HomeMy WebLinkAbout14-2951 i
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��'.�;_,.'���.�� C1TY OF DIAMOND BAR '
I I . I��I . DEPARTMENT OF COMMUNITY&DEVELOPMCNT SERVICES
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��Ili i - 21810 Copley Drivc,Diamond Bar,CA 917fi� PRESS
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, � (909)839-7020 Fax:(909)861-3117 Building Ins�x:ction Hotline(909)839-7027 FIRMLY
�"'"°�� I3UILDINGPERMITAPPLICAT[ON
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� ��MON �ZZ APPLICATION DATE: /�I P/C#
w JOB SITE ADDRESS � /
� ISSUE DATE: ���"�7� PERMITq ����
z APN LOT��TRAC�,T n�
oOWNER /Or V \a184. S ldl � IYPE CONST.�K$`—�Z�,�OCC GROUP:
y ADDRESS Wll'�W i�
� CITY��lNfw(O✓�n /,ISH'fS ZIP TEL.�(�� 9b6-`��oZ ZONING FRONTCKS _ �L RW ❑
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O APPLICANT TEL. REAR
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¢ CONTR,4CTOR W�CI` �`Zl ���(.JOT�W�� ` 0 SIDE/SIDE STREET RW ❑
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�o ADDRESS I�'I/��J F7 R�✓I I Tl� Y�V Iz pROPOSED USE�(..l��R'� �;F��+�T�g ��j i
o CITY"�j� S/1 V�/�Yf'f ZIP�(`/l7 TEL._[9� 7 a.s Z.�FJ� _ CVJ�'Q±a� � t—�V-�`�ivK-Q
o ARCH/ENG/DESIGNER � � �
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o ADDRESS
tl DWEL.UNITS #STORIES #BEDROOMS
a CITY ZIP TEL.
� OWNEA•BUILDEA DECLAIIATION
DESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION
¢ �hereby amrm under penalry ot perjury bat I am enempt from the Conlractor's State License Law lor the reason(s) SFR/ADD/REM
0
o intlicatetl below by Ne checkmark�s�,I have placed next to the app�lea6le item(s)[SecUon 7031.5,Business and Gerage/Carpat
o Professfons Cade:My city m county that requires a permit to construct,alter,improve,demolish,or repatr,any
w strucWre,prior to its issuance,aho requires the applicant for the Dermit to flle a stgned statement Mat he or she � Patio/Deck �'
a Is Ilcensed pursuant to lhe proWsions of the ConUactor's Sfate License Law(Chapter 9)Cmnme�ing with Sedion w
� 7000 of DiWsion 3 of the Buslness and Professions Code]or that he or she is ezemDt hom Ilcensure and the basis for LL P�VSpa
� the alleged exemption.My violation of Section 7031.5 by eny applicaM for a permit subjeds the applicant ro a civil penalry C7
� ol rqt more than five huntlretl dolWrs($500�. Z e-Roo
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o (,I,as owner of the property,or my emptoyees with wages as their sole compensatlon,wIll do(�all of or(,portlorrs � Commercial
� of the work,and Me strucNre Is not intended w ottered for sale(Sectlon 7044,Busfness and Pmfessions Code:The �
� Contractors'State License Law dces not a ro an ovmer ol r e who,throu h em lo ees'm m
Z PP�' P oP nY g p y personal eflort,builds
w or improves the properry,provided that the imprmements are not intended w oflered for sale.If however,the building a
� improvement Is sold within one year of completion,the Owner-Builtler will have Ne burden ol prming ttiat It was not bWtt
p or imprmed for the purpose of sale.).
V I,as owner ot ihe ro 0
� U p pertY,am exGusivety conVactlng wilh Iice�ued ConVactors to consWct Ihe proJect(Sectlon
0 7044,Business antl Professions Code:The Contractors'State License Law dces not a Valuation� 0��' Ad ,4rea:
Z ppty ro an owner of property who 6
� buildsorimprrnesNereon,andwhocontractsiortheprojeclswithallcensedContrectorpursuanttotheContrxtors'Slate pUANTITY DESCRIPTION FEE
Y License Law.). �
o U I am enempt trom licensure under the Contrector's State License law for the following reason(s): �
�
� �
By my signaWre below 1 acknowletlge that,except for my personal residence in which I must have resided fa at least one c~.o
o year prior to compledm of the fmprovements covered by this pem�it,l cannot lepully sell a structure that I have built as an w
� owner-bullder if it has rwt been consWcted in Its ent'uety by Ilcensed contractors.I untlerstaM that a copy of Me applicable
� law.Section 7044 of the Business and Prolessions Code is available upon request when Mis applicalion is submffied or al
X the following Web site:httphwnv.leginfo.p.gov/calaw.html. _
w DATE: SIGN: m
O �
~ LICENSED CONTRACTOfl'S UECLARATION �
ti a
W I hereby amrm under penalty of perjury that I am licensetl under provisions of Chapter 9(commencing wiN Section 7000)
m of Dlvision 3 of the 8usiness and Professions Code,and my license is in full�orCe and efleCt.
v= a `1 I 5�64�,�
uc�r+se -- uc.No�.:, �
Z DATE:� I _,y CONTRACTOR:�CF�I,��� RODF�/ W I'� �
Q WOHNEN'S COMPENSATIDN OECLAAATION �
� I HEREBY AFFlRM UNDER PENAL7Y OF PERJURY ONE OF THE FOLLOWING DEqARATIONS:
� _�� I have arM will maintain a Certfipte of Consent to Setl-Insure for Waker's Canpensatlon,as provided by CONSTRUCTION: ��
� Seclfon 3700 of the labor Cotle,(or ihe pertormance of Me waie tor whkh this permtt is issued. p�,qN REVIEW
� I have and will maintain Worker's Comoensation Insurance,as repWretl by Section 3700 M the Labor Code,for ELECTRIC:
� the performance ot the work fw which this permit is issued.My Worker's CompenSaBon Insurance Carrier antl
Z
¢ PoIi�yNumberc8re1 .�.�. ^ PLUMBING:
� CARRIER .,Tc�`� � V
"' MECHANICAL:
� POLICYNUMBER I ��L IC�Z ^ �
INSPECTION FEE:
�� (THIS SECfION NEED NOT BE CAMPLFfED IFTFIE PEFNIIT I$FpR ONE FRINDRED DOLLARS($1(q)OR LESS�.
� I ce " ihal in the peAormvxe ot uie work far wMch Uis ISSUANCE:
�' permit is issueQ I shau rrot empoy any person in any rnanner so as ro SM I P: �
o become subject to ihe Wakerh Compe�ation Laws o1 Calilomia.Md agree that if I should 6ecane subject in the Worker's
� Com sa'm o1 Section 37Do oQ r Code.�st�n�orlhwin`Co iose�mvisio�s ENERGY P/C:
J DATE ( �
P� W
'i �P��T / "�ca"—�r \ `� � ' ENERGY PERMIT:
� WARNING:Fallure to secure Worker's Compensafion cmerage is unlawlul,and shall subJe an empbyer to criminal
w penalBes and civil fines up to one hundred thousand dolWrs($t00,000),in addition to the cost of ihe compensation, REfENTION FEE:
o damages as provided for in section 3706 W me labor coda,interest,and attomey's tees. PRE-ALT FEE:
a CONSTAUCTION LENUING AGENCY BSAF: ��j
w I hereby aKrm under penalry of perjury�hal there is a ConsUuctlon Lending Ageixy for t�e peAormance ol ihe work tor
� which this permit is issued(Sec.3097,Gv.C.�.
F LENDER'S NAME
Q LENDER'S ADDRESS:
a I certiry ihat I have read ihis appliption and state that ihe aDove in(orma6on is corzect I a ree m cam TOTAL FEES //�� '
� g pty vAth all city and `�
Z counry ortlinances a�state laws relatlng to building construction,and heretry authorize representatives of this counTy to COMMENTS: `
o enter upon the a[rove-mentioned pmperty far inspectian purposes.
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¢ PE E E(PRINn � . �
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F SI F PFAMl1TEE �ATE RECEIPT q PAID BY:V VALIDATION:
WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—Fle Copy,GREEN—Applicant's Copy
CiTY OF DIAMOIVD BAR `
INSPECTION RECORD
. � � . • - • � � v '
SETBACKI LET.TER TRACT AND LEDGER
FDOTINGS.FORMS > - _ - = SWITCH GEAR
S�B', COMMERGAL HOOD
UG.PCUMBING _ T-BAR
UG.EIECTRICAt - ' INTERCEPTER
UFER�GROUND HOT MOP/SHOWERPAN
SEWER LATEfiAL SEPTIC/CESSPOOL
MAIN WATER LINE HERS REPORT RECENED
SEWER CLEANOUT DEMOLITION
ROOF SHEATHING � ROOF DRAINS
FLOOR SHEATHING ROUGH CONDUIT
POOLISPA�'� ` � ' � - , � ��
SHEAR WAL`LS EXTERIDR.., �� ''� ' ''
SHEi4R WALtS INTERIOR' ` - RdUGH PLUMBING �`. �'`� � i, * '`, � f '� �`.
FRAMIN6NENTING = '� ` -- , ROUGH ELEGTRICAL- _� �{�� ` ' { � � �
ROUGH-MECHANICAL , - , ,ROUGH'MECHAN�CAL ;-� � ° 'r ''� � � �'k �:r�
7. F -' .. #\ ,� _.
ROUGH ELECTRICAL W( )C( ) � GAS TEST: � - �
ROUGH PLUMBING ' PRE GUNITE. , h - - � - �''
INSULATION WALL POOL PRE DECK,BONDING >i h � r
��� _ E " �:'..� .
INSULATION CEILING P-TRAP '�: ', � ' �
ORYWALL 'FENCE/GATEJ ALARM ` - _ �� `S � ��- Y�
LATH(PRE) F,INAL POOL- x 4:: '_ .'�. ":-`'� . �.-�
LATH EXTERIOR WALLS:
LATH INTERIOR WALL FOOTING/STEEL
GAS TEST WALL STEEL 1�T( )2"0( )LIFT
SCRATCH COAT WALL BOND BFAM
ELECTRIC METER RELEASE WALL DRAIW SEAL
GAS METER RELEASE WALL FINAL
RO FRAMING PLAN�NNGAPPROVAL ; '�' � '
SPECIAL INSPECTION - '
`" ROUGH FIRE APPROVAL ' Y� � =
FINAL�;BUIL:DING � ."��oo ��5 g 1�{ ��--- ��
FINAL�MECHANICAL � fINAI FIRE DEPART'MENT '' , "�� ' -
FINAL ELECTRICAL> ' F FINAL PUINNIN6 '� � ° �' `` ' -{
,_. r: � ': �:
� �`� ' �� �. . :FINAL ENGINEERI_NGI PW: F�. � r a�" ' � � x�� rr�
FINALPLUMBING• • ` '� - `,� ' '�
T.•C:of OCCUPANCY - �` � FINAL COMMUNITY:,SERVIGES - e" ' _
CERL ofbCCUPANCY -' ` ,� 'FINAL HEALTH DEBT � * 4 �
, . .: ,.,, ,: - :. , ,,.. ,
; . :•- _� � r, ,,' � �
/ � fINAL.INDUSTRIAL;WQSTE � "`
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C O M M E N TS: •�� Ll��� �Jl� "•, rt�, .�t�c t�st,_'. � �,.; � �
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