HomeMy WebLinkAbout14-4186 - _, _.-
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„�"'�, _� C1TY OF DIAMOND BAR .
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,,,,,�,�� � � � � , DEPARTMENT OF COMMUNITY&DEVELOPMGNT SERVICES
�: ,���III�i .;- ' 21810 Copley Drive,Diamond Bar,CA 917fi5 PRESS
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,,,,,�, (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 FIRMLY
���•''��'""�"� BUILDINGPERMITAPPLICATION
g .+ APPLICATION DATE: Z.Z �l P/C#
� JOB SITE ADDRESS �Sf 3� l3 C N14C�I W A`i a
a ISSUE DATE: PERMIT# �L�' ��A�_ I
z APN LOT TRACT
o OWNER S!/�1�)V 1 Z��J TYPE CONST. OCC GROUP:
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N ADDRESS `�-�3Z Qg�TL�%Y WL�7
� CITY ���lHoniDjjAQ ZIP %176STEL. 6�Z6-3'ZZ- �/I'1.) ZONING F ONTCKS RW ❑
� APPLICANT f/Ar..�zh H 3"ya c.e2 vu'�� TEL. 9�� ?sv n7 6 FS REAR ❑
N SIDE/SIDE STREET RW ❑
¢ CONTRACTOR ___ S oLAf�M A�t SIDE ❑
� ADDRESS 3OA�O �Z T� ST � �
PROPOSEDUSE_/lD�F Mouu-r II.1] /[w Sa'LAjZ
o� CITY R/VERSIbC ZIP 25o TEL._�SI 305 076� �!7 /�V MoDu�-�5
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o ARCH/ENG/DESIGNER Z !ti�/EA-'rL R-S 175 g DER-ATEJ7
aADDRESS �
o #DWEL.UNITS H STORIES q BEDROOMS
z CITY ZIP TEL.
� DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
OWNFR-BUILDER DECLAflATION
¢ I hereby aflirm under penalry ot peryury that I am exempt from tbe Contractor's State License Law for the reason(s) SFR/ADD/REM
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p indicated below by the checkmark�s),1 have placed next to the appliCable item(s)[Section 7031.5,Business and Garage/Carport
o Professions Code:Any city ar caunty that requires a permlt W consVuct,alter,improve,demolish,or repair,any
z strucNre,Drior to its issuance,also requires the applicant for Ihe permit to file a signed statemenl that he or she � Patio/Deck
a is licensed pursuant to ihe pravisions of the CoMractor's Sfate License Law(Chapter 9)Commencing with Section W
� 7000 ot Division 3 of the Business and Professions CodeJ or that he or she is ezempt from licensure and the basis for LL Pool/Spa
� the alleged exemption.Any violation of Section 7031.5 by any applicant for a Dertnit subjecis the aDD���nt to a civil penalty Z Re-Roof
� of not more than live hundred dollars(5500�. �
o (J I,as owner of the praperry,or my emp�oyees with wages as their sole compensation,will do(�all 01 or(1 portions � Commercial
� of the work,and the structure is not intendetl or oftered tor sale(Section 7044,Business and Professions Code:The m
� Cantractors'State License Law does not apply to an ovmer of property who,through employees'or personal ettort,builds
� or improves ihe properry,provided that ihe improvemenfs are not intended or oftered for sale.If however,the building or
� improvement is sold within one year of completion,the Owner-Builder will have the burden oi proving that it was not built
p or improved for the purpose ot sale.).
v U I,as owner o1 the property,am exGusively cantracting with licensed Cantractors to consUuct The project(Section
� 7044,Business and Professions Code:The Contractors'Stale License Law does not appty to an owner of properry who ValuatiOn: J J l> Adj.Area:
z builds or improves t�ereon,and who coniracts for the projects wiN a licensed Cantractor pursuant to the Contracrors'State
v� QUANTITY DESCRIPTION FEE
Y License Law.).
o U�am exempt from licensure under ihe ContracWr's State Ucense law lor the following reason(s): � � !N v�?�-�L�
� ¢
"—' By my signature below I acknowledge that,except tor my personal residence in which I must have resided tor at least one w
� year prior to completion of the improvements covered by this permit,l cannot legally sell a sWcture tha[I have buili as an w
a owner-builder if it has not been consiructed in its entirery by licensed contractors.l undersfand That a copy of ihe applicaAte
� law,Section 7044 0l the Business and Professions Code is available upon request when this apDlication is submitted or at
X the following Web site:http/wvnv.leginto.ca.gov/calaw.html. �
z
o DATE: SIGN: �
� LIGENSED COMRACTOfl'S OECLAfiAT10N �
w I hereby attirm under penalty of perjury that I am licensed under provisions ot Chapter 9(commencing with Section 7000)
m ot Division 3 0l the Business and Professions Code,and my license is in full lorce and ettect.
J
� UCENSE CLASS: ��-7�j LIC.NO.: 7 Z U � a
o DATE: T�22�/y CONTRACTOR:_ ��� _
U
� WORKEp'S COMPENS DEC �ON �
� I HFREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING OECLARATIONS:
oI have and will maintain a Certificate af Consent to Self-Insure lor Worker's CompensaUon,as provided by CONSTRUCTION: -1 . 7
� Section 3700 0l the Labor Cade,for lhe pertormance of the work for which Uiis permit is issued. p�qN REVIEW: /�
� �_I have and will maintain Worker's ComDensation Insu2nce,as repuiretl by Section 3700 0(the labor Code,for
o the performance of the work for which ihis permit is iuued.My Worker's Compensation Insurance Carrier and ELECTRIC:
z
a Poli�yNumberare: PLUMBING:
� CARHIER � E MECHANICAL'
� POUCY NUMBER �D '7��/3/ INSPECTION FEE:
� (iHIS SECf10N NEED NOT BE COMPLEfED IFiHE PERMR IS FOR ONE HUNDRED DOLLARS(S10fn OR LESS�. 7
� ISSUANCE: ,�,f,(�
� I certify Oiat in ihe pedortnance of the work for which this permit is issued,I sl�all�1 employ any person in any manner so as to SM I P: �.�
become subject to ihe Worker^s Compensation Laws ol Califomia.Md agree that if I should become subjecl to U�e Worker's
� Compensati n pmvisions oi Section�3700 ot ihe Labor de,I shall toNnvith cn pl ilh ttros '�siens.- ENERGY P/C:
,J—� DATE:���'�'_tAPPLICN�T: ENERGY PERMIT:
� WARNING Failure to secure WorkeYs CompensaG ge i� u,and shali n employer ro criminal RETENTION FEE: N�.•D1�
w penalties and civil fines up to one hundred thousand dollars($1DO,OOOJ,in ad' � e cost of the compensation,
�- damages as pmvided tor in section 3708 of ihe labor cade,interest,and attomey's fees. PRE-ALT FEE:
0 �y A�
a CONSTHUCTION LENDING AGENCY BSAF: ..}'O y�
w I hereby affirm under penalty of perjury ihat there is a Conslruclion Lending Agency 1or Ihe peAomiance of ihe work lor
� which this permit is issuetl(Sec.3097,Civ.C.).
� LENDER'S NAME:
� LENDER'SADORESS: �O
a I certity that I have read this application and state that the above iniorma6on is cortect.I agree to compry with all ciry and TOTAL FEES
Z counry ordinances and state laws relafing ro building construcdon,and hereby authorize representatives of ihis counry to COMMENTS:
o enter upon ihe aUove-mentioned property far inspectian purposes.
J .y
C� 4 �J
a PERMITTEE N M P N
�' 9 2 2 ,� l�
� SI TURE OF DATE RECEIPT N �'�/�.,� 7 PAID BY:�VALIDATION: �`
WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy
CITY OF DIAMO�lD BAR
INSPECTION RECORD ' ��
�
� 0 . � � � � � a ' , l • 0 �
V
SETBACK/LETTER�' � '', ��. ��_� TRACTAND LEDGER
FOOTINGS FORMS � � ': - SWITCH GEAR
g(11g, .; COMMERCIAL HOOD
UG:PLUMBING': `' ��� T-BAR
UG::ELECTRIGAL, � . INTERCEPTER
UFER;GROUND,:, t ' ` ' HOT MOP/SHOWERPAN
SEWER LATERAL SEPTIC/CESSPOOL
MAIN WATER LINE HERS REPORT RECEIVED
SEWER CLEANOUT DEMOLITION
ROOF SHEATHING ROOF DRAINS
FLOOR SHEATHING ROUGH CONOUIT
SHEAR WALLSfXTER(OR= " . r POOUSPA;� - - �
. . ... , y _
SHE�4R,WALLS`INTERIOR��� ��,{ � ROUGH PL'UMBING ��;_ � ' �"� �'�` '
FfiAMING,NENTING ' ' " ; � ! '- < ROUGH ELECTRICAL�� . _ � ;: ' - ' '
. , .
ROUGH ME.GHANICAL _�. >:- : - ' .� ; , . .; �, � :;: ROUGH MECHANICAL , �,. 's
� , � ; -� , ... . ,�. � �
ROUGH ELECTRICAL W(``,�)�I�) .'.=. . :�.� % �c, ;.-�`���. ;' ,. •, �AS TEST;: •: ' _ ', �� ` - -
ROU�H.PLUMBING '"-. . ' '' ; `� ..;i � � ': . : � � PRE GUNITE, -
INSULATION WALL POOL PRE DECK.BO
NDING . - `'
INSULATION CEIUNG P=TRAP "
DRYWALI FENCE/GATEi ALARM ✓ � �
LATH(PRE) FINAL•POOL �
LATH EXTERIDR WALLS:
LATH INTERIOR WALL FOOTING/STEEL
GAS TEST WALL STEEL 1sr( )2N0( )LIFT
SCRATCH COAT WALL BOND BEAM
ELECTRIC METER RELEASE WALL DRAIN!SEAL
GAS METER RELEASE WALL FINAL
SPECIAL INSPECTION R0.FRAMING P'LANNINGAPPRQVAL �
, .,
FINAL BUILDING ` � _ _ `ROUGH FIREAPFROVAL .: ; { .
� � • .
FINAt MECHANICAL�. .��.�-` ',..;"= ' ;,. �_ �.' �-.�- � >-� :FINAL FIRE DEPARTMENT ��� '.:;'� "� - - �"
�FINAL`ELECTRICAL .. :�'�',_ - ( FINAL PLANNING ':. � ' ''�
'�.
fINAL PLUMBING •' :. '- :" ;; ' �. FINAL ENGINEERING/PW '�' � - -
T.G:of OCCURANCY - ` - : , ;' ';, .��� , �''. ' FI,NAL COMMUNITY SERVICES A _
CERT.=of,OCCUPANCY�-; <'r . ,S " .� ... �-: S . .. ` ,:'' .�`; FINACHEALTH;DEPT ,;�'� ' ; � - >;
;FINAL INDUSTRIAC.WASTE Y." '" � ` .
�: �
COMMENTS: �i�! rQp���.,.� ��,-. SlT�,� n r��M