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Home My WebLink About14-5099 a°--�'';��,;;,;.._,,,... CITY OF DIAMOND BAR 1' � � • ? ' +: DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES _ _ ,. � - - 21810 Copley Drive,Diamond Bar,CA 91765 PRESS \.,,,,a��;;; (909)839-7020 Faac:(909)861-3117 Building Inspection Hotline(909)839-7027 �''��" BUILDING PERMIT APPLICATION FIRMLY s JOB SITE ADDRESS x �� aV Gt(�'�". � APPLICATION DATE:A I�I I� ��-O��-� P/C# z APN LOT TRACT ISSUEDATE: N/�Y�'�'D}� PERMIT# I LI',r�� OWNER W 111 �iA6'YL TYPE CONST. OCC GROUP: I � ADDRESS `��o1Co • n CITY ZIP�►��TEL. S'� a ZONING F ONACKS RW ❑ ¢ APPLICANT � TEL. REAR ❑ x � n SIDE/SIDE STREET RW ❑ � CONTRACTOR, ,�n � t �N SIDE ❑ � ADDRESS ��('� I�•- � �'- ^�, PROPOSED USE = CITY ZIP�TEL. C�N�'W'Ib = ARCH/EN /DES GNE � � ADDRESS � #DWEL.UNITS #STORIES #BEDROOMS z CITY ZIP TEL. Q DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � OWNEH-BUILDEfl DECLAHATION = I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the reason(s) SFR/ADD/FiEM I � indicated below by the checkmark(s),I have placed next to the applicable item(s)[Section 7031.5,Business and Garage/Carport I '-� Professlons Code:Any city or county Uiat requires a permit b construct,alter,improve,demollsh,ar repair,any z struclure,prior to its issuance,also requires 1he applicant for the pertnit to Tile a signed statement that he ar she � Patio/Deck I i is licensed pursuantto the provisions of the Cantractnr's Sfate License Law(Chapter 9)Commencing with Section w j 7000 of Division 3 of the Business and PMessions Code]or that he or she is exempt fmm licensure and the basis for � Pool/Spa I � the alleged exemption.Any violation of Sedion 7031.5 by any applicant for a permit subjects the applicant to a civil penalty C7 I = of not 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 of or()portions � Commercial � I y of the work,and the structure is not intended or oNered for sale(Section 7044,Business and Professions Code:The m I Z Contractors'Sta�License Law does not apply to an owner of property who,through employees'or personal effort,builds � or improves the pmperty,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 � L)I,as owner of the property,am exclusively contracting with licensed Cont2ctnrs 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.Are8: I � buildsorimprovesthereon,andwhowntractsiortheprojectswithalicensedContractorpursuanttotheContracrors'State QUANTIIY DESCRIPTION FEE I L''ic✓ense Law.). I � ��am exempt from licensure under the Contractor's State License law fir the following reason(s): � I � ¢ 1 By my signature below I acknowledge that,except for my personal residence in which I must have resided for at lea5t one c~.� 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 heen constructed in its entirety by licensed contradors.I understand thata copy of the applicable � law,Sedion 7044 of the Business and Professions Code is available upon request when this application is submitted or at I X the following Web site:http/www.leginfo.ca.gov/calaw.html. � . L Z C I = DATE: SIGN: � � T� — LICENSED CONTMCTOR'S DECLAHATION � I a I y 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 eftect. J I /� �f/�/'� Q V � LICENSE CLASS� L- to � b�C'.�OS�J� I � LIC.NO.: z Z DATE � �Jf ��CONTRACTOR:�.�1MU W`�"__ ��l1 _�T = I U ¢ WOfll�fl'S COMPENSATION DECLAflATION —�� I � I HEREBY AFFIRM UNDER PENALTY OF PEflJURY ONE OF THE FOLLOWING DECLARATIONS: L � 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 performance 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 of the work for which this permit is issued.My Worker's Compensation Insurance Carrier and ELECTRIC: a PolicyNumberare: le ` PLUMBING: /'�'�� y CARRIER �y�f'GS'� N Q�� 1�'1�i� (t1f MECHANICAL: � POLICY NUMBER �T�D i6J INSPECTION FEE: n (THIS SECTION NEED NOT BE COMPLETED IF THE PFAMR IS FOR ONE HUNDRFD DOLLPRS($100)OR LESS). ISSUANCE: '.�`,�' 7 = I certily that in the performance of the work for which this permR is issued,I shall not employ any person in any manner so as to � �— � become subject to the Worker's Compensation La of Califimia.Md agree ihat'rf I should become subject to the Worker's SMIP: i J Compensa�n pr visions of Section 3700 of the I shall forthwith comply with those provisions. ENERGY P/C: 1 DATE: P NT: . �� ✓ ENERGY PERMIT: � WARNIN :Failure t u Wor r's Compe tion coverage is unlawful,and shall subject an employer to criminal � �� x RETENTION FEE: y penalties and civil fines up to one hundred thousand dollars($100,000�,in addition to the cost of the compensation, T— = damages as provided for in section 3708 of the labor code,interest,and attorney's fees. PRE-ALT FEE: i CONSTFIUCTION LENDING AGENCY BSAF: � = I hereby affirtn under penalry 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: = LENDER'SADDRESS: i I certiry that I have read this application and state that me above information is correct.I agree to comply with all city and TOTAL FEES ��f/� Z county ordinances and state laws relating to building construction,and hereby authorize representatives of this county to COMMENTS: � enter upon the above-mentioned property for inspection purposes. J .. � � h � �� ¢ PERMITTEE N PRIM) / :� L'� � C. ` � = SIGNATUR � R E DATE RECEIPT# '�4 PAID BY:._��__��VALIDATION: WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy �. , �t CITY OF DIAMOND BAR ` INSPECTI4N RECORD � � � • � � � • - • • � � • - �SETBRCKI°CE'�TER "`�'��'�'` "; , _ �� . � ° ,; TRACT AND LEDGER FOO�CINGS:FORMS"'�,��, � - �� " � �" � � � SWITCH GEAR SLAB� � `��°�` '� � __`� �� - � - � =�� COMMERCIAL HOOD UG:`PL'UMBWG: ' ;'.� "r �� >a �` _ T-BAR __.. UG��ELECTRIEAC. . �,�`��' �.9�� . -�� " ; ` . _ ,�_ , INTERCEPTER �UFER GROUN[� � w��' � ' � � � � HOT MOPISHOWERPAN � SEWER LATERAL SEPTIC/CESSPOOL MAIP1�NATER LINE HERS REPORT RECEIVED ; SEWER CLEANOUT DEMOLITION � ROOF SHEATHING ROOF DRAINS FLOOR SHEATNING ROUGH CONDUIT ___ . � ,SH€AR WAL�S EXTEE310R.� � ; �� ' ��u � ° �� POOVSPA _ � � � a�w SNE�4R=WAL�.S INT�RIOR�� ° ' ' ` , � � � . RQUGH PLUMBING � _ � � . A -__ . . . £ FRR � � �t�(NGIVENTING� � _� .,.�� " � �� - � �� ^ , ° � ROUGH ELECTRlCAL = - _ _ , � ta ro-.r . . �RO�GN MEC�HANtCAL`� �� `, �� ROUGH�MECHANICAL � �� R07GH ELEC�#tl < �� „ r . � GAS TEST �' � � << � � : _,. . . ,��-.. RQUCH PLUMBING�-�`� � �� ' " � � � � PRE GUNlTE ° ' � � _.. . _ . . _ �� . , . , INSULATION WALL ' POOL PRE DECK BONDING % g INSULATION CEILING P-TRAP DRYWALL FENCE/GATE/A11aRM LATH(('RE} ��F1NAL�POOL � � � I IATH EXTERIOR WALLS: lA7H Ih?EitIOR WALL FOOTING/STEEL � GAS TEST WALL STEEL 1 sT( )2Ne� )LIFT SCRATCH COAT WALL BOND BFAM ELECTRIC PAETER RELEASE WALL DRAIN/SEAL GAS METER RELEASE WALL FINAL I SPECIAL INSPECTION RO.FRAMING FLANNINGAPFRdUAL _,_. EINAI-BUIl01NG'� :.:_ ��_ � - ; � °�' �� ° � - � ��' , ROUGH FIRE APPROVAL � . ,�„ ; �.., -� . . �� . , ;FIMI�McCHANiCAL £ _�� a� � � � � ; ._, "' ' � . � �FINAL�FIRE DEPARTMENT ° � � �. ., , �� , , �. - FINAL PIANNING ,E1NAL ELEGTiiICAL�� ' . � �� . . , . � �INAL PLUMBING��:�,_. �e��_:� --��. k °; �a � � ' • r� FINAL fNGINEERINGI PW . " - . " � � Y:C��,of,'QCCUPANGY��`� ._ . _' . ' � ��i��`. � �g�a - � � �� FINAL COMMUNITY SERVICES � � ` � � : ,��. r� � CfRT�of�OGGUPANCY- �� ' �� m' � � FINAL HEALTH DEPL ' ._ _. o PINAL INDUSTRIAL WASTE � � � � � � COMMENTS: