HomeMy WebLinkAbout14-3990 �r'�'��. C1'TY OF DIAMOND BAR
� I I i ' �� DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES
��������',–n�, �� '� 21810 Copley Drive,Diainond Bar,CA 91765 PRES�
,,,,� (909)839-702U Fax:(909)861-3117 Buiiding Inspection Hotline(909)839-7027 FIRMLY
���'��°' BUILDINGPERMITAPPLICATION
� APPLICATION DATE: �~ I— �j P/Ci/
�¢ JOB SITE ADDRESS �� — J PERMIT# ��^ , � 7 I
� ISSUE DATE:
zo APN LOT TRACT
o OWNER 1YPE CONST. OCC GROUP:
� ADDRE S r ZONING SEfBACKS
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APPLICANT TEL. REAR a—
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QCONTRACTOR . �y Q ��/ � ���A/] 7 SIDE �
c� ADDRESS /� _/ � �y�,�� �� `+��� ,��h I PROPOSED USE
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o ARCH/ENG/DESIG/NER , � 7���`� n��/'������
a ADDRESS Z�l1'�'7 hYA�/�I�/A TJrI� q DWEL.UNITS��G #STORIES !�" k BEDROOMS
a C�7y / . /��� ZIP 92�i91 TEL.��ID-�/I�'S��)h DESCRIPTION SQ.FL FACTOR PSF ADJ.AREANALUATION
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� 1 hereby aNirm u�er Denatty of periury Ihat I am exempl hom Ne Contractor's State License Law for Uie reason(s) SFR/ADD/REM
� intlicatetl below by i�e checkmark�s),1 have placed nexl ro ttce appl'uxWe item(s)[Section 70315,Buslness an0 Gara e/Carporl
0 9
�'-� Professions Cade:Any city a couMy ihat reqWres a permit to constnict,atter,improve,demolish,or repair,any
z structure,D�or W 14s issuance,also requlres ihe applicant far Ilre permN to flle a s�gned statemenl that be or she � Patio/Deck
a is licensed Dursuant to the provisions of the Ca�actors State Ucense Law(Chapter 9)Camrnencing wilh Section w
� 7000 of Uivision 3 of Ne Business end Protessions Code]or thal he or she is exempt hom licensure and ihe basis lor LL P���Spa
_
N the alleged ezemptlon.Arry violation of Section 7031.5 by eny applicant iw a permit sutil��me aDDlicant to a civil penatry
`—� of not more than five�unAred tloliars(5500). Z Re-Roof
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o (�I,as owner of Ne property,or my employees wIN wages as ihelr sole compensation,wAI do(,J all ot w(�portions � Commerctal
� of the work,and 1ha SWcture is nol IntenAed w ottered lor sale(Seclion 7044,Business and Professions Coda:The �
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� Contractors'State IJcense Law does rwt applq to an owner ol property vfio,thraugh employces'or personal effort,builds
w m improves tlie D�oPerty,prmided ihat the improvemenis are not fntended or oftered lor sale.II however,ibe Uuiltling or
� Improvement is sald within one year of completlon,tha Owner-Builder will have the burden of proving ttiat it was rrot huitt
pw imprmed lor the purpose of sale.).
v U I,as owner ol the properry,am axdusivety contracting wIN Ilcenssd ConVactors to canstruct the proJecl(Sectbn
0 7044,Business and Professions Code:Tho Contractas'Stale Lice�e Law dces not aDP�Y to an owner o1 properry who Valuation: Adj.Area:
z buildsorimprmes�hereon,andwhocaitractsfatheprofectswithalicensedCantraclarpur�anttolheConVaclors'Stala QUANTITY DESCRIPTION FEE
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Y ucense LawJ.
O U���empt hom IiCensure under Ihe Canirdctors Sta10 Lfcense law tor�he foltowing reason(s): �
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`� 8y my sigmture below I acVmowledge tlial,except im my personal teside�e in whicb I must have resided fw at leasl one �
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o year prior[o completion of the improvements covered by this permd.l cannot legally sell a sWcdre that I have built as an �,
� owner-builder it it has irof been consWctetl in its enCuety by licensed contractors.l undersiand ttiai a copy oi Yhe appiicable
law,Section 7044 0l ihe Business and Professiw�s Codn is available upon reQuest when this application is submitled a at
X ihe foilovnng WeD srte:httpJwww.teginio.ta.goWcalaw.htmi. z
w DATE: SIGN: �
� LICENSED CONTRACTOH'S DECLAHATION �
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w 1 hereby aHirm unAer persatry of perjury that I am lice�ed under provisions of Chapter 9(commencing with Seclion 700f1)
� of Divislon 3 a1 the Business and Prolessions Code,and my I�ense is in full force and eflect. �
N �/�27 • �
y LICENSE CLASS: LIC.NO.: Q
o DATE: CONTfiACTOR: w
Zd WORN615 COMPENSATIDN OECUIHATION �
� 1 HEREBY AfFlRM UN�ER PENALTY OF PERJURY ONE OF THE FOLLOWING DEQNiAT10NS:
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¢ 1 have and will maintain a CeA�pie oi Consent W Seif-Insure Iw Worker's Compensation,as provide0 by CONSTRUCTION:
� SecOon 3700 of Ihe Labor Code,tor Ne peAormance of the vrork for which this permit is issued, p�qN REVIEW: '
�
� I have aM will m�intain Worker's Compensation Insurance,as requlre0 by Section 370D of the Labor Coda,for ELECTRIC:
o fhe pertormuice ot the wmk fa which this permit is fssued.My Worker's Compensation Insurance Carrier and
¢ PolicyNumberare: ,L.� /� y� � PLUMBING:
� CwtRIFA �/N/G• /'N/�� MECHANICAL
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Z POUCv NUMBFA � INSPECTION FEE:
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N (TH6 SECIION NffD N0T Bf MPLEfED IFTHE PFJiMR IS FOR ONE HUfJDHED DOLIMS�570�OR LESS). ISSUANCE: --�'`� �
� I certify ihal in the DeAorrnance of the wnrk for wttich permi[ ,I shall rot tmPloy arry person�any manner so as to '�,t� '�
obecome subject to WorleerS Compen,saGon La f Calito � . aqree d I slrould hecame subject to the Worker's SMIP:
u� Compen ' Section 3�00 M a Code,� �an wi Ih uase provisiors. ENERGY P/C:
J DATE: APPLICANT: '' �
� ENERGY PERMIT:
� WAANING: ai re la secure Workers Com tion age is unlawlul,and shali subJect an empWyer to criminal RETENTION FEE: �1-•Q�
¢ penanies and civil fines up to one hundred Nousand dollars($100,000),in atldifion to the cost of the compensation,
"' PRE-ALT FEE:
o dama8�as provided tor ln section 3708 oi the IaDor code,inierest,and attomey's fees.
� CONSTHUCTION LFNDING AGENCY BSAF: ��
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� I hereby affum under penalty of per�ury that there is a ConsVuction Lentling Agency for the perlormance of ihe vuork fw
= whkh this permd is issued(Sec.3097,Civ.C.).
� LENDER'S NAME ��.�,��
� LENDEA'SADDRESS:
a I certify that I have read Nis application and state that the above informalion is corzect.I agree to compty wii�a11 city and TOTAL FEES
� counry ordina�es and Slate haws relating In bullding construction,and hereby authorize representatives of this county to COMMENTS:
Z enter upo th above-mention pe�t f �Purposes.
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a PERM E(PRIN �
= SIGNA R OF ERM p RECEIPT q�lJ jdr.� PAID BY: ✓ �DIO VALJDATION:
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V I WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—Fle Copy,GREEN—Applicant'S Copy
CITY OF DlAMOND BAR
INSPECTION RECORD
. � � , e - s � � • '
SETB¢CKI,LETTEfl ,. - '� ` �.�-��:�. � TRACTAND�LEDGER �
FOOTINGS FORMS - _''' - '"' SWITCH GEAR
_ a '%' : COMMERCIAL HOOD
SLAB '�;, -
UG.PLUMBING:: ' - � T-BAR
UG.EIECTRICAt - - INTERCEPTER -
UFER GROUND '' >�„ ; HOT MOP/SHOWERPAN
SEWER LATERAL SEPTIC/CESSPOOL
MAIN WATER UNE HERS REPORT RECEIVED
SEWER CLEANOUT DEMOUTION
ROOF SHEATHING ROOF DRAINS
FLOOR SHEATHING ROUGH CONDUIT
� POOL/SPA.. - -- ��s
SHEAR WALLS EXTERIOR' . �+ � ,
` ` ' : ROUGH PLUMBIN6 � '.
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SHEAR WALLS INTERIOR' < c _
FFiNMIN6/VENTING �`.* � ° r "�` ROUGHELECTRICAL; �" � �, ' : �s' �
ROUGH�-MECHANICAL �� :.;���� , � � �� r�' �'' � � _ , , , �, , r � �
' �� � �ROUGH MECHANICAL
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ROUGH�ELEGTRICAL WE;=�-�( �� = ` ` ,-� GAS TEST;;- . � ,� ; -
ROUGH•PLUMBING - ` : PRE�GUNITE ' ` �` `�
�-
INSULATION WALL POOL PRE'DECK BONDING �-;� - � `
INSULATION CEILING P"�P - y�
DRYWALL FENCE l GATE/ALARM � ' � � 3�=
LATH(PRE) FINAL',PDOL = - _- _ �`';'
LATH EXTERIOR WALLS:
LATH INTERIOR WALL FOOTING/STEEL
GASTEST WAIL STEEL 1sT/ �2NOi ,u�
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SCRATCH COAT WALL BOND BEAM
ELECTRIC METER RELEASE WALL DRAIN/SEAL
GAS METER RELEASE :_ y
WALL
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,EiO FiiAM1N�PLhtJt�NGAPPROUAL r '
SPECIAL INSPECTION -
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_ > °''" ;� '°- ''; ROUGH FIREAPPROVAL - _ ,'` N ;
FIN7�L BUILDING �` - •- �� �- -
FINAL MECHANICAL , ;/ _ • - .�; . ° FINAL FIRE DEPARTMENT .. '
FINAL ELECTRICAL -_ ` . FINAL�PIAfdNING ' ` "
fINAL FLUMBING = t `� '
r ` . FINAL ENGINEERING/PW :.�. `` � - a
T.C,of OCCUPANCY � ' FINAL COMMUNITY SERVtCES ,��
CERT.-OfOCCUPANCY. ' �� FINALHEALTH-DEPT � r ' � , `� � 'r J
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FINt1L�INDllS1R1AL WASTE,`_ `— _`' `�` t- ��
COMMENTS: � �