HomeMy WebLinkAbout13-1173 �'�:.�,� C11'Y O�DIAMOND[3AR
� i I I I ' DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES
�p�,� `� " 21810 Coplcy Drivc,Diamond Bar,CA 917fi5 PRESS
� ,m , .� (909)839-7020 F;�x:(909)861-3117 Building Inspection Hotline(909)A39-7027 FIRMLY
���'�H"'���� BUILDINGPERMITAPYLICATION
� .
� '2��c� APPLICATION DAT � P/Ck
w JOB SITE ADDRESS J � /���
z APN LOT TRACT ISSUE DATE: � PERMIT# � 3 �
0
o OWNER ( N 1YPE CONST. OCC GROUP:
y ADDRESS 2 2 `COL� � D • ZONING SEfBACKS
y CIlY � N��`T ZIP TEL. ' �I ^ FFONT RW ❑
oAPPLICANT �-�CXL�� L� �_TEL �I�•Cdl�'��Z� REAR ❑
a CONTRACTOR SIDE/SIDE STREET RW ❑
o SIDE ❑
oro ADDRESS
PROPOSED USE
o CITY ZIP TEL. _ �
o ARCH/ENG/DESIGNER . �
w
o ADDRESS
tl DWEL.UNITS #STORIES q BEDROOMS
z CITY ZIP TEL.
� DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
OWNFA-BUILDEq DECUIHATION
o I hereby aflirtn urMer penatty of perjury that I am exempt irom the Contractor's State License Law tor the reason(s) SFR/ADD/REM �
p {ntlipted below by the checkmark�s�,I have placed neM to the appllcable item(s)[Sectlon 7031.5,Buslness and GaragPJCarport
o Protesslons Code:My city a caunty ihat requires a permlt to construc4 alter,improve,demolish,a repair,any
w struclure,prlor to its issuance,also requires the aDP��nt fw the Dermtt to flle a signed statemenl Nat he ar she � Patio/Deck
N fs licertsed pursuant to the provislons oi the Contractor's State License Law(Chapter 9)Comme�ing with Secdon � W
� 7000 of Divlsion 3 of ihe Businm and Prolessio�u Code]or that he or she is exempt hom licensure and the basis for u- PooVSpa
� the alleged eaemption.My violation of Section 7031.5 by any appliqnt fw a permit sub�ects the aDPlicant to a cHil penatty
� ot not more than five hunNetl dollar515500). Z Re-Roof
¢ p
o (�I,as owner of the property,or my employees with wages as their solo compensation,wlll do(,all 01 a(,portlons ? Commercial
� of tlte work,arM the strucNre Is not IntenAod a offered for sale(Sectlon I044,Buslness and Professlons Code;The �
U m
Z Contractors'State License Law dces not appty to an ovmer of property who,through employees'or personal ettort,builds
w or improves the property,provided that the imprmements are not intended or ottered for sale.B however,the building or
� Improvement Is sold within one year ol compleUon,U�a Owner-Builder will have Vie burden of proving that it was rwt bWtt
por Improved for the purpose oi sale.).
� I,as owner of ihe m
0 U p pertg am exclusivety contracUng with licensed ConVactors to construct the project(Section Valuation: Ad Area:
7044,Business and Professions Code:Tne CoMractors'State License Law tloes not apON to an ovmer of Oroperty who 1•
z builds or imprwes Ihereon,and wno contracts(or the Drojects with a licensed Contreclor pwsuant ro tlie Coniractors'State QUANTITY DESCRIPTION FEE
cn
Y ucense Law.). /
o U��exempt hom licensure untler ihe Coniractor's State License law for the Ioliowing reason(s): �
� � - S n.�
"—' By my signatu2 below I acknowledge ihat,eXcept fw my perwnal residence in which I must have resided tor at least one �
o year prfor to completlon of Ne imprwement5 covered by this permit,l cannot legalty sell a structure Liat I have twill as an w e
� owner-builder if It has not been consWcted In its entirety by licensed contractors.I untlerstand ihat a copy of ttie appllpble �1 � , /LI • � - �
� law,Section 7044 of ihe Business and Professlons Code is available upon reduest when this appliratlon is submitted or at
X the following Web site:httpJw�nv.leginfo.ca.gov/calaw.html. _
o DATE: SIGN: �
�. LICENSED CONTqACTOR'S DECLARATION �
n_
� I hereby aftirm under peretty ot per�ury ihat 1 am IicenseA under provisions of Chapter 9(commencing wNh Section 7000)
w
� ol Divislon 3 ot the Business antl Prolessions Code,and my licer�se is in full force and eflect. J
�
cn
� UCENSE CLASS: LIC.NO.: Z
� DAlE: CONTRACTOR: �
WOHI(ER'S COMPENSATION DECLAFIATION g
w I HFAEBY AFFlRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS:
a I have and wiq maintain a Certi�pte oi Consent to Setl-Insure fw Worker's Com ensation,as
o p provided by CONSTRUCTION:
� Section 370D of ihe laba Code,for Ihe pertormance ol the xrork tor which Ihis permit is Issued. p�p,N REVIEW:
> I have and will maintain Worker's Compensation Insu2nce,as repuiretl by Section 3700 of the Labor Code,ta
Z ihe Dertamance of ihe work tor which ihis pertnd is issued.My Worker's Compensation IRsurance Carrier and ELECTRIC:
¢ PoIi�yNumberare: PLUMBING:
� CARRIER MECHANICAL:
w
� POLJCY NUMBEA
INSPECTION FEE:
� (T}4S SELTION NffD NOT BE COMR.ETE�IF TFff PHIMIT IS FOR ONE HUNDRFD DOLIARS 1 OR
� �� �' ISSUANCE:
o i cerlify tliat In the perlormance of the xrork la which this permit Is issued,I s7v311 nol empby any person In arry manner so as to
o becorne sub)ect ro the worka^s Compensatbn Laws of Calilomi�.Md agree Ihat if I shadd bec,rome suaect ro the Worker's SMIP:
�J'- ComPe�atbn provisions a Sec�ion 3700 of Uie�abor Cale,�shau�onlnvith cnmply with those provisions. ENERGY P/C:
'� �A� ���' ENERGY PERMIT:
� WARNING:Failure to secure Worker's Compensa0on coverage is unlawtul,and shall subject an employer to criminal
w per�attles and civil fines up to me hundred mousaiM dollars(StOD,00o�,in additian to the cost ot the wmpensatlon, RETENTION FEE:
o damages as provided tor in section 3708 of the labor code,interest,and attomey's lees. PRE-ALT FEE:
a CONSTHUCTION LENDING AGENCY BSAF:
w I hereby affum under penalry o�per�ury Ihat tlrere is a Construction Lending Agency for t�e pertormance of the work Por
� which this permR ts Issuetl(Sec.3097,Civ.C.).
� LENDER'S NAME
� LENDFR'SADDRE55:
a I certify that I have read this application and state Nat ihe above intormation is wnect I agree ro compty with all Gty and TOTAL FEES ��
Z wunry ordinances and state laws relatlng to building construction,and hereby authorize representatives ol this county to �1
o enter upon the above-mentioned properry for inspectian purposes.
COMMENTS:
J ��
m
¢ PE E F1T)
N �
� SIGNATURE OF PERMfTTFE pAiE RECEIPT# PAID BY: VALIDATION:
WHITE—Department Copy,YELLOW—Fnance Copy,PINK—Assessor Copy,GOIDENROD—File Copy,GREEN—Appticant's Copy
CITY OF DIAMOND BAR _
INSPECTIOIV RECORD � '
,.
o � . � � - • � . - • -
SETBAGK/LETTER �' ��."�� . ` '� TRACTAND LEDGER
f00TINGS FORMS - - �t` =` "� SWfTCH GEAR
S�qg' - "i ;.�:_;'� COMMERCIAL HOOD
UG.PLUMBING: _ — � - ' '_' T-BAR
UC:ELECTRICAL � _ `'.� ' ' ��f INTERCEPTER
U�ER�GROUND��:� ' ,;, ': r;��1 , '"' � '� �: :� ';a� HOT MOPISHOWERPAN �
SEWER LATERAI SEPTIC/CESSPOOL
MAIN WATER LINE HERS REPORT RECENED
SEWER CLEANOUT DEMOLITION
ROOF SHEATHING ROOF DRAINS
FLOOR SHEATHING ROUGH CONDUIT
`SHEAR WALL'S fXTERIDR' ' ' _ _� , _ {' 'POOUSPA:;,?'-` °'' , �' ; .�ra' ,`�� t' S �" ' _ ° ;:
,SHEAR WAILS-INTERIOR;' .,' ' , "� ROUGH PLUMBIN6 - �'r' x�'
FRAMINGNEMING. - '' `` '' - '; ` - ROUGHELECTRICAt{- -- �,� - ° -�
ROUGH MECMANICAL # �' i� ROUGFI•MEGHANICAL * 'r ' k �f sx`�"
a I � , i
..... �.� '� �.� � _r .,�
.. .�� . : �. 'ti .: " ' ,� d
ROUGH ELECTRICAL W(,>)C( ) - � ,GASTEST :: x �� �' �'-�j �r �
AOUGH PLUMBING '�`-�' ++ � `y PRE GUNITE � d� �` `' �'`� � '�
INSULATION WALL POOL PRE'DE�K BONDING '„'i ` ';y ��, � 4r" k -+�' r�`!.=
INSULATION CEILING P'�P T� ' L j` Y
DRYWALL FENCE GGATE/rALARM ` � `P ` - `
�FINAL POOL - _ r�,:°;: =�: � <_';
LATH(PR� � _ - -
LATN EXTERIOR WALLS:
LATH INTERIOR WALL FOOTING/STEEL
GAS TEST WALL STEEL 1sT( )2"0( �LIFT
SCRATCH COAT WALL BOND BEAM
ELECTRIC METER RELEASE WALL DR,41N/SEAL
GAS METER RELEASE WALL FINAL
SPECtALINSPECTION RO.AiAMINGPtANNWGAPPROVAL �' ;�' ; j5 + �
FINAL^BUILDING " ` 'r �� �"' ��"�� ROUGH EIRE`AP'PROVAL ;�'; '�f ,t� ' �=
FINAL MECHANICAI: ' } _ FINAL FIRE DEPARTMENT,n_' `� �
FINAL ELECTRICAL" - - _: 'FINAL PL`ANNING`;` �'" � ` 't'
� . Y
FINAL PLUMBING� - . r ' " ` 'FINAL ENGINEERING!PW :� h �� ` T ��t
' . . ,. ,_ : _ :
T.C:of OCCUPANCX �� ` ` ': ,' . FINAL COMMUNITY:SERVICES y� - � �
CERL of OGCUPANCY.. � , ��; . FINAL HEALTH DEPT ' � � { t `' �
FINAL INDUS'TRIAL WASTE`�':': *�,` ` ` p� �4 �'l ` '`� f
COMMENTS:
�r,/'a(��r� i ���p��^a!i � e• _ °�, � �.�:r•...,:.:�,.'� /� �T.� " }a�,'
{.- �.1 �'"" �`i'1r it lJ��i s,,r— � y�.�.� �S-a�.P-��!,�`/-- �� �� ° "�� �� 6'��
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