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Home My WebLink About16-0565 - ' � CITY OF DIAMON�BAR'� , � '� - � ....� . � I �� ( � I� DEPARTMENT OF COMMUNITY&I'iEVELO�MENT SERVICES �'��:�,�� 21810 Copley Drive,Diamond Bar,CA 91765 PRESS � ,� (909)839-7020 Fax:(909)861-3ll7 Building Inspection Hotline(909)839-7027 � '°"'� BUILDING PERMITAPPLICATION www.cityofdiamondbar.com building@diamondbarca.gov FIRMLY a JOB SITE ADDRESS c ��+� I N V �IM �� APPLICATION DATE: • � � � `�' P/C# � � APN � T T A T ISSUE DATE: � � PERMIT#:T� � � OWNER ' � TYPE CONST. OCC GROUP: � ADDRESS. I a CITY ZI � TEL. o APPLICANT 1I� TEL. Scope of Work . 'a CONTRACTOR N C� •IC 0 � ADD�t S � � #DWEL.UNITS #STORIES #BEDROOMS o CITY CGZ ZIP TEL. O' " ARCH/ENG/ z DESIGNER DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION o ADDRESS SFR/ADD/REM m CITY ZIP TEL. Garage/Carport � OWNEq-BUILDEH DECLARATION w Patio/Deck � t hereby affirm untler penalry of perjury that I am ezempt from the Contractor's State License Law for the reason(s) LL Pool/Spa oindicated below by the checkmark(s),I have placed next to the applicable item(s)[Sectian 7031.5,Business and Z Re-Roof w Professions Cade:My city or county that requires a pertnit to cons6vct,aHer,improve,demolish,ar repair,any 0 a structure,prior to iLs issuance,alsa requires the applicant for the pertnit W file a signed statement that he or she � Commercial � is licensed pursuaM to the provisions of the Contractor's STaTe License Law(Chapter 9)Cammencing with Sectian m N 7000 af Oivisian 3 af the Business and Professions Code]or that he or she is exempt from licensure and the hasis for y the alleged exemption.My violation of Section 7031.5 by any applicanl for a permit subjecCs the applicant to a civil penalty 0 of not more than five hundred dollars($500). e (,I,as owner of the property,or my employees with wages as their sole compensation,will do(..,)all of or(,J portions Z of the work,and the sWcture is not intended or offered for sale(Section 7044,Business antl Protessions Code:The Valuation: Adj.Area: w Cc'�it2ctors'State License Law does not apply to an owner of property who,through employees'or personal effort,builtls or improves the property,provided that the improvements are not intended or oftered for sale.If however,the buildin9 or QUANTITY DESCRIPTION FEE p 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.�. � � Z �)I,as owner of the property,am ezclusively contracting with licensed Cantractors to construct the project(Section Q � 7044,Business and Professions Code:The Contractors'State License Law does not apply to an owner of property who � — builds or improves thereon,antl who contracts for the projecis with a licensed Contractor pursuant to the ConVactors'State � o License Law.). w � (�1 am exempt hom licensure under the Contractor's State License law for the following reason(s�: � z Om � By my signature below I acknowledge that,except for my personal residence in which I must have resitled for at least one � � year prior to completion of the improvements covered by this permit,l cannot legally sell a shucture that I have built as an a � owner-builder if it has not been constructed in its entirety by licensed conhactors.I understand that a copy of the � applicab�e law,Section 7044 of the Business and Professions Code is available upon request when this application is � o submitted or at the following Web site:http/www.leginfo.ca.gov/calaw.html. � a V LICENSED CONTRACTOR'S DECLAflATION = mI hereby afiirm untler penalry of perjury that I am licensed under provisions of Chapter 9(commencing with Section 7000) w � of Division 3 of the B iness and Professions Code,and li s�is i^n full forc and effect. � N LICENS SS: I LIC.NO.: �J"�� CONSTRUCTION: Q DATE: �� CONTrt4CioR: � � pLAN REVIEW: r p WOHKEfl'S COMPENSATION DECLAfiATION aI HEREBY AFF UNDER PENALIY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: ELECTRIC: b/��J� o I have and will maintain a Certificate of Consent to Self-Insure for Worker's Compensation,as provided by PLUMBING: � Section 3700 of the Labor Code,for the pertormance of the work for which this permit is issued. MECHANICAL: o I have and will maintain Worker's Compensa6on Insurance,as required by SecGon 3700 ot the Labor Code,for z me pertormance of e work for which thi permit is issuetl.My WorkePs CompensaBon Insurance Carrier and INSPECTION FEE: i a Policy Number a : �/ � w CAflRIER �1 - r ' ISSUANCE: z � POLICYNUMBER SMIP: N � (THI SECIION NEFD NOT BE COMPLE7ED IF TH MIT IS FOR ONE HUNDRED DOLIJ�RS($100)OR LESS). ENERGY P/C: p I certify that in e rformance of ihe work tor which ihi i iss I shall not employ any person in any manner so�to ENERGY PERMIT: o become subj e Worker's Compensation Lavrs Cal' Md a that if I should become subject to me Worker's �� ` J CompC�tlo p i�n�,tllSectlon 3700 otme Lalw rthwith complywilh those provisions. RETENTION FEE: � �L � DATE:J Y�APPLICANT: PRE-ALT FEE: � WARNING: ail e to secure Worker's Compensation overa e is u awful,and shall subject an employer to criminal gASF: � penalties d il fines up to one hundred thousan do a ($100, 0),in addition to the Cost of the compensation, p damages as provided for in seclion 3708 of the labor ode, , nd attorney's fees. PLOT PLAN: a CONSTfl TION L DING AGENCY ZONING CLEARANCE: w I hereby affirm under penalty of perjury that there i a Const ction Lending Agency for the performance of the work for = which this permit is issuetl(Sec.3097,Civ.C.�. 3 � LENDER'S NAME: � LENDER'SADDRESS: TOTAL FEES ��1 w � I certify that I have read this ap ' 'on a e that the above informatlon is correc[.I agree to comply with all city and Z county ortlinances and sfate I ti to buil ing cons uction,and hereby authorize represeniatives oi this counry to COMMENTS: o ent pon the above- nti e i r ins ction p oses. J � 'm a PERMITTEE NAME(PRIN P/C: PAID BY: VALIDATION: N 3 � I �IC� � RECEIPT# PAID B : VALIDATION: � SIGNATURE OF PERMITTEE DATE WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy ' �� . �. '; . � ' CiTY�OF ulA�1!iJfV�� BQR—� `�: INSPE�TIO��i �i�LORD 4 . � � , � . . � � , . � . SETBACK/LETTER TRACT AND LEDGER FOOTINGS FORMS SWITCH GEAR S�qg COMMERCIAL HOOD UG.PLUMBING T-BAR UG.ELECTRICAL INTERCEPTER UFER GROUND HOT MOP/SHOWERPAN SEWER LATERAL SEPTIC/CESSPOOL MAIN WATER LINE HERS REPORT�RECEIVED SEWER CLEANOUT DEMOLITION ROOF SHEATHING ROOF DRAINS FLOOR SHEATHING ROUGH CONDUIT SHEAR WALLS EXTERIOR POOUSPA SHEAR WALLS INTERIOR ROUGH PLUMBING FRAMINGNENTING ROUGH ELECTRICAL ROUGH MECHANICAL ROUGH MECHANICAL ROUGH ELECTRICAL W( )C( ) � / GAS TEST ROUGH PLUMBING PRE GUNITE INSULATION WALL POOL PRE DECK BONDING INSULATION CEILING P-T�P ' DRYWALL FENCE/GATFJ ALARM LATH(PRE) FINAL POOL U1TH EXTERIOR — 3/� �L WALLS: LATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL 1sr� �2No� )LIFT SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELEASE WALL DRAIN/SEAL GAS METER RELEASE WALL FINAL SPECIAL INSPECTION R0.FRAMING PLANNING APPROVAL FINAL BUILDING � ROUGH FIRE APPROVAL FINAL MECHANICAL FINAL FIRE DEPARTMENT FINAL ELECTRICAL FINAL PLANNING FINAL PLUMBING FINAL ENGINEERING/PW T.C.of OCCUPANCY FINAL COMMUNITY SERVICES CERT.of OCCUPANCY FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE COMMENTS: ��a I h�f � t ,y./ �/ �'�� t��-�' ''� CITY OF DIAMOND BAR�� , , •• ._ . . : I 1 i lI DEPARTMENT OF COMMUNITY&D1"cVELOPMENT SERVICES - -- 21810 Copley Drive,Diamond Bar,CA 91765 PRESS � (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 FIRMLY � �'�"' BUILDING PERMITAPPLICATION www.cityofdiamondbar.com building@diamondbarca.gov � � /� APPLICATION DATE: P/C# a JOB SITE ADDRESS �� ISSUE DATE:�/�y/a�� PERMIT#: �R �Ef - Dfb.r z � APN LOT. T T � TYPE CONST. OCC GROUP: � OWNER � ADDRE S ' �- � � CITY ' , 1 I� � �L. L � Scope of Work �Q l�1,� ��r�l I� rd f�d L✓ o APPLICANT TEL. �' L (�- r � l� a�,/` �4,v►, v A7 G n e/ L�t o CONTRACTOR r i . T�1rta /!es i/t!'t[u4 O'F G d.Do-��'�1 P iRnf I � ADDRESS ? ' � #DWEL.UNITS #STORIES #BEDROOMS o CITY ZIP G�EL. �L L.C�� " ARCH/ENG/ z DESIGNER DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION Z ADDRESS SFR/ADD/REM m CITY ZIP TEL. Garage/Carport oOWNEH-BUILDEH DECLANATION w Patio/Deck o I hereby affirm under penalty of perjury that I am exempt from the Contractor's Shte license Law for the reason(s) LL Pool/Spa w indicated below by the checkmark(s�,I have placetl nezt to the applicable item(s)[Section 7031.5,Business and � Z Professions Cade:Any ciry or county that requires a permit to conshuc[,alter,improve,demolish,or repair,any Z Re-Roof a strucNre,prior W i1s issuance,alw requires the applicant for Me permit to file a signed statemeM that he or she � Commercial � is licensed pursuant to the provisions of the Contractor's STate License Law(Chapter 9)Cammencing with Section m N 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.My violation of Section 7031.5 by any applicant Tor a permit subjecls the applicant to a civil penalry °C of not more than five hundred dollars($500�. 0 � (1 I,as owner of the property,or my employees with wages as their sole compensation,will do(1 all of or(�portions of the work,and the s[ructure is not intended or offered for sale(Sec[ion 7044,Business and Professions Cotle:The V8IY8t/On: Adj.Area: w Contractors'State License Law does not apply ro an owner of property who,Mrough employees'or personal effort,builds � or improves the property,provided that the improvemenis are not intended or offered for sale.If however,the building or QUANTIIY DESCRIPTION FEE pimprovement 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.�. � Z �as owner of the property,am exclusively co�rtracting wiUi licensed Corttractors to construct the project(Section ¢ y 70 Business and Professions Code:The Contractors'State License Law does not apply to an owner of property who � Y builds or improves thereon,and who contracLs for the projects with a licensed Contractor pursuant to the Contractors'State w o License Law.�. � ()I am exempt from licensure under the Corrtractor's Sfate License law for the tollowing reason(s): � LL Z Z m � By my signature below I acknowledge that,except tor my personal residence in which I must have resided tor at least one � ¢ year prior to completion of the improvements covered by this permit,l cannot legally sell a structure that I have 6uilt as an a d owner-builder if it has not been constructea in its entlrety by licensed contractors.I understand that a copy of the w applicable law,Section 7044 of the Business and Professions Code is available upon request when this appliration is � p submitted or at me following Web site:http/www.leginfo.ca.gov/calaw.html. � � LICENSED CONTHACTOH'S DECLAflATION � mI 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 antl Professions Code,and my license is in full force and effect. N LICENSE CU1SS C LIC.NO.: 1�1�� I T 1 _ _ . \ o CONSTRUCTION: ¢ DATE: CONTRACTOR: �.i)�Y��P h. V�� p W O R K E H S C O M P E N S A T I O N D E C L A H A T I O N PLAN REVIEW: ¢ I HEREBY AFFIRM UNDER PENALIY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: ELECTRIC: ��J o I have and will maintain a Certificate oi Consent to Selt-Insure for Worker's Compensation,as provitleU by PLUMBING: Q ction 3700 of the Labor Code,far the performance of the work for which this permit is issued. � I have and will maintain Worker's Com ensation Insurance,as re uired by Section 3700 of the labor Code,for MECHANICAL: o P Q ¢ the pertormance of the work for which this permit is issued.My Worke's Compensation Insurance farrier and INSPECTION FEE: o PolicyNumberare: ` ` �� ISSUANCE: CARRIER 't- � � POLICYNUMBER� Y �` SMIP: F (THIS SECTION NEED NOT BE COMR EfED IF THE PEHMIT IS FOR ONE HUN�RED DOLI ARS($100)OR LESS�. EN ERGY P/C: p I certify fhat in the performance of the work for which ih� r il is issued,I shall not employ any person in any manner so�to ENERGY PERMIT: o become subjec[to th Workers Compensation Laws- a omia.Md agree that if I should become subject tn the Worker's J Compe ti provis'ns of Sectlon 3700 of the Labo ,I shall forthwith compty with those pmvisions. RETENTION FEE: � DATE' L APPLICANT: PRE-ALT FEE: � WARNING:Failur to secure Worker's Compe s tion c verage is unlawful,and shall subject an employer to criminal gASF: w penalties and civil fines up to one hundred t santl dollars($100,000),in addition to the cost of the compensation, o damages as providetl for in section 3708 of the labor cotle,interest,and attorneys fees. PLOT PLAN: a CONSTqUCTION LENDING A6ENCY ZONING CLEARANCE: = I hereby affirm under penalty of perjury that there is a ConsVuction Lending Agency tor the performance of the work for � which this permit is issued(Sec.3097,Civ.C.). , F LENDER'S NAME: w� LENDER'SADDRESS: TOTALFEES �,�. �� a I certiiy that I have read this application and state that the above iniormation is correct.I agree to comply with all city and Z county ordinances antl state laws relating to building construction,and hereby authorize representatives of this counly to COMMENTS: o enter upon t above-m ntioned property F 'spection rposes. m ��. ¢ PERMITTEE NAME(PRINn P/C: PAID BY: VALIDATION: cn L RECEIPT# �AO Y �) PAID BY: I�JQ !/ � VALIDATION:� F SI6NA7URE OF PERMITTEE DATE I WHITE—Department Copy,YELLOW—Finance Copy,PINK—Asseuor Copy CIT,Y,OF DIAIRIIOND �kR - INSPE��IO;J RECORD � • � � • - � • � � � • - SEfBACK/LETTER TRACT AND LEDGER FOOTIN6S FORMS SWITCH GEAR SLAB COMMERCIAL HOOD UG.PLUMBING T-BAR UG.ELECTRICAL INTERCEPTER UFER GROUND HOT MOP/SHOWERPAN SEWER LATERAL SEPTIC/CESSPOOL MAIN WATER LINE HERS REPORT RECEIVED SEWER CLEANOUT DEMOLITION ROOF SHEATHING ROOF DRAINS FLOOR SHEATHING ROUGH CONDUIT SHEAR WALLS EXTERIOR POOUSPA SHEAR WALLS INTERIOR ROUGH PLUMBING , FRAMINGNENTING ROUGH ELECTRICAL ROUGH MECHANICAL ROUGH MECHANICAL ROUGH ELECTRICAL W( )CO GAS TEST ROUGH PLUMBING PRE GUNITE INSULATION WALL POOL PRE DECK BONDING WSULATION CEILING i P-TRAP DRYWALL FENCE/GATE/ALARM LATH(PRE) FINAL POOL LATH EXTERIOR WALLS: LATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL 1sr/ \2ND� �LIFT � , SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELEASE WALL DRAIN/SEAL GAS METER RELEASE WALL FINAL SPECIAL INSPECTION R0.FRAMING PLANNING APPROVAL FINAL BUILDING ROUGH FIRE APPROVAL FINAL MECHANICAL FINAL FIRE DEPARTMENT FINAL ELECTRICAL FINAL PLANNING FINAL PLUMBING FINAL ENGINEERING/PW T.C.of OCCUPANCY FINAL COMMUNITY SERVICES CERT.of OCCUPANCY FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE COMMENTS: