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Home My WebLink About15-1756 *-�z`: CTTY OF DIAMOND BAR �n �g'�� '� DEPARTMENT OF COMMUrTITY&DEVELOPMENT SERVICES �� , ;, {` :_.r�^' ..... ._ � h . 21810 Copley Drive,Diamond Bar,CA 91765 PRESS �, `„„ �� (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 ''�'"f� BUILDING PERMIT APPLICATION FIRMLY s JOB SITE ADDRESS D �1� ` � � APPLICATION DATE: ��0 ^/U P/C# �, �--' 1 ISSUE DATE: �'� D"r PERMIT# ��/,� z APN LOT TRAC `. � � OWNER oBE� G�� TYPE CONST. �✓�'"�� OCC GROUP: � ADDRESS 2d�yS ��61� L�v�2�1 -(�(� � CITY 0��"��9 '��L ZIP TEL. �S a ZONING F ONTCKS RW ❑ = APPLICANT ��'9T'�^^°�- TEL. y �3 yagSc REAR ❑ n SIDE/SIDE STREEf RW ❑ � CONTRACTOR Q P�p��-t. �F S�«,\1(� � ADDRESS ia�^ 'R �- ��P�-•'�'�� SIDE ❑ = CITY �N��'�� ZIP�� JLL7-�g� PROPOSED USE TEL. � � ARCH/ENG/DESIGNER y � ADDRESS #DWEL.UNITS #STORIES #BEDROOMS z CITY ZIP TEL. � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREA/VALUATION I � OWNEH-BUILOER DECLANATION = I hereby affirm under penalty of perjury that I am ezempt from the Contractor's State License Law for the reason(s) SFR/ADD/REM I �o I indicated below by the checkmark(s),I have placed next to the applicable item(s)[Section 7031.5,Business and Garage/Carport � Professions Cade:My city or county that requires a permit to construct,alter,improve,demolish,or repair,any z sVucture,prior to its issuance,also requires the applicant for the permlt to file a signed sTatement that he or she � Patio/Deck I nis licensed pursuaM to the provisions of the Canhactor's State License Law(Chapter 9)Commencing with Section w � 70W of Divisian 3 of the Business and Professions Code]or that he or she is exempt from licensure and the basis for � PooVSpa I � the alleged exemption.Any violation of Sedion 7031.5 by any applicant for a permit subjects the applicant to a civil penalTy Z Re-Roof s of not more than five hundred dollars($500). � I � (,I,as owner of the property,or my employees with wages as meir sole compensation,will do(�all oi or(�portions � Commercial . � I y of the work,and the struc[ure is not intended or offered for sale(Section 7044,Business and Professions Code:The � � Contractors'Staffi License Law does nM apply to an owner of properry who,through employees'or personal eftort,builds m � � or improves the property,provided that the improvemenls are not intended or oftered for sale.If however,the building or �I � improvement is sold within one year of completion,the Owner-Builder will have the 6urden of proving that it was not built � or improved for the purpose of sale.). I :J (,I,as owner of the property,am exclusively contmcting with licensed Cont2ctors to construct the project(Section Valuation: Adj.Area: I �Z 7044,Business and Professions Code:The Contractnrs'State license Law does not apply to an owner of properry who n buildsorimprovesthereon,andwhocontractsfortheprojecfswilhalicensedContractorpursuanttotheContractors'STate QUANTITY DESCRIPTION FEE I License Law.). � U I am exempt from licensure under[he Contmctor's Siate License law for the following reason(s�: � I � I 1 By my signature below I acknowledge that,except for my personal residence in which I must have resided for at least one w I = year prior to completion of the improvements covered hy this permit,l cannot legally sell a shucture that I have built as an w owner-builder if it has not been constructed in its entirery 6y licensed contractors.I understand that a copy of the applicable I � law,Section 7044 of the Business and Professions Code is available upon request when this application is submitted or at ` I � the following Web site:http/www.leginfo.ca.gov/calaw.html. �' I z � DATE: SIGN: � — LICENSED CONTflACTOH'S DECLAHATION � I a I y I hereby attirm under penalty of perjury that I am licensed under provisions of Chapter 9(commencing with Section 7000) � of Division 3 of the Business and Professions Code,and my license is in full force and ettect. J I `` a � LICENSE CLASS: C=�� LIC.NO.: ��S�1 z I � DATE: �I 3l ��S CONTRACTOR: Q��L�N s Q�SwT�� _ U I ¢ WOHI�H'S COMPENSATION DECLAflATION � I y I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: � I have and will maintain a Certificate of Consent to Self-Insure for Worker's Compensation,as provided by CONSTRUCTION: � Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. p�qN REVIEW: � I have and will maintain Worker's Compensation Insurance,as required by Section 3700 of the Labor Code,for � z the performance of the work for which this permit is issued.My Worker's Compensation Insu2nce Carrier and ELECTRIC: ' ¢ PolicyNumberare: PLUMBING: � y CARRIER 5��= �'`-�� MECHANICAL: � POLICYNUMBER �S �,�� J INSPECTION FEE: n (fHIS SECTION NEED NOT BE COMPLEfED IF1HE PFAMR IS FOR ONE HUNDRFD DOLLARS($10�OR LESS�. ISSUANCE: �'� � I certily that in the perlormance of ine work for which this permtt is issued,I shall not employ any person in any manner sa as to � bemme subject m me Worker's Compensabon Lavrs of Califomia.Md agree ihat if I should become subject W the Worker's SMI P: � Compensation provisions of S�ecE61r9,'9 h Labor Code,I shall forthwith comply with those provisions. ENERGY P/C: i DATE:1�� APPIJCANT: � ENERGYPERMIT: � WARNING:Failure to secure Worker's Compensation coverage is ul,and shall subject an employer to criminal y penalties and civil fines up to one hundred thousand dollars($100,000�,in addition to the cost of the compensation, REfENTION FEE: � � 1 damages as provided tor in section 3708 of the labor code,interest,and attorney's fees. PRE-ALT FEE: � i CONSi11UCTI0N LENDING AGENCY BSAF: y I hereby affirm under penalty of perjury that there is a Construction Lending Agency for the pertormance of the vrork for = which this permit is issued(Sec.3097,Civ.C.). � � LENDER'S NAME: . = LENDER'SADDRESS: I i I certiiy that 1 have read this application and state that the above information is correct.I agree to comply with all city and TOTAL FEES ,�'� Z county ordinances and state laws relatlng to building construction,and hereby authorize representatives of this county to COMMENTS: � enter upon the above-mentioned properry for inspection purposes. J Q\ � 47�U�'•�G�Mt+'�� n ¢ PER NAME(PRINn � I,.`+� � �W n = SIGNAlURE OF R I1TEE DATE RECEIPT# PAID BY: VALIDATION: � WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Applicant's Copy CITY OF DIAMOND BAR INSPECTION REC�RD . . - �. .� . .- � • • e , . • . • � � , • � - � �� ,.,�. �, � : ;5fl�BAGK%'LETTER , ` � � ,_ � � _ � �;, TRACTAND LEDGER �. .� — . �OQTINGS,F�ORMS - �r,,,,�� < � �� +� ,� � - � �� ; � �SWITCHGEAR � �5��,� �� ,��,�: � -� � � � � �, �� ,:: �� COMMERCIAL HOOD = � �f � ,UG��'PLUMBING �. � ,H � � - _ : ,• �, �. � � r : T-BAR �LiG�ELECTHIGAL -� x ��•* � : � '' INTERCEPTER � ; _ ,UF'�R GROUi�D= � � �� ' � " _ �' "� � � � HOT MOPISHOWERPAN SEWER LATERAL SEPTIC/CESSPOOL MAIN WATER LINE HERS REPORT RECEIVED SEWER CLEANQUT DEMOLITION ROOF SHEATHING ROOF DRAINS FLOOR SNEATHING ROUGH CONDUIT ,�- � �_ . � - � � �Q. ��n� � � � _ _ .� .�,_� �� , �3tiF4R�WAlLS EXTERIOR e � , � � . ��, . , POOUSPA � � � , ..,��. , . - SHEAR�WALCS INT�RIOR � � �,, a ' , __ �� _ ' ~ � �ROUGH PLUMBING ' _ � ° � � � ; � °' ' .. �, _n - _p ,� _ �FRA�I�1Gl.UENTiNG �°� ��°� ° � � � �� ' � � � � " �' ROU�H ELECTRICAL �� _ , _ w ,_ _ - ' '�`"'� ` � � `� � ROUGHNIEGHANICAL - � _ ,ROIIGF�MECHANICAL`,�_„ � � � � � 'RQUGH�ELECTRlCAL��.W(, )C{�, }�� = r m<= �� °GAS TEST � � � ' � - RQU�H�PLUMBING�` � , � "'7��jl��f' �� 1�`�� ' ' � PRE GUNITE .. , _ . INSUf1�TI0N WALL ' POOL PRE DEGK BONDING � ° '• fi INSl1LATI0N CEIUNG P-T�P DRYWALL ' FENCE!GATEI AIARM . LATH(PREI � FINAL POOL ' ` ' ' LATH EXTERIOR WALLS: , LATH INTERIOR WALL FQOTING/STEEL GAS TEST WALL STEEL 1�( )2NQ( )UFT SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELEASE WALL DRAINI SEAL GAS METER RELEASE WALL FINAL . _ SPECIAL INSPECTION R0.FRAMING PLANNINGAPPROUAL �_... _ , > . F�NAL BUIID�, � � �� OUGH FIRE APPROVAL ING � � � - � � � 'FINAI�MECHANICAL _- �°,s� � � � , � , ' � �. � " � ' � �FINAL FIRE DEPARThAENT � � � `. FINi4L ELEC7RIC�L�` �. ".,. � �' ' �, � ��. � , � '� � _. _� . � FINAL PLANNING _ � a � _ � A <, .,� , _ � � v�_. , _ , FI�IAI.PLUtv�BIN� �m��, _ ° � p �" � � � e FINAL ENGIN�ERING!PW : � �_ � � _ , �. ��, : � � ;T�C;�f�GCUPANCY � . ` ; �� ' �'`'k �" & FINAL COIVIMUNITY 5ERVICES r - �, .�__,. r � � ,,,. .,, , � . :�. � .�. _ FINAL.HEALTH DEPT. CERT of OCCUPQNCY �, � . ,_ � � � , . FINAL INDUSTRIAL WASTE �� °� ' COMMENTS:��°` �0 J�� Gr� ' P/QQI� 1�` » Rv:.��01�6 � F.nc� i