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Home My WebLink About14-3472 `.;:;;'_;,��,, C1TY O['DIAMOND BAR ' I I I i ' ( DEPARTMENT OF COMMUNITY&DEVF;LOPMGNT SERVICES ' �`�� ri�lll��:-s�-,� " 21810 Copley Drivc,Diamond Bar,CA 91765 pRE�� ,,,,�''' (909)839-7020 I+ax:(909)861-3117 Building Inspection Hotline(909)839-7027 FIRMLY "�'DB'� BUILDING PERMIT APPLICATION � � 1 (�� A c� w JOB SITE ADDRESS �'�� j�l�- \�-�G� Y��I APPLICATION DATE: / � P/C# �� a ISSUE DATE: �2 PERMIT# � ��`1�� z APN 1LOT�F�CT � ru��'��w. I o OWNER 1 TYPE CONST. OCC GROUP: I � ADDRESS. � �L � CITY GL' L ZIP TEL ; ZONING F ONTCKS RW ❑ � � APPLICANT i`^'�G' � �v'Z TEL�� 5}� yCi% qEp,q p li o N ' r w�L u SIDE/SIDE STREET RW ❑ a CONTRACTOR C V L1 � SIDE ❑ o ADDRES(S�, ^ �� ' ��- �' � • o CITY 1"C.-IMF�C IV�Gi. ZIP Z � EI�. �.^C% y S � C� � PROPOSED USE �� ' ,t� '41�(, , U-�V J , �L o ARCH/ENG/DESIGNER w z ADDRESS o ti DWEL.UNITS It STORIES k BEDROOMS z CITY ZIP TEL. � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION OWNEH-BUILDER DECLAHATIDN � I hereby aflirm under penatly oi perjury Nat I am exempt from the Contractor's State License Law for the reason�s) SFR/ADD/REM • i � intlicated below by the checkmark(sJ,I have placed neM to the aDD��61e item(s)[Section 7031.5,Business and � o Garage/Carport "� Rotessions Code:Any city ar caunty thal requires a permit to construc4 alter,improve,demolish,or repair,any � �z shucture,prior to ih issuance,also requires lhe applicant far the permit ta file a signed stalement that he or she � Patio/Deck a is licensed pursuanl to ihe provislons of the CoMroctor's Sfate License Law(Chapter 9)Cammencing with Section W � 7000 of Oivision 3 of the Business and Prolessions Code]or that he or she is exempt hom licensure and the basis for � Pool/Spa N the alleged exemption.Any violation o(Section 7031.5 by any apD��cant for a Dermit suDjects the aDPlicant to a civil penalty N Z Re-Roo� V� � � �""' C� � � 01 not more Nan five hundred dollars(3500). � J � "2.. �� . � G 4��. C� o (]I,as owner of the property,or my emptoyees with wages as iheir sole compensatian,will do(J all of or(,portions � Commercial � ol the work,and ihe sWcture is not intended or ottered for sale(Section 7044,Business and Proiessions Code:The m z Contractors'State License Law dces not apply to an owner of property who,through employees'or personal ettort,huilds � or improves the property,provided that the improvements are not intended or oflered for sale.If however,the building or � improvement is sold within one year oi comptetion,Ne Owner-Builder will have the burden of proving ihat it was not built p or improved for the purpose oi sale.). � I,as owner ol the m � � U p perry,am exclusively conVacting with licensed ConUactors to consWct Ne project(Section r �✓� Z 7044,Business and Professions Code:The Contractors'State License Law daes not ap01y to an owner o1 property who Valuation: G^�/� v Adj.Ar'ea: � builclsorimprovesihereon,andwhocontractsiortheprojeciswithalicensetlConhactorpursuanttotheContacrors'State QUANTIIY DESCRIPTION FEE Y License Law.). � o (,I am exempt trom licensure under the ConVactur's State License law 1or the following reason(5): � � ¢ ZBy my signature betow I acknowledge that,except for my personal residence in which I must have resided for at least one W , o year prior to completlon o(Ne improvemenLs covered by this permit,l cannot legally sell a shucture that I have buill as an W a owner-buifder if it has not been consiructed in its entirery by licensed contractors.I understand mat a copy of the applicahle � law,Section 7044 ot the Business and Professions Code is available upon request when this application is submitted or at X the following Web site:httpAwrw.leginfo.ca.gov/calaw.html. � z o DATE: SIGN: � � LICENSED CONTRACTOP'S DECLARATION � w I hereby affirm under penalty ot perjury that 1 am licensed under provisions of Chapter 9(commencing with Section 7000) . m ot Division 3 ot the Business and Professions Code,and my license is in full fqrce and eitect. J • �?(�,// yN �%( ¢ � LICENSE CLASS: C �/ / L NO.: / �`"` �D zQ oZ DATE: �Cr Z ONTRACfOR: �Y1/'��'� O C�VYV � ¢ WOflNEfl'S COMPENSATIDN�ECLARATION g i � I HEAEBY AFFIRM UNDER PENALTV OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: �f i ov I�ave and will maintain a Certificate of Consent to Sell-Insure lor WorkeYs Compensation,as provided by � CONSTRUCTION: �,��.�V � Seclion 3700 of the Labor Cotle,for the pertormance of ihe work far which Nis permit is issued. p�qN FIEVIEW: > �have and will mainfain Worker's Compensation Insurance,as requiretl by Section 3700 of the Labor Code,for ELECTRIC: � the perfortnance of ihe work lor�+hich this Dermit is issued.My Worker's Compensation Insurance Carrier and ¢ PolicyNumberare: `/� / PLUMBING: � CARRIER �l�'�l'. 'f�- •�J �CY w MECHANICAL: � POLiCY NUMBER CJ �% y � � �^ INSPECTION FEE: � (�}iIS SECTION NEED NOT BE COMPLEfED IFTHE PERMR IS FOR ONE HUNDRED DOL.LhRS($100)OR LESS). � ISSUANCE: �Z 0 I ceAify that in me peAomiance of ihe work lor which Ih's permit is issueA,I shall not employ any person in any manner so as to �-f� o �ecome su6jecl to the Worker's Compensation Laws of Califomia.Md agree ihat if I should become subjecl to ihe Worker's SMIP: �l !l � Compeq5ati qr oq�of Seclion 3700 of the /p,�Code,I shall toAhw�ilh omply ith ttrose pm-7visions. ENERGY P/C: DATE:L ..� � APPLICANL �1� V��L L(!�J�� rU G. ENEFIGY PERMIT: d � WARNI G Failure to secure Workers Compensatlon cwerage is unlawful,and shall subject an employer to aiminal RETENTION FEE: v0 W penatties and civil lines up to ane hundred thousand dollars($t00,OD0),in addiGon to the casl of the compensatlon, a damages as provided for in section 3708 of Ne�a6or code,interest,and atlomey's fees. PRE-ALT FEE: 0 a CONSTFIUCTION LENDING AGENCY BSAF: D� w I hereDy attrm under penalty of perjury that ihere is a Constmction Lending Agency for the pedormance of the work fot � which this permit is issued(Sec.3097,Civ.C.). F LENDER'S NAME � LENDER'SADORESS: a I certify Nat I have read this application and state ihat the above informa6on is cortect I agree to compry with all city and TOTAL FEES / ' �')'1 _ � /V z counry ordinances and sfate laws relating N building constmction,and hereby authorize representatives ot this counry to COM MENTS: p enter upon he above-mentloned property for inspection purposes. m � ��,c�a.� � d'!/2 N PER`E NAME1DRIMi) � /J �/ ,. �/�// C! � (.�v � 1 F SIGNATURE OF PERMITfEE �ATE RECEIPT q ` PAID BY: VALIDATION: WHITE—Depariment Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy CITY OF' DIAMOND BAR , INSPECTION RECORD ' � � O � � ° A � � S , � � • � SETBACK/LETTER " `' - TRACT AND LEDGER ,:, _ FOOTINGSFORMS.. „;;�. ,. r �� ? . :` . ... '`, . '_;�; SWITCHGEAR SLAg;` � � ;.�� - �`� COMMERCIALHOOD UG.PLUMBING:: - °_ � T-BAR UG.ELECTR►CAL�� - =�� INTERCEPTER UFER;GROUND'�� ' �' �� HOT MOP/SHOWERPAN ._ ... , � SEWER LATERAL SEPTIC/CESSPOOL MAIN WATER LINE HERS REPORT RECENED SEWER CLEANOUT DEMOLITION ROOF SHEATHING ROOF DRAINS FLOOR SHEATHING ROUGH CONQUIT SHEAR WALCS=EXTERfOR' - PUOL/SPA�� - SHEA.R WQLLS INTERIOR:_ �` •� � ". �. _- .ROUGH PLUMBING .< _ FRAMINGNENTING � " '��` - ROUGHECECTRICAL;`y ' '' ' ' � . �',. ROUGH MECHANICAL ;. �. ;; , " '=.` . ' �� , . . ' ,''- ROUGH MEGHANICAL�;, �. ' ' '` . . _ ; � ,. ROUGH,ELEGTRICAL W(�.;)C,( ) `` '>; .. ` '-. . '•. � � .�ASTEST`� , . - ROUGH PLUMBING . .. ; , � 'PRE GUNITE w - ,� INSULATION WALL ` POOL PRE DECK BONDING ' INSULATION CEILING P=TRAP DRYWALL FENCE L GATE/ACARM, ,,:3� , LATH(PRE) F.INAC POOL , . LATH EXTERIOR WALLS: LATt�INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL 1�T( )2"0( )LIFT SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELEASE WALL DRAIN/SEAL GAS METER RELEASE WALL FINAL SPECIAL INSPECTION RO.FRAMING PLANNINGAPPROVAL - i - FINAL`BUILDING . _ ,; ' "' - , � " ` � - - _ .. . . ..,.' . ,ROUGH FIRE APPROVAL," . ;> ' , ,' FINAL'MECHANICAL . '��.� , '- � :_ �; ��:' "�.""�:_ '� _� , �, ' � FINAL FIRE DEPARTMENT..�- - FINALELECTRICAL' , .;,; , _ " FINALPLANNING ��, -� - - � FINAL ENGINEERIN6%P.W �`' - ;� .� . , ;: ; •. : � �� _- � . . ,. , ', :i. . �'��. FINAL-�;PLUMBING. �- `' �� .. � T.C:`of OCCUPANCY; � ' ` `` FINAL COMMUNITY SERU(CES ` '` � CERT.'of DCCUPANCI':: ` ' �' ; ` _ �; "�: . ,.' ... FINAL HEALTH DEFT. , f; � � � � � FINAL,INDUSTRIA6�WASTE ;;_ ' �:' ' =' � �+Y s :; � ��` � COMMENTS: 1', a � � C/�c/