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Home My WebLink About14-4576 � � .' y-/s� _.:........ . -:"'�� .....�., CITY OF DIAMOND BAR ` ` :� � 9"a • " � _ , ' ` DEPARTMENT OF COMMUNITY&D�,VELI:�VIENT SERVICES � � �, �_ _. ,. 21810 Copley Drive,Diamond Bar,cA 9i�6s RESS ` ,,en��,� (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 FIRMLY �'��''' BUILDING PERMIT APPLICATION i JOB SITE ADDRESS � 1 t � � APPLICATION DATE: � ��'�1- P/C# �4' 4'S,b i ISSUEDATE: ��f��D� / PERMIT# I � 7 z APN LOT TRACT � OWNER�C�� TYPE CONST. OCC GROUP: y � ADDRESS aCITY ZIP TEL. ZONING F ONT KS RW ❑ = APPLICANT TEL. REAR ❑ n SIDE/SIDE STREEf RW ❑ � CONTRACTOR SIDE ❑ � ADDRESS = CITY 7„IP-/ TE�L9. � PROPOSED US I � ARCH/ENG/DESIGNEFi�( �CJO� � V WU/�iU y = ADDRESS � #DWEL.UNITS #STORIES #BEDROOMS z CITY ZIP TEL. � DESCRIPTION SQ.FC FACTOR PSF ADJ.AREANALUATION � OWNEH-BUILDEH OECLAHATION = I hereby aftirm under penalty of perjury that I am exempt from the Contractor's State License Law for the reason(s) SFR/ADD/REM I I � indicated below by the checkmark(s�,I have placed ne#to the applicable item(s)[Sectlon 7031.5,Business and Garage/Carport �-' Professions Code:My city or county that requires a permit to construct,alter,improve,demolish,or repair,any z structure,priar to its issuance,also requires the applicant far the pertnit to file a signed siatement that he or she W Patio/Deck i i is licensed pursuaM to tlie provisions of the CaMractor's State License Law(Chapter 9)Commencing with Sedian � 7000 of Division 3 of the Business and Professions Code]or that he or she is exempt fmm licensure and the basis for � Pool/Spa I n the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty C7 Y n t more than five hundred dollars($500). ZQ Re-Roof I � as owner of the property,or my employees with wages as their sole compensation,will do(_)all o(or�]portions J Commercial I � of t e work,and the structure is not intended or offered for sale(Section 7044,Business and Professions Code:The m I ZContractors'State License Law does not apply to an owner of property who,through employees'or personal effort,builds Qak y or improves the properry,provided that the improvements are not intended or ottered 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 :� (J I,as owner of the property,am exclusively conVacting with licensed Contrac6ors to construct the project(Section Vdlu8ti0n. Ad Afea: � � Z 7044,Business and Professions Code:The Contractors'STate License Law does not apply to an owner of property who 1� � buildsorimprovesthereon,andwhocontractsfortheprojectswithalicensedContractorpursuanttotheContractors'State QUANTITY DESCRIPTION FEE I ucense law.). I � (J I am exempt from licensure under the Cont2ctor's State License law for the following reason(s): � I . � � I 1 By my signature below I acknowledge that,except for my personal residence in which I must have 2sided for at least one w I � year prior to completion af the improvements covered by this permit,l cannot legally sell a structure that I have built as an w owner-builder if it has not been construc[ed in its entirety by licensed contractors.I understand that a copy of the applicable I � law,Section 7044 of the Business and Professions Code is available upon request when this application is submitted or at I Lme following Web site:qttp .leginfo.ca.gov/calaw.html. Z i � DATE�� . 1 SIG �� - � I — ' / LICE SED CONTRACTOH'S DECLAflATION � I d I' I hereby aftirm 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 firce and effect. J I n � I � LICENSE CLASS: LIC.NO.: za Z DATE: CONTRACTOR: � I ¢ WOHI�H'S COMPENSATION DECLAl1ATI0N � I y I HEREBYAFFIRM UNDER PENALTY OF PERJURY ONE OFTHE FOLLOWING DECLARATIONS: � I have and will mainTain a Certificate of Consent to Self-Insure for Worker's Compensation,as provided by CONSTRUCTION:_ �1 9 �7 � Secfion 3700 ot the Labor Code,for the performance of the work for which this permit is issued. PLAN REVI EW: 0 ., > I have and will maintain Worker's Compensation Insurance,as required by Section 3700 of the Labor Code,for Z the performance of the work for which this permit is issued.My Worker's Compensation Insurance Carner and ELECTRIC: _ r7- ¢ PolicyNumberare: PLUMBING: � CARRIER �+ M EC HAN I CAL: z POLICYNUMBER INSPECTION FEE: :� 'n (THIS SECTION NEED NOT BE COMPLETED IFTHE PFAMR IS FOR ONE HUNORED DOLLAAS($100)OR LESS�. �e,� ISSUANCE: = I ceitify that in tl�e perfortnance of the work(or which this permit is issued,I shall not employ any person in any manner so as to � become subjed to me Worker's Compensation Lavrs of Califamia.Md agree that'rf I should become subject m the Worker's SM IP: c/1 � Compensation provisions of Sedion 3700 of the Labor Code,I shall forthvnth comply with those provisions. ENERGY P/C: J _'� DATE: APPLICANT: I 1 ENERGY PERMIT: � WARNING:Failure to secure Worker's Compensation coverage is unlawful,and shall subject an employer to criminal � ` y penalties and civil fines up to one hundred thousand dollars($100,000),in addition to the cost of the compensation, RETENTION FEE: '�4..�^�� i damages as pmvided for in section 3708 of the labor code,interest,and attorney's fees. PRE-ALT FEE: � i CONSTHUCTION LENDING AGENCY BSAF. �,2,�q y I hereby aKrm under penalty of perjury that there is a Construction Lending Agency for the performance ot the work Por 6��— = which this permit is issued(Sec.3097,Civ.C.). � LENDER'S NAME: r LENDER'SADDRESS: i I certify that I have read this application and state that the above information is correct.I agree to comply with all city and TOTAL FEES `�1 ^�a �/� , � county ordinances and state laws relating to building construction,and hereby authorize representatives of this counTy to �� ? COM M ENTS: J enter upon the above-mentioned property for inspection purpo es. n ��N� �` WL^.(� ¢ P�TTEE NAME(PRIFlT) / ,��G /�d q�� C,�� - �r'� �� /r �/� � �1 � �G�,� PAID BY:��_ VALIDATION: = SI ATURE OF PERMITTEE .. � DA�—TE � �-� RECEIPT# WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy CITY OF C��,�,M� •8AR � _ ' INSPE,�fICdN RECORD -. . � e , o � . � � , . � . ;SETBACI(iYI:ETTE� �` ;��" '� �", °�° � `' ,� THACTAND LEDGER FQOTINGS FORMS �� , '°� � ' � �. , ,. , SWITCH GEAR � SLAB ' °�`'`�"� � �ID � COMMERCIAL HOOD UG.�P,LUMBING.. �. �� .r�. �� :. , �� ::; T-BAR ,UG'�.ELECTRICAL 4°�', � �� ,_ �. �� INTEFiCEPTER ,U�ER GROUND� ,�,,, :� �. .,� °' HOT MOP/SHOWERPAN � SEWER LATERAL SEPTIC/CESSPOOL I MAIN WATER LINE � HERS REPORT RECEIVEQ I SEWER CLEANOUT DEMOLITION ROQF SHEATHING ROOF DRAINS FLOOR SHEATHING ROUGH CONDUIT �� ._ . �,� � � ��3, , _�a «. ;SIiEAFt WALLSkEXTEFiIOR �' "", `� � � � POOUSPA ' �'"` �� ;SH�,4R tNALLS INTERIQR �� , � ° ROUGH PLUMBING � _ 'FRAMING/VENTING � �...�� ` � � � .��. ,�� ,�� _ � ROU�6H ELECTRICAL � ` ��. �ROUGH MEGHANICAL� ��_ ; „�„ ,,._ ;,, � ROUGH MECHANICAL ,�, � _ , _ . � . - �.: _�� ;. q�� GAS TEST 'ROUGH ELECTRiCAL VV( )C( ) �� RQWGH-PLtlMBIN.G �' �.�;...� �� ;: PRE GUNITE ,, ,�, �. INSULATION WALL POOL PRE DECK BONDING ' 1(VSULATION CEIIING P-T�P DRYWALL FENCE/GATE/ALARM LATH(PRE) FINAL POOL ° � �� -�� LATH EXTERIOR WALLS: LATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL 1�'( )2N°( )LIFT SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELEASE WALL DRAIN/SEAL GAS METER RELEASE WALL FINAL SPECIAL INSPECTION RO.,FRAMINGPLANNINGAPPRnVAL � ,FINAL BUILDING� _ � � ROUGH FIRE APPROVAL s _ _ ; �FIN7�ILMECHANt�AI� "�' � � � �� FINALFIREDEPARTMENT � � � �� P % , a� �. FINAC Et.ECiRIGAL ` � ;� �� FINAL PLANNING �"�_" ��;,: �� ,� � ��- -�� - � FINAI ENGINEERING/PW � �� Fit+i'AL P�LU�NBItdG � � '� � � D7�C.of OCCUPANCY � �:- �,, � FINAL COMMUNITY SERVICES � ,�,� �< � -� � � 'GERT.oi OGCUPAPICY � �" ~�" � * � �� "" � A '� FINAL HEAL7H DEPT, �� , FINAL INDUSTRIAL WASTE COMMEt�TS: t�,o►A�4� �'b� �SP�Q' --�D �'l-nf�i mN- 9�YTr�b g tS� � �'`� � ��(. oa' lt.o'l� ��