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Home My WebLink About15-0556 , ,�=.,`; .,„.... . CITY OF DIAMOND BAR �� ( I � ` DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES ,� ��:- ——� 21810 Copley Drive,Diamond Bar,CA 91765 PRESS (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 FIRMLY \\`'�e°�� BUILDING PERMIT APPLICATION � �i � APPLICATION DATE: P/C# s JOB SITE ADDRESS � ��y f F �r i ISSUE DATE:��f g�VW I,� PERMIT# `J '�f�"li_ z APN LOT TRACT � OWNER 1 �G TYPE CONSL OCC GROUP: I � � AD SS ' ZONING SEfBACKS � J �- ¢ C , E FRONT RW ❑ = APPLICANT TE � REAR ❑ = SIDE/SIDE STREEf RW ❑ n � CONTRACTOR SIDE ❑ � ADDR SS PROPOSED USE I = CITY ZIP T L. � � � ARCH/ENG/DESIGNER � z ADDRESS � #DWEL.UNITS #STORIES #BEDROOMS z CiTY ZIP TEL. � DESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREA/VALUATION q OWNEH-BUILDEH DECLAHATION _- 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 � � indicated below by the checkmark(s),I have placed nezt to the applicable item(s)[Sec[ion 7031.5,Business and Garage/Carport I Professions Code:Any city ar county that requires a permit tu construct,alter,improve,demolish,or repair,any � stmcture,prior to ITs issuance,also requires the applicant for the permit to file a signed statement that he or she � Patio/Deck � I i is licensed pursuantto the provisions of the Contradar's State License Law(Chapter 9)Commencing with Sectian w ' � 7000 of Oivision 3 01 the Business and Professio�Cade]or that he or she is exempt from licensu2 and the basis for � Pool/Spa I � theallegedexemption.MyviolationofSection7031.5byanyapplicantforapermitsubjectstheapplicanttoacivilpenalty C7 I = of not more than five hundred dollars($500). ZQ Re-Roof � (,I,as owner of the property,or my employees with wages as their sole compensation,will do(,all of or(J 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 I � improvement is sold within one year of completion,the Owner-Builder will have the burden of proving that it was not built j or improved for the purpose ot sale.). i (�I,as owner of the property,am exclusively contrac[ing with licensed Contractors to construct the projed(Section � 7044,Business and Professions Code:The Contractors'State License Law does not apply to an owner of property who ValuatiOn: i � Adj.Ar08: I Z builds or im roves thereon,and who contracts for the ro ects with a licensed Contractor ursuant to the Contractors'State I � P P I D QUANTITY DESCRIPTION FEE Y License Law.). I � U I am exempt from licensure under the Contractor's State License law for the following 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 w I = year prior to completion of the improvements covered by this permit,l cannot legally sell a strudure that I have built as an w � owner-builder if it has not been constructed in its entirety by licensed cont2ctors.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 suhmitted or at I � the following Web site:http/www.leginfo.ca.gov/calaw.html. � I z ? DATE: SIGN: � LICENSED CONTflACTOfl'S DECLAHATION � I a I� I hereby affirm under penalty ot perjury that I am licensed under provisions of Chapter 9(commencing with Sedion 7000) � of Division 3 of the Business and Professions Code,and my license is in full force and etted. J I i � [� a Z LICEN�LASS: ��C , �GSNO_ . �� . � / _ � I � DA � CONTRACTOR� �,� = I U ¢ WOHI�H'S COMPENSATION DECLAHATION � I y I HEREBYAFFIRM UNDER PENALTY OF PERJURY ONE OFTHE FOLLOWING DECLARATIONS: � I have and will maintain a Certificate of Consent to Self-Insure for Worker's Compensation,as provided 6y CONSTRUCTION: a Section 3700 of the Labor Code,for the pertormance of the work for which this permit is issued. p�qN REVIEW: � � I have and will maintain Worker's Compensation Insurance,as required by Section 3700 of the Labor Code,for ELECTRIC: � the pertormance of the work for which this permit is issued.My Worker's Compensation Insurance Carrier and /� ¢ Poli�yNumberare: PLUMBING: �j y� (��„ � CARRIER MECHANICAL: � POLICYNUMBER ,�� INSPECTION FEE: '� (THIS SECIION NEED NOT BE CAMPLEfED IFTHE PFAMIT IS F9R ONE HUNDRFD DOLLARS$100 OR LESS�. ISSUANCE: (�• �f � I certify that in ihe performance of the work for which this ' ued,I sh fempl y person' ner so as m • � become subject m the Worker's Compensation o Califo ' agree t e subjed m the Worker"s SMI P: L Com tion p 'sions ction 37 e e,I shall i h those provisions. ENERGY P/C: J � � ' � APP ENERGY PERMIT: � WARNING:Failure to sec o pensation cove2ge is unlavrful,and shall subject an employer to criminal ` N y penalties and civil fines up to one hundred thousand dollars($100,000),in addition to the cast of the compensation, RETENTION FEE: r�.. �� damages as pmvided for in section 3706 of the la6or code,interest,and attorney's fees. PRE-ALT FEE: i CONSTHUCTION LENDING AGENCY BSAF: I y I hereby affirm under penalty of perjury that there is a Construction Lending Agency for the pertormance of the work for = which this permit is issued(Sec.3097,Civ.C.). � LENDER'S NAME: s LENDER'SADDRESS: TOTAL FEES SM I i I certify that I have read this application and state that the above information is correct.I agree to comply with all city and �7, u Z county ordinances and sTate laws latin i ing construdi nd here authorize representatives of this county to COMMENTS: � � enter upon the above-mentio rry fo ' pec[ion es J � Y1 ¢ PERMI (P IN � � ti �"' � :A = SIG E DATE RECEIPT N J' 0 � pAlp gy; �/ �- _ VALIDATION:� �/—•--- WHITE—Department Copy,YELLOW—Finance Copy,PINK—0.ssessor Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy CITY OF DIAMUND BAR I �''A� IIVSPECTION RECQRD ° � � � • + � • � , � • • � � �5ETBAC{U"tLETTER��"�3 � �� '�'� TR�1Cf AND LEDGER - FOOTINGS FORMS _� � , � ,� SWITCH GEAR ;SLq$ � . � - COMMERCIAL HOOD � � 9,. ... , _ ,UG:PLUMBING ��" ',. ,. T-BAR ,UG:;,ELEC7RiGAL �'„ �� n��;�, , INTERCEPTER ,UFER GROU D � ` � `�� ` HOT MOPISHOWERPAN SEWER LATERAL SEPTIC/CESSPOOL MAIN WATER LINE HERS REPORT RECEIVEd SEWER CLEANOUT DEMOLITION ROOF SHEATHING ROOF DRAINS FLOOR SHEATHING ROUGH CONDUIT ;SHEARWALLS.EXTERIOR � ,� �„�., a POOUSPA ��_ �,. � ��,- � - , � �,� ;,.�,; s� ,- � ,,,o ';�� .r�� - �� ,: �� — ;�Fl�1R WAt�$`INTERIOR ROUGH PLUI1tIBlNG , a �FR�NIINGNENTING �� , ROUGH ELECTRiCAL � n ,�� „ : .� �,�'` � ROUGM MECHANICAL � � a�. � � ;�, �ROUGH`MEC�IANICAL' '';" "�� '"' r � RQUGH E�ECTRICAL W( )C(�) 4 ' 6AS TEST �� • PRE GUNITE _ � �, � �RQUGH PLU�IBING,�',, ��> .x � ,� �: � ',� b� ,.,�, INSULATION WALL POOL PRE dECK BONDING INSULATION CEILING P-T�P DRYWALL FENCE!GATE/ALARM '� �` IATH(PRE} i FINAL POOL LATH EXTERIOR WALLS: IATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL 1 s�( )2Ne( )LIFT SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELEASE WALL DRAIN/SEAL GAS METER RELEASE WALL FINAL SPECIAL INSPECTION RO.FRAMINGPLANNINGAPPROVl;L ,�, ,- � _ ,FI�FJ}L BUIIDtNG� � _.�'�`�� _..� �.:. �� -. �� ROUGH FIRE APPROVAL �� , � .�w �` � `f FINAL FIRE DEPARTMENT ;FINAi.MECHANICAt ,�� FINAL ELEG7RICAL .,, , ;,„ ,, �� . FINAL PLANNING �,� , � ,, _��:+"" R�d �., , ��,. .. :.... �_. ,�..... ..r.... . ...., ... �,... . __ . ,.�.. �.:..... FINAL PLUM��BI'NG .,�E �",: � FINAL ENGINEERING/PW ' � � � ��`� � � FINAL COMMUNITY SERVICES 9T:G,of OCCUPANCY ' ' �> CER'f of dGGUPAPIGY �g"'��" ' ; ';Ya� ^�' �` FINAL NEALTH DEPL <. % FINAL INDUSTRIAL WASTE COMMENTS: