HomeMy WebLinkAbout13-01519 =�':,15j�'_ , C1TY OF DIAMOND BAR . � �
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j I I I i ' (( DEPARTMENT OF COMMUNITY&DEVELOPMCNT SERVICES �
� :;,r,��IIL�� �_ � ' 21810 Copley Drive,Diamond Bar,CA 9176� PRESS
�,,, ,,,� (909)839-7020 Fax:(909)861-3ll7 Building Inspection Hotline(909)839-7027 FIRMLY
� ��''��'���� � BUiLDING PERM T AP LTCAT ON �
w~ � APPLICATION DATE: P/C#
JOB SITE ADDRESS �� �' a �—' �
z APN /� LOT TRAGT ISSUE DATE: PERMIT# I 3— c� 1 �i a
o OWNER_/C.v�•o� 1 JQQ��� TYPE CONST. OCC GROUP:
� ADDRESS�/�y�/I ,,-_,,t=Z r O r�� � �`�'''�-- r/ '
'J CITY �,14�✓c, . q� ZIP G�Q TEL.l�/� ,S/J S�` /�'I S ZONING F ONTCKS RW ❑
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� APPLICANT TEL. REAR ❑
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�' CONTRACTOR ��hCr� �'�� \c�C.r SIDFJSIDE STR T RW CL
o SIDE ❑
� ADDRESS
PROPOSED USE
o� CITY ZIP TEL.
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o ARCH/ENG/DESIGNER
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o ADDRESS
o �i DWEL.UNITS #STORIES #BEDROOMS
z CITY ZIP TEL.
m DESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREANALUATION
a OWNEH-BUILDEfl DECLARATION
� ereby aNrm under penalty of perjury that I am exempt trom the Coniractor's Sfate Ucense Law tor the reason(s) SFR/ADD/REM
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p intlicated below by the checkmark(s),I have D�aced nezt to the aDDlicable item(s)[Section 7031.5,Business and Garage/Carport
'-'� Professions Code:Any city or county that requires a permit to construct,alter,improve,demolish,or repair,any
? struclure,Drior to its issuance,also requires ihe applicant for the permit to file a signed statement that he or she � Patio/Deck
� is licensed pursuant to lhe provisions ollhe Contraclor's State License Law(Chapter 9)Commencing with Section w
� 7000 of Division 3 of the Business and Prafessions Code]or that he or she is exempt hom licensure and the basis for � Pool/Spa
N the alleged exemption.Any violation of Section 7031.5 by any apD�icant tor a permit subjects the apD�icant to a civil penalry C7
� 01 not more than(ive hundred dollars�$500). Q Re-Roof
o (,I,as owner of the property,or my employees with wages as their sole compensation,wiil do(�all of or�J portions � Commercial
� of the work,and the strucNre is not intended ar oftered for sale(Section 7044,Business and Pmfessions Code:The m
z Contracfnrs'State License Law does not apply to an awner of property who,through employees'or personal effort,6uild5
w or improves ihe property,provided that the improvemenis are not intended or oftered tor sale.lf however,the building nr .
� Improvemenl is sold within one year of completion,the Owner-Builder will have ihe burden oi proving mat it was not built
por improved for the purpose of sale.j.
� (1 I,as owner o1 the properry,am exclusively contracGng with licensed ConVactors to consVuct the project(Section
z 7044,Business and Professions Code:The Contractors'State License Law does not appty to an awner ol property who Valuation: Adj.Afea:
� builds or improves thereon,and who contracts tor the projects wiN a�icensed Contractor pursuant to the Contracrors'State QUANTITY DESCRIPTION FEE
Y license Law.). / / ��� � f,� �
O U I am exempt from licensure under the ConVactor's State LJcense law for the following reason(s): �a
� � '��u U /�l+a
LL By my signature betow I acknowledge that,excepl tor my personal residence in which I must have resided for at least one w
o year prior to compledon of ihe improvements covered by mis permit,l cannot Iegalty sell a structure mat I have built as an w
a owner-builder if it has not been constructed in its entirery by licensed contractors.l understand mat a copy olthe applica�le _� s �1'� 2,
� law,Section 7044 of the Busineu and Professions Code is available upon request when this application is submitted or at
a the fallowing We[b��si[e:httphw�nv leginfo.ca.gov/c law.h I. Z
� DATE: � '.T ��N�3 SIGN: �
� LICENSED CONTRACTOH'S DECLAflAT10N �
w I hereby aftirm untler penalty of perjury that I am licensed untler provisions ot Chapter 9(commencing with Sedian 7000)
m ot Division 3 of ihe Business and Protessions Code,and my license is in full force and eftect. J
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y LICENSE CLASS: LIC.NO.: a
o DATE: CONTRACTOR: _
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� WORKEfl'S COMPENSATION DECUiRAT10N �
� I HEREBY AFFIRM UNDER PEIJALTY OF PERJURY ONE OF THE FOLLOWING DECLAAATIONS:
� I have and will maintain a Certifiqte of Consent to Self-Insure for Worker's CompenSaGon,as provided by CONSTRUCTION:
� Section 3700 0l lhe LaDor Code,for Ihe pertormance of the work tor which this permit is issued. p�,p,N REVIEW:
> I have and will maintain Worker's Compensation Insurance,as required by Section 3700 oi the Labar Code,for ELECTRIC:
� the peAortnance of ihe work iw which this permit is issued.My Worker's Compensafion Insurance Carrier antl
a PolicyNumberare: PLUMBING:
� CMRIEn MECHANICAL:
� POLICY NUMBER INSPECTION FEE:
� (fHIS SECTION NEED NOT BE COMPLEfED If iHE PERMR IS WR ONE HUNDRED DOl1ARS(5100)OR LESS).
� ISSUANCE:
o I cedify thal in 1he pedortnance of the work lor which this permit is issuetl,I shall nol employ any person in any manner so as to SM I P:
o become s�ibjed to the Worker's Compeivalion Laws of Califomia.Md agree that if I s�ould become subject ro the Worker's
J Compensati n prwi wns of Seclion 3700 0l the Labor Co iall o i comp �C+'th ttrose provisions. ENERGY PlC:
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LL DATE:�����P�uCANT:y---j��� ENERGY PERMIT:
� WARNING:Failure ta secure Worker's Compensation covera4 is unlawtul,and shail subject an employer to criminal RETENTION FEE:
w penafties and civil lines up to one hundred thousand dollars($700,000),in addi0on to the cost of the compensation,
d damages as provided for in section 3708 ot the labor code,interest,and attomey's fees. PRE-ALT FEE: Z..�'d
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a CONSiflUCTION LENDING AGENCY BSAF:
w I hereby atfirm under penalry M perjury Nal there is a Constmction Lending Agency for the pedortnance ol ihe work Por
� which this permit is issuetl(Sec.3097,Civ.C.).
F LENDER'S NAME
� LENDER'SAD�RESS: �
I certity that t have read this application and state that the abave information is correct.I agree[o comply with all city and TOTAL FEES �
� counry ordinances and state laws relating ro building constmction,and hereby authorize representatives of this rounry to COMMENTS:
enter upon ihe above-mentioned property for inspection purposes.
m ,�o E3 �rT L�1 Y�i� ,�
N PERMfTTEi�� ��� X�*1 � ��I� -
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x SIGNAT E OF PERMITfEE �ATE RECEIPT k \� PAID BY: VALIDATION:
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W HITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy
CITY OF DIAMOND BAR �
_ INSPECTION RECORD .
. � � , . o . • � • - • -
SETBACK/,LETTER ' TRACTAND LEDGER
FOOTINGS FORMS . ;' '�� f- SWITCH GEAR
g�qg�;� _ - - ..:� ��� COMMERCIAL HOOD
UG:PLUMBING::'- - T-BAR
'UG.`ELECTRICAL - � INTERCEPTER
UFER GRDUND ' � � ' - 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' ' � r
PUOUSPA.` -
SHEAR WALLS INTERIOR .,- , � ` . " `_� . 'ROUGH FLUMBING.; r, ��'_
� �. - . �
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FRAMiNGNENTING ;ROUGH E[ECTRICAL,:= � '�
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ROUGN PJIEGHANICAL " , f - :ROUGH MEGHANICAL`; . _ -
,ROUGH ELECjfl►CAL W(::;),C.(� ) - � � - ;GASTEST. `_ - -
,
ROUGH,PLUMBING � : ` `- ', "', RREGUNITE. �� - _
,. - _ __,
INSULATION WALL ���POOL PRE��DECK�BONDING '��� .;:�;�., . .�-` s,. _ =
INSULATION CEIUNG P.=TR,4P - - "
DRYWALL FENCE/GATE(AtARM 7
�_
LATH(PRE) FINAL POOL' :'� _ ;, :::
LATH EXTERIOR WALLS:
LATN INTERIOR WALL FOOTiNG/STEEL
GAS TEST WAIL STEEL 1�( )2ND( )LIFT
SCRATCH COAT � � � WALL BOND BEAM
ELECTRIC METER RELEASE �' /'_ � • WALL ORAIN/SEAL
GAS METER RELEASE WALL FINAL
SPECIAL INSPECTION R0.FRAMING PLANNIN�APPROVAL � ,
;
FINACBUILDING .. ' ;' : " .,.:: --,_ . ' .- ROUGH:EIREAPP.ROVAL
FINAI:MECHANICAL �;` - . �� , . ` " =, ``: FINAL FIRE UEPARTMENT�. .` ..;."
FINAL.ECECTRICAL �. - FINALPLANNING .;- - �
FINAL'PLUMBING `' ; FINAL`ENGINEER{NGL PW -
TC.of OCCUPANCY. `': � ' _ - �:_ `, �: ��:: . FINAC COMMUNITY;SERVICES : - � _
CERT.of OCCUPANCY;;�. . _ FINAL HEAITH DEPJ
,.. _ ,. . _.... . _. .
fINAL INDUSTRIAL;WASTE - -
COMMENTS:
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