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Home My WebLink About16-0631 (9) , �__ _ _ � _ _ CITY OF DIAMOND BAR / � I I i I DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES �- c� PRESS � - 21810 Copley Drive,Diamond Bar,CA 91765 (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 FI R M LY C �'H"', BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@diamondbarca.gov � w Zt�, ��q(` APPLICATION DATE• P/C# a JOB SITE ADDRESS � Gr�e. Cq rl s Jl �� d / �h 2� � APN LOT TRACT ISSUE DATE: � I PERMIT#: �(f/'��/�J 0 � OWNER C.V::/� N SC.I TYPE CONST. ` OCC GROUP: � ADDRESS �z..y7 C<<q� (,�4Z'..� �A�'1 �Ov� �t�r/Q, ¢ ciTv�i�avhov�{�' �bmC� ziP � 65 TE�. �714 34 z, ioZ.`� `� f��o-� f2Pa� /� ` o APPLICANT YCl��(� ��1^F�TEL. n1o�] 6'Z1 �{j'�[, ScopeofWork 3 ` O✓� drql+� ¢ CONTRACTOR p�� -e� �eC'o 0 � ADDRESS ��PSO a C('Ott� �'1��1 �/ C-� � #DWEL.UNITS #STORIES #BEDROOMS o ciTv Mo.�•}C In� r ZIP 91l(o3TEL. �O 9 (o t,l 37(o o ARCH/ENG/ z DESIGNER DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION ZADDRESS SFR/ADD/REM m CITY ZIP TEL. Garage/Carport a Patio/Deck a� OWNEfl-BUILDER DECLANATION w oI hereby affirm under penalTy of perjury that I am ezempt from the Contrac[or's STate License Law for the reason(s) LL Pool/Spa w indicated below by the checkmark(s),I have placed ne�t to the applicable item(s)�Section 7031.5,Busineu and Z Re-Roof 0 w Professians Code:My city or couMy that requires a permit Tn construcf,al0er,improre,demolish,or repair,any � d strucWre,prior to its issuance,alw requires the applicant for tlie pertnit to file a signed statement that he or she � Commercial � is licensed pursuant tn fhe provisions of the Cantractnr's Sfate License Law(Chapter 9)Commencing with Section � N 7000 of Division 3 of Me Business and Professians Cade]or that he or she is exempt from licensure and ihe basis Tor 00 � the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty 0 ot not more than five hundred tlollars($500). � (,I,as owner of the property,or my employees with wages as their sole compensation,will do(1 all of ar(,portions � Z of the work,and the sVucture is not intended or offered for sale(Section 7044,Business and Professions Cotle:The Valuation: Adj.Area: � Conhactors'Sfate License Law does not apply to an owner of property who,thmugh employees'or personal effort,builds . por improves the property,provided that The improvements are not intended or offered for sale.If however,the building or QUANTIIY DESCRIPTION FEE improvement is sold within one year of complefion,the Owner-Builder will have the burden of proving that it was not buitt � or improved for the purpose of sale.). Q Z (,I,as owner of the property,am exclusively contracKing with licensed Contractors to construct the project(Section ¢ y 7044,Business antl Professions Code:Tne Contractors'State License Law does not apply to an owner ot property who � Y builds or improves thereon,anA who contrac[s forthe projects with a licensed Conhactor pursuant to the Contractors'State � o License Law.). w � (J I am exempt from licensure under the Cantrac[or's State License law for the following reason(s): � �' Z �J� O (�Q. Q\(� OY1 �A 1✓1 z m � � By my signature below I acknowletlge that,except for my personal resitlence in which I must have resided for at leas[one � � � � year prior to completion of the improvements covered by this permit,l cannot legalry sell a structure that I have built as an a C� 'ef �' d owner-builtler if it has not been consWcted in ifs entirety by licensed contractors.I understand that a copy of the ��y� � � applicable law,Section 7044 of the Business and Professions Code is available upon request when this application is o submitted or at the following Web site:http/w�vw.leginfo.ca.gov/calaw.html. � � ¢ i LICENSED CONTpACTOH'S OECLAHATION = � I hereby affirm under penalty of perjury that I am licensed untler provisions of ChaDter 9(commencing with Section 7000) � Nof Division 3 of the Business and Professions Code,and my license is in full force and effect. � N LICENSE CLASS:��C �36 LIC.NO.: 7 7 3O I y QDATE: '3—d' 1 S� CONTRACiOR: OC�-��Q� 1.�Q O CONSTRUCTION: p WORKEH'S COMPENSATION DECUIRATION PLAN REVIEW: QI HEREBY AFFIRM UNDER PENALiY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: ELECTRIC: o I have and will maintain a Certificate of Consent to Seli-Insure for Worker's Compensation,as provided by PLUMBING: �� Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. MECHANICAL: p I have and will mainTain Worker's Compensation Insurance,as required by Section 3700 of the Labor Code,for ¢ the pertormance of ine work for which this permit is issued.My Worker's Compensatian Insurance Carrier and INSPECTION FEE: Policy Number are: ` Z CARRIER _ ��I�'C`Q S� N G'T \O YI q 1 ISSUANCE: � POLICY NUMBER T E)OO��3 O��I\ y1 SMIP: � (IFiIS SECIION NEED NOT BE COMPLEIED IFTHE PERMf!IS FOR ONE HUNDRED DOW�RS($100)OR LESS). ENERGY P/C: = I certi that in the periormance of the work for which this ermit is issued,I shall not em lo an y o N P p y ypersoninan mannersoasto ENERGYPERMIT: o become subject lo the Worker's Compensafion Laws of CaliTomia.Md agree that'rf I should become subject to the Worker's � Comp sation provisions of Sec6on 3700 of the Labor Cade,I shall forlhwRh comply with those provisions. RETENTION FEE: �,� � DATe� 'H'I(o APPLICANT: �L��CO CO�11CeI�qS PRE-ALTFEE: � WARNING:Failure to secure Worker's Compensation coverage is unlawful,and shall subject an employer to criminal gqSF: � penalties and civil fines up to one hundred thousand dollars($100,000),in addition to the cost of the compensation, p damages as provided for in section 3708 of the labor code,interest,and attorney's fees. PLOT PLAN: ¢ a CONSiHUCT10N LENDING AGENCY ZONING CLEARANCE: = I hereby affirm under penalty of perjury that there is a Conshuction Lending Agency for the performance of the work for � which this permit is issued(Sec.3097,Civ.C.). H LENDER'S NAME: � LENDER'S ADDRESS: TOTAL FEES �g w � I certify that I have read this application and state that the above information is correct.I agree to comply with all city and Z counly ordinances and state laws relating to building consWctian,and hereby au[horize representatives of this county to COMMENTS: p enter upon the above-mentioned property for inspection purposes. = e �o co�n �e('q s m ¢ PERMITfEE NAME(PRIN -- �� P/C: PAID BY: VALIDATION:�� ' 3- �- l� �// �/J�/� � RECEIPT#�9 '� PAID Bl4-� VALIDATION: (.�r_� � SIGNATURE OF P EE DATE / — ,�i��/6 WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy � �� c,, ':. CITY OF DIAMOND BAR � � '� � INSPECTION RECORD ~� ' � • � � • - � � � • - SETBACK/LETTER TRACT AND LEDGER I FOOTINGS FORMS SWITCH GEAR S�qg COMMERCIAL HOOD UG.PLUMBING T-BAR UG.ELECTRICAL INTERCEPTER UFER GROUND HOT MOP/SHOWERPAN SEWERLATERAL SEPTIC/CESSPOOL MAIN WATER LINE HERS REPORT RECEIVED SEWER CLEANOUT DEMOLITION I ROOF SHEATHWG 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 WALLS: LATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL 1ST( )2"0( )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 � �C FINAL ENGINEERING/PW T.C.of OCCUPANCY FINAL COMMUNITY SERVICES CERT.of OCCUPANCY FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE COMMENTS: