HomeMy WebLinkAbout14-4372 � ,a' S`,� Cl'CY OI'DIAMOND l3AR
I I ( i ' { DEPARTA4EIVT OF COMMUNITY&A�VELOYMCNT SERVICES
• ,��Illyi� ,�, 21810 Coplcy Dri��c,Diamond Bar,CA 91765 `- PRESS
�� (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 FIRMLY
� `� BUILDING PERMIT APPLICAT[ON
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v APPLICATION DATE: ���'y" I�� P/C# «�
W JOB SITE ADDRESS�` �� ��\d � � l � � /
ISSUE DATE: �I �'� II 4 PERMIT# �� � �
oqpN�-;�LOT TRACT
p OWNER X �L'Z �-t;��sd R' ,� TYPE CONST. OCC GROUP:
� ADDR S . �'`1 t � r ZONING SETBACKS
� C1TY � + '� ZIP i'j�S TEL. ( � FRONT RW ❑
� APPLICANTx TEL. REAR Q
o � SIDFJSIDE STREET RW �
> CONTRACTOR � SIDE �
¢ -
I o� ADDRESS �` 'A �` PROPOSED USE
� ciTv�i�rst D'E�-.4+�- ZIP����TEL. � `� �
0
"- ARCH/ENG/DESIGNER
0
o ADDRESS ti DWEL.UNITS - -
Q CITY ZIP TEL. DESCRIPTION SQ. EANALUATION
� ownrn•emioea oEcwunax
¢ I he�eby aflirm under penalry af Derjury that 1 am exempt hom Me Coniractofs Sfate License�aw fa the reason(s) SFR/ADD/REM
� Intlicated below by the checkmark(s),I have placed nexl ro Me aOD�icable item(s)�Sectlon 70375,Buslness and
o Garege/Carpat
w Professions Code:My aty or county that reQuires a permit ta consUuct,atter,improve,demolish,or repair,any
z struclure,pdor to ifs fssuance,also requlres ihe appl'icant for ihe permit to Ble a sign¢d statemen�that he or she W .Pa£�o/Deck .
a is IicCnsed Dursuant to ihe praWslons ot ihe Contrador's Sfate Ucense Law(Chapter 9)Cammencing with Sectlon LL p�VSpa
N 70D0 of�Ivision 3 of the 8usiness and Proiessio�a Code)or that he or she a eaempt hom liceraure antl Ihe basis tor _
_ �
� the alleged exemption.Any vidation of Sectlon 7031.5 by any applicant for a pertnit suUjects the applicant to a civil peretry R� oo��-,,'� �
N ol not mwe than five huntlretl tlollars(3500). .
¢
o (�I,as owner ot the property,or my emDloyees w�th wages as iheir sole compensatlan,will tlo(.�all of or(�poNons � Commercial
� of tha work,an0 ttie strucWre is not intentled or oflered lor sale(Sectloa 7044,Business and Pralessions Code:The m
� Contractors'State Lkense Law does not appty to an owner of property who,ihrough employees'or personal effort,builds
w or improves the properry,pmvided Ihat tha Improvemen[5 aro not Intendetl or ottereU for sale.If however,the building or
� impmvement is sold wilhin one year of completlon,ihe Owner-Builder will have Ne buNen of proving iha[R was not�uitt
por improved for t�e purpose ol sale.).
� (�I,as owner ol the pmperty am exGusNely crontractlng with Iicensed Cnntractors to canshuct the project(Section �
0 7044,Business and Prolessions CoUe:The CantractorS'Stale License Law does nat appty to an owner of property who Valuation: � CJ LQ Adj.Area:
z builds or improves Inermq and who canhxts tor the pro[ects with a�Icensetl Cantrecta pursuam ro the Contracmrs'Sble �UANTITY DESCRIPTION FEE
v�
Y u�ense taW.�. � e�'Y1� C!7
o U 1 am�empt hom Iicensure under lhe CnnitactoY9 Sta10 License law for 1he tollowSng reason(s): �
� � . ¢
LL U
By my signaiure below 1 acknowiedga that,except for my personal residence in which 1 musi have residetl ta al least one w 'C (�
z year prior to wmptetlm oi the improvemenfs covered 6y this permit,l cannot legalty sell a shucdre that I have built as an u�,, ,
0
� owner-builder i�it has rwt been conslructetl in its enfirery by licensed contractas.l understand that a copy oi the apptirable
law,Section 7044 of ihe Business and Professions Code Is available upon request when this applicafion is submitted or�( �«' �-15� , �
X IhefollowingWebsite:htlpJwww.leginfo.p.gov/Cafaw.htrnl. m
�'-� DATE: SIGN: � t
� LICENSED COMRACTON'S DECLARATION � C ` �'f �
d
U
w I hereby aKrm un�er penalty of perjury thal I am liceruued under provi�ions ot Chapter 9lcommeocing with Secfion 7006)
m of Division 3 of the Business and Professions Code,and my license is in full force arnd ettect.
y CENSE tC�LASS: C.-•" � ' LI NO.: ��I"' ... a
oz DATE: 1D�I 3'ti`'i CONTRACiOR: � ' w
Q WORImt'S COMPENSATION OECIARATION �
� I HEREBY AfFlRM UNDER PENAL7Y OF PEAJURY ONE OF THE FOLLOWING DECLAAA710NS: �S , 9\
¢ �have and wiii malntain a Certifipte of Consenf to Seli-insure for Worker's ComDensation,as proNdeO Oy CONSTRUCTION:
� Section 3700 of Ihe Labor Code,tor Ne peAormance o�the wak for which this permil is issuetl. P�qN REVI EW'
�
> I have and will malntain Worker's Compensation insurance,as reQulretl by Section 37W oi the Labw Code,for ELECTRIC:
o the pertormance of the work 1ar which this Dertnd is issued.My Warker's Compensatlon Ir�surance Carrier and
¢ Policy Number�re: (� P�UMBING:
o �ppq�Ep �� p �� a( MECHANICAL
Z POLICYNUMBFA h a.� C� 1� INSPECTION FEE: .�y,
� (THIS SECfION NgD NOT BE COMPLEfED IFiHE PEfiMIT LS FOR DNE MRJDRED DOLLARS(S7 W)OR LESS�. ISSUANCE: � � s T
0 I certi(Y thal m ihe Perfortnance of ihe worlc Im whicli Ihis P�mit�s issued,I sh�ll iwl emPbY�Y P���any rnarmer so as to SM IP: � . 'eO
become subject to Ine Worker's Comper�satbn Laws o1 Calttomia.Md agree Uiat if I shoultl 6ecmne subject m the Waku's
� Cwnpensallon provisbns ot Sectim 3700�la Code,�sh2N�attnvith comoN���p�`^�'�. ENERGY P/C:
'J DAiE:g'��'�`I APPUCANT: `�'��-.� �o�W.-� — - ENERGYPERMIT:
lL
� WARNING:Faiiure to secure Worker's Campensation coverage is un�awlul,and shall sub�eci an employer to criminal RErENTION FEE: �` ��
¢ penattles and civil tines uD to ane hundred NousarM dollars($100,000),in addition to the cost of the comper�satlon,
w PRE-ALT FEE:
� damages as provided tor in sectlon 3708 01 Ne labor code,interest,and attwney's fees.
� CONSTRUCTION LENDING AGENCY BSAF: \' ��
w I here�y amrm under penalty of perlury thal ihere is a Construction Lending Agerrc,y for the perlormance of ihe work fm
= which this permit is issuetl�Sec.3097,Civ.C.).
� LENDER'S NAME
� LENDER'SAD�RESS: A
d I ceriffy that I have read fhis aDPlication and st2te that ihe above iMortnaUon is tortect.I agree N compty with all dry antl TOTAL FEE$ L.�(��-, �v
� counry wdinances antl state laws relating to building construction,and hereby authonze represent�tives of this aunry to COMMENTS:
z
o eMer upon bove-mentioned property for inspection pmposes.
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m
cn ����i �a'��� •�� '��� � 1 I� �C��$ PAIDBY: .S. J LI�ATION:
= 81GNATURE OF PFAM�rfEE �ATE RECEIPT k � �
F-
W HITE—Department Copy,YELLOW—Fnance Copy,PINK—Assessor Copy.GOLDENROD—Fle Copy,GREEN—ApplicanYs Copy
CITY OF DIAMOND BAR � ��
I(VSPECTION RECORD �
. � o . a - • � � • '
SETBACK/LETTER ;_ 'i-' TRACT AND LEDGER '
FOOTINGS FORMS , - 1:e ' , �_ t ;:, > SWffCH GEAR
S�qB,: +� - � '--' - - COMMERCIAL HOOD
UG.PLUMBING`''� - ��=`:� T-BAR
4 :_,
UG.ELECTRICAL - ��` INTERCEPTER
�UFER GROUND,;° `` �� HOT MOP/SHOWERPAN
SEWER LATERAL SEPTIC/CESSPOOL
iUTAIN WATER UNE HERS REPORT RECEIVED
SEWER CL DEMOLITION
ROOF SHEATHIN ROOF DRAINS
FLOOR SHEA ROUGN CONDUIT
_ _ _ - _ �:- ,. ::UOIJSPA� 3 r , = <,; ; : � ` , S �;` ��
SHEAR WALLS.EXiER10 � P " �
SHEAR WALLS�INTERI �� ��,� ` � ROUGH PLUMBING � �;r ;� -� � �� � U �. •
FRAMINGNENTING _ ` � � � ��' `� RQUGH ELECTRICAL':. '�' � ���-� �"�'� �� s ' �;
RQUGH`MECHANICAL ;>r = ROUGH MECHANICAL` -r ``� �'�` ''=` � � 'j1 �
. � ; Y.� "1 . '.
ROUGH ELECTRICAL WS:-)rC( ) : ' �� GASTEST `.` - �t ' `z �:_¢ a'"*'�> '�
ROUGH PLUMBiNG � �I;' = PRE GUNITE -`� � � Y �
y.: )
INSULATION WALL ,POOL,PR@;�ECK BON,DING � ` �� � � ` �� ` �
� r� ,.
INSULATION CEILING P-�P = '` � {+ , : � �: �
DRYWALL EENCE/GATE/ALARM „ �^ �-� �' � � �� '��
LATH(PRE� ;FINAL POOL ` _ _ -,�,'` j• r ���� ~`
LATH EXTERIOR WALLS:
IATH INTERIOR WALL FOOT�NG/STEEL
GAS TEST WALL STEEL 1�( )2ND( )LIFf
SCRATCH COAT WALL BOND BEAM
ELECTRIC METER RELEASE WALL DRAIN/SEAL �
GAS METER RELEASE WALL FINAL
SPECIAL INSPECTION R.0�FRAMIN�PL'AIJNINGAPPROVAL f �'� � ���� � : ' r ��-
.. . � e- F il;�
.,.. ..... . . .:. .., . _.. . �. �,: . �.
;'` �` � :ROUGH F18EAPPROVAL ' ,-r ` ���' `
FINAL BUILDING � ` . �� .'
fINAI MECHANICAL
� FINAL FIRE DEPARTMENT ; ' � -
FINAL ELECTRICAL� � �FINAL PLAPfNING '.�' - �� � ' � ` '` � Y �
. �. - " �
FINAL PLUMBING .�- : ' � . , - � _ . • -- _ � � ,..�. ' `„ :, ri ' �:
'' FINAL ENGINEERING/PW .: `
T.C.of OCCU�PANCY. ��" - FINAL CQMMUNITY�SERVIGES ' ��� �
CERT.of OCCUPANCY , _ FINAL HEALTH DEPT ` ` � `�
-, � � �.� ti �
FINAL INDUSTRI{1L'WASTE_._� _-- .� �. �.r . .. £
COMMENTS:
Q�►ra srL � v��rr�� e��+►w,� -�t�cY-�i3 atr�� svb.,�.�