The URL can be used to link to this page

Home My WebLink About16-0674 _--- i��,��::�r�"�G1/�ir/�i��%�U"�'" ;��;, _ CITY OF DIAMQND BAR ' > ' � I I i i DEPARTMENT C1F C{�MMUNITY$e�u"�EVEIAPMENT SERV ICES , �` � 21$l4 Coptey Drive,Diamond Bar,CA 91765 � � � PRESS {„ ,K,,� (909)839-7Q20 Fax:(909)861-3117 Building Inspection Hotline(909)839-70 7 F�RMLY arca. ov � f i ofdiamondbar.com buildin @diamondb g � '��' BUILDING PERM[T APPLICATION www.c ty g � �- �:` APPLICATION DATE: t �"�� p�C�—/ — ' a J(76 StTE ADDRESS —s,.�4�-�� "'�---��''�"� � �(� '' Z ISSUE DATE � � PERMIT#:�(P_-a!Z------ � APN LdT TRACT a 1 � C7CC GROUP: rLL'- QWNER_ IA � tlel-� - - --- TYPE CONST. � ADDRE�S��L2ro_�—_r_ — � CITY_ �fnw a✓� �F�ZIP TEL. ScopeofWork o APPLtCANT i R�RvG TEL. a CONTRACTOR V� ✓ w+ � � ADDRESS��t�_ � . V'�' #DWEI.UNITS #STORIES #.BEDR0t3MS a cirY �—•� zi—P��_�.E�. '� t 3 ''i `'! C- ��6� a ARCH/ENG/ DESGRIPTION SQ.FT. FACTCfR PSF ADJ.AREANALUATION � QESIGNER SFRlADDJREM o ADDRESS Garage/Carport � ��7y ZIP TEL. � OWNER-BUILDEH DECLAf1ATI0N � Patio/Deck � i hereby affirm under pen2lty of per�ury thef I am exempt from the Coniractor's State License Law for the reason(s) u- PooVSpe aind'+cated below by the checkmark{s),!have placed nezt to the applicable item(s}[Sectian 7031.5,Business and Z Re-Roof W Professions Code:Any cdy or cou�y that requires a pertnR to cnnstruci,atter,improve,demoiish,or repair,any a 'strucNre,prior to iis issuaRce,a!w raquires tt�e applica�rt for tAa permit tu file a sigrted statement that he ar she � Commercial � is licensed pursuant la the provisions of th0 Contractor's State License Law(Chap�r 9)Commencing witli Section m � 7000 of 4ivisan 3 nt the Business and Professions Code]or tflat he or she is exempt hom licensure and the basis for � the alleged examption.Any violatfon of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalry � af not more Nan five hundred daifars{$50Q}. 4 � (�I,as awner of the properry,or my employees with weges as their sole oompensation,will tlo U all of or(J portions Ad' Area: � of the work,and the structure is not intended or offered for sate(5ection 704d,Busfness and Frofessions Code:The Yalii8tf0lt: 1- w Contractors'St�te LiCense Law tloes not appty to an owner of property who,through employees'or personel ettort,builds � or improves the property,provided that the improvements are not intende�or offered for sale.�f hawever,the buiiding or QUANTIIY DESCRIPTION FEE p improvement is soltl within one year of completion,the Owoer-8uilder will have the burden of proving that it was not built � or imprpved for the purpose of seie.}. � � {_}I,as owner of the property,am exclusively conhacting with IicenseA CAntracturs to conshuct ths prolect{Section � � 7044,Busine5s and Pmfessions Code:The Contrac[ors'State License law does not appty to an owner of properry wha U Y buitds a improves thereon,and wha conUacts ta the projects with a licensed Contrac[or pursuant to the Gontractors'State � � License Law.). � {�t am exempt from iicensure under the CoMractor's State Ucense iaw tor the foitowing reason(s}: � w z z m 4 6y my signature below I acknowledge that,except far my personal residence in which I must have resided for at least one � ¢ � year prior to canptetion of the improvements cavered by this permit,i cannot Ieqaity seii a strucWre that i have bulit as an a � owner-builder if it has not been constructed in ifs entirety by licensed conVacrors.I understand that a copy of the W appiicabie iaw,Seetion�044 of the Business and Professions Code is avaiiabie opon reqnest when this appiica6on is � p suhmitted or ai the followinq Web site:http/www.lsginfo.ca.9ov/calaw.html. c� t- �� IJCENSED CONTNACTOWS DECLARATION � � mi hereby affirm under pena�ty of perjury that t am licensed untler provisions of Chapter 9(commencing with SecBon 7000) � � o(Division 3 of the Business and Professioas Gode,and my license is in full force and etfect. t/3 M � uCENSE CtASS: � "1 uC.NO.: ��'�/1G� � /�� G4NSTRUCTtQN: � z DATE: CONTRACTOR:�.y��,(,__.CYy� � a PLAN REVIEW: WBRKER'S COMPENSATiON DECLARATION w ELECTRIC: � I HEREBY AFFIRM UNDER PENALTY OF PEHJURY ONE QF THE FOLLQWING pEGf ARATIONS: o I have and will maintain a Certificate of Consent to Self-Insure tor WarkePs Compensation,as provided by PLUMBING: qSecction 3700 of tlie Labor Code,for the per(�rmance o1[he work for which this permit is issued. �„ MECHANICAL: I heve and will maintain Worker's Compensation Insurance,as required by SeClion 3700 of the Labor Cotle,fnr Qthe performance of the work for which this permit is issued.My Worker's Compensatian insura�e Carrier and INSPECTIt7N FEE: Policy Number er: �� {'' ISSUANGE: �4++ CARPoER��1�'1=._4�(/`� � � PdUCY NUMBER %Q� S � C C.I — S � SMIP: N �- {(HIS SECTION NEED NOT BE COMPLEfED IF hIE PEAMIT IS FOR ONE HUNDHED DOLLARS($1IXla OR LESS). ENERGY P/C: p I certify that in l�e pertormance of the vrork for which Ihis permit is Issuetl,i shall not employ any person in any manner so�to ENERGY PERM IT: p i�ecane subject to the Waker's Canpensation taws of Cafitomia.Md ag�ee that if t stroutd become subject m the Waker's �rJ w RETENTIQN FEE: �L �� Cpmpensation. rorw�si�nsP f Section 370p Q�f the L.a6or Code,l sh II 1o�with comply with tM�se provisions. u_ DATE:��3• K}A�.(CaM:jy,J3,s�,b---- �+A YC� PRE-AlT FEE: 1- � � WARNING:Failure W secure Worker's Compensation coverage is unlawful,and shall subject an emp(oyer to criminal QASF: r �w penatties and civii fines up to one hundred thousand doi�ars($100,000},in atltlltion tp the cost nf the compensation, p damages as pcpvided tor in section 3708 ot the la�or code,inYerest,and attorney's fees. PLOT PkAN: � CONSTflUCTIpN LENDING AGENCY ZONING CLEARANCE: w i hereby aEfirm under penatty of perjury that there Is a Construction lending'Agency for the perfamance of the work ior � , � which this permit is issuetl(Sec.3097,Civ.C.). H LENDER'S NAME: � � � tENOER'S aooREss: T4TAL FEES a"�. I certity that I have read this applicafian and state thet the above iafirma6on is wrrect.I agree to comply wiih all oiry antl �OMMENTS: � pounty ordinances and siake iaws refating to bui�ding wnstructlun,and heraby authorize representatives of this caunty to z p enter upon the above-mentioned property for Inspection purposes. J �1� N .h PER EE NAME(P P/C: � PAIp 8Y:^ VALIpATIQN; ct ��//��,, J �y — tn . ��-(.�--�- �� RECEIPT# PAID BY: VAUDATION: = IGNATUR PERMI E DATE F-� . � �� j� WHiTE—Department Copy,YE��OW—Finance Copy,PtNK—Assessor Copy � , . , . _ CITY OF �lAMOND BAR INSPECTI.Qf�. RECORD '� �� • � � • - � • � • . • . SETBACK/LETTER TRACT AND LEDGER FOOTINGS FORMS SWITCH GEAR S�pg 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/GATE/ALARM LATH(PRE) FINAL POOL LATH EXTERIOR WA��S� LATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL 15�� ZND( )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 ENGINEERIN6/PW T.C.of OCCUPANCY FINAL COMMUNI7Y SERVICES CERT.of OCCUPANCY FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE COMMENTS: (Please fi// out and tear off this portion to /eave with the job card if no one wi//be available to allow the inspector inside the house.) . • • . ._ � INSTALLATION CERTIFICATION For the property located at , I hereby certify that the required , smoke alarms and_carbon mo oxide alarms have been installed as listed above. .-�.. ..,-� �� ►J�7�.l ,�� Signa��e' � Pri�Name D te Relationship to project(please check one): ❑Owner .�Agent for Owner ❑ Licensed Contractor ❑Agent for Licensed Contractor If"Licensed Contractor" or"Agent for Licensed Contractor' is checked, please complete the following: ,��__,�b�. a��t�c�Y��- �- D�/ � � �� Contractor Contract6r's�te License Number .'� . � . ' � ' � , � '�,F�� . •�; X 1 / � � o � � � . . 1, 1 � � �