HomeMy WebLinkAbout14-3982 _ _ _ _
.�,_,-�'�,� C1TY OF DIAMOND BAR •
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i, I I I i � DEPARTAIENT OF COAIMUNITY&DEVELOPMENT SERVICES �
� 21810 Co le Drivc Diamm�d 13ar CA 91765 � RESS
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',,� (909)839-702U Fax:(909)861-31:17 Building Inspection Hot►ine(909)839-7027 FIRMLY
I `4'�"'� BUILDING PERA2IT APYLICATION
~ p APPLICATION DATE:�'� � �!/I� P/C#
a�c JOB SITE ADDRESS D d-�r Q u ,J /� q
d ISSUE DATE: �' 7' a�� / pERMIT# � ! —�'7�J�—
z APN LOT TRACT
o OWNER ` TYPE CONST. OCC GROUP:
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� ADDRESS ZONING SEfBACKS
� CITY ZIP TEL. FRONT RW ❑
a APPLICANT TEL. REAR ❑
�
� A n �I SIDE/SIDE STREET RW ❑
o CONTRACTOR/`I�J�/�I�.�/��CI�I�J'�T21 L�f7//I d%KGIGI��� - SIDE ❑
� ADDRES �r/� � �
I o CITY ZIP EL. q��/ �//%� PROPOSED USE fI
o ARCH/ENG/DESIGNER `� �� �/�J /%�i4�'GJ7
z ADDRESS
o /� #DWEL.UNITS� #STORIES� #BEDROOMS
z CI ZIP TEL %7
� DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
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°C I hereby aKrm under penalty of perjury that I am exempt hom the Contractor's State License Law for ihe reason(s) SFR/ADD/REM
0
o indicated betow by the checkmark(s�,I have placed next to the aDW�ble item(s)�Secllon 7031.5,Business artd Gerage/Carport
w Protesslons Cade:Any city ar county that requires a permR to cons
o iruct,alter,improve,demolish,or repalr,any
iz strucNre,prlor W fts Issuanca,also requires ihe aDP��nt tm the pertntt to Ne a st9ned sWtement ibat he or she � Patio/Deck
a Is licensed pursuant to ihe provisions of the Cantractor's Sfate License Law(Chapter9)Comme�ing wiN Section w
� 7000 of Divlsion 3 of the Buslness and Prolessio�Code]or that he or sha is exempt hom Ilcensure and ihe basis for LL P��Pa
� the aileged exemptbn.My violativn ol Sectian 7031.5 by any applicant for a permit sub�ects the applicant to a civil penalty C�
� of rrot more than frve huntlred dollars(5500). Q Re-Roof
o (,I,as owner oi the property,or my emptoyees wi�h wages as thelr sote compensation,will do(,all oi or U poNons � Commercial
� of the work,arM the strucWre is not lntended a offered Por sale(Sectian 7044,Business and Professims Code:The m
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� Contractors'State IJcense Law does rwt appry N an uwner o1 property who,thragh employees'or personal etfort,builds
u�7 a improves the propeity,pmvided that ihe Imprmements are nat intended or ottnred for sale.If however,tha building m
� Improvement is sold within one year of compleUon,Ne Owner-Builder will have�he 6urden of proving ttiat It was not�uitt
por imprwed for the purpose of sale.).
v I,as owner of ihe m
0 U p perty,am exclusHety conUacting with licensed ConUactors to conshuct the proJect(Section ValUation: Adj.Afea:
7044,Business and Professiais Cotle:The Contractms'State license Law tices imt appty to an ovmer of property who
z builds or im oves ihereon,and who contracts for�he o'ects with a Ifcensed Contracta ursuant to the Coniractors'State
rn � P�1 P QUANTITY DESCRIPTION FEE
Y License LawJ.
o �J I am exempt hom Iicensure untler the Contractur's State License law 1or the I011owing reason(s): �
� g
LL By my signature below I acknowledga ihat,except tm my personal residence In which I must have resided lor at least one �
z w
o year prior fi compleBon of Ne improvements covered by this permi[,I camrot legalty sell a structure that I have bu�l as an w
� owner-builder II it has not been consWcted In its ent'uety by Iicensed contractors.I understarM that a copy ol ihe appliraNe
� law,SecUon 7044 of ihe Business and Professions Code is available upon request when this appiiplion is submHted a at
X Me follovnng Web stte:httplwvnv.leginto.p.govlcalaw.html. Z
o DATE: $IGN: �
� LICENSED COMflACTOR'S DECLAHATION �
w I hereby affirm untler pemalty ot perjury that I arn lice�ed untler prmisions oi Chapter 9(commencing witti SeCfipn 7000)
m ol Divlslon 3 of the Business and Professions Code,and my license is in full torce and effect. J
� �
� LICENSE CLASS: L1C.N0.' z
oZ DATE: CONTfil1CTOR: - � �
¢ WONNER'S COMPENSATION�ECLARATION g
� �HFAFBY PFFlRM UNDER PENAL7V OF PERJURY ONE OF 7HE FOLLOWING DECLARATIONS:
oI have and will maintain e Certifiqte of Consent to Self-Insure for Worker's Compensatlon,as providetl by CONSTRUCTION: 1 �
� /SecGon 370D ot the Labor Code,(ar the pertormance of the work tor which this permit is issued.� p�qN REVIEW:
� ✓ I have and will maintain WorkePs Compensatfon Insurance,as requlretl 6y Section 3700 0l the labor Code,fw
Z the performance o1 the work tar which ihis permit fs issued.My Wwker's ComDe��on Insurance Carrier and ELECTRIC:
a PoIi�yNumberare: �J�j �j' PLUMBING:
� ��� —- °''''^� , v, �� MECHANICAL:
� POUCY NUMBER� ����� INSPECTION FEE: •
� (THIS SCCf WN NEE�NOT BE COMPLETED IF i}g PERMR IS FOR ONE HUNDRED DOLLMS(S10q OR LES57.
� ISSUANCE: �f- r7
� I certiy llut in ihe performar�ce of tlm work lor which Ihis D� issueq I shall�rol emWq'anY Perso�in arry mamier so as to � ,
o become subject to tne Worker§Compensation I.a} ot Cal' ia.Md agree Ihat il I shoWd becorne sut�ect tu tt�e Worke�s SMIP: 1 � LJ 7 I
� Compen i�bf Section 370o af ' Cod � comDH��those prav'siorrs. ENERGY P/C:
J DATE: �`9 APPLICANT:
LL ENERGY PERMIT:
� wARNING: ilure to secure Workers Compensafim coverage is unlawlul,and shall svbject an employer ro criminal RETENTION FEE: .�0
w penallles md civil lines up to me hundred Ihousand dollars($100,000),in addition to the cost of�he compensaUon,
� damages as provided far in section 3708 of the labor code,interest,and attomey's fees. PRE-ALT FEE:
0
a CONSTRUCTION LENDING AGENCY B$QF: 1,��
w I here6y aKrm under penalty of perjury that ihere is a Construction Lending Aqency iw Ihe perforn�ance ol the work lor
= which Ihis permit is issuetl(Sec.3097,Ci¢C.�.
3
� LENDER'S NAME
� IENDER'SADDRE55: �
a I certiry ihat I have read ihis apPlication and s[ate that�he above information is cortect.I agree N compty wi��all city and TOTAL FEES
couny ordinances antl state laws r lallng ro building constructlon,and hereby authorize represeniatives of th's counry ro
z COMMENTS:
o enter upo abave-mentione certY 1or i' cti�ses.
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a rEaM E(Pnir� /
� SIG TU F P M DATE ' RECEIPT# �I�I�D PAID BY: C VALIDATION:
�/ WHITE—Department Copy,YELLOW—Fnance Copy,PINK—Assessw Copy,GOLDENROD—Fle Copy,GREEN—ApplicanYs Copy
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CITY OF DIAMOfVD BAR
INSPECTION RECORD
• � � � • - • � � o '
SETBACK/LETfER .- ��- _ - ..,_ ? TRACT AND LEDGER
�FOOTINGS FDRMS�;, �`F '" � ��" - := SWITCH GEAA
SLAB.; + ��n,, . , '_{ �-��,� , :: „�' COMMERCIAL HOOD
'UG.PLUMBING'- `° { .�,;i ��'. w ' 3 `'� `'�. T-BAR
'UG:EIECTRICAL'. r ` y� � ..=Y INTERCEPTER
UFER GROUND�`' - T`� , , =. } c HOT MOP/SHOWERPAN
SEWER LATERAL SEPTIC/CESSPQOL
MAIN WATER IJNE HERS REPORT RECENED
SEWER CLEANOUT DEMOLITION
ROOF SHEATHING ROOF DRAINS
FLOOR SHEATHING ROUGH CONDUIT
;., `; `r' j- `POOUSPA;; ` `r > ,., ,:
SHEAR WALLS'EXTE810R •:��y. _ �
SHEAR�WALLS tNTERIQR,;,: ' F';„�.' �" 'F� �" ,i :L`„ ,., � _ ?�r�s� �ROUGH PLUMBING -� {, _ `Y � s•,':
FRAMINGNENTING , �'; - s `�'�' r ` � ' � 'fiOUGH ELEGTRICAL: ; � �� �� r ��
ROIJGH MECHANICAL. �= - j1 r y ;x:;:� ``S HOUGH MECHANICAL f ' � } ,' _
ROUGH.ELECTRICAL.W(;.`.;)C( ) ,r; �, - ' _ _ �GAS TEST;;;;� - - ` � -
<,. •�a
ROUGH`PLUMBING _ ' ,�`'' �'r ���` PRE GUNITE, ' ' �'
INSULATION WALL POOL'PRE'DECK BONDING ' .�����, ' • �;, ., �
INSUlATION CEILING 'Ps_�qP ;`a- _ =� r -.���� - ' � , _
DRYWALL �FENCE'/GATFl ALARM � ' i� _ -
LATH(PR� FINAL POOL , _ ' ` = -�
LATH EXTERIOR WALLS:
LATH INTERIOR WALL FOOTINGlSTEEL
GAS TEST WALL STEEL 1�( )2ND( )LIFT
SCRATCH COAT WALL BOND BEAM
ELECTRIC METER RELEASE WALL DRAIN/SEAL
GAS METER RELEASE WALL FINAL
SPECIAL INSPECTION 9 x ,.•-""" ,RO:FRAMING PLANNINGAPPROVAL r' '` �r�'�S r " . , F:<
-_ - , �:, ,
FINAL,BUILDING�� ` �, � � ROUGH FIREAPPROVAI � t
FINAL MECHANICAL y _ FINAL FIRE DEPARTMENT � ` Y
�
- ,- -
-FINAL ELECTRICAL .. ' ' , � '�"` '.,., � ' , "
' fINAL PLAMNING,,; � -j
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' r,-�. � . , � '� •FINAL ENGltdEERING/PW' fi';�; ^,, ,, ���;, , ,.k`1',. � 'r'-
. a _: . .
EINAL���PLUMBING , �_�� :t. �:� �,:,,,. .�.�ti ,. �,:� � .��h��� ���- -
r�- .FINAL COMMUNITY�SERVICES = '�� �`i ` x`
T.C:of OC�UPANCY. `� - ' "" a'' '=
_ _.
CERT.'°of'OCCUPANCY.' ' ,�.:,'. ,,_;r ;', FINAL H�LTH DEPT ; � �'` F
FINAL INDUSTRIAL WASTE;=', . -
COMMENTS:
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