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Home My WebLink About15-1957 r � •� CITY OF DIAMOND BAR � � ��`� . - `��I_ I i P„'��'; DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 9�� _.: ' - � 21810 Copley Drive,Diamond Bar,CA 91765 P S , ,�,.� (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 FIRMLY `��'��'°' BUILDING PERMIT APPLICATION � � 2 3 ��d � n n u w►en� C U n y u� I�t P�PPLICATION DATE: �"�,L�' /�;�P/C# � I s JOB SITE ADDRESS / /pp-- i ISSUE DATE: �� I�� PERMIT# /S'//J� z APN LOT TRACT � OWNER �T(J�C� P rP c, f Ll�v TYPE CONST. I/h � OCC GROUP: � n ADDRESS ,3� N 3� s. ZONING SEfBACKS � � CITY ZIP TEL.QUy FRONT RW ❑ = APPLICANT � O G�A 3 I d TEL.�T I`� 3 t� 3 kll REAR ❑ � (� w ¢ CONTRACTOR 1`e � nC J' SIDE/SIDESTREET RW ❑ P 1" u SIDE ❑ � ADDRESS 1 �3�^G Pr1 �l�(I �j( f!''�l�� s CITY �C�.�-�G ZIP R�� TEL. d ��'� � �-� PROPOSED USE � � ARCH/ENG/DESIGNER � � ADDRESS #DWEL.UNITS #STORIES #BEDROOMS z CITY ZIP TEL. � DESCRIPTION SQ.FC FACTOR PSF ADJ.AREANALUATION � OWNEH-BUILDFA DECLAIIATION x SFR/ADD/REM = I hereby affirm under penalry of perjury that I am exempt from the ContractoYs State License Law for the reason(s) I � � indicated 6elow by the checkmark(s),I have placed next to the applicable item(s)[Section 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 I L structure,prior to iTs issuance,also requires the applicant for the permit W file a signed statement that he or she � Patio/Deck i is licensed pursuant to the provisions of the Contractor's STate License Law(Chapter 9)Commencing with Section w � 7W0 of Divisian 3 of the Business and Professians 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 for a permit su6jects the applicantto a civil penalty C7 = of not more than five hundred dollars(5500). ZQ Re-Roof I � (_,)I,as owner of the property,or my employees with wages as iheir sole compensation,will do L)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'State 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 oTfered for sale.If however,the building or I � improvement is sold within one year of completion,the Owner-Builder will have the burden oi proving that it was not built � or impmved for the puryose of sale.). I '� _ �1 I,as owner of the property,am exclusively cont2cting with licensed Contmcturs to consVuct the project(Section Z 7044,Business and Professions Code:The Contractors'State License Law does not appty to an owner af property who Valu8tiOn: Adj.Area: I � buildsorimprovesthereon,andwhocontraclsfortheprojecCswithalicensedConVadorpursuantrotheContrectors'State QUANTITY DESCRIPTION FEE I Y License Law.). I � (,�I am ezemp[from licensure under the Contractor's State License law for the following reason(s): ¢ � � I � 1 By my signature 6elow I acknowledge that,except for my personal residence in which I must have resided for at least one � I Z � � year prior to completion of the improvements covered by this permit,l cannot legally sell a sfructure that I have built as an w I owner-builder if it has not been constructed in its entirety by licensed contractors.I understand that a copy of the applirable � law,Section 7044 of the Business and Professions Code is available upon request when this application is su6mitted or at e � �ap� I� •��k�,N�p� I � the following Web site:httphwnv.leginfo.ca.gov/calaw.html. � ' `" _ �ATE: SIGN: � I r V C �l ke /"l At(1 I — LICENSED CONTMCTOfl'S DECLANATION � /"l O.n' {J I (� I a I � I hereby affirm 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(ull force and effect. J I �j LICENSE C SS:1 �� LIC.NO.: �� ` � � , Z DATE: ��1 �/1 S CONTRACTOR:__�_eTpe '�/ � I I ¢ WOflI�H'S COMPENSATION DECLAMTION � y I HEREBYAFFIRM UNDER PENALTY OF PERJURY ONE OFTHE FOLLOWING DECLAflATIONS: I � I have and will mainTain a CeRificate of Consent to Self-Insure for Warker's Compensation,as provided by CONSTRUCTION: I � ./ Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. p�,qN REVIEW: � v I have and will maintain Worker's Compensation Insurance,as required by Section 3700 of the Labor Code,for � the performance of the work for which this permit is issued.My Worker's Compensation Insurance Carrier and ELECTRIC: ¢ PolicyNumberare: PLUMBING: �j� � CARRIER We 5 �O MECHANICAL: � � POLICY NUMBER 4/✓��J(Q `I N f S INSPECTION FEE: � (THIS SECTION NEED NOT BE CAMPLE�ED IFTHE PFAMfT IS FOR ONE HUNDRED DOLLARS(�100�OR LESS). ISSUANCE: � ��/ = I certify that in the performance of the work for which this permit is issued,I shall not employ any person�in any manner so as fi become subjed fu the Worker's Compensation Laws of Califomia.And agree that rf I should become subject to the Worker's SMIP: J Compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with those pmvisions. ENERGY P/C: i DATE: �l�� APPLICANT: __ � � ENERGY PERMIT: � WARNING:Failure to secure Worker'S Compensa ion coverage is unlavrful,and shall subject an employer to criminal y penalties and civil fines up to one hundred thousand dollars($100,000),in addition to the cost of the compensation, RETENTION FEE: � �f 1 damages as provided for in section 3708 of the labor code,interest,and attorney's fees. PRE-ALT FEE: �. i CONSTHUCTION LENDING AGENCY BSAF: y I hereby'affirm under penalty of perjury that there is a Construc[ion Lending Agency for the performance of the work for = which this permit is issued(Sec.3097,Civ.C.). � — LENDER'S NAME: Y LENDER'SADDRESS: i I certfy that I have read this application and state that the above information is cortect.I agree to comply with all city and TOTAL FEES ��r�D � counTy ordinances and state laws relating to building construction,and hereby authorize 2presentatives of this county to COMMENTS: z ,� enter upon the above-mentioned property for inspection purposes. � �Vn {�.�n y ; t �, d a PERMITTEE NgME(PRINT� � v � �� D/� �/j i ./ I' = SIGNAn1RE ERMITfEE DATE RECEIPT ri �GU 7 ) PAID BY: Y ��'1 VALIDATION: I WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy CITY OF DIA�JIOf�C.BAR �._ INSPECTION RECORD � . ,'r_^ . � '♦ e B � � � . . � � l • � � aSETBACKI'LETTER -�M� ��`" TRACTANO LEDGER . �_� FOOTINGS.FORMS :" �,�_ � __�_� � _ � `�� SWITCH�EAR � � ,SLAB F��,_ � e x"��;, �� COMMERCIAL HOOD I s�.,. � . . �UG:PLl1MB1�NG��a � �� T-BAR ;U��ELECTRICAL' � �x' ^ ** - ._ ` � � ,�. ; ; ' � � ��r � INTERCEPTER � �,��. `UFER GROUND�`°�`: ,��,�� °:, HOT MOPJSHOWERPAN � SEWER LATERAL SEPTIC/CESSPOOI MAIN WATER LINE HERS REPORT RECEIVED SEWER CLEANQUT DEMOLITION ROOF SHEATHING ROOF DRAINS FLOOR SHEATHING i ROUGH CONDUIT ,�,. ,_ _ . ,, . � a9�.�< . p_, � �� .• s� , �SHE�tR WAL',LS EXTERtOR`��;"` � ' `" i POOUSPt1 • � v��. :�. . . . - � a, ,_ .�.,.... .t � ,SNE4R WALLS�INTERIOR, :�°�� ,�� ' � �� _ - ' ROUGW PLUMBING ' � �� .�, �� ob . � . �a a, � .M FRAMIN�VE�JTENG '�°;q� . '`� ` `'� � � � � � ��ROUGH ELECTRICAL � � � � .�s� : " � ��;•� �;;" ��_�a.� ° , � �flOUGH MECHANICAL �j01�GH MEC�IAN1CAi�� ' � �,v , ROI�H EL�CTftIG4L Vi�(L}.G;(�� ';`s° � � , >'�� GAS TEST � � R(?UGH_PCUMBIPIG�� °� � � � - �� rr �� _ ,g " : � � �PRE GUNITE � � � INSULATION WALL POOL PRE DECK BONDING INSULATION CEIIING P-T�P DRYWALL FENCE/GATFJ ALARM IATH(PRE} �INAL POOL � � � � � LATH EXTERIOR WALLS: LATH INTERIOR WALL F�QTING/STEEL GAS TEST WALL STEEL 1 sr� �pNei )LIFT SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELEASE WALL DRAIN!SEAL GAS METER RELEASE WALL FINAL --- SPECIAL INSPECTION RO,FHAMING PLANNINGAPPROVAL � , _ _ _ � , _.. . � � _�IN�iL"<BUII;aING��;��, - ' �' �°�:� � . � ` ROUGH FIREAPPHOVAL � .�� ,�a o. � � PINAL MECttANICAL � .�„ "' ,� � �� . � `�� FINAL FIRE DEPARTMENT �� , ��.q � � - FIN'' ��' ' , _AL ELE�'fRIGAL�_ ��. � �� ` , ,� � FINAL PLANNING � � _ , � ,� - ;P�i � ,FIt��L PLUNIBING ��' � �� ,f g� �FINAL�ENGINEERINGI PW . � _ °� � }°`% `�� ` � FINAL COMMUNITY SERVICES ° ` ' �FG�.�of°OCCUPANCY.�� ° � .� , u ,� � �s. .. � � �� ,�� C�RT�of'OC£UPANCYx �' _ ��M ' �" >�. � • FINAL�HEALTH DEPT. FINAL INdUSTRIAL WASTE COMMENTS: � � ��- � � ��