HomeMy WebLinkAbout14-3984 „�'',��'�.� C1TY OF DIAMOND BAR
' 1 I i ' I DEPARTMENT OF COMMUNITY Rc DEVELOPMGNT SERVICES
�iup;,ii�:,� 21810 Copley Drivc,Diamond[iar,CA 91765 PRESS
�' ' ~�� . FIRMLY
,,,,�1 (909)839-7020 Fax: (909)861-31:17 Building Inspection Hotline(909)839-7027
� ��'"%+�`”� BUILDLNG PERMIT APPLICATION �
� APPLICATION DATE: ✓ � W/I P/Cli
�¢ JOB SITE ADDRESS �' ISSUE DATE: /� -/ " tl►/_,_I�PERMIT# �'7 _�9 O �
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z APN LOT TRACT
o OWNER ' ' TYPE CONST. OCC GROUP:
y ADpRESS ZONING SEfBACKS
� C�Ty Ip TEL. FRONT RW �
¢ APPLICANT TE�. REAR �
o ' SIDE/SIDE STREET RW ❑
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¢ CONTRACTOR �� � � SIDE �
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o ADDRESS
� � PROPOSED USE
o� CITY ZIP EL. �
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o ARCH/ENG/DESIGNER �" �
o ADDRESS #DWEL.UNITS� k STORIES� #BEDROOMS
a �� - �D ZI TEL. �
OWNEH-BUILDER�ECIARATION DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
� I hereby aKrm u�er penalty o(perjury tliat I am exempt irom Me CantraClor's State License Law far the reason(s) SFR/ADD/REM
0
o irMicated below by tlie checkma�k�s),t have O�aced neut to ihe ap➢���b1e item(s)(Seclion 7031.5,Buslness and Garege/Carport
"-� Rofessions Code:Any city or county that requires a permit to co�truct,alter,improve,demolfs�,or repair,any
Z structure,Drior to Its issuance,also requires 1ha appilcant tor the pennit to flte a signed statement that he or she � Patio/Deck
� is licensed Dursuant to ihe provlsions ot ihe Conhactor's State llcense Law(Chapter 9)Comme�ing wlfh Sectlon w
� 7000 of Divislon 3 of ihe Business and Professlons CodeJ or thai he or she ls exempt hom licensure and the basis for LL PooVSpa
N fhe alleged exemDtion.My vioiation of Section 7037.5 by any applicant fw a permit subjects the aDD�icant to a civil penatty
� � ot not more than five bundretl Aotlars(5500). ZQ Re-Roof
o (J I,as owner of the property,a my employees wlth wages as thefr solo compensation,will do(1 all of or(�portbns -� Commercial �
0 ot the work,arid the struciure is not inten0etl or offeretl tor sale�Seclion 7044,Busfness and Protessions Code:The � .
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� Contractors'State License Law dces not apply to an owner ot properly wha,through employees'or persanal effort,builds
w or improves ihe property,provitletl Uiat the improvemenis are not intended or otlered lor sale.I�however,the builtling or
� Improvement Is sold within one year of compleHon,ihe Owner-Builder will have the burden of proving ihat i[was not Ouilt
por imprmed for ihe purpose of saie.).
V
� (J I,as owner of the propeAy,am exGushely cantractlng with Iicensed CanVactors to construcl Ihe pro�ect(Secfion Valuation: Adj.Af80: -
0 7pqq,Business and Rolessions Code:The Contractors'Shate License law dces not appty tn an ovmer ol property who
z 6uilds w improves Inereon,and who contracis im ihe prolects wilh a licensed Contractor Dursuant to the Contracrors'State pUANTIIY DESCRIPT40N FEE
cn
Y Ucense Law.).
o U�gm exempt hom licensure under the Cnniractor's Sta�e Ucensa law tw lhe tolbwing reason(s): �
�y ¢
`=` By my sigrtature befow I acknowledge that,except tor my personal residence in whic�I must have resldetl tor at leasi one �
Z year prior to completlon of the improvemen4 covered by fhis permit,l pnnot legally sell a sUuctuw that I hava bultt as an ,��,
0
Q owner-auilder it It has not been consWcted in its entirery by licensed conbactors.I understand that a copy ot the app11ca61a �
¢ law,Section 7044 of iho Business and Professions Cotle is available upon request when this applicatlon is submitled m at
a the lollovring Web site:httpAvww.leginfo.ca.gov/calaw.htrnl. z
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w DATE: SIGN: O°
�
� LICENSED CONiRACTDR'S DECIARATIOH �
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w I hereby affirm under penalty ot per�ury that I em licensed under pravisions ot Chapter 9(commencing wilh Section 7000)
� of Divislon 3 of the Business and Professions Code,and my license Is in fiAl force and effect. •� �
� �
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� L10EfdSE CLASS: UC.NO.: z
a
o DATE: CONTRACTOA: c=.� '
zd WOflNER'S COMPENSATION�ECLARATION g
� I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARAT10N5: � r/��
¢ I have and will malntsin a Certificale o1 Consent lo Sett-1nsure Iw Wo`her's Compensalion,as provided by CONSTRUCTION: �
� /Section 3700 0l thn Labor Code,tor the perfamance ol the worle for which this permit is issued. p�qN REVIEW:
� � I have aiM vnll maintain Worker's Compensatlon liuurance,as reqWretl by Section 3700 of Ihe Labor Code,tor
o —K the performance ol the wark fw which this permit is Issued.My Worker's Compensation Insurance Camer and ELECTRIC:
¢ Pdi�yNumDerare: o PLUMBING:
� CARRIER V'�� - MECHAN4CAL:
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Z POLICYNUMBEA 7�7� � �f INSPECTION FEE:
cry
� (T}9S SECiION NEED N0T BE COMP[FffD IF7NE PERAIIT lS FOR ONE MINDRED DOLINiS(`S100j OR LESS�.
ISSUANCE: '
� I certify ihal In the pertormance o(the v.ork lor whkh Ihis pertni[ ' eQ I slnll rrot empby arry person in any rnanner so as to �{�7
oDeoome subi�to Ne Waker9 CompensaUan of Cal' .Md agree I�at If I s�wkl become subject to the Worker,s SMIP: �• �
� com on a secern s7oo a code, Wy wiln upse vrrnisbns. ENERGY PlC:
J DATE� APPLICANT: �
,� ENERGY PERMIT.
� WARt71N6: ilur to secure Workers Com ensation cwe2ge is uMavrlul,and shall sub}eci an employer to cnminal REfENTION FEE: �' �
¢ penattles and civil fines up to one hundred thousantl dollars($/00,000�,In adtliUon to the cost of thn comDensatlon,
"' PRE-ALT FEE:
�- tlamages as provided ta in section 3708 ot the labor code,interest,and anomey's fees.
� CONSTRUCTION LENDING AGENCY BSAF: ��
w I here�y af(um under penalty of perJury ihat ihere is a Construction Lending Agency ta ihe pedmnwnce of th9 work for
= which this permit is issued(Sec.3U97,Gv.C.).
� LENDER'S NAME . � �
� LENDER'S ADORESS: ' �� O,
a I certity that I have read this aDP���N��tl state that Ne above Informatlon is correcL I agree to comply with all city and TOTAL FEES
� counry wdlnances and state laws relating m building constructlon,and hereby authorize representatives of this county to COMMENTS:
� enter upan t bo�e-mention p perty foyfn�pecib�urposes.
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¢ PERM EE (PRINn
= SIGNATURE 0 E ITTEE = OATE � RECEIPT k .,IO�7 7 PAID BY:./��I/�V VALIDATION:�T,_
�
'L WHITE—Depariment Copy,YELLOW—Flnance Copy,PINK—Assessor Copy,GOLDENROD—Fle Copy,GREEN—ApplicanYs Copy
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CITY OF DIAMOND BAR ,
INSPECTION RECORD
• � � � s - � • � . - • -
` �;�' '� , � � '` TRACTAND LEDGER
SETBACK/:LETTER ;. . � ;. , ,.. _ .,:
�FOOT�NGS FORMS - ��� ���'� -- � �` SWITCH GEAR
SLAB.. '
� : ,:,' ,, <<.�;� COMMERGAL HOOD
UG.,PCUMBING*,:;. ' - � � �,s; � .,;� ..��� T-BAR
.UG.ELECTRICAL. ° ' r r' � � � �� INTERCEPTER
UFER'GROUND'•.' a.,.... . � ` ' ��� � - , �. `.? ���9 `_�"� `� �',��-'� HOT MOPJSHOWERPAN
. , � �-,� ., .. � �
SEWER LATERAL SEPTIC/CESSPOOL
MAIN WATER LINE HERS REPORT RECEIVED
SEWER CLEANOUT DEMOLITION
ROOF SHEATHING ROOF DRAINS
FLOOR SHEATHING ROUGH CONDUIT
_ t , _- ; P,DOUSPA,_: "
SHEARWALLSEXTERIOR ' =:�, _ -
�SHEAR�WALLS:INTERIORT :�. , � � ` , ROUGH PLUMBING := , < <
FRAMINGNENTING 7 �� , �r y' � � F �� - r � �
� ROUGH ELECTRICAL
���� 'x`,z ROUGH�MECHANICAL-, � v '� '° � �:��` �, �
RQUGH MECHANICAL � rr
r � � • GAS�TEST _�`` � - �,� `���` '�- m
'ROUGH ELECTRICAL W( `)C( ) - � + �
, x ,;
BING
��r �, ,r �,�,'' PRE GUNIT,E � "
GH PWM �. . �
60U ��.
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,�:F .: _ , �� .�, . _ �� _
INSULATION�WALL �POOL PREpECK BONDING ' `=� � �; ���i ��� � ���' � ��,
P-TFlIaP �:>-- �� ,:�; x: _ , � � ; � `,,;,
INSULATION CEILING � �
DRYWALL FENCE/GATE!ALARM ` F '�� ��� �= � s"
LATH(PRE) FIN;4L�,POOL _ �. ;` _ ,`-: `� -
LATH EXTERIOR « <4 WALLS:
LATH INTERIOR WALL FOOTING/STEEL
GAS TEST WALL STEEL 1�T( )2ND( )LIFf
SCRATCH COAT WALL BOND BEAM
E�ECTRIC METER RELEASE WALL DRAIN/SEAL
GAS METER RELEASE WALL FINAL
. :�, �
SPECIAL INSPECTION � ING PLA1dNINGAPPR6VAL , � . 3° L � �
RO FRP�M
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FINAC BUILQING `"' ` - � t".' r :� - '° ROUGH FIREAPBROVAL t
d ` � � ' ; ��
F1NAL MECHANICAL �'' '�' � � '_ � FINAC�FIRE DEPARTMENT , � ^ �� s ��' r ' �����
, � ; ,
FINAL ELECTRICAL � �`` � FINAt PLANNING `..�, ' � : �}' ��� ` S ,
� - - FaNAL ENGINEERING/PW ��� "'� �� � r �' � `� ` ��
FINAL PLUMBING
LG:ofOCCUPANCY _ FINALCOMMUNITY;SERV(CES ,• � }' : tFF
CERL;of OCCUPANCY,; ` � /: ,�_�, . EINAL HEALTH DEPT ,`� ;' ` , 1
, . . . .•' s � _
_� , ., _ ...., , : ,, �� - _
FINAL INDUSTRIAL-WASTE`,:�' _ ` � ''
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COMMENTS: /�o Tog �I�z��►Is�r� FoR��/�tp �l�l��`�'