HomeMy WebLinkAbout13-01392� � .{ . __ _ .�_ .
:�,•'� CITY OF DIAMOND BAR i
� � � � DEPARTMENT OF COMMUNITY&DEVELOYMENT SERVICE5 i
�III�j'`:- � ' 21810 Copley Drivc,Diamond Bar,CA 91765 PRESS
.,, ,,,,� (909)839-7020 Fax:(909)861-3117 Building Inspection'Hotline(909)839-7027 FIRMLY
�"'"°� BUILDING PERMITAPPLICATION
Q JOB SITE ADDRESS_ _��� 4 ��C� /v 1 �L��-0 7�C� I� APPLICATION DATE: � ( p/Cq i 3' B�3�[Z I
z APN LOT TRACT ISSUE DATE: 1 PERMIT# I 7j'— C�l �l� Z
0
o OWNER G( ( � FG'-+� TYPE CONST. OCC GROUP:
� ADDRESS �-N c
� CITY � ZIP � TEL. ZONING F ONT KS RW ❑
oAPPLICANT f7� TEL.��Z- 7/R-7SYag REAR ❑
r CONTR,4CTOR V�rc C F"��e ('0� G �J1� SIDE/SIDE STREET RW ❑
I oro ADDRESS ��3 0-9 ����(-r•�� SIDE ❑
A✓•c
¢ CITY C��'Ko Ip �( I�TEL. ��y 5�7� 'SI$ C7 PROPOSED USE
0 t
o ARCH/ENG/DESIGNER � N-Q r h fC /�f�{ F��K� .
z ADDRESS ���� C'Z^�-N'^�� • �
a CITY w C �ZIP G t7i� TEL. �1''� S7��V�S� �DWEL.UNITS #STORIES k BEDROOMS
� OWHFA-BUILDER UECLAFIATION DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
� I heraby attirm under penatty ol perjury that I am exemp[hom the CanUactor's State License Law for Vie reason(s) SFR/ADD/REM
o indicated below by me checkmark(s�,I have placed next ta the appllpble ilem(s)[Section 703/.5,Buslness and Gare e/
o Protesslons Code:Any city or caunty that requires a permit to conshuct,alter,improve,demolish,or repatr,any 9 �a�Port
w structure,prlor to its issuane&also requires ihe applicant for the permit to ftle a signed sfatement that he ar she � Patio/Deck
a fs licensed Dursuant ta tha Orovisions of the CaMrector's Sfate License Ww(Chapter 9)Commencing with Section w
� 7000 of Dlvislon 3 of ihe Business and Protessions Cade]or ihat he or she is ezemD�from Iicensure and the basis fw � P�USpa
N Ne atleged exempfion.Any viWation o!Sec6on 7031.5 by any applicant for a permit subjects the apPlicant to a civil penalty C7
� of rwt more U�an frve hundred dWlars(5500). , Q Re-Roof
o (,I,as owner of the properry,m my employees wIN wages as thelr sole compensatlon,will tlo(.J all oi or(,poAlons —� Commercial
w of the work,and ttie structure Is not intended or oftered tor sale(Sectlon 7044,Buslness and Professions Code:The �
� Contractors'State License Law does nat apply to an ovmer of property who,through emptoyees'or personal effort,bullds m
w or imprwes the property,provided ihat ihe Imprwements are rrot intended or oKered tor sale.If however,the building w
� Improvement is sold within one year of completlon,Ihe Owner-Builtler will have Uie 6urden of proving that it was rot buitt
por imprweU for t�e purpose of sale.).
V I,as owner o1 the ro e
� (-1 P P�AS am exdusively contrac6ng with Ilcensed CortVactors to conshuct the project(Section
0 7044,Business an0 Prolesslons Code:The Contradors'State License Law daes not appty to an awner ot property wtq Valuation: Adj.Ar'Ba:
Z Duilds or improves mereon,and who contracts ta the projects wim a Ilcerisetl Contractor pursuam to the Contractors'Stare QUANTITY DESCRIPTI ON FEE
�
Y ucense Law.).
o U I am exempt from Ifcensure umfer ihe Coniractnr's Stale llcense law lor the lollwv(ng reason(s): �
� �
11 By my signature below I acimowledge that,except tor my persoral residence In which I musl have resided far at least one c�i
z w
o year prior to completlon of Ne improvements covered by ihis permi[,I pnnot legally sell a structure ihat I have built as an �
a owner-builder il it has irot been constructed in its entirety by licensed contractws.I understand fhat a copy ol tice applica�Ie w
¢ law,Secfion 7044 of the Busines5 and Protessions Code is availabla upon request when this application Is submitted w at
wfhe following Web stte:http/www.leginfo.ca.gov/plaw.htrnl. _
� DATE: SIGN: �
F LICENSED CONTfiACTON'S�ECLARATION �
a
� I hereby affirm untler perelty ot perjury that I am liceraed untlar provisiorts oT Chapter 9(commencing with Sectian 7000)
m of Division 3 of the Business and Professions Code.and my Ilcerxe is in full force and eflect. J
� �c�s�c�us:�/6 R27�32 N : � 2 �
z
Z0 oar�:�%►��IJ coKrw�cron: rc''c C 3- .� .� .`1�-- �
a ` � WOHKEA'S COMPENSIUION DECLAAATION g
� �HEAEBY PFFlRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLAFiAT10NS:
oI have antl will malntaln a Certi�q�e ol Consent to Setl-Insure fw Worker's ComD��bn,as provided by CONSTRUCTION:
� Sectian 3700 0l the Labw Code,for Ihe pertormance ot the work for which this permit is issued. p�qN REVIEW:
> I have a�will maintain Worker's Compensation Insurance,as requlretl by Section 3700 0l the Labor Code,for ELECTRIC:
Z� the performance ot the work tar which this permit is issued.My Worker's Compensatlon Insurance Carrier and
¢ Policy Number f� PLUMBING:
� CARR�Ep ��''rC'C I� Q.rL'Ltn-. �yVrj�, �J, MECHANICAL: �
� POUCY NUMBER � � � INSPECTION FEE:
� (TH5 SECf10N NEED NOT BE COMPLEfED IF THE PERMR IS FOR ONE HUNDRED DOWJiS($70�OR LESS�.
o � ISSUANCE: ��`��/
cerlity thal in the G�ortnance o(tl�e wmk for which this pertnit is issuetl,I shall not emPbY�Y Person rt�arry manrcer so as to SM I P:
o becarre subject to fhe Worker�Compe�dUon la f Calitania Md agree Ihat If I shoultl hecame subject ro the Workei's
� Com �on prmds of Seclion 3700 of tlie Cod I I with comPly with 1�Se Provisions. ENERGY P/C:
,� DATE: � � nvPUCfwt ENERGY PERMIT:
� WAANING:Failure to secure Workers Com erage ts unlawlul,and shall subject an employer to criminal RETENTION FEE: !
w penatties and civil tines�p to ane hundre thousan dollars($100,000),In atldition to ihe cost ol the compenSaUon,
o damages es provided tor In sectlon 3708 of the labor code,interest,and attomey's lees. PRE-ALT FEE:
a CONSTRUCTIONLENDINGAGENCY BSAF: ����
,� 1 hereby affum under penalty of per�ury that there is a ConsUuction Lending Agency fa the pedormance of the work fm
3= which this permit is issu ( 7,�Iv. �/� L�^ ,�J
LENDER'S NAME�'�/ 1��-(� ! l�I��. /'T•�{GL-�.-�.�._
� LENDER'SADDRESS: I J
a I certiry that I have read this applicaUon and state that the above infortnation is cortect I agree to compry with ell ciry antl TOTAL FEES �f/�.//�//�
�, i,�•N- •7 7
Z caunry ordinances and state laws relating tn building construction,and hereby authorize represeniatives of Nis county to COMMENTS: �V `
p enter upo� m ti ed perry far in tion purposes.
m �i�V" f�����
a PERMff1EE NA (R1Nn
v� ' ��
� a-� /
N A PAID BY: VALIDATION:_
F SIGNATUR OF ATE RECEIPT H �J
WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—Rle Copy,GREEN—Applicant's Copy
CITY OF DIAMOfVD BAR
INSPECTION RECORD _
s � � . � . . � � . • -
SETBACKI LETTER , _ `� ��� ' � �:.� ` ��- " �' TRACTAND LEDGER
FOOTINGS FORMS ;, x�> , ,� � . '.`� _ ,r= � ;`� :"' SWITCH GEAR
` 3x� f 1 �' r ' '' COMMERCIAL HOOD
k, 1_
SLAB� - �, �. r , �� � �
,UG PLUMBING'�`� .. - .`'~ ? _ � ``� �- _ T-BAR
UG:ELECTRICAG: , t�� ���, , . " � � ��� �' ,,:�.�,� -. ��'� INTERCEPTER �
UFER:GROUND,` E''T' �?u, �'�°'' � :r w`�`.'i'�i.,�, :'ii � HOT MOP/SHOWERPAN
SEWER LATERAL SEPTIC/CESSPOOL
MAIN WATER LINE HERS REPORT RECEIVED
SEWER CLEANOUT DEMOLITION
ROOF SHEATHING ROOF DRAINS
FLOOR SHEATHING ROUGH CONDUIT
� - �'� �BOOUSPA�' P.��<��, _ � � �
SHEAR WALLS EXTERIOR';� ;.f ':� � _ �,,s 5,�` , '` � r' -
� ° '` J , 7 :� ROUGH'PLUMBIN6 ` ` � S' "ti
.SNEAR�WALLS"INTERIOR.�, �- �- �rt �� - �� � '�r '' � �
FRAMINGNENTING � "�- � �' '-'`� �� �"� � �ROUGH ELECTRICAL� �r i �,-��i � � ,�ti �' '-r �� � �� �r �'�,
�.,� r ' .�,; *3 k-�.� s. ' ; �
ROUGIi'MECHANICAL� , ' �' " ' � .:•.. r t '�'r:. � �*,;� ,� ,,�,;�� , a .,; ;ROUGH,MEGHANICAE: ' �` ,, * � 7 �,w ;�, S `r
ROUGIi ELECTRICAL W(,')C,{,) � "` � �<-i +=r';- �' ` ;:, GASTESTf _� >, 'a t � r { `„§," � �' fi �' ?,
r .� - �
� `" PFiEGUNITE , ��r " 4 , r��
ROUGH PLUMBING. : ' , ., �_. . _ . , * t `'� � �
INSULATION WALL POOL PRE'DECK BONDING ' :"' � ` :� ,i �� � ��
� <� � r ��
INSUlATION CEILING P,;TRAP ' '��` �����, ti:��� -' � � �':
DRYVJALL FENCE/`6ATEl AL'ARM '`1 ` r � a= +s �� `.
LATH(PR� FINAL POOL� `K,. a_....b j` � >,� _- �,���� ��, ;-
LATH EXTERIOR WALLS:
LATH INTERIOR WALL FOOTING/STEEL
GAS TEST WALL STEEL 1ST( )2ND( )LIFf
SCRATCH COAT WALL BOND BEAM
ELECTRIC METER RELEASE WALL DRAIN/SEAL
GAS METER RELEASE WALL FINAL _
RD FRAMINGP�ANNINGAPPHOVAL ' a : ,- �
SPECIAL INSPECTION '^
FINAL.BUILDING � - �'> � '` - ROUGH FIRE APPROVAL "' ^' { �;' <� y W '"
FINAL MECHANICAL, .'; '� �" '� ; 's , ;�° �, , � FINAL FIRE DEPARTMENT = ` ' `a'� �-
FINAL ELECTR,ICAL ; ; ' , , �' ' ` FINAL PLANNING ;; � ' - `' r'
� � ` �.s �, " -
FINAL'PLUMBING . ;-'_�; � '� `' � : ' .,F�,; h ' FINAC''E.NGINEEHINGI PW ` - ` N`" 'r
: 4��
T.C.cof OCCUPANCY',� -, . {� '' �. � = =A. �F.INAbCOMMUNITN SERVICES � �" ' ' � �_
' ` ` 3; n' `FINAL'HEA'LTH DEPT ' ,:; r�J �
CERTs tif UCCUPANCI(;' > ' + 5. ,"'' � ' h ' "
FINAL'INDUSTRIAL.WASTE�:;T' = ' �- ' ��7� �."''r " :��� �
COMMENTS: