HomeMy WebLinkAbout14-4497 01�
�„��:��.I C1TY OF DIAMONll BAR 1!�'��
; I I � �i DEPARTMENT OF COMMUN;TY Ri i1GVELOPMCNT SERVICES
�411_II���% •- � ' 21810 Copley Drive,Diamond 13ar,CA 91765 � PRESS
,,,�� (y(19)839-7020 Fax:(909)R61-3117 Building Inspection Hotline(909)839-7027 FIRMLY
��y'��+'"�. BUILDINGPERMITAPPLICAT[ON
� !'u�(/ APPLICATION DATE: ���—a D�_�P�CN � 7- yy9� �
� q� /�/• D��ohd-�'i-�/�/d.�f�.�,l j� �/ yn
¢ JOB S1TE ADDRESS ISSUE DATE: I� I Z�I� �19I� PERMIT# � I � � 7�
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� OWNER��l%� OLPg ��I� bfGY�^^�rr.� ps�� L� TYPE CONST. OCC GROUP:
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�- ADDRESS ����/- L ZONING SEfBACKS
N CITY aH'10 oL Y ZiP�LQ��L. G�-�9(�2=5�� FRONT RW ❑
a APPLICANT T�� �� TEL. - Z - REAR �
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o SIDE/SIDE STREET RW �
> NTRACTOR ����N^q"'� �^'� �� � SIDE �
ow ADDRESS��{Sv W��'���"e 81- g� PROPOSED USE _
o cirv l.v k�i zia q oo IU TEL. ZI�l'��s gD-O l T`1 -F
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ARCH/ENG/DESIGNER 'Z!'Y1D�vo �'1'� i � %HLINo'�f/�!9 S-FWIL'f�
o ADDRESS #�DWEL.UNITS ?t STORIES k BEDROOMS
Q CITY ZIP TEL. DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION
� ow►�as-sm�n�x oEcu+aanow
� I hereby aKrm under penalty of perjury that I am exempt from the Contractar's Stah License Law for the reason(s� SFR/ADD/REM
� irMicated below Dy the checkmarlys),I�ave placed ne�1 to the apD�icable flem(s)�Seciion 7031•5,Business and
o Garage/Carport
w Professions Cotle:MY aty m county thal requires a permlt ta co�truct,alter,(mprove,demolish,or repaf�,any
wstrucNre,prior to its issuance,also requires the applicant tor Me permil to fiie a signed sWtement that Ae or she rA PatiolDeck
a Is Ilcensed Dursuant to the provisions of the Contractor's State Lfcense Law(Chapter 9)Commencing wilh Section w
N 7000 of Division 3 of tha Business and Professions Code]or that he m s�e is exemD�hom Ilcensure and the basis for LL Pool/Spa
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� Ne alleged exemption.Any violation of Section 7031.5 by eny applicant for a pertnit subjects the apD�icant to a civil penairy Z Re-Roof
� of rrot rtwre than frve hundretl tlollars(E500).
�
o (J I,as owner of the property.or rtry emDloyees with wages as iheir sole compensation,will do()all of or(�porUortc j Commerclal
0 0l ihe work,antl the strucNre Is not intended or oflered lor sale(Secdon 7044,Buslness and Professfons CoAe:The m
� Contracturs'State License Law dces not appty to an awner of property who,through employees'or personal eFfort.builds
w or improves ihe property,provided ihat the improvements are rrot intended w ottered for sale.Ii however,the building or
� Impmvament Is sold within one year ol complcUon,the Owner-Bullder will have fha burden of proving that it was not huilt
� or Impraved fw Ihe purpose af sale.).
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� I,es owner af the ro 1
r U D DehY�ar"exclusively coaVactlrtg wiN Acansed ConVactors to canstrucl the pro ect{Sect3on Valuation: � Adj.Nea:
0 7pqq,Business arM Professions Code:The Con[ractas'Stale Llcense Law does rrot appty to an owner of property who
Z builds or impmves thereon,and who contractsfw the projecls with a I�ensed Contractor Dursuant to the ConVacrors'State QUANTITY DESCRIPTION FEE
Yuce�sa�aW.�. 11 E�.Q.L 0 wE le
°C U 1 am e�cemp[hom ifcensura under the ConVaclnr's State License law tor the tollowlm)reason(s): .
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"-- By my signature below I ac)mowledge tlut,excep�for my personal residence in whicA I musl have resided tOr at least one w '
Z year Dhor to com{Netion of the Improvements covered by ihis permit.l canrrot legally sell a structure that I have twill as an „J,
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� owner-Uuilder ii It has rro�been construcled in ils entirery by lice�etl contractors.l understand ttiat a copy of Ihe appiicable
� law,Section 7044 of iho Business and Professlons Cotle is availablo upon request when ihis epplication Is submitted or at
o- Ne following Web site:�ttp/vn»v.Ieginfo.ta.gov/calaw.�trnl.
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�'-� DATE SIGN: � ,
� LICENSED COMHACTOH'S�ECLARATION � .
�
w I ereby aHirm un�er peretty ot perjury thal l am licensed�nder provisiwu of Chapter 9�commencing wilh Secfion 7000)
'� ot Division 3 ot the Business and Prafessions Code,and my license is in full force and eflecl. �i NG�O S 1 �% e✓
� LICENSE CIASS: d �C.NO.: O�"� O�! ` a 2 ��O �M�v h
o DATE CONTRACTOR: T� N"�O �O+�+rw� H^'�i�.��---'�S =
Zd WORI(EN'S COMPENSATION OECIARATION �
� I HFAEBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: � , "1
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¢ I have and will malntain a Cerlifin�e ol Consent to Setl-Nsure lor Worker's Compensafion,as providetl by CONSTRUCTION: �
� Section 3700 01 the Labor Code,tor tha per(ormance of the work for wh�h this permit is issued. '�
� PLAN REVIEW:
� I have and wal malntain WorkeYs ComD����Insurance,as requiretl by Sectfon 3�00 of Ihe Labor Code,for ELECTRIC: �
o the peAormance of the work tor which this Dermd fs Issued.My WorkePs Compensafion I�urance Cartier antl ,.,,—_
¢ Poli�yNumderare: PLUMBING:
o CARRtER MECHANICAL: �i �''�7
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� POUCYNUMBER INSPECTION FEE:
� (TH�SECiION NFED NOT BE CAMR_EIEU IFTriE PER511T 4S FOR ONE tH1NDRED DOLLAAS(5700)OR LESS). ISSUANCE:
oI certily that in ihe pe�tam�nce ot the worle(or which thts permit s issuetl.l shall not empby arry person in airy manner so as to / r'
become subject to me WakerS Comper�sation Laws ol Cali(anla.Md a�ee�hat If I shaild became subject tn the Waker.s SMIP:
� Campensatim prwlsi«is ot Sec6a�3700 ot the taoa Code.l shall IorUrxith mmvN with ttrose pruvisi«�.. EN ERGY P/C:
� 7 .
—' DA7E AaPUGwT: ENERGY PERMfT:
LL /�/y
� WARNING:Failure to secure Workers Compensation cmerage is unlawful.and shall subject an empbyer to criminal RETENTION FEE: ���V{�—
w penatties and civil fines up to one hundred thousand dollars(3100,000),In atldition to the cost of the compensatim,
n- oamages as prrnided fw in section 3706 M the labor code,imerest,and anomey's fees. PRE-ALT FEE: l /�n
� CUNSTRUCTION LENDING AGENCY BSAF: `'�'V y
Z 1 hereby aKrm under penalry oi perjury that there is a Construction Lemling Agen�y Iw Ne pedormance of the work lor
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= whic�lhis permil is issued�Sec.3097,Civ.C.).
� LENOER'S NAME
�
� LENDFR'SADORESS: �
ow.. 1 certiry that I have read Nis applicaGon and state thal the above information is correcf.l agree to compty wiN all city and TOTAL FEES %1 )/�( ��
� county ordinances and state laws relatin tn buildin constructlon,antl hereby aumorize re resentatives ol this caunty to �/d
z g A P COMMENTS:
o enter upon the above-men6onetl properry fa inspeclion purpases. _
¢ MRTEE NAME(PflINn e�-�',i� LLN.I�� � 3 /
� 1 L /1
N RECEIPT q �a�� PA1D BY:��_VALJDATION:�� .
_ -SIGNATURE OF PER E OATE
�
WHITE—Department Copy.YEILOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—Fle Copy,GREEN—Applicant's Copy
CITY OF DIAMOND BAR � ,
INSPECTIOfV ,fiE�4JRD
. e � . • - • � � � -
A `"` TRACTANd LEDGER '
;SETBACK/l.ETTER -
FOOTINGS FORMS ='a - _ � �� S�NITCH GEAR
g�qg�., " ` , � _= «� . :' r. � �� COMMERCIAL HOOD �
UG:�PLUMBING'-' ' �� T-BAR �
UG.ELECTRICAL�, ;; , , � ' ,�,.::�%, ' "�'� �` INTERCEPTER
:UFER;GROUND.': ` � `�� � ` ,�t '':" '" '��`' � HOT MOP/SHOWERPAN
SEWER LATERAL SEPTIC/CESSPOOL
MAIN WATER LINE HERS REPORT RECEIVED
SEWER CLEANOUT DEMOLITION
ROOF SHEATHINU ROOF DRAINS
FLOOR SHEATHWG ROUGH CONDUIT
Y� � ' ` �PQOUSPA': t _ � ���� � , y
SHEAR'WAL'LS EXTERIOR,`y � ,�= t `' a r _ ` � � 'L
SHEARWALLS�:INTERIOR:�� " ROUGH PLUMBIN� >M 3 `, - � h ` '`_
: � � ', � r � ,', ; ,w;,
FRAMWGNENTING '":°� +' _'` �,�; - RQUGH.ECECTRICAL�. �r" '� � _ �� � � .- �'� _ �. 'W
ROUGfi,MECHANICAL � f � '� ��+ " < t RQUGH,MECHANICAL'� � ' ` � t �3 ` ' "�. ' - � �+ 7 x
. � �
ROUGH ELECTRICAL W(; )C(_,) -;�L ' � _ �4 GAS TEST� t , `� `k r ': �` � '� � �
ROUGFI'PLUMBING , � k Y` � <' � PRE GUNITE�'�,� ��� `�' �„ ' �� �r ti � `� `�
.� � ��� r, .
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— _ - —
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INSULATION�WALL ��� � � � '
FODL P,RE�DECK BO[VDING =;?y G ; a, F� � +`?�, x � '
INSULATION CEILING � � � �f ��� � � ���� ��`
P;TRAP .� � x * F `
DRYWALL FENCE/GATE!Af_ARNI „ � ' F:: ' f �; y �y` � "`�``���
. .. .. �_-f� Y.� ;—� _,< -�.'.
LATH(PRE) FINAL POOL` , �+..t-� ' n ' r�*,f'
LATH EXTERIOR WALLS:
LATH INTERIOR WALL FOOTING/STEEL
GAS TEST WALL STEEL 1�T( }2N0( )LIFT
SCRATCH COAT WALL BOND BFAM
ELECTRIC METER RELEASE WALL DRAIN/SEAL
GAS METER R�LEASE WALL FINAL
SPECIAL INSPECTION 0 FRANIING PLANf��1GAPP Ai. ' , �� '
R ° ROV
� •-�- , �, � - °� �' �`' ' ' `ROUGH FIREAPPROVAL '�'� � ¢ � �' � a'r� - � � �.� , ��, ,
�
.FINAL��BUILDING ��� � f��� �. =7 � ` � � � � �
�FINAL�MECHANICAL , - ��r ^ �� �� _ � � s , �� ,`'_ " ' _ r ti+ � � ��
� � 5 F'INAL FIRE�EPARTMENT � �
i` - i FINALPLANNING , " �'-�'�f�� � �- '�:' �"v-
�FIWAL ELECTRICAL � Z�=! - � � � ' ;
� :.. _
..... 4 .� � .�_ ����. .` ., F:4�' ��,. 'FINAL ENGINEERING/PW " ' _ � � }Y .�� ' ,.�' ' �
FINAL PLUMBING iZ. -I � ,
T.C.of OCCURANCY� �`- ;FINAL COMMUNITY`SERVICES * i �;�3; i � �3 ?
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F �'�S � . .' . .
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CERT.�of.00CUPANCI' :�s, .. - r�'�� ,_. ,��k,, �. �, E�NAL NEALTH DEP,T �� � ��
r u c f J�n� i'F 4 Lr, � �t
� ��INAL�INDUST,RIAL:�,INASTE��=� ���a t '' ;'�-,�,. '`��.� ti�,
_._. __ . _
COMMENTS: ,�� �, i�.n��,�P� ,,,� I ,?� �,�,L., r►� S„' �. �1�11 A e�,�v, r, a' .t �-rc
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