HomeMy WebLinkAbout14-4415 �'-'`:'� C1TY OF DIAMOND BAR
� I I { ' I DEPARTMENT OF COMMUNITY&DEVELOPMGNT SERVICES �
'�; ipl��,��``�� ' 21810 Copley Drivc,Diamond Bar,ca y��Fs PRESS
,,,,,� (909)839-7020 Fax.(909)861-3117 Building Inspection Hotline(909)839-7027 R F�RMLY
`�'�x°'�. BUILDING PERI�IIT APPLICAT[ON
~ APPLICATION DATE: �+� � �� / P�C# r (� �y ��
� JOB SITE ADDRESS '�SI� V-�►i�Z ALt� L-�'�'� �SSUE DATE: O��1 L I�A I�'�PERMIT# ��"' `7�)s
z APN LOT TRACT
o OWNER r-�'Q r'�GLS SGOZT TYPE CONST. OCC GROUP:
N ADDRESS 7�S'�� ►�n�1Z-P"�L�►+c 1—�►f.l E' ZONING SEfBACKS
N C�7y f71y►�rwp�+'� P�ACL ZIP�II7LT TEL. FRONT RW ❑
`= APPLICANT6i�/Zl�rc 'ESoti1r+�-0.� TEL.QSI�31�—'32Z9 REAR �
�
� SIDE/SIDE STREET RW ❑
a CONTRACTOR S/LV�9 /J � ,i�7 SIDE �
oro ADD ESS 3�O A�4� � G pROPOSEDUSE �1 S�li3'��� ��s�Ji7e—��+TA'C.�
o ciTv��.l�l,e C'�.�q�wl� 70� rE�.q04 - �1�0- �-z_�s�'To�
o ARCH/ENG/DESIGNER
o ADDRESS q DWEL.UNITS #STORIES #BEDROOMS
a CITY ZIP TEL. DESCRIPTION SQ.FC FACTOR PSF ADJ.AREANA�UATION
� OWNER-BNLOEfl DECLAffATION
°C I hereby atfirtn under penatly ol perjury that I am ezempt hom the ConUactor's State lJcense Law for me reason(s) SFR/ADD/REM
� iiMicated below by the checkmark�s),I have placed nezt to the aDD���Ie item(s)[Section 70315,Buslness and
p Garage/Carport
Protessiom Code:My city or county that requires a permit to construct,alter,Improve,demollsh,or repafr,any
z structure,prlor to its issuance,also requires lhe applicant for the permtt to file a signed statement thal�e or she tn Patio/Deck
a Is licensed pursuant to ihe provisions ot the Contractor's State License Law(Chapter 9)Commencing with Section W
� 7000 of Divislon 3 of the Business an0 Protessla�s Code]or that he w she is exemD�tram Iicensure and Uce basis tor LL PooVSpa -
N the alleged exemption.My violation of Sectian 7037.5 by any applicant fw a permit su0jecis the apDlicant to a civil penalty Z Re-Roof
ot not mae itqn five huntlred dollars 1$500). �
o U I,as owner of the property,a my employees with wages as thelr soie compensation,will do(�all of or(_,)porlions � Commercial
0 oi ihe worlc,arid ttie struclure is nat intended or offered for sale(Sectlon 7044.Busfness and Professiwis Code:The m
� Contractors'State License Law dces not appy to an owner of property who,through employees'm persomai effoA,builds
w w imprrnes the D�operty,providetl ihat the Imprwements are not intended or ottered for sale.It however,ihe building or
� improvement is sold within one year of canpletlon,Ne Owner-Builder will have Ne burden o1 proving ihat it was not buitt
pa Improved for ihe purpose of sale.).
� I,as owner of ihe ro e
U P D rtY�am exGusivety conVacting wiN 6censed Contractors to canstruct ihe projeCt(Section
�— Valuation: r � Adj.Area:
0 7044,Business and Protessions Code:The Coniractors'Sqle License Law does not aDDN���er of proD�Y who
Z builQs or improves thereon,and who contracts tor ihe D�ojecls wilh a licer�setl Contraclor pursuant to the Contracrors'State QUANTITY DESCRIPTION FEE
� .l
Y License Law.). O �G ( l
o U��exempt lrom licensure untler tt�e ConVactor's Stele License law for ihe folbwing reason(s): �
� ¢ i �u 6s
� By my signature below I acknowledge thal,except for my personal residence in whic�I must have resided lor at least one w 2 C �
o year prlor to cnmpletion of Ne imprmements covered by mis permit,l cannot legally sell a structure that I have buill as an �,�,
� owner-builder if it has not been construUetl in its entirery by licensed contractors.I understand that a copy of the appliphk
� law,Sectian 7044 0l the Bvsiness and Professiau Code is available upon reQuest when this applicatlon"s submitled a at
a the following Web slte:htlplwww.leginio.ca.govlplaw.htm�. z
� DATE: SIGN: 0°
o �
� LJCENSED CONTRACTOR'S DECLAHATION �
U
w 1 hereby aftirm untler penatty of perjury Ihat I am lice'uued under provisions ot Chapter 9(cOmmencing w'M Seclion 7000)
m of Dlvision 3 ot the Business antl Protessions Code,and my Ilcense is in full torce and aflecL J
N �
�, ��,���: U ��.No.:.�1 f�243�� a
0Z oa�:02'2 ' � CONTMCTOR' �LIJ►7 Q� l,� n ;
Q WORI(ER'S COMPENSATION DECIARATION �
� I HEREBY AFFlRM UNDER PElJAL1Y OF PEFiJURY ONE OF THE FOLLOWING DECLARATIONS: /1
oI have and will malntain a Certiflcate ol Consent to Setl-Insure for Warker's ComDensation,as provided hy CONSTRUCTION: +� ��� D
� Section 3700 ot Ihe La�or Code,tor Ihe periormance of the work far which this permH Is issuetl. p�qN REVIEW: . / e�
� I have and will maintain Worker's ComD�iion Insurance,as reqWred by Secfion 3700 of Ne Labor Code,for ELECTRIC: J���
� the performance ot the v✓ork for which this permit is issued.My Worker's Compensa8on Insurance Cartier antl
a PolicyNumberare: PIUMBING:
� CARRIER MECHANICAL:
� POl1CY NUMBFA INSPECTION FEE:
� (T}flS SEC�ON NffD NOT BE COMPo.EfED IFTHE PERMR 5 FOR ONE HUNDRED DOLLARS(S10�OR LESS). ISSUANCE: � ����
� I certity ihat in ttie perlormarxe o(ihe�wrk fa which ihis permit's issueQ I shall rrot employ arry person in arry maru�er so as to
� becane subjecl to the Waker`s Compensation Laws of Califania.Md agree Ihat il I shoulU Uecorne subject in the Warker.s SM IP: � �.��
� comper�saum urovisions a sedim 370o m uie tabor code,�sna��roruiwilh canpry wim tnose provisia�s. ENERGY P/C:
�
LL DA1E: APPUCANT: ENERGY PERMIT:
� WARNING:Fallure to secure Worker's Comperrsatim coverage is unlawtul,and shall subjecl an employer to crlminal {��'ENTION FEE: Z 'G
w penatties and civil fines up to one hundred ihousand dollars($100,000),In addi6on to the cost of the compensation,
� darnages as prwided fm in sectim 3708 ot the labor code,interest,antl attomey's tees. •PRE-ALT FEE:
0 �.�1
� CONSTFIUCTION IENDING AGENCY .BSAF: �•�✓
d
w I hereby atfirm under penalry of perjury that there is a ConstrucGon Lending Agency lor Ne pedorn�ance ot the work tor
� which this permii is issued(Sec.3097,Gv.C.).
r LENDER'S NAME
� LENDER'SADDRESS:
a I certify that I have read this appliqtlon and state that the above InformaUon is correcL I agree fn compty with all city antl TOTAL FEES � � q'S�.�'�.1
� county ortlinances antl sfate laws reladng to building construction,arM hereby auNorize represerttatives of MVs counry to COMMENTS: �
�Z enter u n the above-meniqned ro for i tion ur
P Per�' �SPec P Poses. .
m A��p �. L l4 /+
¢ M NAME PRI �, � ! � � b `�7 (� �-.- .
_ � SIGNATURE OF PEAMfTTEE DATE RECEIPT q �� PAID BY: 1�H f� VALJDATION:�
r
- WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy
CITY OF DIAIVIOND BAR
INSPECTION RECORD
. � e , . e . . e e , � .
;SETBACK/,l.ETTER , , - � ;`;' :rj `,,r :; i TRACTAND LEDGER
FOOTINGS'FORMS, , '� ' �' � �+ '� y<:'-.,;,; SWITCH GEAR
_ ,�;'��-
SLAB- � . ,_, �< `-" ` r�;`� , �t�; COMMERCIAL HOOD �
UG PLUMBING -` 'W „r. :^ }'`.;�, � `t 'r� ` T-BAR
UG.EL'EGTRICAL':, ,„ , °;�; �;� F ,��,��r ' � � ,? INTERCEPTER
UFER GROUND�``.' F' F�:`' .� �, :�J� �.�' _ ; w HOT MOP/SHOWERPAN
SEWER LATERAL SEPTIC/CESSPOOL
MAIN WATER LINE HERS REPORT RECENED
SEWER CLEANOUT DEMOLITION
ROOF SHEATHING ROOF DRAINS
FLOOR SHEATHING ROUGH CONOUIT
. _ ,_ - , : _, ,
_, .
SHEAR�.WALLS,EXfERIOR_�.:; � ;' �• � , .�:'�. � ��� ' 'POOLlSPA = "` �� - - `�''�
,R , , , ,,
-� y," F�' �� . r �. �.� ._ -'< , t J:i'�� ..'J
°SHEARtWAL'LS'INTERIOR r: ` ; �;;k ;;5� � _'.;', ROUGH PLUMBING � "- < <�r ' ;3
FRAMWGNENTING �1� ., '�� � ���T. �.� , �� � '� ;� r;:�f, �ROUGH ELECTRICAL. :; �:�-h: r��. :,; �. �� ��� ' '
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ROUGIi MECHANICAL r'' �`a;-:': a, .;;' �, �"` 'ati,, �; , i � _::�{; ROUGH,MECHANICAL;> ' �; �;:i +� =' � "`. i A'` s.�::
�RQUGH:�ELECTRICAt W! ?<C(.,) � " ' ' ` � �=�' GASTEST �^} ��_ `�,` 5 - `�
=��. � �r� �:: , 1„ � � ��� ' ,,
ROUGH;PLUMBING `=� �.�� z :: PRE GUNITE,` �` ' - � � '• i �;
INSULATION WALL 'POOL PRE.DECK BONDING ,,.,� _ , ., .. .;. l �:4 . 1, ,=',• �� ?'' °� �� �--�
INSULATION CEILING 'P-TRAp k,';'� _ _ ` �`
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.. ,. ...�� ..�. �;: ,;� Y _'_ '}� F :�h �:. ....
DRYWALL FENCE I�GATEJALARM���� ;�,��� ' � � � .
_ Y � r
LATH(PR� �FINAL POOL-' ,Y; - ` �� `�
LATH EXTERIOR WALLS:
LATH INTERIOR WALL FOOTING/STEEL
GAS TEST WALL STEEL 1sr� �2No� ����
SCRATCH COAT WALL BOND BEAM
ELECTRIC METER RELEASE WALL DRAIN/SEAL
GAS METER RELEASE WALL FINAL
SPECIAI INSPECTION R0.`FRAMIN6�Pl1WMN�APPROVAL; '' ;, ,-, .��� ' ' ';-`
�
FINAI:,BUILDING`` ",, � ,,;; , r r; �q '" ` "+ �;� ' RQUGH FIRE"APPROVAL � ,� - ` � ' �., .�.�(,� _' ` ' ,`;i;
FINAL�MECHANICAL . �� `� `� '�� `.r:' - FINALFIRE;DEPARTMENT '; � ' � `
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FINAL'ELECTRICAL ' ' i " :� � ` �' FINAL PLANNING �-'; �. ,�: ` ,r .; ' �: € ';, ;_,c... '_
,>� �-.,. � _.��� '
FINAL:�PCUMBING . d,e Z,. „' - ' ` { �'T,k '= FINAL`ENGINEERING/PW. "` ` - - 's�` � .;_;f� ,.,;. •
T.C.of OCCUPANGY ` �'''` ` `,:, " ,�": �,'� ' � �& �'t; FINAL COMMUNI�'1l"SERVICES' n . . � `.� . '��., ;�:
� f F �� t, �.
CERT.:of"OCCUPANCY •-, � _ k r � '` _ -'
� FINAL-HEALTH DEPT::, � ;:,�� - r.. „.
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FINAGINDUSTRIAL WASTE`. `'�= ' �� "�, '` wt. �'{ '='�� �
COMMENTS:
� Jarrod Williams Inspections
���Y 4433 Earle Avenue, Rear • Rosemeade, CA 91770
In��� (818) 601-3393 • Email: jarrod.williams58@yahoo.com Z
�'� y-�
REGISTERED INSPECTOR'S DAILY REPORT '1aDNo� �
rro�oF o��a c«,«e� a sa���n��, o a,�ay c«wa
INSPECT1oN O Poat Ter►sio�ed Conaete O Flro P►oofinp ❑�
REGUtRED ❑Reinforoed Masonry ❑Asphe�t �po�ry
.bo�...s 2 3..ri/ nJti'�cr���" ��-c `�Y j>ir�M�-�o ,Q�-�
Job Nams Permit No ,�,l ��g�, /
S,y ,s�
Typ�o!Sduauro ,St� a�ni��n
Mat�ri�l Ds�eriP�ion ltype.q�ads,aourc�) G�D X E^qm�e'
Contracta S/Lv�
�nsv�orts)Nams �-A 22 o O (.�, ��.f Suecontraaa
TESTS PERFORMEO
TYPE OF SAMPLE SIUMP QUANTII'Y tN SET AD�ITIONAL REMApKS ON SAMPLES
IMSPECTIOH SUMMARY—�Oce►r�ONs OF wOaK iNSPECrED,rEST S�wPLES r�rcEN,wOiiK aE.IECTEO,J08 W408LEMS.PAOOIqESB,i1EMARIt�,�TC,
INCIUDES INFONMATION ABOUT-AMOUNTS OF MATERIe1�PIACED OR WORK PERFORMED,NUM8f0.TYPE i IOENT.Np'$
OF TEST SAMP�ES TAKEN�STRUCT.CONNEC?IONS(1NEL0 MAOE H.T.801T$TOROUE�CMEd(ED:ETC.
d(s'Sr�c�� Ir�- � 2 c'z�v�r�r� ��.�o�Ti�h ���ca=j
H >S 3/v `' ��� v s ,h.g � .s' v���z.S �� � r���f c��
�ja�- T Y,�a G`—C'`'}C`� CJSub .S/��f�;n .f�'T�C6' �-r9�7/c. �S ��
CERTIFICATfON OF COMPLIANCE CONTINUED ON NEXT PAGE O PAGE QF
I NENEBV CERTIFI'TMAT 1 MAVE 1NSPECiED 70 TME BEST Of MV KNOW�ED6E ALl
Oi TME ABOVE REPOATED WOAK UNlfSS OTHERN�rSE NOTED.i ruvE FOUND na5 TfME IN TIAE pUT REG,NOURs O.T.110{1R� CrLM�tw{
WORK TO ODA/►lY WITN TYIE APIFIOVED PLANS.SGECIFIGTIONS.ANO AVPLICABIE
SECTIONS 0� OVERNIIip BUILdN6 UW. //�J
Atl�nsp�ctions Das�d on a mmimum o1�hours r�A o»►1 Aour�•S hour
nwnimum.In W�ition,any inap�ction M�nOinp pW rwon haa irill b�M 0
NA7UR/E pi REO�STEREO, CTOp �our mmimum.
� � `/'}��-"L�`Z �� 7 � ACWOvod By
SPEG�ITY NO AGFNCv ProNtl SupMiMMWM1
� WHITE-OFFICE. CANARV-ACCOUNTING COPV, PINK-INSPECTOR'S COPV