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Home My WebLink AboutPR15-2440CITY OF DIAMOND 13A11:'1 DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 PRESS (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-702 FIRMLY III BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@ t ondbarca.gov JOB SITE ADDRESS G J &0 P,LUr7D a PL APN &][ 9T it TRACT O"11ER Tu w.' ADDRESS 62-S .1 CITY Dr—A400 6A,2 ZIP 9i7f,i TEL. ROi'— — 7749 APPLICANT TEL. 903- T17- 9:79!) CONTRACTOR ADDRESS CITY ZIP TEL. ARCH/ENG/ DESIGNER)C rIAVid U ADDRESS lbbb rjnA ("(0vi1.11 %,W -tL l� CITY ZIP 9I "16EL. - 1 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 Wof t more than five hundred dollars ($500). rl, 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: httpAvww.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. LICENSE CLASS: LIC. NO.: DATE: 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 (THIS SECTION NEED NOT BE COMPLETED IF THE 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 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. 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-mentioned property for inspection purposes. T1A ]Viii s L 1 PERMITTEE NAME (PRINT) 0 /— SIGNATURE OF PERMITTEE DATE APPLICATION DATE:_,Ac- S P/C#Ste— �a I ISSUE DATE: ��,/ \P: Y 7ERMIT# �,I^� a Y O TYPE CONST. OCC GROUP: V Scope of Work hr'60 as. eA 'L49 o� y ; add; # DWEL. UNITS If STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM •� C:�V n/•�- Ei 'C'ea-'�'io Garage/Carport k7 C.c�v b� Cr w Patio/Deck q W LL Pool/Spa ZRe -Roof I Commercial Z) CID Valuation: 35 A C�,'CIO cN Adj. Area: QUANTITY DESCRIPTION FEE 2 U w J Z+ 9-4 kke 14 w co M m J a L) Q x U CONSTRUCTION: mid •_ _,_ G1-- PLAN REVIEW: Co Z ELECTRIC: �� ,nr PLUMBING: MECHANICAL: J ^ INSPECTION FEE: ISSUANCE: /Dc, 4 a. SMIP: H` ENERGY P/C: ENERGY PERMIT: l.o X - Cz,a. RETENTION FEE: PRE -ALT FEE: BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: P/C: 'atey $� PAID BY: J VALIDATION: 9.-1 RECEIPT # PAID BY: ` VALIDATION: WHITE — Department Copy, YELLOW — Finance Copy, PINK,— Assessor Copy •, V F+, CITY- .F DIAI7ONv,S, AR INSPECTION AECORD t INSPECTION DATE O. 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 1S'( )2 N . D( ).LIFT WALL BOND BEAM WALL DRAIN/ SEAL WALL FINAL R0. FRAMING PLANNING APPROVAL ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT FINAL PLANNING FINAL ENGINEERING/ PW L / FINAL COMMUNITY SERVICES FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE COMMENTS: vIA f� G� e gar ae 1/i 7 i SETBACK/LETTER FOOTINGS FORMS /7 / SU6 / UG'. PLUMBING UG. ELECTRICAL UFER GROUND SEWER LATERAL MAIN WATER LINE SEWER CLEANOUT ROOF SHEATHING FLOOR SHEATHING SHEAR WALLS EXTERIOR SHEAR WALLS INTERIOR FRAMINGNENTING ,3 ROUGH MECHANICAL ROUGH ELECTRICAL W( ).0 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 INSPECTION DATE O. 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 1S'( )2 N . D( ).LIFT WALL BOND BEAM WALL DRAIN/ SEAL WALL FINAL R0. FRAMING PLANNING APPROVAL ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT FINAL PLANNING FINAL ENGINEERING/ PW L / FINAL COMMUNITY SERVICES FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE COMMENTS: vIA f� G� e gar ae 1/i 7 i "�ytxGfLEs t2��jOitp{ CITY OF DIAMOND BARlk u DEPARTMENT OF BUILDING AND SAFETY STRUCTURAL OBSERVATION REPORT FORM REPORT NO. -1 THIS REPORT INCLUDES ALL rONSTRI Ir.TInN 1AIC)PW TI-IRnI ITI-I nA V r,r , o PROJECT ADDRESS: 623 JUNEWOOD STRUCTRUAL OBSERVER DAVID LI STRUC. OBS. PHONE NO. (626)-288-1216 OWNER LIC. OR REGISTRATION NO. C58075 BUILDING PERMIT NO. OBSERVED STRUCTRUAL ELEMENTS AND THEIR CONNECTIONS LOCATION AND DATEPORTIONS OF BLDG. - _ _ _A -T t BELIEF: PRESTRESSED CONCRETE SLABS _ ❑STEEL MOMENT -ORDINARY 2 , RESPONSIBLE CHARGE, HAS PERFORMED THE REQUIRED SITE VISITS AT EACH SIGNIFICANT CONSTRUCTION STAGE TO VERIFY IF _ gi .iAi❑- ❑_ 3. ALL DEFICIENCIES WHICH I DOCUMENTED HAVE BEEN CORRECTED UNLESS OTHERWISE INDICATED ABOVE, ❑ ❑- ❑- 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. vo��rww utrwltiv�Its: 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; []DEFICIENCIES CONTINUED:fi 3. ALL DEFICIENCIES WHICH I DOCUMENTED HAVE BEEN CORRECTED UNLESS OTHERWISE INDICATED ABOVE, ON ATTACHED FORM (B&S 261 A) 4. 1 UNDERSTAND THAT FINAL ACCEPTANCE OF THE STRUCTURAL SYSTEMS BY THE DEPARTMENT OF BULIDING AND SATIETY 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. FyG: 6. 1 HAVE PROVIDED STRUCTURAL OBSERVATION ACCORDANCE WITH THE REQUIREMENTS OF THE CITY OF LOS ANGELES. QQ�� PCHtN�( V/)) iQ 9 r.._._......:.. -�p5SQ-2 � - ......._ .i'..._ SIGNED C {✓'JOF Cl 2016 AT DIAMOND BAR CA DAY...!.MONTH, \G�� `+ YEAR'. ;:.',-:,.,CITY QF `C,t�� /� -- WET SIGNATURE OR-REGISTERE CIVIL OR STRUCTURAL- ENGINEER OR LICENSED ARCHITECT EXPIRE DATE: 06/30/2016 STAMP OF ENGINEER OR ARCHITECT STRUCTURAL OBSERVATION DOES NOT WAIVE ANY OF THE REQUIREMENTS FOR BUILDING INSPECTION 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)