The URL can be used to link to this page

Home My WebLink About14-4073 __�''�_ C1T��OF DIAMOND BAR ��/�/"� ;IT� I 1 I i � i '" DEPARTMENT OF COMMUNITY&DEVELOPMGNT SERVICES .. - ��'� �III�� :-.�— 21810 Copley Drive,Diamond 13ar,CA 91765 PRESS ,�� (909)839-7020 Fax:(909)861-3ll7 Building Inspection Hotline(909)839-7027 �'�"° � BUILDING PERMITAPPLICATION FIRMLY a�c JOB SITE ADDRESS D� N. D� � APPLICATION DATE: ��J � W/�y P/C# __ -�- r,�-�aiy iy_ �/ � a ISSUE DATE: PERMIT# � 7 z APN LOT TRACT o OWNER A L�W�'1.��A / TYPE CONST. OCC GROUP: N ADDRESS q ZONING SEfBACKS y CITY DY/ G1/ ZIP 3 S�TEL. � FRONT RW CL ¢ APPLICANT TEL. REAR CL � 0 SIDE/SIDE STREET RW ❑ a CONTRACTOR �W�1 P� SIDE ❑ 0 oro ADDRESS PROPOSED USE C O � - ��r � CITY ZIP TEL. 0 o :ARCH/ENG/DESIGNER w z ADDRESS o �i DWEL.UNITS #STORIES #BEDROOMS z CITY ZIP TEL. m DESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREANALUATION a OWNER-BUILDER DECLAflATION � I he2by a�rtn under penalty o(perjury Mat I am exempt from the Conlractor's State License Law tor me reason(s) SFR/ADD/REM p indicated below by the checkmark(s�,I have placed next to the applicable item(s)[Sec6on 7031.5,Business and Garage/Carport '-'-' Protessions Code:Any city or county that requires a permit to carstruct,alter,improue,demolish,or repair,any z struchire,prior W its issuance,also repuires the appiicaM tor fhe permit to file a signed sWtement fhat he or she W Patio/Deck a is licensed pursuant to the prorisions ot ihe Co�actor's State License Law(Chapter9)Commencing with Section � 7000 of Uivision 3 of ihe Business and Professions Code]or that he or she is exempt hom licensure and the basis for � Poo��Spa � the aileged exemption.Any violation oi Section 7031.5 by any applicant for a pertnit subjects the aDD�icantto a civil penalry C7 � oi not more than five huntlred doliars($500). Q Re-Roof o U I,as owner of the property,or my employees with wages as their sole compensation,will do(J all of or(�portions � Commercial � of the work,and the strucNre is not intended or offered tor sale(Sectlon 7044,Business and Professions Code:The m Z Contractnrs'State License Law does no1 appty fi an owner of property who,through employees'or personal eftort,huilds w or improves the property,pmvided that ihe improvements are not intended or offered for sale.If however,the building or � improvement is saltl within one year af completlon,the Owner-Builder will have the burden of proving mat it was not built por improved for me purpose o(sale.). U (�I,as owner of the property,am exdusively cooVacling with licensed ConVactors to canstruct the project(Seclion Valuation: Ad Area: Z7044,Business and P�ofessions Code:The Corrtractors'State License law dces not apDN to an owner of properry who �� buildsorimprovesthereon,andwhocontractsiartheprojectswithalicensedContractorpursuanttotheConiractors'State pUANTIIY DESCRIPTION FEE Y License Law.). o U I am exempt from licensure under the ConVactor's State License law for the tollowin9 reason(5): � � ¢ `—` By my signature below I acknowledge that,except tor my personal residence in which I must have resided for at leasi one W o year prior M completlon of the imprwemenLs covered by Nis permit,l cannot legally sell a sV�cWre Nai 1 have built as an w a owner-builder if it has not been constructed in its entirety by licensed contracto rstand that a wpy of the applicable � law,Section 7044 ot the Business and Protessions Code is available upon r uest w licatio ' hmitjfd or at X the followi W b si :htt .leginfo.ca.govlcalaw.Mml. � Z o DATE: SIGN: � � LICENSED CONTRACiOfl'S DEC Q w 1 hereby affirm under penalry ot perjury that I am licensed untler provisions of Chapter 9(commencing wiih Sedion 7000) m ot Division 3 ot the Business and Professions Code,and my license is in full force and eflect. J N U � LICENSE CLASS: LIC.NO.: z a o DATE: CONTRACTOR: _ . � U ¢ WORKEP'S COMPENSATION DECLAflATION � � I HEREBYAFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: - � - t - /� oI have and will maintain a Certificale of Consent to Self-Insure tor Worker's Compensation,as provided by CONSTRUCTION: � � � � - ' /� ',ry � Sectinn 3700 of the Labor Code,for the pedormance of ihe work far which Nis permit is issued. p�qN REVIEW: � I have and will mainiain Worker's Compensation Insurance,as required hy Section 3700 of the Labor Code,for � the peAormance ot the work for which this pertnd is issued.My Worker's Compensafion Insurance Cartier and ELECTRIC: z ¢ PolicyNumberare: PLUMBING: „� CARRIER MECHANICAL: � POLICYNUMBER INSPECTION FEE: � (�HIS SECTION NEED NOT BE COMPLETED IFTHE PERMR IS FOR ONE HUNDRED DOLLARS(^s100)OR LESS). � issuaNCE: 3r.1''� � I ceAify that in me pertormance of fhe wark lor which this pertnit is issueq I shall not employ any persan in any manner so as ro .�. 0 become su6jed lo ihe Worker's Compensation Laws of Califomia.Md agree that if I should hecnme subject ro me Worker's SM IP: . J � J Compensation provisions ot Section 3700 of the Labor Code,I shall IoAtnvith comply with tlrose provisions. EN ERGY P/C: LL DA7E: APPUCANL ENEFGY PERMIT: � WARNING:Failure to secure Worker's Compensation coverage is unlawful,and shall subject an employer to criminal RETENTION FEE: � .j}� W penatties and civil fines up to one hundred thousand doliars($100,000),in addition to the cost of ihe compensation, d damages as prrnided for in section 3708 of ihe labor code,interest,and attomey's fees. PRE-ALT FEE: 0 d CONSTRUCTION LENDING AGENCY BSAF: �{�� w I hereby affirm under penalry of perjury ihat there is a ConsVuction Lentling Agency for the pedormance ol the work for � which this permit is issuetl(Sec.3097,Civ.C.�. � LENDER'S NAME: o- � LENDER'SADDRESS: I� �++ 7 a I certify that I have read this application and state that the above informatlon is correct.I agree to compty vnth all ciry and TOTAL FEES Z county ordinances and siate laws relating fn building constructlon,and hereby aumorize representatives of ihis county to COMMENTS: p enter upon ihe above-mentioned property for inspection purposes. J � m a PERMfTTEE NAME(PRIt�IT) � � � � SIGNATURE OF PERMfTTEE �ATE RECEIPT q c��,�__ PAID BY:�_VALIDATION: WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy � . � CITY OF DIAMOND BAR ' � - INSPECTION RECORD � ' � . � , , � . . � � , . � . �SETBPCK/LETfER : .- , -' ' ; • TRACT AND LEDGER FO,OTNGSfORMS; ,,': - SWITCHGEAR SLAE� :'r:; COMMERCIAL HOOD UG;PLUMBING , - °-;. = ' :. . . _; T-BAR UG:fLECTRICAL ' INTERCEPTER U�rER GROUND . `. ' � ;' ` :' � , '' HOT MOP/SHOWERPAN SEWERLATERAL SEPTIC/CESSPOOL MAIN WATER LINE HERS REPORT RECEIVED °SEWER CLEANOUT DEMOLITION ROOF SHEATHING ROOF DRAINS FLOOR SHEATHING ROU6H CONDUIT SFIEAR WALLS EXTERIOR - , POOUSPA . .; 5HEAR WALLS INTERIOR �., � . ROUGH PLUMBING = - _ FRAMINGNENTING` : .: ' RQUGH ELECTRICAL � :` . :- :. � , • ` ROUGH.MECHANICAL � " _ ` ' - . � : ROUGH MECHANICAL , ; ° - ' : - ROUGH ELECTRICAL` W( )C("`,) ' ' GAS TEST . • _ ROUGH PLUMBING. PRE GUNITE, . -: + , _. INSULATION WALL POOL PRE DECK BONDING -�'' INSULATiON CEILING P-i'RAP - DRYWALL FENCE/GATE/ALARM 5' •.` tATH(PRE) FINAL POOL LATH EXTERIOR WALLS: LATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL 1�T( )2ND( )LIFT SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELEASE WALL DRAIN/SEAL GA5 METER RELEASE WALL FINAL SPECIAL INSPECTION RO.FRAMING PLANNINGAPPROVAL ' FINAL BUILDING `"; '. '' ; ' ROUGH FIRE'APPROVAL '•" ` FINAL MECHANICAL ,--.'• FINAL FIRE DEPARTMENT•' FINAL ELECTRICAL _:;;':; - ' . FINAL PLANNING ':` , FINAL PLUMBING. '='' . .'' - � -' ` `- FINAL EN6INEERING/PW :' ' - T.C:of OCCUPANCY :: "' �"'.: FINAL COMMUNITY SERVIGES ' �i CERT.of OCGUPANCY' : - - FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE COMMENTS: 9 �'!y�