HomeMy WebLinkAbout15-0968 �-.g*`� _ ._.., CITY OF DIAMOND RAR . •` �' �
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� ' � s DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES �� `��Q
' �� 21810 Copley Drive,Diamond Bar,CA 91765 PRESS
,,� (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 � FIRMLY
�'�""� BUILDING PERMTT APPLICATION
s JOB SITE ADDRESS 7 -- R APPLICATION DATE: '1 a, ��S P/C# P� �S- dllc�
i ISSUE DATE: t7 "��'IcS PERMIT# /���lJ/Gd
= APN LOT TRACT I, ,
L OWNER)�Pl-11�"� M\C.LFc..SL TYPE CONST. �(wGI/�IlI/l� OCC GROUP:
;� ADDRESS
� CITY ZIP TEL. ZONING F ONTCKS RW ❑
Y APPLICANT TEL. REAR ❑
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SIDE/SIDE STREEf RW ❑
Q CONTRACTOR S��Y7 L� J=��LST SIDE ❑
� ADDRESS Z��o n/. G,,z,a..►,� d y�. Y �/,�li�r�//�
�j PROPOSEDUSEX a� S1niC��,F, ScaS'c.Y fl�\�•
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� ARCH/ENG/DESIGNER 1� �'f Ci SE�V\L�.S �t�J�LLSN b'�
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= ADDRESS �
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z CITY ZIP TEL.
¢ DESCRIPTION SQ.FL FACTOR PSF ADJ.AREANALUATION �
OWNFA-BUILDEN DECLAAATION
� I hereby attirm under penalty of perjury that I am exempt from the Contractor's STate License Law for the reason(s) SF A EM •�'� I
� indicated below by the checkmark(s�,I have placed nezt to the applicable item(s)[Sectlon 7031.5,Business and Garage/Carport I
� Professions Code:Any city or county that requires a permit to construct,alter,improve,demolish,or repair,any
� structure,prior to its issuance,also requires the applicant for ttie pertnit to file a signed statement that he or she � Patio/Deck I
i Is licensed pursuaM to the provlsions oTMe Cantractor's State License Law(Chapter 9)Commencing with Section w
� 70W aT Oivision 3 of the Business and Professions Code]or that he or she is exempt from licensure and the basis for � Pool/Spa I
� the alleged exemption.Any violation of Section 7031.5 by any applicant far a permit subjects the applicant to a civil penalty C7
,Y of not more than five hundred dollars(5500). ZQ Re-Roof I
� (,I,as owner of the property,or my employees with wages as their sole compensation,will do(,all of or(,portions � Commercial �I
y of the work,and the structure is not intended or offered for sale(Section 7044,Business and Professions Code:The m I
� Contractors'Sh�License Law does not apply to an owner of property who,through employees'or personal effort,builds
� or improves the property,provided that the improvements are not intended or offered for sale.If however,the building or I
� improvement is sold within one year of completion,the Owner-Builder will have the burden of proving that it was not built
� or improved for the purpose of sale.). I
:�
(,I,as owner of the property,am exclusively contracting with licensed Contractors to construct the project(Section
� 7044,Business and Professions Code:The Contractors'State License Law does not appty to an owner of property who V8luation �, Adj.ArBa: I
'}�� buildsorimprovesthereon,andwhocontractsforlheprojectswithalicensedContractorpursuanttotheConVactors'State QUANTIIY DESCRIPTION FEE
License Law.�. I �
� O1 am exempt from licensure under the Contrador's State License law fir the following reason(sf. � `d '��-r PT4 L L E S I I
� ¢ �1- �1 I
'�l By my signature 6elow I acknowledge that,except for my personal residence in which I must have resided for at least one � + � � � �� I
� year prior to completion of the improvements covered by this permit,l cannot legally sell a structure that I have built as an w
owner-builder if it has not been constructed in its entirety by licensed contractors.I understand that a copy of the applicable � sw�T ES I
� law,Section 7044 of the Business and Professions Code is available upon request when this application is submitted or at I
i the following Web site:http/www.leginfo.ca.gov/calaw.html. � � I
`.� Z I
= DATE: SIGN: �
— LICENSED CONTAACTOH'S OECLAflATION � I
a I
_�� I hereby aftirm 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 etfect. J ` ������ � P�� �� I
�� � a
LICENSE CLASS: ���D� �2 a �Eq� � �S M I
' Z DATE: � ISr CONTRACTOR: � = I
� -.� U
¢ WOflKEH'S COMPENSATION DECLARATION g I
y I HEREBYAFFIRM UNDER PENALTY OF PERJURY ONE OFTHE FOLLOWING DECLARATIONS:
� I have and will maintain a Certificate of Consent to Self-Insure for Worker's Compensation,as provided by CONSTRUCTION: �n R• (�'�
� Section 3700 of the Labor Code,for the pertormance of the work far which this permit is issued. PLAN REVI EW: �J • g �
� I have and will maintain Worker's Compensation Insurance,as required by Section 3700 of the Labor Code,for
Z the pertormance of the work for which this permit is issued.My Worker's Compensation Insurance Carrier and ELECTRIC: � ,r��
¢ PolicyNumberare: PLUMBING: > `t1a
� CARRIER I�SW�d►�E-E. C_[��w1'POFTN'�L.��S MECHANICAL: U.�/7
� POLICY NUMBER��(Z��Z�4� d'v
INSPECTION FEE:
n (iHIS SECTION NEED NOT BE CAMPLEfED IFhIE PERMfT IS F9R ONE HUNDRFD DOLLARS($100)OR LESS�. .y/�3��r� ; L _/�
ISSUANCE: ,��� q•
� I certify that in the performance of the work for which this pertnit is issued,I shall not employ any person in any manner so as to �
become subject tn the Worker's Compensation Laws of Califomia.And agree that A I should become subject to the WorkeYs SMIP:_ -- ry/��—
L Compensali pro sions of Section 3700 af the Code,I all forthwith com I with mose provisions.
J ���� � � PY ENERGY P/C: �J �L g
i DATE: APPLICAN7: ENERGY PERMIT:
� WARNING:Fai re to secure Worker's Compensation coverage is unlawful,and shall subject an employer to criminal
y penalties and civil fines up to one hundred thausand dollars($100,000�,in addition to the cost of the compensation, RETENTION FEE:
1 damages as pmvided for in section 3708 of the labor code,interest,and attorney's fees. PRE-ALT FEE:
�
i CONSTf1UCTI0N LENDING AGENCY BrS�A,F. ��
= I hereby affirm under penalty of perjury that there is a Construction Lending Agency for the performance of the work for �`o� P�Gv� ay4\ $g
� which this permit is issued(Sec.3097,Civ.C.).
LENDER'S NAME:
z LENDER'SADDRESS:
i I certiry that I have read this appliration and state that the above information is correct.I agree to comply with all city and TOTAL FEES �7j,• (ps '� f�
7
Z county ordinances and state laws relating to building construction,and hereby authorize representatives of this county to COMM ENTS:
� enter upon the above-mentioned property for inspection purposes.
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¢ PER E(PRIt� �I C �� `� �,
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= SIGNAlURE OF PERMITfEE • DATE� � �� RECEIPT# S� PAID BY: N dQ�� VALIDATION:�
WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy
CITY OF Dt�k1�V1QiVD B�►;�R �._ ,
� INSPECTiC3'N R`ECOi�D ; � ��,
� s s � � - o � � . � .
�SETBAGK!LE7TER � � � �� � � � � � � TRACT AND LEDGER
> �� '� `�
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FOOTINGS,FQRMS; ,` - �°�� �' % ` � " ' ' � SWITCH GEAR
SLAB :�; , ,�'„� , _- � � � � � � � -- � - COMMERCIAL HOOD
UG:�P,LUMBING ���=; � � � ��� � � � � . T-BAR
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��`�� � '� � � � ����� � ` � INTERCEPTER
UG:`ELECTRIGP,L �'�u a �� a ��� _. � �. � _
LlFER;GROUND ��Y; ��� °�-���'°` ' °����� � ' � ° `` ^' "' " � HOT MOP/SHOWERPAN
SE4'VER LATERAL SEPTIC/CESSPODL
PJIAIN WATER LINE HERS REPORT RECEIVED
SEWER CLEANOUT DEMOLITION
ROQF SHEATHING / � ROOF DRAINS
FLOOR SNEATHING ROUGH CONDUIT
,SHEkR WAtLS EXTERIOR � � � � ;'� � � � �" 'P'OOUSPA ' � � � � � ���� � �- �
� �
, � � �
SHEAI�WALL��,� ,.� � - � ., , � � ,_ _ _ _ _
S INTERIt�R .g . ` � ROUGH RLUMBING - � � � -x �� ° �� '� '
� �.
�FRAMiNG/VENTING�-� � �� ''' ` �' `� ' �� � �ROUGH ELECTRICAL ' ` �� � � � � ��� � �
o � � _ .; . _
R'Ot�GH MECHANICAL�� , � � � � � ROUGH MECHANICAL � � � �
�ROI�GH ELEGTRICAL W( )-C�(� )' � �! ,�� , GASTEST � ' �
:
�ROUGH PLUMBING � ���� ����� � '��� � � � PRE GUNITE � � �
, . �
INSi1LATI0N WALL POOL PRE DECK BONDING x
INSiJLATION CEILING p-T�p " "
DRYWALL FENCE 1 GATEl ALARM R y � � �
IATH(PRE) FINAL POOL = � `
LATH EXTERIOR WALLS:
LATN INTERIOR WALL FOOTING/STEEL
GAS TEST WALL STEEL 1 sT( )2Ne( )LIFT
SCRATCH COAT WALL BOND BEAM
ELECTRIC METER RELEASE WALL DRAIN(SEAL
GAS METER RELEASE WALL FINAL
r � ,, . , ,-
SPECIAL INSPECTION RO.FRAMING PLANNINGAPPROVAL
�� � � _ _ HOUGH FIRE APPROVAL , ° , � _ °
,x �
FINAI BUILOIt�G_ � � - - >- .: . .� � � a � . ,
;�, AL_MECtiANIC1� ' '�; � � "� ' � � � � ��FINAL FIRE DEPAR7MENT � � � � � _ � I
-- ' - FINAL PLANNING � Z�
'FiN�1l El�E��RICAL= �, r� � .�, o.1,�.� � � � �
, - x . _ _ x �
FINA�PLUMBING��� �' �� , �' �'�` � � � `FINAL ENGINEERINGI PW ( I) .,� ��
� � , � . M �_ � • � °
;i,C of�O�CUPANCY���. ".,�.�s,�z� ��� � � ��FINAL COMMUNITY SERVICES � � °
,<. _� � . . , , . .
CEitT�of�OCCUPAPiCY "� '° _ �� ��� ; ' � ' ' � " ���FINAL HEALTH DEPT.
�fiNAt INDUSTRIAL�WASTE � � � � � � �� � ° � �
COMMENTS: � . �--
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