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CIT YOF'DIAMONDBAR'
h DEPARTMENT OF COMMUNITY' -A, DEVELOPMENT SERVICES
4 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
APPLICATION DATE: 0 ?_01 �P//Cff
ISSUE DATE: 7`— c, "�d,rPERMIT# :
TYPE CONST.
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OCC GROUP:
JOBSITEADDRESS
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# BEDROOMS
APN LOT TRACT
OWNER A �L� 7 0490.-!!�I
ADDRE
CITY ZIP TEL.
APPLICANT TEL. 7
CONTRACTOR
ADDRESS 141
CITY U 4,A4�kn ZIP &L.
ARCH/ENG/
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DESIGNER ✓I
ADDRESS
CITY Un ZIP EL.
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 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/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 is in full force and effect.
U
LICENSE CLASS. LIC. NO.: 1
DATE: CONTRACTOR:
WORKER'S COMPENSATION DECLAR ION
II HE FARM 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
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Policy Numberare"IaQ
CARRIER r/�
POLICY NUMBERA,4 ALA
(THIS SECTION NEED NOT BE COMPLETED IF THE PERM IS FOR 66E 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 Califomia. 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 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.
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.
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PER ME (P� T) -
SIGNA RE 0 PERMITTEE DAT
APPLICATION DATE: 0 ?_01 �P//Cff
ISSUE DATE: 7`— c, "�d,rPERMIT# :
TYPE CONST.
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OCC GROUP:
Scope of Work 0 CaU%-2
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# DWEL. UNITS # STORIES
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# BEDROOMS
DESCRIPTION SQ. FT. FACTOR PSF
ADJ. AREA/VALUATION
SFR/ADD/REM
Gar a/Carport
IfifilDeck f
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-Roof
Commercial
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Valuation:
Adj. Area:
QUANTITY DESCRIPTION FEE
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ONSTRUCTION:
LAN REVIEW: 0r6
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ELECTRIC:
PLUMBING:
MECHANICAL:
INSPECTION FEE:
ISSUANCE:
31i 1 L11
SMTP:
21
6,21
ENERGY P/C:
ENERGY PERMIT:
RETENTION FEE:
PRE -ALT FEE:
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BASF:
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PLOT PLAN:
ZONING CLEARANCE:
TOTAL FEES
COMMENTS:
ITM 7/
P/C: �JJ PAID BY: . / / G/ /A� VALIDATION:
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RECEIPT # 7 2 pL PAID BY: (/ d6 VALIDATION
WHITE — Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy
Y CiTY'OP D!.ANIOPZD BAR '
INSPECTION R--EC'ORC1
INSPECTION
DATE
INSPECTOR
SETBACK/ LETTER
FOOTINGS FORMS
II
SLAB
UG. PLUMBING
UG. ELECTRICAL
UFER GROUND
SEWER LATERk '
1
MAIN WATER LINE
SEWER CLEANOUT
ROOF SHEATHING
FLOOR SHEATHING
SHEAR WALLS EXTERIOR
SHEAR WALLS INTERIOR
FRAMINGNENTING
ROUGH MECHANICAL
-
ROUGH ELECTRICAL W( ),C( •) // /o
ROUGH PLUMBING
INSULATION WALL'
INSULATION_ CEILING
DRYWALL
LATH (PRE)
LATH EXTERIOR
LATH INTERIOR
GAS TEST
SCRATCH COAT
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ELECTRIC METER RELEASE
`
GAS METER RELEASE
SPECIAL INSPECTION
FINAL BUILDING
7G /
FINAL MECHANICAL
FINAL ELECTRICAL
$ ZCo
FINAL PLUMBING
T.C. of OCCUPANCY
CERT. of OCCUPANCY
INSPECTION DATE INSPECT"
TRACT AND LEDGER
SWITCH GEAR
COMMERCIAL HOOD
T -BAR
INTERCEPTER
HOT MOP/SHbWERPAN
SEPTIC/CESSPOOL
HERS REPORT RECEIVED
DEMOLITION
ROOF DRAINS'
ROUGH CONDUIT
POOL/SPA '
ROUGH PLUMBING _
ROUGH ELECTRICAL
ROUGH MECHANICAL -
GAS TEST .
PRE GUNITE
POOL PRE -DECK BONDING `
P -TRAP -
FENCE/.GATE/ALARM
FINAL POOL'
WALLS: ;..i
WALL FOOTING/STEEL r '*
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
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�r DETAILED
1230 Ponderosa Ave.
Brea, CA 92821
a NSPECTION909 731-6479
AsDetailed@yahoo.com
Registered Deputy Inspector's Report
❑ Reinforced Concrete ❑ H.S. Bolts ❑ Sprayed Applied Fireproofing
❑ Post Tensioned, Concrete Welding ❑ Quality Control
❑ Reinforced Masonry ❑ Shop ❑ Drilled In Anchors
Job Address 3015•Wagontrain Rd.
city Diamond Bar
Job Name Duan Residence
Permit No. PR15-2284
issued By Diamond Bar
Mix Design and Samples Made
Architect Phil May
Engineer
Contractor
Inspector(s) Name Dan Kiefer
Subcontractor
Project Date Wednesday, 10/21/2015
Provided inspection for the field welded connection on the roof framing of patio cover frame and the 5/8" diarneter anchor studs
at roof level. Inspection passed visual test at roof level for eight locations from columns to the HSS10x6 Header and the 5/8" studs
at the perimeter tube steel. Complete using FCAW process as per detail on Roof Framing Plan S-1 and 4/:S-1.
As per Final Report requirements, the work above that required special inspection structural steel welding and anchor studs was,
to the best of my knowledge, completed in conformance with the approved plans and specifications and applicable
workmanship provision of the codes.
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TIME IN TIME OUT REG. HOURS' O.T. HOURS CYLINDERS
4 N/A N/A
All inspections based on a minimum of 4 hours and over 4 hours - 8 hours minimum.
In addition, any inspection extending past noon hour will bean 8 hour minimum.
I Approved by
Project Superintendent
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CERTIFICATION OF COMPLIANCE
I HEREBY CERTIFY THAT I HAVE INSPECTED 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, SPECIFICATIONS,
AND
�APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS.
SIGNATURE OF REGISTERED INSPECTOR
Structural Steel Welding ICC #5238658
SPECIALTY NO. AGENCY