Loading...
HomeMy WebLinkAbout15-0190�.. ... I CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 PRESS (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 FIRMLY BUILDING PERMIT APPLICATION JOB SITE ADDRESS APN LOT TRACT I OWNER ftlr "� V'V' �{ ADDRESS 3 �i �i 9561 C d Y Ili' !f) e� /, t CITY. It A t-� � �, ir- ZIP TEL. APPLICANT TEL. 6NTRAC TOR Le moi► `1 - a2 V Air Q c, 4 , :gDDRESSI 4,i t f' ( 6 V4 -e w -0r o N CITY .-eldrV Ll ZIPl/7101 TEL._ b'Cf82_12621 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 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 (.J all of or (J portions .of.the!ivork aftl,the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Co fractd's';.State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improvesht e' property, p p rty, provided that the improvements are not intended or offered for sale. If however, the building or improveme6nt is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or improze r the purpose of sale.). (_)4, 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.). (Ji 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,) 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.htmi. DATE: SIGN: i 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 andel Professions Code, and my license is in full force and effect, ply, LICENSE CLASS' it /,� t LIC. NO.: i� 1 6 6 S DATE: �r CONTRACTOR: �Od1L2 .�dl �£�Jlt',�'1+4''Bd� WORKER'S COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OFTHE FOLLOWING DECLARATIONS: Llqm 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: Z' 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 enter upon the above-mentioned property for inspection purposes. 04 PERMITTEEIVME (PRIM SIGNATURE OF PERMITTEE DATE APPLICATION DATE: P/C# � ISSUE DATE: 1 I I) Ip PERMIT# I — ;9 ,TYPE CONST. OCC GROUP: � ZONING SETBACKS FRONT RW REAR SIDE/SIDE STREET RW SIDE ❑ ❑ ❑ ❑ PROPOSED USE # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport rn LU Patio/Deck LL Pool/Spa ZRe -Roof f O 02 Commercial m Valuation: Adj. Area: QUANTITY DESCRIPTION FEE a( g ( U V&ATO 4!>6 II 0 cc 7'S, 4 7 U ,+ ra✓ w co Ri a zd w CONSTRUCTION: PLAN REVIEW: ELECTRIC: 1 -7, ' PLUMBING: A'o. n MECHANICAL: INSPECTION FEE: ISSUANCE: SMIP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: BSAF: wu TOTAL FEES ,J COMMENTS: C0nIrLI r all 1 /1 1 :' k h /" y 1� r6 :�' r i�l 01 n o f-0 `(1416,nOl / n 4.1f N !) 4 pr 'NA ,°y^ RECEIPT # PAID BY: VALIDATION: WHITE — Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy, GOLDENROD — File Copy, GREEN — Applicant's Copy CITY OF DIAMOND BAR INSPECTION RECORD r (/LETTER TRACT AND LEDGER iS FOEiMS` SWITCH GEAR _ �COMMERCIAL HOOD JIBING. d : , T—BAR JRICAL.,_ INTI ERCEPTER OUND I HOT MOP/SHOWERPAN SEWER LATERAL MAIN WATER LINE SEPTIC/CESSPOOL HERS REPORT RECEIVED SEWER CLEANOUT INSULATION CEILING i DEMOLITION ROOF SHEATHING FENCE/GATE/'ALARM` ROOF DRAINS FLOOR SHEATHING LATH EXTERIOR ROUGH CONDUIT VAtLS EXTERIOR POOL/SPA VAU S INTERIOR . u,�, e,�� ROUGH PLUMBING a/VENTINGROUGH ELECTRICAL MECHANICAL i ROUGHMECHANICAL �= GECTRICAt W(` }.0-( w... y: x GAS TEST ROUGH'PLUMBING� }• PRE GUNITE A INSULATION WALL POOL PRE DECK BONDING INSULATION CEILING i P—TRAP DRYWALL I FENCE/GATE/'ALARM` LATH (PRE) ; FINAL POOL LATH EXTERIOR WALLS: ( WALL FOOTING/STEEL LATH INTERIOR i GAS TEST WALL STEEL 1 &F( ) 2N°( ) LIFT SCRATCH COAT I WALL BOND BEAM ELECTRIC METER RELEASE ! WALL DRAIN/ SEAL _ GAS METER RELEASE WALL FINAL SPECIAL INSPECTION FINAL BUILDING FINAL MECHANICAL FINAL ELECTRICAL FINAL PLUMBING COMMENTS: FIRE FINAL ENGINEERING/ PW FINAL COMMUNITY SERV FINAL HEALTH DEPT. FINAL, INDUSTRIAL WAST OVAL �' A . . .. 1 4 6 F City of Diamond Bar c Building & Safety Division ��. 21810 Copley Drive Diamond Bar, CA 91765 Building Division (909) 839-7020 / Inspection Request Hotline (909) 83977027 PERMIT # ©1 �Iy DATE ISSUED: ADDRESS: f 2 C ^dW+ DESCRIPTION: �, r Am l0 I"ay►91yl&q,�j 4- l p f t r POST IN SAFE, CONSPICUOUS PLACE AT FRONT OF JOB. PROVIDE PERMIT NUMBER WHEN CALLING FOR INSPECTION. HAVE APPROVED PLANS ON JOBSITE ATTIME OF INSPECTION. INSPECTION REQUESTS SHALL BE MADE 24 HOURS IN ADVANCE. YOU MAY CALLUS THE DAY OF YOUR INSPECTION AT 9:00 AM AT (9091839-7020 TO OBTAIN AN APPROXIMATE TIMEFRAME. INSPECTION DATE: SIGN: INSPECTION DATE: SIGN: SETBACK / LETTER TRACT AND LEDGER FOOTINGS FORMS SWITCH GEAR SLAB COMMERCIAL HOOD UG. PLUMBING • T -BAR UG. ELECTRICAL INTERCEPTER LIFER GROUND HOT MOP/SHOWERPAN SEWER LATERAL SEPTIC/CESSPOOL SEWER CLEANOUT HERS REPORT RECEIVED MAIN WATER LINE DEMOLITION ROOF SHEATHING ROOF DRAINS FLOOR SHEATHING ROUGH CONDUIT SHEAR WALLS EXTERIOR POOL/SPA: SHEAR WALLS INTERIOR ROUGH PLUMBING FRAMING/VENTING ROUGH ELECTRICAL R0. MECHANICAL ROUGH MECHANICAL R0. ELECTRICAL W( ) C () GAS TEST RO. PLUMBING PRE GUNITIE INSULATION WALL POOL PRE DECK BONDING. INSULATION CEILING P -TRAP DRYWALL FENCE / GATE / ALARM LATH (PRE) FINAL POOL LATH EXTERIOR 4VALLS. LATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL 1ST( ) 2ND( ) LIFT SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELEASE WALL DRAIN / SEAL GAS ­ ,METER RELEASE WALL FINAL SPECIAL INSPECTION RO. FRAMING PLANNING APPROVAL FINAL BUILDING ROUGH FIREAPPROVAL FINAL MECHANICAL FINAL FIRE FINAL ELECTRICAL FINAL PLANNING FINAL PLUMBING FINAL ENGINEERING/ PW T.C. of OCCUPANCY FINAL COMMUNITY SERVICES CERT.OF OCCUPANY FINAL HEALTH DEPT. INDUSTRIAL WASTE FINAL