HomeMy WebLinkAboutNo Permit Number (22)Q.. =d -rG(1CA P U
C1TY OF DIAMOND BAR I
I I I DEPARTMENT OF COMMUNITY&DEVELOPMCNT SERVICES YZ'1 ••
u, ; ' 21810 Copley Drive,Diamond Bar,ca vi 6s PRESS
j'909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027
U"' I3UILDINGPERI IITAPPLICATION FIRMLY
W APPL CATION D P/C
w JOB SITE ADDRESS
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ISSUE DATE. PERMITN
o OWNER TYPE CONST. v A OCC GROUP: "
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ADDRESS
ZONING SETBACKS
CITY • ZIP FRONT RW
o APPLICANT i•TEL. REAR
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SIDE/SIDE STREET RW
a CONTRACTOR
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ADDR'E`SS` i/lJ. d'.i:CiC fC a C
PROPOSED USE
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CITY ZIP EL'' 'I `
DESCRIPTION SQ.FL FACTOR PSF ADJ.AREANALUATION OYVlIEA•BUILDEA DECLANATION
o I hereby attirm urWer penalty of Derjury fhat I am ezempt trom the Coniracmr's State License Law for the reason(s)SFR/ADD/REM
intlicated 6ebw by the checkmarlc s),I have Dlaced neut to tfie aDW ble dem(s)[Section 70315,Buslness and Gerage/Carport
o Professions Code:My city a county that reqWres a permit to canstruct,alter,improve,demolish,or repatr,any
Z structure,prior to its issuance,also requires the applicaM fa the permtt to file a signed sfatement that he or she 7 Patio/DeckaIsIicensedpursuanttotheprovisionsoftheContractor's State License Law(Chapter 9)Commencing wfth Seclion w
70W of DlWsion 3 of the Business and Professlons Code]or that he or she is exempt ham Iicensure and Uce basis for LL P VSpa
the alleged exemplion.Any vblation of Section 7031.5 by any applicant iw a pertnit subt is the applicant to a civil penalty
of rwt more than five huntlred dollars(y500). Z Re-Roof
o U.as owner oi the property,or my employees with wages as the(r sole compereatlon,wlll do(all of or(,porllons Commercial
of the work,and the structure Is not in[ended or oflered for sale(Section 7044,Buslness and Professbns Code:The
z Contraclors'State License Law dces not appty ro an owner of property who,ihrough employees'w personal ettart,bullds
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w or improves tlie property,prwided that the improvements are not irrtendetl or ottered for eale.It however,the building or
improvement is sold within one year of completion,the Owner-Builder wi0 have ihe burden of praving tliat It was nut hulttporimprovedforttiepurposeotsale.).
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I,as oWnef 01 tlreU property,am cluslvely conUacting witli Ilce ed Contractors to can,truct the projecl(Secllon
o 7044,Business and Professions Code:The Contractars'State L ense Law dces not appy ro an owner ot property who ValuatiOn. Adj.A ea:Z
builds or improves mereon,and who contracts tw ihe projects wim a Iiceiued Cantractor pursuam to me Contrxmrs'State pUANTITY DESCRIPTION FEEYLicenseLaw.).
o U exempt from Iicensure under the Contractur's State llcense law fw ihe folbwing reason(s):
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By my sfgnature below I acknowledge ttiat,ezcept for my personal residence fn wtuch I must have resided for at least one
o year prior to wmplotion ot ihe imprwements coveretl by this permit,l cannot legalty sell a structure that I have twilt as an W
owner-bullder Il lt has rwt been consiructed in iLc entirery by licensed wntractms.I understand tliat a copy of the applicable aya
law,Section 7044 0l the 8usiness and Professlons Code Is available upon request when this applicatlon is submitted or at 3 r
the lollowl Web site:httpJ wnv.leginfo.ca.gov/calaw.html.
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DATE: SIGN:
LICENSED CONTRACTOR'S DECLARATIOH
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w I hereby anrm untler penatty ol perjury that 1 arn licen5ed wtler pravisions of Chapter 9(commencing wlth Section 7000)
of Division 3 ot the Business and Professions Code,and my license is in fWl force and eflect.
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13 No.:59 S
0 DATE J'"L I CONTRACTOR:[1P v
WORI R'S COMPENSATION OECLARATION g
I HE F,Y AFFlRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWIN ECUIRATIONS:w
o I have and will maiMaln a Certificate ol Consent to SeR-Insure lor Worker's Compensation,as provided by CONSTRUCTION:
Seclion 3700 of ihe LaOor Code,for Ihe performance of ttie work tw which ihis permit is issued. p qN REVIEW;
I have and will maintain WorkePs Compensatim Insu2nca,as reQuired by Section 3700 of the Labor Cade,for
z the pertormarice of the work for which this DermR Is Issued.My Warker's COmpensation liuu2nce Carrier antl ELECTRIC:
PolicyNumberare: PLUMBING:
CARRIER SCS.- MECHANICAL:w
POLICYNUMBER 9$,Q as- i 3 INSPECTION FEE:
T}IIS SECf10N N NOT BE fAMPIETED IF TFiE PERMR IS fOR ONE FNNDRED OOLIARS($10 OR L.ESS.
0 IcertirylhallnmepeAormar cedtheworkforwhichihis
ISSUANCE:____
permit ts'ssuetl,I sF aV rrot empby arry pa son in arry manr er so as ro
SM IP: BobecornesubjecttoIheWakerSCampersatbnLavrso1Caiitomia.lu d agree Ihat fl I shadd become subjecl to the Worker's
Compensation provisions ot Section 3700.aL-bor Cglg,i sha JpdM^nm cmnpry with tlmse prwisbns. ENERGY P/C:
LL DAiE:s-N'l i ApPur,quT: .Al;,, p I.a e.L. ENERGYPERMIT:
WARNING Fallure to secure Worker's Compensatlon coverage is unlaxTul,and shall subject an employer to crimfnal RETENTION FEE:penalties an0 civil fines up ro one hundred thousand dollars(y100.000J,in eddition to the cost of the crompensatlon,
IodamagesasprovidedforInsection37060lihelahorcode,interesl,and attomey's fees. PRE-ALT FEE:
d CONSTHUCTION LENDING AGENCY ggqF: d
w 1 hereby amrm under penaity of perjury ihat there is a Co utruction Lending Agertcy fw Ihe perlormance of the vrork fm
which this perm0 is issued(Sec,3097,Civ.C.).
LENDER'S NAME
LENDER'SADORESS:
TOTAL FEES , iZ Q'a I cerllty that I have read this appl atlon and state that ihe above informatlon is cnrrecL I agree to compty wlih all tity and
JzcountywdinancesandstatelawsreWtingtobuildingconstruction,antl hereby authorize representatives oi this county to COMMENTS:
9 e upon the above- en' d property fw inspecibn purposes.
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SI OF PERMR7EE DATE RECEIPT H PA1D BY: VALIDATION:
WHITE—Department Copy,YELLOW—Fnance Copy,PINK—Assessor Copy,GOLDENROD—Fle Copy,GREEN—ApplicanYs Copy
CITY 01F DiAM4ND AR
INSPECTIt3N RECC3RD
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SETBACK/°LE7TER '''>, TRACTAND LEDGER
F[107tNi'7o-dRMS , i .` _,.,.3 a'r,w ,, JW(fCH 17EAR
SUtB a'' , w,a
r ,:;': CdMMERCIAL HOOD
llG:FCUN1BiN. T-8AR
UG.E ECTRIGAI.= y, , ,, ' r i z . `:. ,. ,: INTERCEPTER
UFER GROUND `.', k `? ' 3 ' r NQT M4PlSHQWERPAN
SEWER LATERAL SEPTIC/CESSPOOL
MAIN WA7ER LINE NERS REPOR7 RECENED
SEWER CLEANOUT DEMOLITION
ROOF SHEATHiNG ROOF DRAINS
fL00R SHEATNiNG ROUGH CONDUIT
SliEAR WALLS EX7ERIOR POOt:lSF'A
SHEAR WALLS.INTER#{}R ,,_,. ROUGH.P UMBING ' ;,'•_ .3
FRAMINGNENTIN6 .. f, '„RQk1Gfi`ELEGTRICAL
RO!!GH MEGH'ANlCAL - ,. a:;, ir ;x;>, , ,,.c.:`R4UGH[NECNANICAL , t; r '
RqUGH-ELECTRICAL'.WI ?(r?
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GAS TEST
ROUGH PLUMBING. , b_;, 4;;' "PRE GUNITE
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INSULATION WALL jPOOL;RRE;DECK BONDING. - u
INSUlATiON CEIUNG P TRRP';•, , .
DRYWALL FENCE`%-GATFJ AL RM .. ` ;` ; , .. . 3 ,
t,ATN(PRE}FIAfA P40L
LATH EXTPAIOR UUALIS,
lATH INTERl4R WALI FOOTING/STEE
GAS 7EST WAL STEEL 1 T( )2N°( )LIF7
SCRA7CH COA7 WALL BOND BEAM
ELECTRIC METER RELEASE WALL DRAIW SEAL
GAS METER RELEx1SE WALL FINAL
SPECIAL iNSRECT1dN Rd F+11NG PIANNIPlG'APP.RO tAt `s
FtNALBUlLDIN6.; r ROU6li-F1#iEAPPROVAt ='f, `` `
FINAI:MECtiliNSCAL ` ,,: :' k, FINAL,FIRf,DEPAFiTiUIEPlT-:,r
EINAL ELECfRIGA z FINAL'PUWNlNG::, " ' w,
FINAL PLUMBlNG lNAL EIUGlNEERItdGI PW ".r.
T.C.'af OCCUPANCY - ; , = x; s' 1 ` "
i 'INAL:COMMUNIiY SERVICES, . r;i^
CERT.of QCCUPANCY' rFINAI:-HEdITH DEPT fi
FINAL'INDUSTRIAL WASTE`j' .
COMMENTS;