HomeMy WebLinkAbout14-3891r
�:.�'�'�"�._ ___. C1TY 0(+DIAMOND BAR
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� I ( I i ' D�PARTMENT OF COMMUNITY&DEVELOPMGNT SERVICES �j
;��111���,'�:� ' � 218]0 Coplcy Drivc,Diamond Bar,CA 91765 � PRESS
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��,� ;�,,,���� (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027
:r�H.- FIRMLY
EUILD[NG rERN11T ArrL1CATION
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APPLICATION DATE:
¢ JOB SITE ADDRESS � /� `y� q� /
a ISSUE DATE: —�7� � ��PERMIT# J' �
z APN T TRACT
o OWNER TYPE CONST. P ���'V1 b�/Y� OCC GROUP:
y ADDR SS '
ZONING SEfBACKS
� CITY IP T . � " FRONT RW ❑
a APPLICANT TEL. REAR ❑
�
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SIDE/SIDE STREET RW ❑
a CONTRACTOR � C} � SIDE ❑
� ADDRE � M K r •
B� . PROPOSED USE
o CITY ZIP TEL. I
a ARCH/ENG/DESIGNER �
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o ADDRESS #DWEL.UNITS #STORIES #BEDROOMS '
z CITY ZIP TEL.
m DESCRIPTION SO.Fr. FACTOR PSF ADJ.AREANALUATION
a OWNEH-BUILDER DECLAHATION
� I hereby aflirm under penalty ol Derjury ihat I am exempt from ihe ContractoYs State License Law(or the reason(s) SFR/ADD/REM
0
p intlicated below by the checkmark(s),I have placed next to the apDlicable item(s)[Section 7031.5,Business and Garage/Carport
w Protessions Code:Any city or county ihat requires a permit to construct,alter,improve,demolish,or repair,any
? structure,prior to its issuance,also requires the applicant for the permil to file a signed statement that he or she � Patio/Deck
a is licensed pursuant to ihe prorisions ot the Contractor's State License Law(Chapter 9)Commencing with Seclion W
� 7000 of Division 3 ot the Business and Professions Code]or that he or she is ezempt hom Iicensure and the basis(or LL Pool/Spa
N the alleged exemption.Any violatian of Sec6on 7031,5 by any applicant lor a permit subjecls the apDlicant to a civil penalty �
� of not more than(ive hundreU dollars(5500). ZO Re-Roof ,
o (�I,as owner oi the property,or my employees with wages as their sole compensation,will do(,�all of or(,portions � Commercial
� ol ihe work,and the structure is not intended or aftered for sale(Section 7044,Business and Prolessions Code:The m
� Contractors'State License Law does not appty to an ovmer af property who,through employees'or personal effort,builds �� �.
� or improves the propeAy,pmvided that the improvements are not intended or offered tor sale.It however,the building or �
� improvement is sold within one year of comple5on,the Owner-Builder will have ihe burden of proving that it was not built
p or improved for the purpose of sale.).
� O I,as owner of ihe properiy,am exclusivety wnVacUng with licensed ConVactors to canshuct the project(Section
Z 7044,Business and Professions Cotle:The Contractors'Stale License Law does not apply ro an owner of property who Valuation: Adj.Area: i
� builds or improves thereon,and who contracts for�he projecis with a licensed ConVactor pursuant to the Contractors'State QUANTITY DESCRIPTION FEE
Y License Law.).
o U�am exempt from licensure under the ConVactor's State License law 1or the lollowing reason(s): �
� 2
ZBy my signature below t acknowledge that,except tor my personal residence in which I must have resided for at least one w
o year prior to comptelion of the improvements covered by this permit,l cannot legally sell a strucNre that I have built as an w
Q owner-builder if it has not been conshucted in its entirety by licensed contractors.I understand that a capy olthe appliqble
� law,Section 7044 of the Business and Professions Code is available upon request when this app�ication is submitted or at �
X the lollowing Web site:httpfwww.leginfo.ca.govlcafaw.html. Z
o DATE: SIGN: �
� LICENSED CONTRACTOfl'S UECLARATION � '
H a
w 1 here6y aftirm untler penalry ot perjury that I am licensed under provisions of Chapter 9(commencing with Section 7000) Q :�::�. '
m of Division 3 of the Business and Protessions Code,and my license is in 1 I tar and ettect. J . - � � -�, ��
� LICENSE CLASS: � LIC.NO.:_l�,� � a
o DATE: CONTRACTOR: _ '
z U
¢ . WORKEp'S COMPENSATION DECLARATION g
� I HEREBY AFFIRM UNDER PENALTY OF PERJURV ONE OF THE FOLLOWING DECLARATIONS:
oI have and will maintain a Certifiqte of Consent to Setl-Insure lor Worker's CompensaUon,as provided 6y � CONSTRUCTION:
� Section 3700 0l the Labor Code,for the peAormance of the work for which this permit is issued. P�N R���_
�
I have and will maintain Worker's Compensation Insurance,as repuired by Section 3700 of the Labor Code,for ELECTRIC:
� the peAormance ot ihe work fm which ihis permit is issued.My Worker's Compensation Insurance Carrier and
a Poli�yNu re: PLUMBING: � ,�� �-�
w CARRIER � MECHANICAL'
� POLICYNUMBER ` ' INSPECTION FEE:
� (f}iIS SELTION N BE fA PLETED IF PERMR NE �D DOLLMS(5700)OR LESS).
� ISSUANCE: •��
o I cediy llial in the peRormance ot the vrork for which ihis permit is issued,I shall not employ any person in any manner so as to S M IP:
o become subjecl to ihe Worker�Compensation taws of California.Md agree Nat it bject to ihe Worker's
J Compe IID vis' ot SecUon 3700 of ihe labor Code,�shall tort ' y wi ns. EN ERGY P/C:
LL DAiE� � ' APPLICANT: ENERGY PERMIT:
� WARNING:failure to secure Worker's Compensalion coverage is�unlawlul,and shall su6je employer to criminal REfENTION FEE:
w penatties and civil lines up to ane hundred mousand dollars(5100,000),in addi6on to the cast of the compensation, �
o damages as provided for in section 3708 oi ihe lahor code,interest,and attomey's fees. PRE-ALT FEE: .�-r�6
a CONSTHUCTIONLENDINGAGENCY , BSAF:
w I hereby affirm under penalry oi perjury that there is a ConsVuction Lending Agenby lor Ne Dedormance of ihe work for
� which this permit is issued(Sec.3097,Civ.C.). •
�.._ LENDER'S NAME:
� LENDER'SADORESS:
a I certily that I have read this application and state that the a6ove intormation is correct.I agree tn campry with all city and TOTAL FEES
Z county ordinances and state laws relating to building consWcfion,and hereby authorize representatives ot ihis county to COMMENTS:
p enter upon the above-m tioned proDerty for in ection purpases. ,
J
_ •
m
a PERMITfEENAME(PRINn l
� ► �.
�
= SIGNATURE OF PERMITfEE DAT RECEIPT# / I PAID BY: VALIDATION:
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� WHITE—Department Copy,YELLOW—Finance Copy,PINK—Pssessor Copy,GOLDENROD—File Copy,GREEN—Applicant's Copy
CITY OF DIAM(�ND BAR
INSPECTION RECORD
• • � � • e - � � � � � • -
SETBACK/LE17ER ' � : TRACT AND LEDGER
FOOTINGS FORMS ` `-:'- SWITCH GEAR
SLAB ` �� � . %. COMMERCIAL HOOD
UG.PLUMBING.''� , - - T-BAR
UG.ELECTRICAI: ,. ` INTERCEPTER
UFER GRDUND;�.' '� � ' `� `: HOT MOP/SHOWERPAN
SEWER LATERAL SEPTIC/CESSPOOL
MAIN WATER LINE HERS REPORT RECENED
SEWER CLEANOUT DEMOLITION
ROOf SHEATHING ROOF DRAINS
FLOOR SHEATHING ROUGH CONDUIT
, _
SHEAfl WALLS.:EXTERIOR�'. . �� `::, -.�:' �`, ��. ;; �: �POOUSPA" , �� ; ,�.
:SHEAR WALLS INTERIOR� - ' ROU6N PLUMBIN6 �..` - _
_ . : ..: _ _ _
_ , .: . . .
FRAMINGNENTING..,,•, , :' . _ .:�- ; " ,_. '. _. ' ': . . ; ' RQUGH ELECTRICAL:, . ='. �, '
ROUGH MECHANICAL, „`; � + - � :ROUGH MEGHANICAL`. 5 � ,:, , ' ' > : ,:.;'
-ROUGH ELECTRICAL W{ +;)C(.) �": '" - ' GAS TEST = �-,:: - n '�
ROUGHPLUMBING. -: ` +ZC .'�I' "' PREGUNITE '` °��� �. `.'
INSULATION WALL ' POOL,PRE`DECK BONDING�, :: t; ' ,�. �. ;+� e�
INSULATION CEILING �R-TRAP< <=z� � :3� ,.,,:;
DRYWALL �FENCE t-GATE1 ALARM., `�
LATH(PRE) FINAC P'OOL , 't �
LATH EXTERIOR WALLS:
LATH INTERIOR WALL FOOTING/STEEL
GAS TEST WALL STEEL 1sr� �2so� �LIFT
SCRATCH CQAT WALL BOND BEAM
ELECTRIC METER RELEASE WALL DRAIN/SEAL
GAS METER RELEASE ' WALL FINAL
SPECIAL INSPECTION ,RO.FRAMING,PWVNINGAPPRQUAL ,' '�t , °:
. ,., , '" -: .,. _
fINAL;BUILDING ,. '-= - ` `.� :` ROUGHFIREAPPROVAL ," ;: -
FINAL MECHANICAL `- � `' FINAL FIRE DEPARTMENT-' -r;
,..:.._ ,_ -
FINAL ELECTRICAL ..-. ` ... �% .:�_ ,: � '. ': ' :' -- FINAL PLAEdNIN6 .. ;:= � .:: .:k _
, , , .... ,. . ,
�FiNAI-PLUMBING . ' +' '!:, � �°.. .. r - FINAL ENGINEERING/PW ':- ' ' !,:_
.
T.C;:�of OCCUPANCY `� �� `` „�'� ��;- ��` �--���=" � � ��� ��` �,. F.I,NAL COMMUNITY�SERUICES � ' -_ -
CERT.of OCCUPANCY,:, ; = ;. .` ,. .` ` . , � �FINAL HEALTH.DEPT. .. ..
' : _ ,�:. ,,
FINAL INDUSTRIAL°WASTE�:'� ..: . : ' , . . � , �
COMMENTS: ' � , f ! �