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Home My WebLink About15-3003 ' " CITY OF DIAMOND BAR , '-- `` il � I i i DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICE5 �:3�II( �l=-�" 21810 Copley Drive,Diamond Bar,CA 91765 � � PRESS (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 FIRMLY � �'8"'� BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@diamondbarca.gov � w " APPLICATION DATE: P/C# a JOB SITE ADDRESS �� ^ �0�� APN LOT TRACT ISSUE DATE:� I '�PERMIT#: 0 N OWNER�.�e6,�� TYPE CONST. OCC GROUP: I =i ADDRESS a ' CITY Z ��TEL. p � ScopeofWork �►-��Gt�it�t � '� �w �cy�+c o APPLICANT —` � TEL. �I �' � 4°��S� i > r��'��'��1 a_ RJ cr.�ca��,.,. ao CONTRACTOR �� ADDRESS �� CO�r�c,'"' #DWEL.UNITS #STORIES #BEDROOMS o CITY 2!��f�� ZIP�b TEL. o ARCH/ENG/ z DESIGNER DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREA/VALUATION o ADDRESS SFR/ADD/REM z m CIN ZIP TEL. Garage/Carport a � Patio/Deck ¢ OWNEN-BUILDEp DECUlFIATION w oI hereby affirm untler penalry of perjury that I am exempt from the ConVactor's State License Law for the reason(s) � PooVSpa w intlicated below by the checkmark(s),1 have placed next to the applicable item(s)[Section 7031.5,Business and � zProfessions Cade:My city or county that requires a pertnit to construcf,alter,improve,demalish,or repair,any Q Re-Roof � structure,prior to its issuance,also requires the applicant for the permit to file a signed sfatement that he or she � Commercial � is licensed pursuant to the provisions of the CoMracinr's Sfate License Law(Chapter 9)Commencing with SecOon m � 7000 of Division 3 of the Business and Professions Code]or that he or she is exempt from licensure and the basis for N the alleged exempGon.My violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty 0 of not more than five huntlred dollars($500�. � ()I,as owner of the property,or my employees with wages as their sole compensation,will do(,all of or(�portions Z of the work,and the structure is not intended or offered for sale(Section 7044,Business and Professions Code:The V8luatiOn: � 6r�. Adj.Area: w Cantractors'State License Law does not apply to an owner of property who,through employees'or personal effort,builds p� or improues the property,provided that the improvements are not intended or o(tered for sale.If however,me building or QUANTITY DESCRIPTION FEE improvement is soltl within one year of completion,the Owner-Builder will have the burden of proving that it was not built , � or improved for the purpose of sale.). � 2,()a� �-r�ti� y� Z ()I,as owner ot the pmperty,am exclusively contractlng with licensed Contractors to construct the project(Section � ,(��r - N 7044,Business and Professions Code:The Contractors'State License Law does not appry to an owner of property who � , Y builds or improves thereon,and who conUacts for Ne projecis wim a licensed Contrac[or pursuant to the ConVactors'State � o ucense law.). u' �, (J I am ezempt hom licensure under the ConMactor's State License law far the following reason(s): c7 z m By my signature below I acknowledge that,except for my personal residence in which I mus[have resided tor at leasi one � year prior to completion oi the improvements covered by this permit,l cannot legally sell a sWcture that I have built as an a �� owner-builder if it has not been consVucted in its entirety by licensed conVactors.I understand that a copy of the w applicable law,Section 7044 of Me Business antl Professions Code is available upon request when this application is � o submitted or at the(ollowing Web site:http/www.leginfo.ca.gov/calaw.html. � c�i a LICENSED CONTRACTOH'S DECLARATION = mI hereby affirm under penalty of perjury that I am licensed untler provisions ot Chapter 9(commencing with Section 7000) � � of Division 3 of the Business and Professions Code,and my license is in full force anU eftect. �' uCENSECusS: —� uC.NO.: ICOn�Q�� 1 CONSTRUCTION: a-jd,./�' 0 Q DATE:� CONTRACTOR:�`'��0.j r e, �/—' �^S � � I ^� � WOflI(ER'S COMPENS ITA ON DECLARATION PLAN REVIEW: QI HER B RR�UNOE�R PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: ELECTRIC: J�/). � � o I have antl will maintain a Certificate ot Consent to Self-Insure for Worker's Compensation,as provided by PLUMBING: � Section 3700 of the Labor Code,for the peAormance of the work for which this permit is issued. MECHANICAL: � p I have and will maintain Worker's Compensation Insu2nce,as required by Section 3700 ot the Labor Code,for Q the performance of the work for which this permit is issuetl.My Worker's Compensation Insurance Cartier antl INSPECTION FEE: Policy Numbei are: ` Z CAHHIER�A�iP r��ti. �-�$� ISSUANCE: �� POLICY NUMBER a l �La3�� SMIP: a.� y t �; (IHIS SECtION NEED NOT BE COMR_EfED IF 7HE PFRMfT IS FOR ONE HUNDRED DOLIMS($100)OR LESS�. EN ERGY P/C: p I certify that in the pertormance of Ne work for which ihis permi[is issued,I shall not em lo an � p y ypersoninanymannerso�to ENERGY PERMIT: o become subject to the Worker's Compensatlon Laws of Cal'rfomia.Md agree fhat if I should become subject to ihe Worker's J Compe7sabon provisions of Sectlon 3700 of the Labor Cqde,I shall forthwith mply with ,ose provisions. REfENTION FEE: ��,�, � LL DATE: 12 (7L.IIs APPLICANT: ��ab F=1 �Pr-P� � � L— PRE-ALT FEE: � WARNING Failure�o secure Worker's Compensation coverage is unlawful,antl shall subject an employer to criminal gASF: _ i' � ' � penalties and civil fines up to one hundred thousand dollars($100,000),in addition to the cost of the compensation, p damages as Drovided for in section 3708 of the labor code,interest,antl attomey's fees. PLOT PLAN: Q d CONSTIiUCTION LENDING AGENCY ZONING CLEARANCE: w I hereby affirm under penalry of perjury that Mere is a Cons[ruction Lending Agency for the pedormance of the work for = which this pertnit is issue0(Sec.3097,Civ,C.). � H LENDER'S NAME: � LENDER'S ADDRESS: TOTAL FEES � � �^/.� w �� a I certily that I have 2ad this application and state that the above infortnation is correct.I agree to comply with all ciry and Z county ortlinances and state laws relating to 6uilding consVuction,and here6y authorize representatives of this county to COMMENTS: o ente(upon The above-mentioned property tor inspection purposes. m k1-�(� C—l ��re� N PE Mf1TEE AME PRI � P/C: PAID BY: VALIDATION: N DAT RECEIPT#�a,tJ pAID BY: �� VALIDATION:� r 6NAIURE OF ERM J— WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy � �IT'.Y O,F �OIAMOND BAR � INSPECTION RECORD ' , • • � � • - • � � . � . SEfBACK/LETTER TRACT AND LEDGER FOOTINGS FORMS SWITCH GEAR SLAB COMMERCIAL HOOD UG.PLUMBING T-BAR UG.ELECTRICAL INTERCEPTER UFER GROUND HOT MOP/SHOWERPAN SEWER LATERAL SEPTIC/CESSPOOL MAIN WATER LINE HERS REPORT RECEIVED SEWER CLEANOUT DEMOLITION ROOF SHEATHING ROOF DRAINS FLOOR SHEATHING ROUGH CONDUIT SHEAR WALLS EXTERIOR POOUSPA SHEAR WALLS INTERIOR ROUGH PLUMBING FRAMINGNENTING ROUGH ELECTRICAL ROUGH MECHANICAL ROUGH MECHANICAL ROUGH ELECTRICAL W( )C( ) GAS TEST ROUGH PLUMBING PRE GUNITE INSULATION WALL POOL PRE DECK BONDING INSULATION CEILING P-T�P DRYWALL FENCE/GATE/ALARM LATH(PRE) FINAL POOL LATH EXTERIOR WALLS: LATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL 15T! �ZND( )LIFT � SCRATCH COAT '� � WALL BOND BEAM ELECTRIC METER RELEASE I•� Y"-/(,� ,� f %r.. :/f4- WALL DRAIN/SEAL GAS METER RELEASE l WALL FINAL SPECIAL INSPECTION R0.FRAMING PLANNING APPROVAL FINAL BUILDING / /� ROUGH FIRE APPROVAL FINAL MECHANICAL r / FINAL FIRE DEPARTMENT �- FINAL ELECTRICAL i� — 14� : �, . ; � .- � FINAL PLANNING f4 FINAL PLUMBING FINAL ENGINEERING/PW T.C.of OCCUPANCY FINAL COMMUNITY SERVICES CERT.of OCCUPANCY FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE COMMENTS: _�;.,� -�� j`�• { ' �) ��.:�✓.tl '�� 1� �,��.0 �;.:'a11�j-..• ,;.