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Home My WebLink About15-0561 v�a 1 t6 �vYAn 3��L�1°�n � �"�,.,,�„ CITY OF DIAMOND BAR � � � ; DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES F11�lAL1ZED _ _ 21810 Copley Drive,Diamond Bar,C�917fi5 PRESS �.,,,,rc;;,�� (909)839-7020 Fax:(909)861-3117 �Building Inspection Hotline(909)839-7027 �''�""�� BUILDING PERMIT APPLICATION FIRMLY APPLICATION DATE: P/C# i JOB SITE ADDRESS Q /' i ISSUE DATE:��7! ��f PERMIT# 1,J� ' �f s I z APN OT TRACT � OWNER � f' TYPE CONST. OCC GROUP: i n ADDRESS J CITY � ZIP I TEL.If H 2 '�7�� ZONING F O TCKS RW ❑ n z APPLICANT TEL. - - REAR ❑ � � �. j SIDE/SIDE STREET RW ❑ � CONTRACTOR � . / � � _ SIDE ❑ � ADDRES. I� �Q,� �/J�hL(/__G�t/e PROPOSED USE /r G(/� S � = cirv�i�le� ziF�f2833� fEL 7�N-! —//Z�_ � � ARCH/ENG/DESIGNER ,-6o e � � = ADDRESS � #DWEL.UNITS #STORIES �Zi #BEDROOMS z CITY ZIP TEL. ¢ oWNEH-BUILDEH DECIAHATION DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREA/VALUATION � = I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the reason(s) SFR/ADD/REM I � indirated below by the checkmark(s),I have placed next to the applicable item(s)[Section 7031.5,Business and I y Garage/Carport � Rofessions Code:Any city or county that requires a permit tn construct,alter,improve,demolish,or repair,any I � structure,prior to its issuance,also 2quires the applicant for the pertnit to file a signed sfatement that he or she � Patio/Deck i is licensed pursuant to the provisions of the Contractor's State License Law(Chapter 9)Commencing with Sectian w � 70W of Divisian 3 of the Busineu and Professions Cade]or that he or she is exempt from licensure and the basis for � Pool/Spa � the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjecCs the applicant to a civil penalty C7 I Y of not more than five hundred dollars($500). ZQ Re-Roof 2 I � U I,as owner of the property,or my empioyees with wages as their sole compensation,will do(�all of or(,poRions � Commercial I y of the work,and the struc[ure is not intended or offered for sale(Section 7044,Business and Professions Code:The m I Z Contractors'State License Law does not apply to an owner of property who,through employees'or personal eftort,builds � or improves the property,provided that the improvements are not intended or oftered for sale.If however,the building or I � 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.�. I � ()I,as owner of the property,am exclusively cont2cting with licensed ConVacturs to construct the project(Section Valuation: Ad Area: Z 7044,Business and Professions Code:The Contractors'State License Law does not apply to an owner M property who 1� � � buildsorimprovesthereon,andwhocontractstortheprojectswithalicensedContractorpursuanttotheContractors'Shte QUANTITY DESCRIPTION FEE I License Law.). I � (,I am exempt from licensure under the Contractor's State License law for the foliowing reason(s): � I � � 1 By my signature below I acknowledge that,except for my personal residence in which I must have resided for at least one c~i _ I = year prior to completion of the improvements covered by this permit,l cannot legally sell a structure that I have built as an w . I owner-builder if it has not been constructed in its entirety by licensed contractors.I understand that a copy of the applica6le � law,Section 7044 of the Business and Professions Code is available upon request when this application is submitted or at I � the following Web site:httpMnvw.leginfo.ca.gov/calaw.html. Z I = DATE: SIGN: � — LICENSED CONTIIACTOH'S DECLAHATION � I a I � I 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 and Professions Code,and my license is in full force and effect. J I ynj LICENSECLASS: C.� IJC.NO.: "Ic�CJ !�� U ' Z I � DATE: CONTRACTOR: ��.�(��[�S �( /�� I Q w WOHI�H'S COMPENSATION DECLARATION � I y I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: i I � I have and will maintain a Certificate of Consent to Self-Insure for Worker's Compensation,as provided by CONSTRUCTION: a A� � I li � �Bection 3700 of the La6or Code,for the pertormance of the work for which this permit is issued. PLAN REVI EW: � ✓ I have and will maintain Worker's Compensation Insurance,as required by Section 3700 of the Labor Code,for Z the pertormance of the work for which this permit is issued.My Worker's Compensation Insurance Carrier and ELECTRIC: ¢ PolicyNumberare: �(pr�f / }� PLUMBING: � CARRIEn I�OY%�" E � h��CS� MECHANICAL: � POLICYNUMBER rY/FiI O�` INSPECTION FEE: � (i}iIS SCCTION NEED NOT BE CAMPLEfED IF7HE PERMR IS FOR ONE HUNDRFD DOLLARS($100)OR LESS). �r„� ISSUANCE: ? I certify that in the pertortnance of ihe work for which this permft is issued,I shall not employ any person in any manner so as tn ` �� become subject m the Worker's Compensation Laws of Califomia.Md agree that if I should become subject to the Worker's SMI P: � J Compensatio pro'ions of Section 3700 af the Labor Code,I shall tortlj�yith comply with those provisio . ENERGY P/C: � 1 DATE: APPLICANT: T�p1/��f^ ��;i�y�2� ENERGY PERMIT: � WARNIN :F re to secure Worker's CompenSation coverage is unlawful,and shall subject an employer to criminal y penalties and civil fines up to one hundred thausand dollars($100,000),in addition to the cost of the compensation, RETENTION FEE: �•p() 1 damages as provided for in section 3708 of the labor code,interest,and attorney's fees. PRE-ALT FEE: � r i CONSTflUCT10N LENDING AGENCY BSAF: � Q y I he2by affirm under penalty of perjury that there is a Construction Lending Agency for the performance of the work for = which this permit is issued(Sec.3097,Civ.C.�. � LENDER'S NAME: s LENDER'SADDflESS: i I certify that I have read this application and sTate that me above information is correct.I agree to comply with all city and TOTAL FEES �/� ,/�� :.7 � r/ Z county ordinances and shate laws relating to building construction,and he2by authorize representatives of this county to COMMENTS: � enter upon the above-mentioned property f inspection purposes J � 1] ¢ PE MITTE NAME(PRI � :n � :A ` = SI TUR PERMITfEE E RECEIPT#�_1��_,� pAID BY: V f D II VALIDATION: .�c WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy CITY OF DIAMOND BAR �6��,J,�� INSPECTIUN RECORD , , . • � + • o - • • � � . � . _ . SETBAGKI L,`E7TER."`� ;r '�� `"�� _ . , , y . TRACTAND LEDGER � w�„ ��tt , ._ �F(�(�TING�FORMS � ,� � � °�� ;;, �.. � �, `� ` : SWITCH GEAR SIAB , ,.�� ` �� , �. �> `�� COMMERCIAL HOOD � �� F : �� ,G6�PLUMBING:� g� . � °�� . � � T-BAR UCy�:aELECTRIGAL ' ` �;-' `�" ' °" � �� ' INTERCEPTER i �. ,UFfR,.GROU�I� ;:; ��,�� ' ° ` HOT MOP/SHOWERPAN SEWER LATERAL SEPTIC/CESSPODL MAIN WATER LINE HERS REPORT RECEIVED � SEWER CLEANOUT DEMOLITION ' RQQF SHEATHING ( � (S'~ ROOF DRAINS FLOOR SHEATHING ROUGN CONDUIT _ ,SM�AR WAELS EXTERIOR� �� ' �POOUSPA ' �� ,� � � - � ., . = _ � � _, _ ,SNEAR WALLS�INTERIOR, � � e� ; ' � o �.��`.' � ._ � � ROUGH,PLUMBING' � � � � � �� ° s � .. _ �R�MltJGN,EtV71NG' �r. - � ��-"°�� ROUGH'ELECTRICRL � `� "�' °� , ,�� e , s 'RO�J6H MECHANI�AL � �� ; �,� `e_ � �� ROUGW MECHANICAL � � � � ROUGH ELECTRICAL�UV(�}C( l� °��a � �� ;��. . �GAS TEST � , ,�..� _ . _ a . g ROl1GH PLt�MBING�� x �� ' PRE GUNiTE " , �-_ ; INSULATION WALL FOOL PRE DECK BONDING INSULATION CEILING I P-TRAP ` ' DRYWALL I FENCE/GATEi ALARM UaTH(PREI ` FINAL POOL LATH EXTERIOR WALLS: LATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL 1 sT( )2Ne( )LIFT SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELEASE WALL DRAIN/SEAL GAS METER RELEASE WALL FINAL SPECIAL WSPECTION R0.FRAMING PLANNINGAPPROVAL � " - � °�� ,, . o� _ _ _ �INAI BLlICDING � � �`r �� r '� ROU�H FIRE APPROUAI � � � � � � AR • FIN{1L MECHANICAL:°�, � „ �� . � : `��'tt a - .- - FINAI FIRE DEPAR7MENT � �, _ , 9_ _FINA��ELECTRiCAL_. ��s �.�� _ � �� FINAI PLANNING ° � � � � m , ,.,b, .� �� - , ;FINaL RI.UNIBING ��; � � ° FINAL ENGINEERING/PW � �, _ , ., ,,s : � T _ T:C's'of OGCUPANGY "��a"�" _ `�°�. � ��4 . � � �� FINAL COMMUNiTY SERVICES � � � , �.,�., GEfCf.'ot OCCUFANCI� . - �� ' ' � � ` � .��.. ; PINAL HEALTH DEPL � FINAL INDUSTRIAL WASTE T �� COMMENTS: