HomeMy WebLinkAbout14-1837 ,=��.�.; CITY OF DIAMOND BAR
k � I 1 i ' I DEPAKTMENT OF COMMUNITY&DEVELOPMENT SERVICES
�,,� ������;,�, ` ' 21810 Coplcy Drive,Diamond Sar,CA 91765 R
t � (909)839-7020 Fax: (909)861-3117 Bailding Inspection Hotline(909)839-7027 IRMLY
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�"���'�"�" Bi)ILDING PERMIT APPLICATION �
� � APPLICATION DATE: � � � P�C�
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ac JOB SITE ADDRESS r4.. �Q �_
� w ISSUE DATE: PERMIT# �
a
z APN LOT T T �
� o OWNER � TYPE CONST. OCC GROUP:
� ADDRE S '' � ZONING SEfBACKS
� CITY ZIP TEL. � ' � FRONT RW ❑
'¢ APPLICANT TEL. REAR �
o ./ SIDE/SIDE STREEf RW �
a CONTRAGTOR
� �'� f� !/ e�/ 6 !� SIDE �
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o� ADDRESS PROPOSED USE �
� CITY ZIP��EL. � n 6�
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`� ARCH/ENG/DESIGNER
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z ADDRESS #DWEL.UNITS k STORIES k BEDROOMS
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a C�7y ZIP TEL. DESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREANALUATION
� OWNER-BUILDEFI DECIMATION
� I Aereby attirm under penatry of D�lury that 1 am e�cempt trom the Coniractor's State License Law fw the reason(s) SFR/ADD/REM
� indicated below by the checkmark�s�,I have D����xt to Me aDD����e��em(s)[Section T031S,8uslness and Gara e/Carport
u9 9
Professions Code:My dty or county that requires a permit lo comtruct,alter,improve,demolish,or repalr,any
Z structure,prim to iTs issuance,a15o reqWres ihe aDP���nt tor ihe permtt to file a slgned statement that he or she p3 Patio/Deck
Nis licensed Dursuant to ihe provisfons of Ihe ConVactor's State License Law(Chapter 9)Commencing wiN Sectlon W
� 7000 of Divisfon 3 ot the Business and Protesslwu Code]or that he or she is exemDt hom licensue and tlie basis fw LL P�VSpa
� the alleged exemptwn.My violation ol Seclion 7031.5 by any applicant 1or a Dermit subjecCs the aDDlicant N a Gvll�relty Z Re-Roof
`n at not more than five huntlred dollars(8500). . .
¢
o U I,as owner of the pmperty,or my emplayees with wages as Uielr sole compensation,wfll do(�all of or(,portions 9 Gommercial
� ot Mo work,and the struclure Is not intended a oflered ior sale(Section 7044,Business and Protessions Code:7ne m
� ContracWrs'State License Law tloes not appty to an uwner o1 Droperty vfio,thraugh employees'or personal eBort,bullds �
w a imprwes the properry,Providetl t�at Ihe improvements ara not intended a oNered lor sale.B however,the building or
� improvement is sold within one year of canD�etion,the Owner-Builder wIU have the hurden of prwing ihat it was irot bullt
por Imprmed for the purpose ol sale.).
� I,es owner ot the ro 1�
(, p peAy,am exclusively contracling with Ifcensed ConVactors to construct the pro (SecGon Va{uation: Adj.Area:
0 76qq,Business aiM Prafesslons Code:The Contraciors'Stale Lice�e Law does not appty to an owner of property who
Z builds or imprwes mereon,and who crontrxts tor me projects wfin e Ilcensetl Contractor pursuant to the Convxtors'Stale QUANTITY DESCRIPTION FEE
�
Y ucense Law-). . r
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o U��exempt hom licertsure untler ihe ConVactofs State License law tor Ne tollowing reasoMs): �
� �
`L 8y my signature betow f acknowledge ihat,except tot my personal residence in whicti I must have reslded Iw at least one � �
Z year prior to completlon of Ne improvemen�covered by this permit.l canrrot legally sell a structure that I have built as an „—',,
0
� avner-bWlder if ii has no1 been consirucied In its eniirery by Itcensed cmtraclors.I understand that a copy o11he appliq�fe
law,Section 7044 of the Business arid Professions Coda is available upon request when ihis applicallon Is submftted or al
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X the foltowing Web sde:httpJwww.leginfo.ca.govJcalaw.ntrnl. z�
'L DATE: SIGN: � .
� UCENSED COMAACfOfl'S�ECLARATION a
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w I hereby aKrm�nder pe�lty of perjury ihat I am licensed untler provisions of ChaRter 9(commencin9 with Sectio�7000) .
� ol Division 3 01 the Business �tl Professians Code,and my license Is in full force and eHect. � .
� �: o?��b`� �
"' ucer+se c �
u, c.No.: �
o DATE: � � COMRACTOR� f � c.�
zd WONI(ER'S COMPENSATION OEClAF1ATI0N g �
� I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLAFiAT10NS:
w
4 I�ave arM wi0 mainlain a CeAiLca�e oi Conseni to Setl-Insure for Worker's Compensalion,as provided by CONSTRUCTION:
� Seclbn 37�of the La�or Code.for Ure perfwmance of tl�e work tor which thls permit is issued.
� PLAN REVIEW:
j _I have and will maintain Waker's Compensatbn Insurance,as required by Sectian 3700 M the Labor Code,for ELECTRIC: 'O —
o Me perlormance ot lhe wak fw which thi�permit is issued.My Worker's Compensatinn Insurance Cartier and �
¢ PolicyNumberare: ` / PLUMBING:
o CutRiER S � G�Q �/� MECHANICAL
Z POt1CYNUMBFA� � �, INSPECTION FEE: �
t7
N (T1dS SECTION NFED NOT BE fAMR.ETED If 7HE PEM4R 6 FOR ONE F4RJDRED DOLIAAS(810�OR t.ESS). ISSUANCE: �
oI certity ll�al m the performance ol the�wrk fa wh�h Ws pemdt is' s1�a0 wt emWoy am!Persm in any manne�so as to
beoome subjecl to the Nbrfeer9 CompensaUon Laws ol Cal' ia. aqree that il I shadd becane subject eo tlie wakefs SMIP:
� Campen tion p 'ia�s o tian 370o at or ortmvith compN with ihose 9ro'^sias. ENERGY PlC:
�
LL DA �" � APPUCaHt: ENERGY PERMIT:
� WARNING:Failure to secure Worker mpensauon coveraga s uNavRul,a�M shall sub}ect an employer ro criminal REfENTION FEE: �
� penattles and civll fines up to on hundred thousand dollars($1�,000),in addition to the cost ol the comperaation,
w PRE-ALT FEE:
a Aamages as provided for in section 3708 of the IaDoi code,interest,arM attomey's fees.
a CONSTAUCTION LENDING AGENCY BSAF:
w I hereDy amrm under penatty of per]ury ihat there is a ConsUucfion Lending Agenq lor the pertormance of ihe work for
� whicb this pertnit is issu¢d�Sec.3097,Civ.C.).
� LENDER'S NAME
¢ LENDER'SADDRESS: �
TOTAL FEES
a I certlty that 1 have read Ihls aDDlication antl state that Ne above information is cortec�.l agree ta compty with atl ciry a� . ?j
� county wtlinances and state laws rolatlng ro building cansWcfion,and hereby authorize representatives of this counry ro COMMENTS:
Z enter upon the above-mentwned prope for ins ciron purposes.
�
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¢ PERM ME
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N � RECEIPT k PAID BY: VALIDATION:
� SIG RE R �AT�
WHITE—Department Copy,YELLOW—Finance Copy,PINK—Pssessor Copy.GOLDENROD—File Copy,GREEN—ApplicanYs Copy
CITY OF DIAMOND BAR
INSPECTION RECORD � '� � '
� � � , . s . . � e , . � .
�SETBAGIO LETTER ,'fi�.;:,i � ., ,'�+, , = ' _ `-�`� � -. � = TRACT AND LEDGER
FOOTINGS'FORMS "' �`F;�.,,�, _ ",�U " ..i,,� , y�,�. . �'' SWITCH GEAR
SLAB -
`-� t�� �;,, � ��' ,�� z � .;;�; COMMERCIAL HOOD
UG.P.LUMBING�` �" ` - -' ' `':+ T-BAR
U6.,ELECTRICAL;, `=' -'z '�' }°" , f_.s' :s `" =' INTERCEPTER
UFER GROUND__`: ,�i•`�_ ±' �", , ` �` '.'��k . - HOT MOP/SHOWERPAN
SEWER LATERAL SEPTIC/CESSPOOL
MAIN WATER LINE HERS REPORT RECEIVED
SEWER CLEANOUT DEMOLITION
ROOF SHEATHING ROOF DRAINS
FLOOR SHEATHING _
ROUGH CONDUIT
SHEAR'WALLS ExfERIOR r�rJ � ��� POOUSPl1`` § ;� s �',
SNEAR�.WALL'S`sINTERIOR `� � `�� � �� � ROUGH'PLUMBINGs� �; ��; � �� '�'
FRAMING/VENTING � ~�: i � �� ` , z ROUGIi ELECTRICAL- '. ` ' ' ' :- S f r r ; '�
,
ROU�H MECHANICAL�rf � � �:: �- �_ ;sk - r�`w� = ,. ROUGH MECHANICAL�: � s> � .� �� , ` , �`� '�� �s�'r � °.
. �, _ .� s ci�, t,^ r ti r 4
ROUGH ELECTRICAL W(.�),C{,} �`, � _ .GAS TEST:� ; ��,,,,. - + � Y j
ROUGH PtUMBING �r , , _ �'. �_ -': ' ' m , . _ `-' PRE GUNfTE" �,,.. ' � � `^ 4
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INSULATION WALL �PODL�PRE_DECK�BONDING _��_� �. . � � � a r� ` ��`�' �'.`
INSUTATION CEILING � � ��' �� ��
� P=.TR�4P '` : , :, �t�, ��' , �. �
DRYWALL FENCE/GATE/ALARM s � , ' ' ^ :-r x ' ` �� 'k�
LATH(PRE) FINAL'POOt ., � �" - � ;: �� c�=_
LATH EXTERIOR WALLS:
LATH INTERIOR WALL FOOTING/STEEL
GAS TEST WAIL STEEL 1�T( )2ND( �LIFT
SCRATCH COAT WALL BOND BEAM
ELECTRIC METER RELEASE WALL DRAIN/SEAL
GAS METER RELEASE WALL FINAL
....rl u,.;Ii ..'I. C:
SPECIAL INSPECTION RO FRAMING PLAlJNINGAPPftOVAI , -- � '
'"ryr " '` { ' ` ROUGHFIREAPPRQVAL - � `� � -� '
FINAL BUILDING ' ' M � " _" �
,�� :. •- . . . .�
FINAL;MECHANICAL, . ., 1 u ` _' t � '', FINAL�FIRE DEPARTMFJJT — ' : � � ':�
�.r ' �,,' ""�' :, ' � F,INALPLANNlNG��; u` , ` - � �� {, `
F�NAL'ELECTRICAL ,_„ ,�-
FINALP,LUMBING r - : ' { ' ' FINAL'ENGINEERING/PW. ,: ;i' t' �' '" ` '`
T.C:Of OCGUPANCY _ -� ` z,,',� `A " �,Y�.:r �',' FINAL COMMUNiTY'SERViCES �` � = ,> 4 -_ �-
CERT;�of OCCUPANCY''�, s ,k�, r, - �.�° �,r. .'. .�'.:_ , �FINAL.HEALTH DEFT ; � ;` ` `. �
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FI "INDUSTRIALWASTE� �_ . .` T ' '_ �' t-' `�`
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COMMENTS: �-- �� ��
C/N � �� ,� .