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Home My WebLink About15-240 ..,.J....__ :,"':-� �. CITY OF DIAMOND BAR �•r Z 6'—�S I . � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES � �'= ' 21810 Copley Drive,Diamond Bar,CA 91765 PRESS �,,��^„„� (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 FIRMLY BUILDING PERMIT APPLICATION y JOB SITE ADDRESS I ` , ��/� �' APPLICATION DATE: P/C# 1 ISSUEDATE: ��'U�� PERMIT# �'� � �y z APN �L�� LOT�TRACT � � OWNER ML7��f W 1 ULI�Y15 TYPE CONST. OCC GROUP: � � ADDRESS � CITY ZIP TEL. �'� ZONING F ONT KS RW ❑ = APPLICANT 'KL TEL.G��ZG1�Z�p�� REAR ❑ � Q CONTRACTOR ��- SIDE/SIDE STREET RW ❑ � SIDE ❑ � ADDRESS � �- � = CITY��V� ZIP��/TEL.��7��IC.� � PROPOSED USE t��C/� -�1-`G �` . = ARCH/ENG/DESIGNER � = ADDRESS #DWEL.UNtTS #STORIES #BEDROOMS z CITY ZIP TEL. b DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREA/VALUATION � OWNEH-BUILDEN DECLARATION s I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the reason(s) SFFVADD/REM . I � indicated helow by the checkmark(s),I have placed ne�R to the applicable item(s)[Sectlon 7031.5,Business and Garage/Carport I � Professlons Code:Any city or county that requires a permit to construct,alter,improve,demolish,or repair,any z structure,prior to its issuance,also requires the applicant Tor the permit to file a signed sfatement that he or she � Patio/Deck I i is licensed pursuant M the provisions of the Co�actor's State License Law(Chapter 9)Commencing wlth SecTion j 7000 of Diviston 3 of the Business and Professions Codej or that he or she is ezempt from licensure and the basis for � PooVSpa i n the alleged ezemption.Any violation of Section 7031.5 by any applicant for a permit subjecLs the applicant to a civil penalry � I sof not more than five hundred dollars($500). Z❑ Re-Roof � (J I,as owner of the property,or my employees with wages as their sole compensation,will do()all of or(,portions � Commercial I y of the work,and the structure is not intended or offered for sale(Section 7044,Business and Professions Code:The m I Z Contractors'State License Law daes not apply to an owner of property who,through employees'or personal effort,builds � or improves the property,provided that the improvements are not intended or offered 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 oi the property,am exclusively cont2cting with licensed ContracTurs to construct the project(Section Z 7044,Business and Professions Code:The Contractors'State License Law does not apply to an owner of property who Valuation: Adj.Area: I n buildsorimprovesthereon,andwhoconhacl5formeprojectswithalicensedContractorpursuanttotheConVactors'State QUANTITY DESCRIPTION FEE I License Law.). � U I am exempt irom licensure under the Contmctor's State License law Por the following reason(s): � � I � � I 1 By my signature below I acknowledge that,except for my personal residence in which I must have resided for at least one � I � year prior to completion of the improvements covered 6y this permit,l cannot legally sell a strudure that I have built as an w owner-builder if it has not been construded 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 � the following Web site:http/www.leginfo.ca.gov/calaw.html. z I = DATE: SIGN: � LICENSED CONTflACTOH'S DECLAFIATION � I a I � I hereby attirm 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 � ��`�1 �a a � LICENSE CLAS : LIC.N Q � � DATE: CONTRACTOR: .�. �CJtA� �,Qo� 'Fi � z � ¢ WOHI�B'S COMPENSATION DECLAHATION g 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: � �� Section 3700 of the Labor Code,for the pertormance of the work for which this permit is issued. p�,qN REVIEW: �.� � �I have and will maintain Worker's Compensation Insurance,as required by Section 3700 of the Labor Code,for Z the performance af the work for which this permit is issued.My Worker's Compensation Insurance Carrier and ELECTRIC: � ,� ¢ PolicyNum ae t /^ PLUMBING: � CARRIER ��ll. M A lY�`�•W . MECHANICAL: Z PouCYNUMBER'��'� �IA� i-n1 INSPECTIONFEE: � � ��a,, � (MIS SECTION NEED NOT BE COMPLEfED IFhIE PFRMf!IS FOR ONE HUNDRFD DOLLAAS($100)OR LESS�. ISSUANCE: �1 f�j/ . = I certify that in the performance of the work for which this pertnit is issued,I shall not employ any person in any manner so as to �—�� become subject tn the Worker's Compensation Laws of Califomia.Md agree that if I should become subject to the Worker's SMIP: JCompensation provisions of Section 3700 th pr��I �" p y with mose pmvisiona ENERGY:�P(C: 1 DATE: 2'� APPLICAN7:� L��J \. /� ENERGY PERMIT: � WARNING:Failure to secure Worker's Compen tion 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: ,�„Q� i j damages as pmvided for in section 3708 of the labor code,interest,and attorney's fees. PRE-ALT FEE: i CONSTflUCT10N LENDING AGENCY BSAF:_ �� y I hereby affirm under penalty of perjury that there is a Construc[ion Lending Agency for the performance of the work for = which this permit is issued(Sec.3097,Civ.C.). � LENDER'S NAME: x LENDER'SADDRESS: i I cer6ty that I have read this appliration and state that the above information is correct.I agree to comply with all city and TOTAL FEES �/�r�j,^ :� �� 1lCf . Z county ordinances and state laws relating to building construction,and hereby authorize representatives of this county to COMMENTS: Jenter u n the above-�entioned property for inspection purposes. _ 'C.� n ¢ PERMITTE N M ^� � / /� = SIG ,PERM DATE " RECEIPT# a •!i PAIDBY: �rl 6Qq VALIDATION: WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy CITY OF DIAMOND BAR INSPECTION RECORD e � � � - � e • � a - �.,,.� s�; �r � �ETBACKIoLE�TTER� `� `�� - � � TRACT ANO LEDGER 'FOOTINGS�FORMS ��a � � � SWITCH GEAR m . .��r a , , �.�._ � A�- SL�IB� � � � .�� COMMERCIAL HOOD � �� _. _ , =UG�PLUMBING ��;° ° � � ° � � T-BAR � . , fo-. �: UG�ELECTRI�AL°��° ;,,��, �;�a�� ':'' ' �� INTERCEPTER � ,UFER GROUNI� �� . � � HOT MOP/SHOWERPAN SEWER LATERAL SEPTIC/CESSPOOL MAIN WATER LINE HERS REPORT RECEIVED SEWER CLEANOUT DEMOLITION ROOF SHEATHING ROOF DRAINS FLOOR SHEATHING ROUGH CONDUIT , ,,� � .��<. �..____� ,SHFAR�WAL'LS;EXTER�OR x �� ° `:;: � POOVSPA , `� ``.� - .�� sm�, . , SHF�4R,WAL°LS;INTERI,�IR�; ; �� : � � , �. � °. ROUGH PLUMBING s,. , ,� _��" . � . �.� . �, _>,. e � FRAMINGNENTING,�� : §�� '� � �� •� � � � , ROU6H ELECTRICAL ��"� � � R0�[GH MECHANIGAL�° ��_� � � : � ��`a'' � �HOUGH MEGHANICAL � � �� 6,. � .�:`: �GAS TEST � , � ROUGF�„EL�ECTR(CAL')N( }C( �� _ ,��r: �_ _ � , , � . rQ�s.z . ��.: ROUGH�(�LU(�BING��- �;� ��; , � �` � � � PRE GUNITE �, �- � � � INSULATION WALL POOL PRE DECK BONDING ° "` INSUlATION CEILING P-TRAP DRYWAIL FENCE/GATE/ALARM LATH(PRE) FINAL POOL LATH EXTERIOR WALLS: IATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL 1sr/ 1 2N0� ��FT „ SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELEASE WALL DRAIN/SEAL GAS METER RELEASE WALL FINAL SPECIAL INSPECTION — fl0.FRANIIN�PIANNINGAPPROVAL Y�. � � �, FINAL�6UILDING ��,, �� p r. ` �� ` S !�� ROU�H FIRE APPROUAL - ,,, _, - FINAt�MECHANiCAL�� - s ��x �� „: r�_ FINAL FIRE DEPARTNIENT• ` . _ { <.�� , . . e, FINAL�ELEG7RlCAL,, '��;, °��. ';��:� � � <�� ' FINAL PLANNING "' ' ` _ >�, �� _ � , .P_ .2 ,_ . _ fIN �� - �� AL�PLUM�INC�,xs �� ' ��' �. . :;.� � � � � � � FINAL ENGINEERINGI PW •�; � �T:C;�.of,OCCU�AN'CY -��:�� °�'� ��' � _ � �FINAL COMMUNITY SERVICES �� , ,�� ,�.,„a ,., � , . , . GERT.;of Ot�UPANCY �e � `�� ;�E� � °:� � �fINAL HEALTH DEPT, � FINAL INdUSTRiAL WASTE .a a , COMMENTS: