HomeMy WebLinkAbout14-3620 — �":�:"�'`�'�.�,. C1TY OI'DIAMOND BAR
'' "��1 v:r�i.!1.�I i . i i DEPARTMENT OF COMMUNITY&D�VELOPMGNT SERVICES
'•�� ��III������+ ' 21810 Copley Drivc,Diamond Bar,CA 9176� PRESS
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�,�;'„`,`,,� - (909)839-7020 [+ax:(909)861-3117 Building Insptction Hutline(909)839-7027 FIRMLY
�'�g'- BUILDING PERMITAPPLICATION �
� JOB SITE ADDRESS APPLICATION OATE: SI o��I I I�}-- P1C# � � ' 3
w (7`��O� �I� PERMIT# �y'�' �D�
z APN LOT TRACT ISSUE DATE:
o OWNER TYPE CONST. �"1--. OCC GROUP:
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� ADDRESS �
� CITY _ ZIP .�TEL. ZONING F ONT KS RW ❑
� APPLICANT TEL. REAR �
c�n SIDE/SIDE STREET RW ❑
a CONTRACTOR SIDE ❑
oro ADDRESS � �' PROPOSED USE S S
¢ CITY / ZIP TEL. G
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o ARCH/ENG/DES�IER 1)
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o ADDRESS
#DWEL.UNITS #STORIES k BEDROOMS
z CITY ZIP TEL.
m DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
a OWNEH-BUILDER DECLAflAiION
� I hereby attirm under penalty of Derjury that 1 am exempt from the Contractor's State License law(or the reason(s) SFA/ADD/REM
pindicated below by the checkmark�s�,I have placed next to the aDDlicable ilem(s)[Section 7031.5,Business and �
w Garage/Carport
o Professions Code:Any city or county lhat requires a permit to consUuct,alter,improve,demolish,or repair,any
z structure,prior to ils issuance,also requires the applicant for the permit to file a signed statement Nat he or she � Patio/Deck
a is licensed pursuant to the prorisians ol the Contractors Siate License Law(Chapter 9)Commencing with Seclion w
� 7000 of Uivision 3 of the Business and Professions Code]or that he or she is ezempt from Iicensure and the basis for LL Pool/Spa
Nthe atleged ezemption.Any violation of Section 7031.5 by any applicant 1or a Dermit subjects the aDPlicant to a civil penalry Z Re-Roof
� of not more than live hundred dollars($500). �
o U I,as owner of the property,or my employees with wages as Iheir sole compensation,will do(�all ot or�1 portions � Commercial
� ot the work,and the structure is not intended or ottered tor sale(Section 7044,8usiness and Professions Code:The m
Z ConVactors'State License Law does not apply to an owner of property who,through employees'or personal effort,builds
w or improves the properry,provided that the improvements are not intended or ottered tor sale.I(however,the builtling or
� improvement is sold wi[hin one year of compleBon,[he OwnerBuilder will have the burden ol proving that it was not built
por improved for the purpose of sale.).
FO I,as owner af the proDertY�am exdusively conVacting with licensed ConVactors to construct the project(Seclion �� ' �
0 7044,Business and Professions Code:The Contracrors'State License Law does not appty to an owner of proDertY Who Valuation:�� r7(p�"� 3 O Adj.Afea:
Z builds or im roves thereon,and w�o conVacts tor lhe ro ecls with a licensed ConUactor ursuant to the Contractors'State �
� P P � P QUANTITY DESCRIPTION FEE
Y Lice se Law.). .� �
p I am exempt irom licensure under the ConVaclor's Stale License law for the lolfowing reason(s): a l
� � ¢ C,
ZBy my signature below I acknowledge that,except tor my personal residence in wnich I must have resided tor at least one W
o year prior to completion of the improvements covered by this permit,l cannot legally sell a structure that I have built as an w .
a owner-builder if it has not been constructed in ifs entirety by licensed conhactors.I undersfand that a copy olthe applica�le
� law,Sec�ion 7644 of the Business and Professions Code is available upon request when this application is submitted or at �
X the following eb s' :http .leginto.ca.gov/cal hnl. �^
z
� DATE: � SIGN: �
� LICENSED NT A R' LAflATION �
w 1 herebY aftirm under penalty of perjury thal l am licensed der provisions of Chapter 9(commencing with Section 7000)
m of Division 3 0l the Business antl Professions Code,and my license is in full force and ettect.
a �
N UCENSE CLASS: � LIC.NO.: q��3 z , �
a
o DATE: CONTRACTOR: _
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a WOHNER'S COMPENSATION DECLARATION g
� I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: �
� I have and will maintain a Certificale of Consent to Selt-Insure for Worker's Compensalion,as provided 6y CONSTRUCTION: A S�p . �3
� . Sec�ion 370(1 of lhe Labor Code,for the performance of the work tor which U�is pennit is issued. p�,qN REVIEW: T,b. ��
� I have and will maintain Worker's Compensation Insurance,as required by Section 3700 0l the Labor Code,for
o the pedormance of�the work Por which this permit is issued.My Worker's Compensation Insurance Carrier antl ELECTRIC: �' - ��
z
a PolicyNumberare: , PLUMBING:
� CARRIEp ' MECHANICAL:
� POUCYNUMeER INSPECTION FEE:
� (fHIS SEC�ION NEED NOT BE COMPLEfED IFiNE PERMfT IS FOR ONE HUNDRED DOLLMS($100)OR LESS).
r ISSUANCE: �
o I certify that in the pedormance ot the work for which this permit is issuetl,I sl�all not employ any person in any manner so as to SM�P: , 6.y,�
o become subject lo Ihe Worker's Compensalion Laws ol Califomia.Md agree that ii I should become subject to me Worker's
J Campensatio rovisi ns of Section 3700 of the Labor Code,l a orlhwith comply wiU tlwse pmvisions. EN ERGY PlC: �n
J DATE: APPLICANT: h
LL � ENERGY PERMIT: : V I
� WARNING: ilure se ure Worker'S Compensatlon co rag avA ,and shall subjed an employer to criminal RETENTION FEE: %
w penatties a d civil fines up to one hundred[housand dollai ( 0 0 ,in addiGon to the cosl of the compensation,
a damages as provided for in sectinn 3708 ot the labor code,int est,and atlomey's fees. PRE-ALT FEE:
0 1
a CONSTAUCTION LENDING AGENCY BSAF: y.0 d
w I here�y affirm under penalry of perjury thal there is a Constmction Lending Agene�for t�e pedormance of the work tor
= which this permit is issued(Sec.3097,Civ.C.).
� LENDER'S NAME:
� LENDER'SADORESS:
�D,!`J`. %/'`
a I certily that 1 have read this applicatlon and state that the above information is correct.I agree to comply vn[h all city and TOTAL FEES S �3• �'1 a
counry ordinances and sfate laws rela6ng ro building construction,and hereby authorize represeniatives of this caunty to
penter upon the abave-mentioned property for inspection purposes. COMMENTS:
J
�
m
a PERMITfEE NAME(PRIN� p� S � `� �,�
N
�, .li I C. -
= SIf+NATURE OF PERMITfEE DATE RECEIPT k 1 �7� PAID BY: C � VALIDATION: r
�
WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROO—File Copy,GREEN—ApplicanYs Copy
C1TY OF DIAMOfVD �AR
INSPECT�ON RECORD . - • 1 - �
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• s � � � • - • • o � • -
SETBACK!LETlER' :;; . _ '` TRACT AND LEDGER
FOOTlNGS FORMS �"j SWffCH GEAR
SLAB�€����`.. � � _; COMMERCIALHOOD
UG.;PL.UMBING�'�' �� � _, T-BAR ��
UG'ELECTRICAL ' ` '•,j;= INTERCEPTER
UFER GRdUND., � � �' � , " `� HOT MOP/SHOWERPAN
SEWER LATERAL SEPTIC/CESSPOOL
MAIN WATER LINE HERS REPORT RECEIVED
SEWER CLEANOUT OEMOLITION
.ROOF SHEATHING ROOF DRAINS
FLOOR SHEATHING ROUGH CONDUIT
, .- • ; - -
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SHEARWALLSEXTERIOR ���= -:; �:�, ���: , ' ..��",: '�� � - �'� POOUSPA�: �� .. -� -= -
SHEAR.WALLS INTERIDR , - ROUGH"PCUMBIN6 _ �'';
FRAMINGNENTING �;: , :.;:, L , '" ' ` -` � _ ,
,.. ,�,= . - :-. :FlOUGN ELECTRICAL:' _: "..:' � ', :i. . �.', :� .. .�°s . �
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RQUGH�MECHANICAL ';,` .� . ::. . .. % . <>;. - =; .',r ,ROUGN MEGH'ANICAL r ' � '
ROUGH;ELECTRICAL W(�C.('=":) 1= y, ; - - �6ASTEST.�r '. , ` ' � '.� -
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- , . �` PRE GUNITE . .. ;�' �_�
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ROUG!i�PLUMt31NG, ,, , : � - ._ � � �� . � .� ..__� .
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INSllLATION WALL POOL PRE';DECK BONDING= - .,,' ; �-
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INSULATION CEILING P=TRAP � '` `` ' ``' f `
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DRYWALL L L4' FENCE/'GATE/ALARM �
LATH(PRE) FiNAL P00L �.� - --
LATH EXTERIOR WALLS:
LATH INTERIOR ' WALL FOOTING/STEEL
GAS TEST WALL STEEL 1�( )2ND( )LIFT
SCRATCH COAT WALL BOND BEAM
ELECTRIC METER RELEASE WALL DRAIN/SEAL
GAS METER RELEASE WALL FINAL
SPECIAL INSPECTION RO FRAMWG PL'ANNI.NGAPPROVAL � -l .�_ .
FINAL BUILDING� ' ROUGH FIREAPPROVAL'" ` `
_ _ _ �- = �
FINAL MECHANICAL .:_ . `- �' ; �'' .- : � ' ` FINAL.FIRE DEPARTMENT, ; -
FINAL ELECTRICAL '° : , . : , . -, ,_ ' � 'FINAL PLANNING.�', - -
,:;, . , _ .
FINAL PLUMBING.- '�I , � :. � : '`. ` '=,`" FINAL'ENGINEERING/PW " „ . .: -.°
T:C,of OCCUPANCY, FINAL COMMUNITY.SERVICES _ . ,'
CERT"of OCCUPpNCY ' _- , ` , ; <: ," .
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,� ,, �,.:: ���. EINAL HFJILTH DEPT
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FINAL INDUSTRIAL WASTE.,.` , - - '
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COMMENTS: j'6�Anr �l�l�o��Q,�
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