110.1 92.1 3 1/16/17 2 1 9.5 109.8 91.9 4 1/16/17 On -grade I 9.7 109.5 91.6 5 1/16/17 On -grade 1 11.0 107.9 90.3 CITY OF DIAMOND BAR DEPARTMENT OF BUILDING AND SAFETY ENGINEER'S CERTIFICATE OF COMPLIANCE FOR COMPACTED EARTH FILLS LOCATION OF FILL: APN. 8717-029-037 JOB ADDRESS: 23126 RIO LOBOS ROAD, DIAMOND BAR, CALIFORNIA SOIL TESTING AGENCY: DON SOILS ENGINEERING, CO. PROPERTY OWNER'S NAME: SUNG BUM PARK OWNER'S ADDRESS: 3359 HAWKWOOD ROAD, DIAMOND BAR PER REPORTS ON OUR PROJECT NO. G-3051 DATE WORK STARTED ON PROJECT: JANUARY 5, 2017 DATE FILL WAS COMPLETED: JANUARY 16, 2017 DATE OF THIS CERTIFICATE: JANUARY 17, 2017 TO THE SUPERINTENDENT OF BUILDING: *I hereby certify that I have personally inspected and tested the placing of compacted earth fill on the above described property, and on the basis of these inspections and tests it is my opinion that the same was pl . .ty with the requirements of r,H Y UN F• i California Building Code. NIo.4,73Uj Exp.1v 59739 • For the purpose of this Certificate, to "have personally inspected and tested" shall include inspection and testing performed by any person responsible to the licensed engineer signing this certificate. Where the inspection and testing of all or part of the work above is delegated, full responsibility shall be assumed by the licensed engineer whose signature affixed thereon. PLOT PLAN AND TEST LOCATIONS Rio Lobos RD. Scale 1"=20' I r I Existing Swimming Pool Wit/ Legend : the limit of compacted fill : the depth of compacted fill : test no. and approx. locations SWIMMING POOL BACKFILL PROJECT NO. G-3051 23126 RIO LOBOS ROAD. DIAMOND BAR, CALIFORNIA DRAWING A DON SOILS ENGINEERING, CO. CONSULTING FOUNDATION ENGINEERS & ENGINEERING GEOLOGIST