HomeMy WebLinkAbout13-01563 _, ;j�,,�w,��� C1TY OF DIAMOND BAR ✓
�y� � ' ' MMUNITY&DEVELOPMGNT SERVICES �
� I I �_ DEPARTMENT OF CO RESS
�•J�III��'� 21810 Copley Drive,Diumond Bar,CA 91765
� (909)839-7020 Fax:(909)861-3ll7 I3uilding Inspection Hotline(909)839-7027 FIRMLY
�� '�.�f•�•;l BUILD[NG PERMITAPPI.ICATION
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� /�j� APPLICATION DATE: � � P/C#
w JOB SITE ADDRESS � '�"`�� ` `
a
ISSUE DATE: �L I�1��3 PERMIT# \3 ""���� 3
z APN LOT TRACT �(,.�� ��/ OCC GROUP:
'I �` TYPE CONST.
o OWNER /�
N ADDRESS�I��/` � ZONING SETBACKS
� CITY��/���'D �Lle�TEL ����y FRONT RW �
� APPLICANT TEL.
REAR �
o L SIDE/SIDE STREET RW �
a CONTRACTOR �
C T SIDE �
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c� ADDRES^S _ PROPOSED USE
Q CITY �//�'�AN�' , ZIP �%7�7TEL. 'g�/ �`V M\L t� Y
� ��
o ARCH/ENG/DESIGNER
o ADDRESS ti DWEL.UNITS k STORIES # E OOMS
Q CITY ZIP TEL. DESCRIPTION SO.FT. FACTOR PSF ADJ.AREA/VALUATION
� OWNEFI-8U11DEA DECtAFlATION � �
� I hereby aKrm under penatty af perjury that I am exempt 1rom the Contractor's State License Law for tha reason�s) SFR/ADD/REM
� indirated below Dy the checkmark(s),I have placed next to the applicable ilem�s)[Secfion 7031b,Buslness artd
o Garage/Carpwt
W Professiwis Code:Any city or county lhat requfres a permit lo consWcl,aller,Improve,demolish,or repair,any
z structure,Driw to its issuance,also requires tha applica�ri for the pertnit to file a signed statement that he or she w Patio/Deck
I a is licensed Dursuant to ihe proWsians of the Contractor's State llcense Ww(Chapter 9)Comme�ing with Section LL poof/Spa
N 7000 of Division 3 of the Business an0 Prole551om Code]or that he or she is ezemDt hom licensure and the basis for
� �
� the atleged ezemD�n,My violafion of Section 7031.5 by any apD�icant fa a pertnit subjeCts the apD�icant to a civll pertalty Z Re-Roof �
� of not more than five huntlred tlollars(E500).
O
o (,I,as awner of the Droperty,a my employees with wages as their sole compensation,will do(�all ot or(,partbns � Commercial
� of the work,anA llie struclure Is not Intended a ottered lor sale(Sectlon 7044,Busi�ress and Pralessiw�s Cade:The m
� Contractors'State License Law dces not apply ro an owner of property who,ihrough employees'or personal eBort,builds
w a improves the properry.Prwided that the Impmvements are not intended or ottered for sale.If rwwever,the building w
� impmvement is sold within one year of compleoon,the Owner-Bullder will hava the bur0en of proNng Ihat it wa5 nat huitt
por imDrrned for the purpose ot sale.).
V (,t,as owner ot the property,am exclusivety cuntracting with 1(censed ConVactors ta caosWCt lhe proJflct(Section
o �pqq,Buslness and Professions Code:The Con�ractors'State License Law does no�appty to an owner of properry wl�o ValUati . ��O C76� 0 Adj.PuBa:
Z boildsaimprovestnereon,andwhoconVxtslortheprojectswilhalice�edGantractorpursuanUotheContrxtnrs'State QUANTITY DESCRIPTION FEE
tn
Y License LawJ.
O (�I am exempt hom Ilcensure under Ihe Contractor's State Llce�e law tor Ne toltowing reason(s): �
� �
'� Bq my sigreiure betow I acbrowledge that,except for my personal residence in which I mus[have resided Im at least one w
� year priw to completion of the improvemenfs covered by this permit,l cannot legalty sell a strucNre that I have buill as an „–',
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Qowner-builder it it�as not been construc�ed in Its entin:ry by licensed contrac�mt.I understarM ihat a copy ol ihe appllcable
� law,Sectan 7044 of the 8usiness artd Professions Code is available upon request when this appiicallon is submitted w at
X Ihe tollowing Web sRe:hUplwvrv+.leginfo.w.gov/plaw.�Vnl. m
W DATE: SIGN: �
� LJCENSED COMRACTON'S DECIARATION � .
n.
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W i hereby alfirm untler penally oi perjury tt�al l am licersed under provisiau of Chap[er 9(comme�ing wllh Secl'wn 7000)
� of Divlsion 3 ot Ne Business and Protessions Code,and my-license is in full Imce and ettect. �
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N ucer+se cuvss: uc.No.: �Z_� �/s 7s Q
�Z DATE:� CONTMCTOR: w
¢ WORI(E S ENSATION DECLARATION �
� I HEREBY AFFlRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS:
w l IOTS.�`3
¢ I have and will maintaln a Certilirate ot Consent to Setl-Insure la Worker's ComOensatbn,as provided by CONSTRUCTION:
� Uon 370D of Ihe Labor Cade,tor Iha pertormance af the work far which ihis permil is issued. PLAN REVIEW:
�
j I hare and will maintain Wwker's Compensation Insurance,as repuhetl by Section 3700 01 the Labor Code,lor ELECTRIC:
o the Dertormance of the vrork for which this permit is issued.My Worker's Compensation liuurance Carrier antl
¢ PNicyNumberare: PLUMBING:
o �qRq�Ep r��.- MECHANICAL:
� POIJLYNUMBER = --.—�, �y INSPECTIONFEE� (2rL
N (�FOS SECfION NEED NOT BE COMPLE'fED�F 1}�PERMIT IS FOR ONE HUNDRED (S70�OR LESS7. ISSUANCE: �
oI certiry ihat(n Uie Pertamance d the vraA(or which ihis pertnit is iss�ietl,I sl�all not empby anY Persai in anY manner so a5 to SM I P:, `. �
o Decmne subJect lo Ihe Worlta's CamPensa�ion Laws o1 Califomia.Md agree Ihat if I shadd 6ecome subject to the Worker's
� Com m � ot 5�.�.tion 37D0 ot the IB�'�Cod�shau lonhvrith compiy wim ttbse pravMJasI.,�.�` ENERGY P/C: �
������'y�' ��'�%� ������= �C��� ENERGY PERMIT:
LL DATE: APPUCANT:�
� WARNI G Fai ure to secure worker's pe�c;a6on coverage is unlawlul,nnd shall suDJecl an employer to criminal RETENTION FEE: 2���
w penatties and civil fines up to ane hundred thousand dollars($t00,000J,in addition to the cost of the camperesation,
a damages as provided fa In section 3708 of ine labor code,interest,and attomeys fees. PRE-ALT FEE:
� GONSTRUCTION IENDING AGENCY BSAF: �
Z I hereby�rm under penalry of perjury thal there is a Construction Lending Agency for the perlormance of fhe work for
3 whicb this Permit is issuetl ISec.3097,Gv.C.j. �
r LENDER'S NAME
� LENDER'SADDRESS:
a I certify Nat I have read Nls application and state that the above Intormation is wrtecL I agree[o compry with all city and TOTAL FEES
� counry ordinartces and siate laws retating to bulltling cortswcuwi,and hereby authorae representatives ot this county ro COMMENTS:
z enter u n the abwe-menlloned mpert/for inspection urposes.
o po P P
�m ���f?�'1/k
Q PER lTTEE NAME IPRIP(T) �y/` � �,�
N d (�
N D 7E RECEIPT# � PAID BY: ` VALIDATION: '
= S1 URE OF PERM
�
WHITE—Department Copy.YELLOW—Finance Copy,PINK—/lssessor Copy,GOLDENROD—Fle Copy,GREEN—ApplicanYs Copy
CITY OF DIAMOND �AR • _
INSPECTION RECORD
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�SETBACKI-IETTER .:�}° _ - ��' TRACTAND LEDGER
FOOTINGSFORMS �.�=E� _ �,; ., - ,_ , :s, = SWffCHGEAR
g�qg ; - , ;f, . ,.'�. —': COMMERCIAL HOOD
UG.PLUMBING' . ` � <. � � �� fi T-BAR
UG.ELECTRICAL � 5 .� ."� ��'. a r. ; � INTERCEPTER
UF,ER GROUND,,,: � . ,.'�� ,;.�q"' �` '` �: NOT MOP/SHOWERPAN
SEWER LATERAL SEPTIC/CESSPOOL
MAIN WATER LINE HERS REPORT RECENED
SEWER CLEANOUT ' DEMOLITION
ROOF SHEATHING ROOF DRAINS
FLOOR SHEATHING ROUGH CONDUfT
SHEARWAILSEXTERfOR , � - � � � 'PUOUSPA;::� _ `� '` + a
SHEAR WALLS=INTERIOR.;: � ' ,x ��' '' , ROUGH PLUMBING ` � '� ^ ` :' `�:� {� = -
FRAMINGNENT.IPIG_ =j;`; � F L�:` RQUGH ELECTRICAL ` � ' � ' '� ' � ��� 'f ?
,� U � �.�: z �� �
ROUGH MECHANI,CAL , �'+, - � ��� , � �` ROUGH MEGHANICAL, � �. � �' 1�, _ . r'�. 's �:
ROUGH ELECTRICAi� W(���)C( ) � �f 3 ;; < ����,� GAS,TEST ;;' r '' .,;c'� � �, ' � �.¢ �
ROUGH PLUMBWG `` � - - ,� _ _ P.RE GUMITE' " �, � �1' ,,,;; -� + ��,+ { ^'
INSUlATION WALL POOL'-PRE'DECK.BONDING' �t '` '�" �'�• ` �;' ,i "
INSULATION CEILING p-��p; � '- � � �� ���� � - ��� � � �
'� ���� �� ` � , .� �r:
DRYWALL FENCE%.GATE/ALARNI �� `e ` - ''
LATH(PRE) FINAL POOL . .�i: _ - - �;- Sz' _ � ` ;:
LATH EXTFAIOR 1. WALLS:
LATH INTERIOR WALL FOOTING/STEEL
GAS TEST WALI STEEL 1�T( )2ND( )LIFT
SCRATCH COAT Z WALL BOND BEAM
ELECTRIC METER RELEASE WALL DRAIN/SEAL
GAS METER RELEASE WALL FINAL
SPECIAL INSPECTION � { --i� c r L� � .~ �L�< � ;
.. p� �
RO FRAMINGPL.ANfdiNGpPPROU - � f e
�FINAL BUIL'DING . ROU6H FIRE APPROVA� ` ' �'� 1
s�. . ��� _
FINAL�MEGHANICAL „�,�_. - � ,�'.��: ���'��. � " FINAL FIRE�DEPdRTMENT �� < �f ��i �?�
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FINAL��ELECTRIGAL i - �FINALPLAP1NINf� _ � " s� � ��� '�
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��FINAL PLUMBING � %�� . " ' '' ' FI'NAL ENGINEERINGI PW '�� �
LC:of OCCUPANCY`. "`: ', � fINAL�COMMUNITY�SERV(CES = , -' x ��
CERT uf OCCUPANCY `,�; - „�. : . �,,._ ;: - FINAL HEAITH DEPT � � '' r:' �
FINALINDUSTRIAL":;WASTE - � � � ` " "�L� r -, �'�
CO M M E NTS: - � � ` �:.� �� '�"v�- -�:..�vti`'-�' '� i yr+l\r4,_ �,�, '�`•.,a�;�
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A.�'^RU!!ED
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YFiE APPROVAL OF +'+._5��• P. �a SHALL NOT BE
�.ONUSTRUECI TO BE�•�'c.�:>'•-7'''U� ANY VIOLATION
OF APIY CODE OR OFZDI,,..-�t' .�_ OF THIS CITY.
THESE PLANS :;��', L .. �- ���E JOO
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