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Home My WebLink About15-0302'� ::r�� :.'�`;.-. _ CITY OF DIAMOND BAR � � I DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES �,'- 21810 Copley Drive,Diamond Bar,CA 91765 PRESS �,�R�,� (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 FIRMLY BUILDING PERMIT APPLICATION = `�- (� . ic�,onl+ ,ga1/b�'/✓ ��Gl�•a"n- �A/ L6i ljlT a0 f,f°` i APPLICATION DATE: P/C# y JOB SITE ADDRESS �� ,L ISSUE DATE: �f% / ��J PERMIT# �.I�"�i ,�(/e�+ i z APN��LOT TRACT � OWNER G�ti1'r}C �'l/ '�� TYPE CONST. OCC GROUP: � ADDRESS �Z+.S t• J ,�. T ZONiNG SErBACKS � CITY !'��[/ ? 1�'p� ZIP qy�a TEL. " S —S FRONT RW ❑ Y APPLICANT �d/l�� /�'Itl/'LP.�d TEL.��U'YLG�%��i REAR ❑ � � � �� r', , Y SIDE/SIDE STREET RW ❑ q CONTRACTOR J�' SIDE ❑ � ADDRESS � O . IrL Y�C Y�C I' . AITCc,� ZIP Z TEL.7� 'S�s7'D7Q.� PROPOSED USE fi/Rt-oY�G �—G �.t/ � � CITY �� w/ � / 1 ARCH/ENG/DESIGNER '"� Y� i � y � � ADDRESS #DWEL.UNITS #STORIES #BEDROOMS z CITY ZIP TEL. � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � OWNEH-BUILDER DECLANATION x I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the reason(s) SFR/ADD/REM I � I � indicated below by the checkmark(s),I have placed next to the applicable item(s)[Section 7031.5,Buslness and Garage/Carport � Praiessions Code:My city or county that requires a permit to construct,alter,improve,demolish,or repair,any I z structure,priar to its issuance,also requlres the appliwirt far the pertnit to file a signed statemeM that he or she � Patio/Deck i is licensed pursuarrt to the pravisions oi the Contractor's STate License Law(Chapter 9)Commencing with Section w � 7000 ot Division 3 of the Business and Professions Code]or that he or she is exempt from licensure and the basis for � PooVSpa I � the alleged exemption.Any violation of Sedion 7031.5 by any applicant for a permit subjects the applicant to a civil penally �7 Yof not more than five hundred dollars($500). QZ Re-Root . U(J I � U 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 does 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 � improvement is sold within one year of completion,the Owner-Builder will have the burden of proving that it was not built I � or improved for the purpose of sale.). I "� ()I,as owner of the property,am exclusively contracting with licensed Cont2ctors to construct the project(Section i�, Z 7044,Business and Professions Code:The Contractors'State License Law does nM apply to an owner oi property who Valuation: � Adj.A�ea: I .n huildsorimprovesthereon,andwhoconhactsfortheprojeciswithalicensedContractorpursuanttotheContractors'State QUANTITY DESCRIPTION FEE I License Law.). I � L)I am exempt from licensure under the Contrac[or's State License law ftir the(ollowing reason(s): � 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 impravements covered by this permit,l cannot legally sell a slructure that I have built as an w � — owner-builder if it has not been constructed in its entirely 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 X the following Web site:http/www.leginfo.ca.gov/calaw.html. Z I � DATE: SIGN: � LICENSED CONTflACTOfl'S DECLAHATION � I a I � I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9(commencing with Section 7000) n of Division 3 of the Business and Professions Code,and my license is in full force and effect. � I ?/� �J �/ a � LICENSE CLASS: G J% LIC.NO.: / �'Y L� z I � DATE:Z• _j.S CONTRACTOR: C�✓,//✓7�1�'I� t I'L i � I ¢ WOHI�q'S COMPENSATION DECLAHATION � I � I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: i � I have and will maintain a Certificate of Consent to Self-Insure for Worker's Compensation,as provided by CONSTRUCTION: � dion 3700 of the Labor Code,for the performance of the work for which this permit is issued. PLAN REVIEW: > I have and will maintain Worker's Compensatlon 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 Insu2nce Carrier and ELECTRIC: ' ¢ PolicyNumber�i�T PLUMBING: y CARRIER ✓ .l--b-- �I1�Cl�I.G�G ��/^�SL'Zs./'� —��/yG��v � �� MECHANICAL: � POUCYNUMBER INSPECTION FEE: ��, �? (THIS SECiION NEED NOT BE COMPLEfED IFhiE PFAMfT IS FOR ONE HUNDRFD DOLLARS($100)OR LESS). ISSUANCE:__ � �`7,� = I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as m � become subjed to the Worker's Compensalion Laws af Califomia.Md agree that'rf I should become subject to the Worker's SMIP: L Compensation provisions of Section 3700 of the Code,I shall rthwith com�/p�ly/with those provisio . ENERGY P/C: i � �GL� � /�_-L � d DATE�' I APPLICAN7: BC ENERGY PERMIT: sWARNING:Failure to secure Worker's Compensation coverage is unlawful,and shall sublect an employer to criminal RETENTION FEE: �e i penalties and civil fines up to one hundred thousand dollars(5100,000�,in addition to the cost of the compensation, � damages as provided tor in section 3708 of the labor code,interest,and attorney's fees. PRE-ALT FEE: � i CONSTHUCTION LENDING AGENCY BSAF: j � � y I hereby affirm under penalty of per' that there is a Construdion Lending Agen�y for the peAormance of the work for � which this permit is issue ( ,Civ.C.). LENDER'S NAME: � � LENDER'SADDRESS: � s i I certity that I have read this application and state that the above information is correct.I agree to comply with all ciry and TOTAL FEES �� I � county ordinances and state laws relating to building construction,and hereby authorize representatives of this county to COMMENTS: z � enter upon the above-mentioned property for inspection purposes. J '/ b f V" i � ¢ PERMITTEE NAME " 2. � = SIGNANRE OF ERMITfEE DATE RECEIPT#�L�__ pAID BY:� VALIDATION: WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Applicant's Copy CITY OF DIAMOND BAR INSPECTION RECORD � ' � � � � � e - � � � j . � . 5ETBACIU°l�7TER�° '�' `' ` �' � � � � � � F , � y__ _ TRACTAND LEDGER �� Q, . .. . �_ �F��TINGS�FORMS--�_�� '�"� _ ; 5WITCH GEAR ,�� , � _ . :>, - � . . , . ��_ -�� ° ' " COMMERCIAL HOOD .UG.PLUMBI�IG ` ;�: �; . ,', � , �`�._ g, T-BAR , -_� r ,UG'.�LECTRlGAL ;_x�, . �I, ;� ° ,� � � INTERCEPTER ,UFER�ROUND , ° ' � ' �� - � � � � � HOT MOP/SHOWERPAN SEWER LATERAL SEPTIC/CESSPOOL MAIN WATER LINE HERS REPORT RECEIVED SEWER CLEANOUT DEMOLITION ROOF SHEATHING jd�S b ROOF DRAINS FLOOR SHEATHING�� ROUGH CONDUIT �� ___ _ ShIEY�R"WA��XTERIOR��.��' ' �POOUSPA �` �, ` . . , . � � ._ _ � . , a� __ ,_s �SHE4R:WALLS=INTERIO#i�� '� ` � � �� '_ ��ROUGH PEUIVIBlNG ; ` ° ` �'° ` ' �" �-�� . �, '� � � , � . . . ... FRAMINGNEh�TI(�G �: ° �"�� '�` °: . , .� °� � __ ROUGH E'LECTRICAL � ,. °��' ROI�GH MECHANIGRL�� • � _ '�� 10UGN MECHANICAL � - ` � � . _ _� . , _� . � , � � RQUC�H�LECTRICAL.W�{ .�)��.i 1' �� „ . �� a ,z � GAS TEs�T � .t, . « ROt�GH'PL'UMBING m'��' f��_� , '� � . � � � PRE�UNITE INSULATION WALL POOL PRE DECK BONDING ' ' � INSULATION CEILING P-TRAP � DRYWALL FENCE/GATEI ALARM LATH(PRE) FINAL PdOL LATH EXTERIOR WALLS: LATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL 1s�( )2N0( )LIFT SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELEASE WALL DRAIN/SEAL GAS METER RELEASE WALL FINAL SPECIAL INSPECTION R0.FRAMWG PI.ANNINGA('PROVAL _, � _ FINA�BUiI=DING�`: =��„�°° .rl' i �� -� �� ° ° ° r � ROUGW.FIRE�APPROVAL �� „��. ��.�ri :.. � ` �� ' ° ° ` FINAL FIRE DEPARTMENT � � 4=(NAL�M6CHI�P1(CAt E��,� �� . . . . , �,, .�� . � � �. ,, .d � yFINAL:ELECTRIC,4L u�.., ��` t."�� , � � ��FINAL PLl1NNING , ,: : .m � , � , . z � �., , , -� � «.� � - _� � . _ � � m�:-, . - - FINt�L PLtlM�ING: , ,��r, _� �� *� � �FINAL ENGINEERINGI PW � � � ��_ _ , 7.�,=af OGCU�AN�CY� � � � �� ` ��`��;; � � FINAL COhANiUNiTY SERVICES �� " - _ � CER'�of O[;� � � ��,. „� ,�� .��r. - � . ,:. r� � � tlPp1+ICY' _ _T ,, ��,�, , . , FINAL HEALTH DEPT. .: a= ' FINAL�INDUSTRIAL WASTE � r COMMENTS: