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Home My WebLink About15-0575 =.'�i. ..............� CITY OF DIAMOND BAR •' _ ., � i DEPARTMENT OF COMMUNITY&'DEVEL`OPMENT SERVICESY ' �i a`' � 21810 Copley Drive,Diamond Bar,CA 91765 '" ��ESS ;,„; (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 '��'� BUILDING PERMIT APPLICATION FIRMLY ^ I' APPIICATiON DATE: P/C# s JOB SITE ADDRESS `� �( l I�V S L Q �(� ,//�j�D/f" PERMIT# /.I��W �f z APN LOT TRACT ISSUE DATE:_ � OWNER V:�II-Qn't" S('�I�,�ZQr TYPECONST. OCCGROUP: � ADDRESS � CITY ZIP rE�. �iv9 R13 5 L ( ZONING F ONTCKS RW ❑ � APPLICANT � K. � S TEL.1(`[ 3(J '3�t 1 i REAR ❑ ¢ CONTRACTOR/,. R� D l � �y^ y SIDE/SIDE STREEf RW ❑ � ADDRE,.S{S�' ,_`3 L��-t �r G � � �L-i� � SIDE ❑ s CITY 1 �r 7-an�il ZIP 3 5 6 TEL. ��g ��Z 2�Z-� PROPOSED USE � � � ARCH/ENG/DESIGNER L = ADDRESS � #DWEL.UNITS #STORIES #BEDROOMS z CITY ZIP TEL. � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREA/VALUATION � OWNFA-BUILDEH DECLAHATION I z I hereby affirm under penalty of perjury that I am ezempt from the Con[ractor's State License Law for the reason(s) SFR/ADD/REM � indicated below by the checkmark(s),I have placed next to the applicable item(s)[Section 7031.5,Business and Garage/CarpoR I '-� Protessions Code:Any city or caunty that requires a permit to construct,alter,improve,demollsh,or repair,any � Iz structure,priar to its issuance,also requires the applicaM for the permit tn file a signed statement that he or she � Patio/Deck � is licensed pursuantto ttie provisions of tlie Co�actor's State License Law(Chapter 9)Cammencinp with Section w � 7000 of Division 3 of the Business and Professions Code]or that he or she is exempt fmm licensure and the basis for LL Pool/Spa I � the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicantto a civil penalty C7 'n—$ of not more than five hundred dollars($500�. ZQ Re-Roof I � ()I,as owner of the propeRy,or my employees with wages as tt�eir sole compensation,will do(,all of or U portions � Commercial I � of the work,and the structure is not intended or offered for sale(Section 7044,Business and Professions Code:The m I Z 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 �� --�� I � improvement is sold within one year of completion,the Owner-Builder will have the burden of proving that it was not built - jor improved for the purpase of sale.�. I '� (�I,as owner of the property,am exclusively contracting with licensed Contractors to construct the project(Section Z 7044,Business and Professions Code:The Contractors'State License Law does not apply to an owner of property who Valuation: Adj.AreB: I .� 6uildsorimprovesthereon,andwhocontractsforlheprojeciswithalicensedContractorpursuanttotheCantractors'State QUANTITY DESCRIPTION FEE I Y License Law.). I � (�I am exempt from licensure under ihe Contractor's State License law for the following reazon(s): a I U Q l By my signature below I acknowledge that,except for my personal residence in which I must have resided for at least one � I Z J � year prior to completion of the improvements covered by this permit,l cannot legally sell a struc[ure that I have built as an w I owner-builder if it has not been constructed in its entirety by licensed contractors.I understand thata copy of the applicable � law,Section 7044 of the Business and Professions Code is available upon request when this application is submitted or at � �, �x I � the following Web site:http/�wrw.leginfo.ca.gov/calaw.html. � ' z I ? DATE: SIGN: � f� — LICENSEDCONTfiACTOH'SDECLAHATION � �iXi I,f /� ) I a I ' I hereby affirm urider 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. J I � LICENSE CLASS: � �� LIC.NO.: I�� C Z z I I � DATE: CONTRACTOR: C� i � ¢ WOHI�H'S COMPENSATIO DECLAHATION g I y 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 CONSTRUCTION: Q �Section 3700 of the labor Code,for the performance ot lhe work for which this permit is issued. p�qN REVIEW: > V I have and will maintain Worker's Compensation Insurance,as required by Section 3700 of the Labor Code,for � the pertormance of the work for which this permit is issued.My Worker's Compensation Insurance Carrier and ELECTRIC: ¢ PoIi�yNumberare: �e �� PLUMBING: �' � �/ � CARRIER MECHANICAL: L ' POLICY NUMBER �✓ G�3 �� fY n INSPECTION FEE: _ (TFiIS SECTION NEED NOT BE COMPLEfED IFTHE PFAMfT IS FOR ONE HUNDRFD DOLIARS($100)OR LESS�. ISSUANCE: ,� r.f", � I certity that in me yerformance of ine work for which mis permtt is issued,I shall not employ any person in any manner so as m � become subject to tl�e Worker's Compensation Laws of Califomia.Md agree that if I should become subject to the Worker's SMIP: � CompensaUon provisions of Section 3700 of the Labor I shal p�IhWjm comply with those provisions. ENERGY P/C: . J i DATE: APPLICANL l I ENERGY PERMIT: � WARNING:Failure to secure Worker's Compensation coverage is u, wFul,and shall subject an employer to criminal RETENTION FEE: �O y penalties and civil fines up to one hundred thousand dollars($100,000�,in addition to the cost of the compensation, i damages as pmvided for in section 3708 of the labor code,interest,and attomey's fees. PRE-ALT FEE: � i CONSTRUCTION LENDING AGENCY BSAF: = I hereby affirm under penalty of perjury that there is a Construction Lending Agen�y for the peRormance of the work for � which this permit is issued(Sec.3097,Civ.C.). LENDER'S NAME: z LENDER'SADDRESS: i I certify that I have read this application and sTate that the above information is correct.I agree to comply with all city and TOTAL FEES ��t /ry � �d Z county ordinances and state laws relating to building construction,and hereby authorize representatives of this county to COMMENTS: � enter upon the above-mentioned property for inspedion purposes. � J � s?__�'J[I (C i/1 U� I 4� � ¢ PERMITTEE NAM�(PRINT� i � r� /��t' :n ` = SIGNATUR MITfEE DATE RECEIPT# PAID BY: �[ VALIDATION: t WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Applicant's Copy I ,,, � .GlTY OF DIAMOND BAR ' � ' ' ' �� '' ' INSPECT.-IJN'REC�RD � � • � � • � - • • � � . m . SET�ACK/�L�TTER� � � � � fl ° TRACTANU LEDGER FOQTINGS FORMS', ,;.: °� � � � ' `' � � ` SWITCH 6EAR - � ° � � SLAB w "� �,„�.� R.�,.� ,, , �.,. � � � � COMMERCIAL HOOD UG;�PLUMBING�. � , g , T-BAR UG��ELECTRI�AL' m�°�"� � �� " �' � ' � INTERCEPTER UFER GROi1ND �'��' �� W�� ,w� ',� . � � �, � ��. HOT MOPISHOWERPAN SEWER LATERAL SEPTIC/CESSPOOL MAIN WATER LINE HERS REPORT RECEIVED SEWER CLEANOUT DEMOLITION ROOF SHEATHING ROOF DRAINS FLOOR SHEATHING ROUGH CONDUIT ;SH�AR�WACL�EXT�FiIOR� �'� ` �'` � � � �� POOUSPA � �� SHEAR6NALL5INTER�� _ � _ - � _ °� ' � � � � IQR . �. ,, � . � � " � o � A - ROUGH PLUMBING FRAMIN�NENTING, � � � � � � � � � � �� ~ ° � � RQUGH ELECTRICAL � � � `� � � '� �� 'RQUGH:MECHANICAL � � � � �` '' � � ' ` � ROUGH MECF�ANICAL � �R(�UGH�ELECTRIGAL W( )C�,( � ' � � GAS TEST - r � � ,� � . � ,RQUf H PLt1MBiNG . , r ` a � "� � _ - PRE GUNITE _. INSULATION WALL POOL PRE DECK BONDING , , INSULATION CEILING P-TRAP DRYWALL FENCE/GATE/ALARM LATH(PRE) 'FINAL POOL LATH EXTERIOR WALLS: LATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL 1 sr� �2Nc�� )LIFT SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELEASE WALL DRAIN/SEAL GAS METER RELEASE WALL FINAL SPECIALINSPECTION � �RO.FRAMWGPLANNIN6�iPPROVAL� � � � �� " �, � � ,� �� F1NAL 6UIl�lING ��' �� '� � , ,, �, . , �ROUGH EIRE APPROVAL �- � � '� � � - �� FINAL FIRE DEPARTMENT ° ' � ` � � ' ` �� ' ' FlNA1.MEGHANICAL _ � �, E � � � fINAI ELECTR(CAL=> , �� : � "� ° ' FINAL PLANNtNG v � � ;FI�I�AL PLUhA�ING, "��''� � "�.� � .� � � FINAL ENGINEERING/PW � - ' r �-..._a �� _ _ � . d LG�of QGCUPANCY � �, a: � ,� ; .� . s � , � �PINAI:COMMUNITY SERVICES �� ° � � � , . %�. � p 'FINAL HEALTH DEPL ;C�f3T.ot OCCUPANCY ��.�. _ � � ` FINAL INDUSTRIAL WASTE � �, ,y COMMENTS:�I�► �/��l/i!^ `I��xo�r� d��C�9�f �� !►��AD�,�i-