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Home My WebLink About14-4993 �� C1TY OF DIAMOND I3AR � � ;I DEPARTMENT OF COMMUNITY&DEVELOPM�NT SERVICES ,� �.�, . ��j„�;:= 21810 Coplcy Drivc,Diamond I3ar,CA 917fi5 PRESS _� ' �k,�'�,,,,� (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 FIRMLY BUILDING PERMIT APPLICATION � � �� , a� r� APPLICATION DATE: P/Ctl w JOB SITE ADDRESS u 'y ^� zo APN LOT T T ISSUE DATE:�(Z�I� PERMIT# I�1 a Y��J o OWNER � I`R/�� OM �' TYPE CONST. OCC GROUP: � ADDR SS CITY . O ZIP TEL. ZONING SETBACKS I cn FFONT RW ❑ a APPLICANT TEL. REAR p ¢ 0 ./ ¢ CONTRACTOR G/'(ti� /' �` � SIDE/SIDE STREEf RW ❑ o SIDE ❑ �o ADDR S r'%��-G. LGG� ¢ CITY ZIP 3 /TE�. /�d�� - 9 ?j PROPOSED USE //� / o ARCH/ENG/DESIGNER ��y � � GLr � a w o ADDRESS tl DWEL.UNITS �t STORIES k BEDROOMS Q CITY ZIP TEL. � OWNEH-BUILDER DECLANATION DESCRIPTION SQ.FC FACTOR PSF ADJ.AREANALUATION o I hereby aKrm under penalty of Derjury Nat I am ezempt from the Contractor's Slate Lfcense Law fm the rea5on(s) SFR/ADD/REM p irMicated below by the checkmark(s),I have placed nea1 to Me aDPlicable item(s)[Secllon 70315,Buslness and Garage/Carport - o Professlons Code:Any city or county tliat requires a permlt to caixtruct,alter,Improv&demollsh,a reDalr,any z struclure,prlor lo f�s issuance,also requires the applicant lor the pertnit ta file a slgned stalement that he w she � Patio/Deck = is licensed pursuant to the provlslons of the Cantractor'S State License Law(Chapter 9)Commencing with Sectlon w 7000 of Oivisfon 3 of the Buslness and Professlom Code]or that he or sha is exempl hom Ilcensure and the basis fw LL P��/Spa N Ne alleged exemption.My violation M Section 7031.5 by any applicant lor a permR sub)ects the appllcant to a civil penalry C7 � o�not rtwre than five hundretl dollars(5500). Z Re-Roof o (J I,as owner of the property,a my employees wlth wages as thelr sole compensatlon,will do()all of or(,portions � Commercial � ol the work,and the sWCNre Is not Intended a ottered for sale(Sectlon 7044,Business and Professbns Code:The m � Contracrors'State License Law does rrot appty to an owner af praperty who,through employees'or personal effoA,builds w a imprwes the property,providetl ttiat�he Imprmements are not intended w otteretl tor sale.tt however,the bullding or � Impmvement Is soltl within one year of completion,the Owner-Bulltler will have t�e burden of proving that it was not buitt - p w Imprmed for the purpose of sale.). � I,as owner o(the m e � U p p rty,am exclusively contracting with licensed Contractors to construct the proJect(Section � 7044,Business arM Professions Cade:The Contractors'Stale License Law does rrot aDDN��ol properry wtq Valuation: � Adj.Area: � builds m imprmes Ihereon,and who cbntrxts tor the proJects wiN e licensed Contrada pursuant to the Contracrors'Sfate QUANTITY DESCRIPTION FEE Y ucense Law.). o (�I am exempt hom Ilcensure under the ConVactor's State Llcense law tor tha following reason(s): � � � �—` By my signature below I acknowledge that,except for my personal reslder�ce in which I mus[have resided for at least one c~.o o year prlor to completlon of the Imprwemerrts crovered by this pertnit,l canrrot legally sell a sWCWre thal I have bulfl as an � w � owner-builder if it has rqt been conslructetl in Its entirery by Ilcensed contractors.I undersfand ttiat a copy of the appllp�Ie law,Sectbn 7044 ot the Business and Professtons Code is available upon request when this applfcation Is submitted or at � the following Wnb site:http/www.leginfo.ca.gov/calaw.html. Z � o DATE: SIGN: � ~' LJCENSED CONTRACTOR'S DECLAHATION � F— � w I hereby aKrm un0er penalty ot perjury that I am licensed untler prwisqns of Chapter 9(commencing wfUi Setfipn 70IX1) � ol Division 3 of Ne Business antl Professions Code,and my Ilcerxe is in full force and eflect. � LICENSE CLASS: �_ L1C NO� (O �� DAiE: CONTRACTOR: _QIILL �.S �A'YY'S �'WL. � r� WOHIlEp'S COMPENSATION DECLARATION � � I HFAEBY AFFIRM UNDER PENAL7Y OF PER,IURY ONE OF THE FOLLOWING DECLNNTIONS: ¢ o I have en0 will maintain a CertAlple of Consent to Sett-Insure fa Worker's Compensation,as providetl by CONSTRUCTION: `3 8 O e �� Section 3700 0l the Labor Code,tor Ne O�wmance ol the work tor which this permit Is issued. p�qN REVIEW: � �I have a�will maintain WorkePs Compensation Insurance,as reqWred by Sectbn 3I00 of the Labor Code,for ELECTRIC: � the peAormaixe o1 the work tor which this Dermit is issuetl.My Worker's Compensatlon hisurance Carrier antl ¢ PolicyNumberare: J 1 �� PLUMBING: � CARRIFA 5��Lai '�'-' MECHANICAL: � POLICY NUMBER_T � � INSPECTION FEE: (1}tlS SECfION NFED NOT BE COMPLEfED IFTFiE PHIMfT I$Fpp ONE HUNDRFD DOIJAFiS(570�OR LFSS). ISSUANCE: �5,. � I certity that in the performar�ce ot the wark lu which Ihls permit is issuetl.I shall iroi em SM I P: 2• y o PbY�Y P��arry manner so as ro o becortie subject to Ihe Worlcer's Comper�satia�Laws of ia.Md aqree that i�I should becane subject tn Vre WakEr's � Crnnper�sa' or Sectim 3700 ot e, ith compry with ttpse provlsi«s. ENERGY P/C: "� DATE:� APPIICANT: 11- ENERGY PERMIT: � > WAANIN :Fallure to secure Wwkers Co nsation coverage is unlawlW,and shall sub�ect an employer to criminal w penatlies and civll Ilnes up to me hundred thousantl dollars�5700,000),in addition to the cost of the compensation, RETENTION FEE: Z,..o � O o darnages as provitled tor In section 3708 ot Ne labor code,interest,end attameys tees. PRE-ALT FEE: a CONSTRUCTION LENDING AGENCY BSAF: » O ,z I hereby amrm under penalty of per�ury that there is a Constmction Lending Agency tor the pedomiance of the xrork lor � which this permit Is Issuetl(Sec.3097,Clv.C.). � LEN�ER'S NAME � LENDER'SADDRESS: a I certify that I have read this appliption and state mat the above informatlon is cortect.I a ree to com TOTAL FEES J 1 y�'O( � A ph with all city and r•� �� Z canry ortlinances and state laws relating to building construction,and hereby auttwrize represeniatives o(NIs caunty to COMM ENTS: p enter upon the above-menUo d property ar inspection purposes. J L _ ��15 ,D m ¢ PERM ME(PR )� `�' %� rg QY F SIGNA E OF PE (TTEE ATE RECEIPT p Z��S� PAID BY: Z VALIDATION:�_ WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—Fle Copy,GREEN—ApplicanYs Copy CITY OF DIAMOND BAR INSPECTIOP! RECORD • � � ' • ' ° ' ' � � SETBACK!LE7TER ' ` � `• J`: � � $ ; : �� =r�� TRACT AND LEDGER FDOTINGS FORMS �, % � - � SWfTCH GEAR S�B . _ _ - , � ,� . � ; COMMERCIAL HOOD UG:PGUMBING °;`.. - # ' y T-BAR UG.�ELECTRICAL; , - °? - '-� INTERCEPTER UFER GROUND ;''_., ,, '` :,�, =4 -`� � " HOT MOP/SHOWERPAN :.. . � . � , r� , . _. . SEWER LATERAL SEPTIC/CESSPOOL MAIN WATER LINE HQiS flEPORT RECEIVED SEWER CLEANOUT DEMOLITION ROOF SHEATHING ROOF DRAINS FLOOR SHEATHING ROUGH CONDUfT SHEAR�WALLS'�E'XTERIOR:. .'` � POOL/SPA,�� f � � ,.: SHEAR�>WALLS:iNTERIOR�:� , , � '��" ��rt ' ROUGH RLUMBING � � ` � � y � .�;' r�� ' � FRAMINGNEN7ING A ,� a� �'��' ' t � 'RqUGH ELECTRICAL-=: ♦'� ` � _ � �: i F ROUGH MECNANICAL r ` ' ;' '. ROUGH'MECHANICAL: �^' •° � , } . - :� ROUGH ELELTRICAL W(-'')C�( ) ' - f - �GAS TEST�: - ROUGH PLUMBING ,'� _ ' P-,RE GUNITE � � � ;', . � ' , _ , . . ;.. , ._ ' '' ..._ ,. . . � �.. , .r, INSULATION WALL �ROOL,PRE_DECK BONDING `� =: 'x :� v INSULATION CEILING � � -� �� r �� , ;� ��' - � ' � P=TRAP � , DRYWALL F,ENCE!'GATE/ALARNi '�� '` � s FINAL`POOL;. , , r �; " = ' LATH(PR� - LATH EXTERIOR s A /¢ WALLS: l�1TH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL 1�T( )2"D( )LIFT SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELEASE WALL ORAIN/SEAL GAS METER RELEASE WALL FINAL SPECIALINSPECTION ;RO'.Fi�AMINGPLANN�NGAPPROVAL - ` -� ` �`F FINAL BUIL`DING ��`- ' 'ROUGH`fIRE APPRO,VAL„ �� r Y FINAL MECHANICAL, V � FINAL FIRE DEPARTMENT ; - - 5 ? FINAL�ELECTRICAL r � ° ��- � r � �FINAC PLANNING��, r r z� t �� . . :., . �� :. .. .. . �h Vt. �� ` FINAL EN6INEER{NG/P � .'� EINAL PLUMBING �r:;`: ° t� � �� T.C.of OCCUPANCY . ', '; y" _ ,FINAL COMMUNITY SERVICES - ` � " r' _ . � , ,. , _ . . .. : `CERT..uf OCCUPANCY:. � ' � FINAL HEALTH DEPT � ,� � " � ° F '� .3- ::,' .c1: �_. ' . . . . �� . . , .�. ' ' _ . ..: . . .� . .. . . . .�': ' . . -:.,i �. L �+ �i FINAL INDUSTRIAL WASTE�_;= �'' '^ :. ' _; � COMMENTS: