HomeMy WebLinkAbout14-4630 •,:"��; CITY OF DIAMOND BAR
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i _ __ DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES
, = � PRESS
21810 Copley Drive,Diamond Bar,CA 91765
HI ,, (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 FIRMLY
• ,'�°'� BUILDING PERMIT APPLICATION
APPLICATION DATE: ��/ 1� P/C#
i JOB SITE ADDRESS �/y (,/ j/� (� /�
i ISSUE DATE: �//�/0`UI / PERMIT# /-7– �0 I�'
z APN LOT TRACT L
yOWNER�'�1a 't'FS�cL►G'(Z ��I eT 1�� TYPE CONST. OCC GROUP:
n ADDRESS ZONING SEfBACKS .
� CITY�i'�VIcY�R�A�ZIP �o TEL. Q��• �I� �7J3 FRONT RW ❑
= APPLICANT TEL. REAR ❑
� SIDE/SIDE STREEf RW ❑
¢ CONTRACTO`R K I � SIDE ❑
� ADDRESS b�Z.4 �-�Q �'�� •
a PROPOSED USE� ������¢v�`F`'* �Kra�'F'o 1� �
= CITYd��AlQ PI�RK ZIP �+" � ' TEL. ���ZLL� d�99 �(�t�dLl 3 /ZL.�20�14 �,(�,vDawyr�"EG�+�C.�_ ��i�Lj 6���1�
? ARCH/ENG/DESIGNER _'Sc�l_� �✓ALvL� E�Q.'�A G�.a• N• a _ �/- / 4! ,tir
? ADDRESS —�Sy �A(��.F- �L� �E'L�UNITDS�� �ST�SG� #BEDROOMS
� CITY�ON� �k ZIP TE�. ti/� 2Zg a o99 DESCRIPTION SQ.FC FACTOR PSF ADJ.AREANALUATION �
OWNER-BUILOFA DECLAHATION I
'= I hereby atfirm under penalty of perjury that I am ezempt hom the Contractor's State License Law for the reason(s) SFR/ADD/REM
� indicatad below by the checkmark(s),I have placed ne#to the apDlipble ftem(s)[Sectlon 7031.5,Buslness and Garage/Carport
I
�-' Professla�s Code:My city a cowrty that requires a permtt b conshruct,atter,Improva,tlemolish,or repalr,any
z structure,prior tn its Issuance,also requires the appllcairt for tha pertnit to Nle a signed statemerrt that he or she � Patio/Deck I
i Is Ilcensed pursuarrt W the provlsions ot the Ca�trac[or's State License Law(Chapter 9)Commencing wNh Sectlon w I
� 7000 of Divislon 3 of tice Business and Protesalans Cade]or that he or she is exempt from Ilcensure and the hasis for u- PooVSpa
� the alleged exemptlon.My violation of Sectlon 7031.5 by any applicant for a permtt subjects the applicant to a clvil penalry C7 I
'n of not more than five hundred dollars($500). ZQ R�Roof
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� (�I,as owner of the property,or my employees with wages as iheir sole compensatlon,will do�1 all of or(�partlons J Commercial
y of the work,and the structure is not intended or offered for sale(Secfion 7044,Business and Professions Code:The m I
Z Contractors'State License Law does not apply to an owner of pmperry who,through employees'or personal effort,bullds
y or improves the property,provlded that the improvemenb are not Intended or oflered for sale.If however,the building or I
� Imprmement is sold vnthin one year of completlon,the Owner-Builder wlll have the burden of prwing that ft was not buitt
� or improved for the purpase of sale.).
`"� (,I,as owner of the property,am exclusively contracUng wtth Ilcensed Conhac4ors to anstruct Me proJect(Section
� 7044,Business and Professions Code:The Conhactors'State License Law dces not apply to an wvner of property who V81u8tiOn: � .A O Adj.Ar98:
Z buildsorimprwesthereon,andwhocontractsforthapro�ectswtthallcensedContractorpursuantrotheContractors'State QUANTITY DESCRIPTION FEE
n
Y Ucense Law.�. � �'Q , I
� (,I am exempt hom licensure under the Contractor's State LJcense law tor the followinp reason(s�: �
�i oc � .. (-1 d _rli .
1 By my signature below I acknowledge that,ezcept for my personal residence In which I must have resided for at least one �
Z year prlor to completlon of ihe improvemenLs covered by this pertnit,l cannot legally sell a structure that I have buitt as an w � �' I
� I
owner-bullder If It has not been consWcted in its entirety by Ilcensed wntracYors.I understand that a copy of the applicable '�
� law,Section 7044 oi the Business and Professions Code Is available upon request when this applicaUon is submltted or at �N I
i the following Web site:http/vnwtlegirrfo.ca.gov/plaw.html. _
� DATE: SIGN: � '��''��� I
— LICENSEO CONTFIACTOH'S DECLAAATION � �
' I hereby affirm under penalry of perJury that I am licensed under pmvisions of Chapter 9(commencing wlih Sectlon 7000) �
y
� of Dhdslon 3 of the Business and Protessions Code,and my Ilcense Is In full force and effect. J i �DD i µ I
n LICENSE CLASS: � L� L1C.NO.: c77���3 � T� �X NJ �
� DATE: CONTRACTOR: = I .
U
Zd WOfll�fl'S COMPBISATION DECLAHATION � I
� I HFREBY RRM UNDER PENALTY OF PERJUfiY ONE OF hIE FOLLOWING DECLARATIONS:
y /
a have and will maintain a Certifpte of Consent to SeB-Insure for Worker's Compensatlon,as provided by CONSTRUCTION: � /
� Sectlon 3700 of the Labor Code,for the performance of the wark for which this pertnit is issued. p�qN REVI EW: �`�
� �I have and will maintain Worker's Campensatlon Insu2nce,as required by Sectian 37�of the Labor Code,for ELECTRIC:
� the performance of the wark fw which this pertnit is issued.hry Worker's Compensation Insurance Cartier and
zd PoIIcyNumberar �T PLUMBING:
y CARRIER ����(�.�5 -+fUS • MECHANICAL: 6D.,�iI
� POUCY NUMBER A i-{� �,/�_ �3�s 7�i INSPECTION FEE:
� (IHIS SECIION NEED NOT BE COMPLEfED IF1HE PBiMR IS FOR ONE HUNDR�DOLLARS($10�OR LESS�.
ISSUANCE: /��id-�
� I cerGfy that in the pertormance of ine worlc for which ihis permit is Issued,I shall not employ any person in arry manner so as in �
� become subject m the Nbrkers Canpensatlon Laws of CalKomla And agree that ff I should become suqect to the Workers SM IP: �1 �
� Compensa0o provisions of Section 3700 M the labor Cade,I shall faNrv�ith canpry with those provlsbns. ENERGY P/C:
J
i �A� ����'�T ENERGY PERMIT:
� WARNING:Failure to secure Worker's Compensatlon croverage Is unlawful,and shall sub�ect an employer to criminal RETENTION FEE: ���
= penalties and civil fnes up to one hundred thousand dollars($100,000),In addition ro the cost of the compensatlon,
= damages as pmvided for In sectlon 3708 of the labw code,Interest,and attorney's fees. PRE-ALT FEE: I
i CONSTHUCTION LENDING ACENCY BSAF: !����
y I hereby affrm under penalry of perjury that there Is a Conshuctlon Lending Agency for the performance of the vrork for
� which this permR Is issued(Sec.3097,Gv.C.�.
LENDER'S NAME: � � -�
� LENDER'SADDRESS:
i I certify that I have read this appliCation and state that the above informatlon is correCt.I agree to comply with all city and TOTAL FEES
Z county ordinances and state laws relating to bullding construction,and hereby authorize representatives of this county to COMMENTS:
� enter upon the abme-menUoned property for Inspectbn purposes.
� S � K ��ati �
¢ P MI E E(PRI
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= SIGNA E DAlE RECEIPT# J-I PAID BY: � � �VAUDATION:
WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—Flle Copy,GREEN—ApplicanYs Copy
CITY OF DIAMOND BAR
INSPECTION RECORD
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�"°� `���`"��� TRACTAND LEDGER
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�SETBACKJ LETTER � . ���� " ��� � �
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FOOTINGS FORMS °„>� , ���"� °���������� �-���"�� SWITCH GEAR
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eSIAB' � ���"' ���.��� ���'���������� `� �`""�� COMMERCIALHOOD
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UG�ELEC7RIGAL ��'��` " °���� p������� � INTERCEPTER
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SEWER LATERAL SEPTIC/CESSPOOL
MAIN WATER LINE HERS REPORT RECEiVED
SEWER CLEANOUT DEMOLITION
ROOF SHEATHING ROOF DRAINS
FLOOR SHEATNING ROUGH CONDUIT
`SIiFAR�WALLS EXTERIOR�a����� � �,�w�«. ... .�.��` �� _ - � �;: POOUSPAE,� , _- �- �a�. ,�:: � „��� 3 ��„�.u��.' H�
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ROUGH ELEC?RICAL W(�sj�C.�¢.: � �.�`��; GAS,TEST��,; ,m`���m.;�e.�t..��� � ����W,�'r��,�.�, ��;�� ��,�� ���
ROt1GFJ PLUMBING .:`� � .�.� n�" ' "«�� PRE'GUNlTE' `����� �$ " u� � , �
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INSULATION WALL ���POOL PRE��DECK BOPlDING„��r` � ���'�� �,�
INSULATION CEWNG P-TRAP � ' ���, ,.. � "` �
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DRYWALL 9 FEN�E I G�ATElALA#tE�E ��- � -=� � ������ � -
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LATH(PRE) FINAL�POOL �.��.t������� ..� ��o . .. ��,r�,��� �_�,..$;b . ���
LATH EXTERIOR WALLS: -
LATH INTERIOR WALL FOOTING/STEEL
GAS TEST WAIL STEEL 1sr� )2�0� )UFT
SCRATCH COAT WALL BOND BEAM
ELECTRIC METER RELEASE WALL QRAIN/SEAL
GAS METER RELEASE WALL FINAL
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SPECIAL INSPECTION RO FE3AM0VGPLpNNIt�fMPFiOVAL ������$ �°��`������� ''�''� � � � "`"'� �
FINAL`BUILDING ;�� . ����¢ �'��'�`�'����' `� ROUGH FIRE APPFtdVAL�°������,.� �<x .,��^�� , � �.
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