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'�i5i� C1TY OF DIAMOND BAR �
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I � I I DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES
�III��� " � 21810 Copley Drive,Dia�nond I3ar,CA 91765 PRESS
, .� (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 FIRMLY
�'�"""�. BUILDING PERMIT AYYLiCATION
�
� APPLICATION DATE: 7—�� �'y P/C#
� JOB SITE ADDRESS o- /�+�
z APN LOT RACT ISSUE DATE: �d � ��y PERMITiI � �"I '���7 /�
o OWNER I� � TYPE CONST. �I�� b� I�1�_pCC GROUP:
� ADDR SS •
� CITY (7 ZIP / T L. O - ' O U ZONING F ONTCKS RW ❑
o APPLICANT TEL. REAR
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a CONTRACTOR SIDFJSIDE STREEf RW ❑
o SIDE ❑
c� ADDRESS PROPOSED USE 6 L� L(�a-
¢ CITY ZIP TEL.
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o ARCH/ENG/DESIGNER
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o ADDRESS
#DWEL.UNITS k STORIES #BEDROOMS
a CITY ZIP TEL.
� owr�A•BlmoEn oEc�aqnnoN DESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION
o I hereby aKrm uMer penalry of perjury Nat�am exempt from Ne Contracta's STate tJcense Law for the reason�s) SFR/ADD/REM
p indicated below by the checkmark(s),I have piaced nract ta the applicable item(s)[Section 70315,Buslness a�M Gerage/Carport
o Profes5ions Code:Any city m county Ihat requires a permit to cor�struct,alter,improve,demolish,or repalr,any
Z structure,prtor to its issuance,also requires ihe applican�Por tlre permtt to file a Slgrted sWtement that he or she � Patio/Deck
a is licensed pursuant to Ne provislons of the Contractor's Sfate LJcense Law(Chapter9)Commencing wiUi Section W
� 7000 of Dfvision 3 of ihe Business and Professiom Code]or that he or she is ezempt hom ticensure and the basis for � P�VSpa
�
� the allegetl eaemptian.My violafion of Section 7031.5 by any applicant tor a permit subjecLS the apPlicant to a civil penatty C7
� ol noSai6re Vian five huntlretl tlollars(3500). Z Re-Roof
�
�� CJ�as owner of the property,or my employees wlth wages as ihelr sole compensatian,wlll do(J all 01 w(,porllons � Commercial
� of Ne work,antl the strucNre is not Intendetl m otteretl for sale(Section 7044,Business and Professiom Code:The �
� Cantractnrs'Siate LJcense Law does rwt a m
Z �ry ro an owner o1 property vfio,through emplayees'or personal eflart,builds
� w improves Ne property,provided that ihe imprwements are not intended or offeretl ta sale.If Iwwever,ihe buildfng or
� Improvement Is sold within one year af compleUon,the Owner-Bullder wI0 have the burden of proving that It wa5 rrot buitt
p w improved fa the purpose ot sale.).
� as owner of ine m
r . p perty,am exGusNely contracting with licensed ConUactas to conshuct the prqect(Sec�ion Vafuation: Ad Area:
0 7044,Business and Professions Code:T�e Contractas'Stale License Law does not appty to an owner of property who 1�
� buildsorimprovesthereon,andwlwcontrxtsloriheprojeciswiNallcensetlContractorpursuanttotheContracrors'State pUANTITY DESCRIPTION FEE
Y License Law.).
o U�am exempt lrom Iicensure untler the Coniraclnr's State llcense law tor ihe following reason(s): �
3 �
`l By my signaNre below I acknowled e ihat,exce t for m
g p y personal residence in which I mus[have resided for at least one �
o year priw to completion of Ne improvements covered by thfs permit,l canrwt legally sell a strucWre that I have buifl as an w
Q owner-builder If it has not been constructetl in its entirety by licensed contractas.I undersfantl that a copy ot the applica6le
¢ Ww.Section 7044 of the Busir�ess and Pro(esslons Code is available upon request n this applintlon is submitted ar at
a the followi We :h .leginto.ca.ov/ w.htrnl, �
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�''� OATE: SIGN: m
O g
� LICENSEO CON CTOH'S DECLARATION �
I hereb aftirtn unAer �'
w y perelty ot perJury Nat I am licensed under provisions of Chapter 9(commencing with SeCtion 7000)
� ol Diviston 3 ot the Business and Protessions Code,and my licer�se is tn fuU torce and eflect.
�
�
cn LICENSE CLASS: LIC.NO.: Z
o DATE: CONTRACTOR: �
� WDRI(ER'S COMPENSATION DECLARATIDN g
� I HFAEBY AFFlRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECU1RAl10N5:
a I have aiM will mainhain a CertRinte ot Consent to Sett-Insure tar Worker's Compensatlon,as pmvided hy CONSTRUCTION:
�
a Sectlon 3700 of the labrn Code,for the perfwmance ol the xrork for which this permit is issued. p�,JjN REVIEW:
� I have aiM will mainqin WOAcer's ComDensatlm Insurance,as requiretl by Section 3700 0l the Labor Cade,for ELECTRIC:
� the performance ot the work iw which this permit is issued.My Worker's Compensation Insurance Carrier and
z
a PolicyNumberare: PLUMBING: J �,�.J"
� CARRIER MECHANICAL:
w
Z POLICY NUMBEA
`� INSPECTION FEE:
� (TFflS SECfION NffD NOT BE COMPLE'fED IF TF�PEAMIT IS FOR ONE NUNORED OpUARS(g1 p0)OR LESS�. ,`.. �.�
ISSUANCE: �J
o I certity that in the peAormance ot ihe wnrk lor wti�ch thts permit is issuetl,I slall nol employ arry person in arry rn,yu�er sp as to
o bc�come sub)ect to Ihe Worker's Compe�alion lawa of Calnomia.Md agree tl�at it I sMWd become subject ro tlre Worker's SM IP:
� Compensatbn prwLsions ot Sectlon 3700 0l lhe Labor Code,I shau IoNnviUi cortipry wiN those provisians. EN ERGY P/C:
LL DAiE: APPUCAN7: ENERGY PERMIT:
� WAANING:Fal�ure to secure Warkets Compensalion cweraga is unlawful,and shall subJect an employer to criminal 1 M
w pen2tties and civil fines up to one hundred thousand dollars(3100.000),In additim to the cost of ihe wmpensation, RETENTION FEE: U,��,�1
.�—
o tlamages as provided for In sectlon 3706 01 the labor cotle,interesl,arM attomeys tees. PRE-ALT FEE:
a CONSTRUCTION LENDING AGENCY BSAF:
w I hereDy aKrm under penalty of perJury that there is a ConsUuction Lendirtg Agency fa the peAormance of the xrork for
� whlch ihis permit Is Issued(Sec.3097,Civ.C.).
F LENDER'S NAME
� LENDER'SADDRE55: .��
a I certify that I have read this aDP���tion and s[ate ihat the above informatlon is correct I agree tu campry wtth all city and TOTAL FEES
Z counry ordinances aM sfate laws relating[0 6ullding constructlon,and hereby auNor¢e representatives of this county to COMMENTS:
p enter upon the above-menti ned prope r inspection pu ses.
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a PERMfTTEE NA E(PRINn
� �—g�
�`� .�Oi.� "�
SIGNATURE OF PERMRTEE DATE RECEIPT p a PAID BY:�[��VALJDATION: r
WHITF—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy.GOLDENROD—Fle Copy,GREEN—Applicant's Copy
CITY OF DIAMOND BAFi "
INSPECTION RECORD
� • , � o • � � + S � � �
SETBAGK/,LETTER - �` ��� �"_ '` �" �'' TRACT AND LEDGER
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FdOTINGS FORMS � '=Ya� s,�` � :'' `� , �' _- �: SWITCH GEAR
SLAB`��G .:�� ���, � „« �s. �r r�� �:r�= CO(ViMERCIAL HOOD �
UG.PLUMBING�".. �,, �`,° .z .-i{ � `;' z=c .� ; T-BAR
UG.ELECTRICAL', M = =�� ` �; �' == INTERCEPTER
UFER`GROUND"� �'� s..°���- ��� ..'' �-'�� ��'�� '��� HOT MOP/SHOWERPAN
SEWER LATERAL � SEPTIC/CESSPOOL
MAIN WATER LINE HERS REPORT RECENED
SEWER CLEANOUT DEMOLITION
ROOF SHEATHING ROOF DRAINS
FLOOR SHEATHING ROUGH CONDUIT
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SHEAR WALLS�FXT'E�iIOR��_ � ��` ��, �, :� 3 �z POOUSPA:_ `�� , �
SHEAR WALLS INTERIOR , ° ' �" ` � °
ROUGH PLU(VIBIN ,
_ .� , ti�� �-��
g _ t�.
�FRAMING/VENTING � - � ` f � " 'ROUGH FLECTRICAt'1 ` � '` �' � ���� *'� �� }'��
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ROUGN MECHANICAL < � Y ' r�' , a_; �'''` ROUGH.MECMNNICAL ,y � 1, <�� ' "` �`'� '' ' '` �' � ' �_
� ' ,-� � < � �t .� t ��,�,�
�ROUGH EIECTRiCAL' W( r)C( ) " �; , -r "»� , ; s' �AS TEST-:, `� ` ;
ROUGH PLUMaING , ', ,,:�.....a; - - 'P,RE GUNITE' . ;; - �F �; �. � 1 , ''
POOL PRE DECK.BONDING � � ' � � �� t ��
INSULATION WALL �' �' ` ` �'`A '{
� �.M -� ,� ,�
INSULATION CEILING P`�P "`� � °'`� �
FEEilCE Y GATE/,AtJARNI � � � '
DRYWALL �f
LATH(PRE) - �FWAL POQL , _ - = �' "_%` `- ''
LATH EXTERIOR . WALLS:
LATH INTERIOR WALL FOOTING/STEEL
GAS TEST WALL STEEL 1�( )2ND( )LIFf
SCRATCH COAT WALL BOND BEAM
ELECTRIC METER RELEASE WALL DRAIN!SEAL
6AS METER RELEASE WALL FINAL
SPECIAL INSPECTION 'R0:fl1HNIING PLANNWGRPPROVAL "' � , ��_; r ,�
., „ ;. '� � �' �:` " �ROUGN FIRE APPH01lAL '��;�' ��z- _ -
FINAL BUILDING _ ,
FINAL MEC'HANICALf h ? '. : '' v � ' � -• +� < ' FINAL FIRE DEPARTMENT "
FINAL:ELECTRICAL s � :r FINAL PLANNING :`� �s � ' ' ` } .
FINAL'PLUMBING, �rA:� � J /. I - _ �; '� FINAL ENGINEERING/PW ;' �; ' 'f '� E'` � T� ��
T.C.of OCCUPANCY. '^, '`�`' ' ` FINAL COMMUNITY SERVICES = = r ,.;�.;a r
CERT.'of OCCUPANCY:` ` 'r ? 4 ' � ,FINAL�H,EALTH DEPT + ` ` 4
.. A � ; `' � � �
. �- . . +.� ,. .ri�`.,r :[ c�,.:�'• . � .� �.
. _ . .. ,. T'�.-k .� ��ti_�� 4�` rr
;FINAL`•INDUSTRIAL.WASTE - .. ' •'-.- „'�-
COMMENTS: C