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Home My WebLink About14-1040 ��,;;�"_�,,� C1TY OF DIAMOND BAR � i I I I �� DEPARTMENT OF COMMUNITY&DEVELOPMCNT SERVICES ��'�,: "{j�j;�,; ✓—� 21810 Coplcy Drivc,Diamond 13ar,cA yi��s PRESS 'i ,,,�� (909)839-7020 Eax:(909)861-3117 Building Inspection Hotline(909)839-7027 FIRMLY ��"�d"'_ BUILDING PERMIT APPLICATION � ��-- � U� � O� � IrU,��I � O1 APPLICATION DATE: � —� P/C# � JOB SITE ADDRESS ISSUE DATE: ��/ �� PERMIT# ��L�Orr/ z APN LOT TRACT o OWNER �)_�G� ��U �C�/'I� TYPE CONST. OCC GROUP: N ADDRESS S ' ZONING SETBACKS � CITY Z1P TEL � � b�` �� FRONT RW ❑ � APPUCANT V� C;i1 S��TEL. , ��3 O`3 REAR Q 0 51DFJSIDE STREET RW ❑ N f� O a CONTRACTOR � - r� SIDE o� ADDRESS (�� r� � "�y 5�� PROPOSED USE ¢ CITY��1Q/��1 UIr�ZIP �� `(o3TEL. ��D ��r-51�j � 0 o ARCH/ENG/DESIGNER z ADDRESS ri DWEL.UNITS k STORIES k BEDROOMS 0 � CITY ZIP TEL. ? DESCRIPTION S(].FT. FACTOR PSF ADJ.AREANALUATION � owr��+-sminm oEcwunor+ ¢ 1 hereby affirtn u�er penatly ol peryury that I am emmpt from the Contractor's S[ate License Law�or me reason(s) SFR/ADD/REM � Intlicated below by the checkmark(s�,I have placed nea1 to the appfica6le iiem(s)[Section 7031.5,Buslness an0 Gara e/Carport o � '-'� Protessiars Code:My dty or county that requires a permit to construct,alter,imprave,demolish,m repalr,any z structure,Driw lo ils iss�nnce,also requires the appllcant for IAe permit to 81e a signed statement thal�e or she w Patio/Deck NIs�icertsed Dursuant ta the provistons of tha Cantrector's Sfate Ltce�cse Law(Chapter 9)Commericing with Section W � 7000 of Dlvislon 3 of the Business anA Prolesslons CodeJ or ihat he or she is ezempt hom Ilcensure and ihe basis for � P��Pa N the alleged exemD�ion.Arry viofation of Section 7031.5 by any applicant for a permit su6jects the aODlicant to a Gvll penalry Z Re-qoof - � ot not more tl�an frve hundre0 tlollars($500). � o U I,as owner ot the properry,or my employees with wages as thelr sale compensation,will do(�all of or(.�Do�o� � Commerclal 0 of Ihe work arM the strucWre is not intended a oflered ror salo(Sectbn 7044,Business and Rofessbns Cade:The � w m c� Contractas'State License Law dces not appN to an ovmer af property who,Nrough empbyees'or personal eftort,builds � u77 or improves the Droperry,D�'�ed that ihe imprrnements are not intended or offered lor sale,tl powever,the builtling or � Improvement Is sold within ane year af compleUon,tho Owner-Builder will have ihe burden of proving tha�it was not 6uilt � w improved fw ihe purpose ot sale.). 0 � (�I,as owner ot the property,am excluslvety conUacting with licensed Contractors to cansin�ct Ne proJact(Section 0 7044,Bisiness an0 Rofesslons Code:The CoMractors'Sfale License Law dces not appty t�an owner ol properry who ValuatiOn: Adj.A�ea: Z buildsorimprrnesthereon,endwhocontractsfarthepro�eclswithallcensetlContraclorpurwanitotheConhxtnrs'State OUANTI'fY DESCRIPTION FEE N Y License Law.). o (�1 am exempl irom licerrsure under Ne ConVactur's Slate Llcense law tor Ihe tollowing reason(s): � . � � LL By my signature below I acimowledge that,except tor my persanal residence in which I must have resided fw at Ieast one w z year prlor to completlon of tha imprmements covered by ihis portnit;l canrrot legally sell a struc[ure that 1 have buitt as an „�, 0 Q owner-builder if It has not been constructed In iis entlrery Dy Ikensed contractors.t undersiand ihat a copy ot the applip6le OC law,Section 7044 of the Business and Professlons Code is available upon request when this epplicatlon a submitted ar at � [� � � thefollowingWebslte:http/www.leginto.ca.gov/plaw.html. z x w OATE: SIGN: � � LICENSEO CONTflACTOH'S�ECLARATION - a U W 1 hereby a�rm un0er peinity of per}ury Ihat I am licensed under provisiau of Chapter 9 icommenCing with Section 7000) m oi Divtsion 3 of ihe Business and PrMessions Code,and my ticense is in fWl force and eflect. . � ! �/ � N LICENSE CIASS: L 3 a� uC�A;��7� / 2 � h oZ DATE:�I �T_ CONTRACTOR: i� F w ¢ WORKEl1'S COMPENSATION OECIARATION � � I HEREBY AFFlRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DEClJUN710NS: w ~¢ 1 have a�will maintaln a CertRicate ot Consent to Sen-Insure 1a Worker's Compensatlon,as provldetl by. CONSTRUGTION: � SecGon 3700 of the Labar Code.lar Ihe O��ce ot ihe work tor which this permil is issuetl. p�qN REVIEW: � � I have and will mainhain WorkeYs ComDensatlon Insurance,as requiretl by Secfion 3700 oi the Labor Code,for ELECTRIC: o the peAormance of the wak for which this ce�it is issued.My Worker's Compensation Insurance Carrier and ¢ Po�icyNumberare: PLUMBING: �� CARRIEA �-��e } � MECHANICAL: w z POLICYNl1MBER f7 )t 2--D �'� y 7 I INSPECTION FEE: � — � (T}fl5 SECf1DN NffD OT BE COMPLEIED IF1HE PHN1R IS FOR ONE FAINDRED DOW+RS(S100j OR LfSS). ISSUANCE: � ��' 0 1 cer6ty tlut m the pertormance ot ihe Nvrk lor which N's permit is issucd,I ShaV rol emptoy a�ry person in any rtaruier so as to SM I P: o becmie si6jecl lo the WorkerS ComP��.�d agree that if I sFwWd becorne sibject to the Wak.er'S � Compensali prwisions ot Sec:tion 3700 a(the Labor Cale,I sha@ laltnvitl�comON'+��P��- ENERGY PlC: DA7E: � �� nPPLICANT: ENERGY PERMIT: `' � WARNING Failure to secure workers Compe tlon coverage Is unlawful,ano shall subject an employer to cnminal RETENTION FEE: i ��Ov W penattles and civil fines up to one hundred thousand dollars($100,OD0�,In atlditlon to the cost of lhe compensation, � - � damages as prmided for in section 3708 0l the labor code,interest,and attomey's lees. PRE-ALT FEE: � CUNSTRUCTION LFNOING AGENCY BSAF: w I hereby afFlrm under penalry of per�ury mat there is a ConsVuctbn Lending Agen�y for the perlamance ol the»rork Por � wn�cn�n�s aermn�s�ssuee tse�.aos�.c��.c.�. � �No�s wune � LENDER'SAD�RESS �� a 1 certify that 1 have read Mis appiiption and slate that the aDove informaGon is cortect.t agree to compry wim all city antl TOTAL FEES � counry ordinances and state laws retatirtg to building consWcdon,and hereby aumorize represenG�ilves of this counry to COMMENTS: a enler upon the above-menYwned roperty lor inspec�wn pur 9 _— � m - a PERMfffEE NAME(PRINn /� l� " G = SIGNATURE OF PERM ' ATE RECEIPT q � AID BY: VALIDATION: � WHITE—Depertment Copy,YELLOW—Fnance Copy,PINK—Assessor Copy.GOLDENROD—File Copy,GREEN—ApplicanYs Copy CITY OF DIAMOPID BAR INSPECTION RECORD . � � . s - • e , � • - SETBACK/�LETTERy, _ �.�`' •- �L ,.�.;: . �� TRACTAND LEDGER FOOTWGS FORMS � ' �•t r j,�,t . ; SWITCH GEAR S�B ;r �,, '�`'' _ - COMMERCIAL HOOD .5 t .,; ��-�� UG;PLUMBING 1 - ` � T-BAR r �: UG.ELEGTRICAL` = s,��; ,� ;'� �' �` INTERCEPTER UFER GROUND�� >.r�i , j�' � ; "= . � "�; HOT MOP/SHOWERPAN SEWER LATERAL SEPTIC/CESSPOOL MAIN WATER LINE HERS REP�RT RECENED SEWER CLEANOUT DEMOLITION ROOF SHEATHING ROOF DRAINS FLOOR SHEATHING ROUGH CONDUIT ' L POOL/SPAi. ` '4rz. , {x�' 5HEAR'WALLS EXTERfOR�= � �'�° � �� - _ _ �� SHEAR WALLS�INTERIOR�� '� �� `�r� � � � ROUGH PI.UMBtNG _: � ' �� FRAMINGNENTING ' .' ` _ - ROUGH.ELECTRICAL``> - - r Y_� ` �'t „ � , t b�: �`' ' _ ROUGH iVIECHANICAL ' � �` Y �� -�� 'r �' ��s � � ,ROU�H MECHANICAL - � � " ! '��4�' ] �1 I. ROUGH�EIEGTRICAI W( _)C,{ ) � � R S „�` GASTEST'�; ' ROUGH,PLUMBING � ` `�° `� -d l ,_ ,_.° :PRE GUNITE , ''� ' �' ' INSULATION WALL P�OL PRE`:DECK BONDING ,�- - s� ' '� �� INSULATION CEILING P'�P ' ' ' . DRYWALL FENCE`/GATE/ALARM 'y ` " LATH(PR� FINAL POOL, _ ° � - ' ` ,t.. LATH EXTERIOR WALLS: LATH INTERIOR WALL FOOTING/STEEI GAS TEST WALL STEEL 1�T( )2ND( )LIFT SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELEASE WALL DRAIN/SEAL GAS METER RELEASE WALL FINAL RO F�iAMiNG FIANMNG APPROVAL "� � ' ` [r ' SPECIAL INSPECTION � ' ` '� - FINAL-�BUILDING �'` - "' `' " ' ''� � ROUGH'FIRE APPROVAL �� ' , � � .` FINAL MECHANICAL } ' _ ' r': i , L _ ,,y� ` FINAL FIRE DEPARTMENT , _ - �4 �� , _ . ; . � , _ `� FINAL ELECTRICAL ' 1 FINAL PLANNING'{;r fINAL;PLUMBING ,�. � � �'��F, Z�%;l� ` "' ' _�� '� �FINAL ENGINEERIN�G/PW_-,> - � � �'_ ` - FINAL COMMUNITY SERVICES Er'� T,C.of OCCUPANCY � ` � ` ` � fINAL HEr4LTH:DEPT { � CERT.�of OCCUPANCY_-`' - - '��` � � �' � �� <<;< fINAL INDUSTRIAL WASTE_; , �� = COMMENTS: