HomeMy WebLinkAbout14-5094 (8) L � '�x� DEPARTME T OF COMMUN
� ITY&DEVELOPMENT SERVICES
"• =�G 21810 Copley Drive,Diamond Bar,CA 91765 PRESS
;h�,v�„�� (909)839-7020 Fa�c:(909)861-3117 Building Inspection Hotline(909)839-7027 � FIRMLY
�''�""J BUILDING PERMIT APPLICATION
11�\�� 1�-l- Pica
g , APPLICATION DATE: 0 TC
y JOB SITE ADDRESS ��
i ISSUE DATE: /�l�I Y PERMIT# �1���y
= APN LOT T ACT �—
� OWNER O TYPE CONST. OCC GROUP:
y
� ADDRE �,
J CITY ZIP EL. ZONING SEfBACKS
FRONT RW ❑
� APPLICANT TEL. REAR ❑
�
� SIDE/SIDE STREEf RW ❑
� CONTRACTOR SIDE
❑
� ADDRESS � � PROPOSED USE
x CITY ZIP EL.
� —
� ARCH/ENG/DESIGN R
y
= ADDRESS
� #DWEL.UNITS #STORIES #BEDROOMS
za CITY ZIP TEL.
� OWNEA-BUILDFA DECLAMTION
DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION �
= I hereby affirm under penalty of perjury ihat I am exempt from the CoMrador's Sfate License Law for the reason(s) SFR/ADD/REM I
L indicated below by the checkmark(s),I have placed next W the applicable item(s)[Sectlon 7031.5,Business and Garage/Carport � I
� Professlons Code:My city a couMy that requires a permit to canstruct,atter,improve,demollsh,ar repair,any
z structure,prla to Itv issua�e,also requires the applicairt for the permit to flle a slgrred stetement tliat he a she � Patio/Deck I
i Is Il�d pursuairt M the provislo�of the Contractw's State Llce�e Law(Chapter 9)Commencing with Sectlon W
� 70W of Dlvlsion 3 of the Business and Prolesslons Cade]or that he or she Is exempt from licensure and ihe basis for � PooUSpa I
n the alleged ezemptlon.My vidation of Sectlon 7031.5 by any applicant for a permit suhjects the appllcaM to a civll penalty C7 I
'n of not more than five hundred dollars($500�. Z Re-Roof
s I
� (J I,as owner of Vie propeRy,or my employees wMh wages as their sole compensaUon,will do(�all of or U portions � Comme1cial
y of the work,and the strudure is not irrtended w offered for sale(Sectlon 7644,Business and Pmfessions Code:The � I
> m
Contractors'State License Law does not appty to an owner of propeRy who,through empbyees'or personal effort,bullds
y or imprwes the pmperry,provided that the Imprmements are not intended or offered for sale.lf however,the building or I
� improvement Is sold within one year of completlon,the Owner-Builder will have the burden of proving that tt was not bultt
� or improved for the purpose of sale.). I
� I,as ownar of the ro
(_.) p perty,am excluslvely corrtracting with Ilcensed Contractors to construct the project(Sectlon
Z 7044,Business and Professlons Code:The Contractors'State License l.aw does not appty to an owner of property who Valudtion' Adj.Ar88: I
� bulldsorimprovesthereon,andwhocoMractsfatheprojeclswtthalicensedContractorpursuanttotheContractas'State QUANTITY DESCRIPTION FEE � ��-
Y License Law.). . �...
�
� U��exempt from Ilcensure under 4he ContractoPs Siate Llcense law for Ne follovnng 2ason(sp � V^ S
i ¢ I
Z By my signature helow I acknowledge that,except for my personal residence in which I must have resided fw at least one � I
= year prior to completion of the Imprmements covered by this permit,l cannot legally sell a structu2 that I have built as an w I
owner-builder if It has not 6een constructed in tts entirety by Ilcensed conUactors.I understand thata copy of the applicable
� law,Secdon 7044 of the Business and Professions Code is avallable upon request when this application Is suhmitted or at I
'i the following Web site:http/w�wi.leglrrfo.ca.gov/calaw.h4nl. = I
jDATE: SIGN: �
— LICENSED CONTNACTOfl'S OECLApATION � I
y I hereby aftirm under penatty of per�ury that I am Ilcensed under provislons of Chapter 9(commencing with Sectlon 7000) I
� of Divislon 3 of the Business and Professions Code,and my Ilcense is in full force and eftect � I
� LICENSE CLASS: � �;V L1C.NO.: l___�'�t
Z DATE: � CAMRACTOR: � i
¢ . WOfll�A'S COMPENSATION DECLANATION � I
y I HEREBY AFFIRM UNDER PENAL7Y OF PERJURY ONE OFTHE FOLLOWING DECLARATIONS:
� I e and will malntaln a Certificate of Consent to Sett-Insure for Wwker's Campensation,as prmided by CONSTRUCTION:_ /.r�-•d�
� ection 3700 of the Labor Code,for the peAormance of the work tor which this permlt Is issued. p�qN REVIEW:
� I have and wlll maintaln Worker's Compensation Insurance,as requlred by Sectlai 3700 of the Labor Code,for �
� the pertormance of the work for which thls permit Is issued.My Worker's Compensation Insurance Carrler and ELECTRIC: � ��_
� CP.RRIEAmberare:�'�r n^G`�� . PLUMBING:
/
1J �'L MECHANICAL:
� POLJCY NUMBFA �� .-`
' INSPECTION FEE:
n (iFilS SECTION NFED NOT BE COMPLEfEp IFTHE PfAMfT IS FOR ONE HUNDR�DOLLARS($10�OR LESS�. I
ISSUANCE:
� I cerMy ihat in the perfurmance of the waic for which ihls pertnit Is fssued,I shall rot emplo9 any person In any manner sp as to — � �
� become subject to the Worker's Canpensatlon Laws of Califomia.Md agree that If I should becotrie sub�ect to the Worker's SMIP:
iL Compensa nq�lons of Sectlm 3700 af or Code,I hall t � ' co ty vrith 1h e isions. EN�RGY P/C:
OATE: � �O APPLICANT: ENERGY PERMIT:
� WARNING: lure to seCure Worker's Compensati coverage is unlaw(ul,and shall sub�ect an employer to criminal y��
y penattles and civll flnes up to one hundred ihousand dollars($100,000),in additlon lo the cost of the compensation, RETENTION FEE:
� damages as provided ror in secuon 3�08 of ine labw code,Interest,and attomey's tees. PRE-ALT FEE:
i CONSTNUCTION LENDING Af�ICY BSAF: J,�i?
= I hereby affirm under penalty of perjury that there is a ConsWctlon Lending Agen�y for the performance of the work for
� which this permtt is issued(Sec.3097,Civ.C.).
LENDER'S NAME:
x LENDER'SADDRESS:
i I certify that I have read this application and state that ihe above information is correct.I agree to compty with all city and TOTAL FEES ///!!!
� county wdinances and shate laws relating to bullding consWction,and he2by authorize representatives of this county to COMMENTS: ��•��
z
� enter upon the above-mentioned property for inspection purposes.
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¢ PERM E(PRI �
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� �0�� PAID BY:_���.�VALIDA710N:__�__
x SIGNA RE OF P ITTEE DA1E RECEIPT#
WHITE—Department Copy,YELLOW—Flnance Copy,PINK—Assessa Copy,GOLDENROD—File Copy,GREEN—Applicant's Copy
CITV OF DIAMOND BAR
INSPECTION RECORD
s � � a � � � � � � �
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�SETBA�KI�LETrTER���`�.:; ��""��` ��� ,�, �� _��, ,u,�,�..��. °^ ' "�° "� � TRACT AND LEDGER
FOOTINGS`FORMS�°�`�°������",���y��Y}��"�=���'� �' SWITCH GEAR
;SLAB���"� �.�4�����. ' �•'` '�� ���" _ .�`� ��� �� COMMERCIAL HOOD
�� �� � �
�1G�PLUMIBING�� ���',�� �° ,� �'�` ,_ :��, �. `�'::j� T-BAR
,UG'.ELECTR(GAL �; � �������� � "��.'�� �� ���`°�«�� -.' � "�� INTERCEPTER
� � � �����. ,������������":� HOT MOP/SHOWERPAN
�UFER,GR�UND��� �y�4� ...., . •
SEWER LATERAL SEPTIC/CESSPOOL
MAIN WATER LINE HERS REPORT RECEIVED
SEWER CLEANQUT DEMOLITION
ROOF SHEATHING ROOf DRAINS
F100R SHEATHING ROUGH CQNDUIT
, � .. � m �,, t�;'.� a �}� � � � F k�" '�' .,� qat s � {
'SFtE4R WALLS,F�(TERIOR� �y �"� � ,� ,POOUSPA�� a ��� � �y ,. , y_�
�° � �' � ���,;,��.��� ��� `����:.�� � �k�� "`ROUGH.PLtJMBi(�G ��..,��, KK ;..�� ,, :':�s�� ° �� �u`����" �- �
>SHEAR WALLS'tNTERiOR � ;� `
y � o�, . � ,xe ��� � .. �� �.+��-,: � �_",*- .a ..��,. �, t �',� ���:'e �za"1.��.:
FRAMiNGfVENT(NG� � �, '�: �,� � �� �� ROUGH ELECTRICALn � � -� ��� .�M �
,iiOU�H MEGHqPV�CAL�°��.�'� ���"'��� , -=�.�'a��.��;b��:����Au �' ROUGH MECNANIGAL '�'� � � :����:� �� ; ��;. '�°�`� ��°,; �
ROUGH ELEGTRlCAL IN(�)�t =,1� ��� � � �� �`�',�� ` � ;�A�TEST���� ,� ���� �� �� �a� �� � ��:� � .<� °� ��
+'� zur � �' -.,. �� �� ... �r� � ��a°e � �.� y� sgtt +,� '��� ,�s� � " �. �,..
'ROUGH PLUINBlNG, �a'.��, �,,.�� ;����� ��4.�� :��. �PRE GUNiTE "�`����� x � � i .�.�$�. '� .,.�� �. � �
. _ . :.�� ., , �� , �
INSULATIONWALL `I?OOL;RRE_dECK�BONDING� � �� �f�;����.�4� ����.`;��� � `�s. �
�P�7RAP��'��� .,� �� ��; �;� :� �;���:"������� �
INSULATION CEILING � - �
DRYWALL
'FENCE,/GA7E/ALARM� _�=,.� � � -��` �':�v = ' ;�;;���„°: ��'�.
LATH(PR� 'FINAL,POaL��� ��. „� �°�"� _� �� -�°� �;� `a
LATH EXTERIOR 1'2r �'� WALLS:
� LAThI INTERIOR WALL FOOTING/STEEL
GAS TEST WALL STEEL 1�( )2"�( )LIFT
SCRATCH COAT WALL BOND BEAM
ELECTRIC METER RELEASE t Z I WALL DRAIN/SEAL
GAS METER RELEASE WALL FINAL
SPECIAL INSRECTION #HO FRANfQiIGPI°{WMNGAPPR�I%A�� .`�-- ��f.�� ; � °"� � ��� ���"�� �'�`
, �,.: , � 3 � �� � �. _- �.� �F3aUGH�FIRE�APPFiOUAL �� ��'`� s, � s_ �� ��* +,�� +:
FIt�AL BUII-DING�����-� � : �`�� � � -- �
� - .a, �, ��,������>� , �'9 `�°'; '���%� ,��F,,„�� �FINAl�FI MENT�`.�����'° � � r"� �...;` ���'�4 �,��
FINAL MECHANICAL � } �, ,� �RE DEPAftT
r,� ��,� , � � ""`:``� �` .,�. + �' �FINAi..P NNING �� � �.s�� �':� � �;�¢� ��,� ,,�
FINAL EL�CTRICAL���,� � �� �� � � � � �� _� � � ' �
'FINAL PLUMBING,,;����� � ��.:;� � ����� ,� . d���' f�iNAL,ENGINEERItJGI P'W �'' �� �` .� �' �'�� �' .�� ���� �:
T.C:'ofyOC€UPANCY��� �, � ���' � � �,������."���..' �,:�� �� ;FINAL�COMMUNI7�1'SER1110ES�� ��. P ` � � � �"��` �."
;GE[iT`of,OCCUP,ANCY�� ��,��� � `� °�'��•`�� ' � �,�� 'FINAL�HEALTH�DEPT r r � � ������ ����� �°������",�;:�
;-���,� - ,„
. . ,FtNAE INDIlSTRiAL�WASTE�s,��m� �°�',"� .:':��,� `'��'��� � r,�=-�� �,�,',
COMMENTS: "'
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