HomeMy WebLinkAbout14-4986 . _ __�_
' '.'...._ J:''�- CITY OF DIAMOND BAR
i . DEPARTMENT OF COMMUPIITY&DEVELOPMENT SERVICES
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�` �'� 21810 Copley Drive,Diamond Bar,CA 91765 � PRESS
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,,,� (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 FIRMLY
''�"'� BUILDING PERMIT APPLICATION
APPLICATION DATE: P/C#
= JOB SITE ADDRESS ,7
i ISSUE DATE: f��J�/��I� PERMIT# �N- y9�,�
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� OWNER TYPE CONST. OCC GROUP:
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r APPLICANT TEL. REAR ❑
� SIDE/SIDE STREEf RW ❑
� CONTRACTOR SIDE ❑
� ADDRESS
PROPOSED USE C � ° ,
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� DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
OWNEH-BUILDER DECLAHATION
r I hereby attirm under penalry of perjury that I am exempt from the Contractor's State License Law for the reason(s) SFR/ADD/REM I
� indicated below by the checkmark(s�,I have placed next to the applicable item(s)[Section 7031.5,Business and Garage/Carport
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�-' Professions Code:Any city or county Mat requires a permit ro construct,alter,improve,demolish,or repair,any
z structure,prior to ifs issuance,also requires the applicant for tlie pertnit to file a signed statement that he or she � Patio/Deck I
i Is Iicensed pursuant to the provisions of the Contractor's State License Law(Chapter 9)Commencing with Section w
� 7000 of Division 3 of the Business and Professions Code]or that he or she is exempt from licensure and the basis for LL Pool/Spa I
� the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalTy � Re-Ro f l
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of not more than five hundred dollars($500). V� I
� (�J I,as owner of the property,or my employees with wages as their sole compensation,will do(,all of or(J portions -� mercial
y o(the work,and the structure is not intended ar offered for sale(Section 7044,Business and Professions Code:The m I
Z Contractors'State License Law does not apply to an owner of property who,through employees'or personal eftort,builds
L or improves the property,provided that the improvements are not intended or offered for sale.If however,the building or I
� improvement is sold within one year ot completion,the Owner-Builder will have the burden of proving that it was not built
� or improved(or the purpose of sale.�. I
"� I,as owner of the ro e am exclusivel conVactin with licensed Contractors to construct the ro ect Section
U p p�' Y g p � � Vatua' 0 Adj.Area: �
Z 7044,Business and Professions Code:The Contractors'State License Law does not apply to an owner of property who
� buildsorimprovesthereon,andwhocontractsfortheproject5withalicensedContractorpursuanttotheContractors'State QUANTITY DESCRIPTION FEE I
Y Lice e Law.�. I
� �m exempt fram licensure under the Contrador's State License law for the following 2ason(s): a
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l By my signature below I acknowledge that,except for my persqnal residence in which I must have resided for at least one w I
= year prior to completion of the improvemenTs covered by this permit,l cannot legally sell a structure that I have built as an w
owner-builder if it has not been construded in its entirery 6y licensed contractors.I understand that a copy of the applicable �
� law,Section 7044 of the Business and Professions Code is available upon request whe this application is submitted or at I
� the following Web ite:htt/www.leginfo.ca.gov/ .t Z I
� DATE: SIGN: _ �
— UCENSED CO ACTOH' DECLAHATION � I
a Iy 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 full force and effect. I
� a
� LICENSE CLASS: LIC.NO.: Q I
� DATE: CONTRACTOR: = I
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¢ WONI�fl'S COMPENSATION DECUlFIATION g I `
� I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OFTHE FOLLOWING DECLARATIONS:
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� I have and will maintain a Certificate of Consent to Self-Insure for Worker's Compensation,as provided by CONSTRUCTION: rQ�• �6
� Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. p�p,N REVI EW:
� I have and will maintain Worker's Compensation Insurance,as required by Section 3700 of the La6or Code,for ELECTRIC:
� the performance of the work for which this permit is issued.My Worker's Compensation Insu2nce Carrier and
¢ PoIi�yNumberare: � PLUMBING:
,�, CARRIER MECHANICAL:
Z POLICYNUMBER INSPECTION FEE:
:�
n (THIS SCCTION NEED NOT BE COMPLEfED IF1HE PERMR IS FOR ONE HUNDRFD DOLLARS($100)OR LESS).
ISSUANCE:
= I cer�fy that in the pertortnance oithe work for which this permit is issued,I shall not employ any person in any manner so as to
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become subject to the Worker's Compensa6on Laws of Califomia.Md agree that ii I should become subject m the Worker's SM IP: t• �
� Compensation provisions of Seclion 3700 of the Labor Code,I shall forthwith comply with those pmvisions. ENERGY P/C:
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i DATE: APPLICANT: ENERGY PERMIT: 1
� WARNING:Failure to secure Worker's Compensation coverage is unlawful,and shall su6ject an employer to criminal RETENTION FEE: d..�
y penatties and civil fines up to one hundred thousand dollars($100,000),in addition to the cost of the compensation,
1 damages as provided for in section 3708 of the labor code,interest,and attorney's fees. PRE-ALT FEE:
�
i CONSTHUCTION LENDING AGENCY BSAF: I r��
y I hereby affirm under penalty of perjury that there is a Construction Lending Agency for the performance ot the work for
= which this permit is issued(Sec.3097,Civ.C.�.
�
LENDER'S NAME:
= LENDER'SADDRESS:
TOTAL FEES )�/
i I certify that I have read this application and state that the above information is correct.I agree to comply with all city and ���� P 7
Z county ordinances and state laws relating to building construction,and hereby authorize representatives of this county to COMMENTS:
� enter upon the above-mentioned property for inspection purposes.
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¢ PERMITTEE NAME(PRINT) I
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= SIGNATURE OF PERMITTEE DATE RECEIPT N �.�.d 1 PAID BY: �V VALIDATION:
WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Applicant's Copy
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CITY OF DIAMOND BAR � -
9NSPECTION RECORD
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SEWER LATERAL ( SEPTICiCESSP00l
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MAIN WATER LINE HERS REPORT RECEIUED
SEWER CLEANQUT i DEMOLITION
ROOF SHEATHING i 1!// �) �i ROOF DRAINS
FLOOR SHEATHING I j ROUGH CONDUIT (
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INSULATION WALL POOL�PREgDECK,�BONDING" . ,�x��� ` _ �_,r� � �� '�
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LATH(PRE) I FINAL POQL__ � ''����� :` �.f� "$� _ ' �L �"�� ' : � �< �� ;
LATH EXTERIOR I I WALLS:
LATH INTERIOR I WALL FQQTING�`STEEL
GAS TEST ' WALL STEEL 1 S�( i 2N°{ j LIFT
SCRATCN COAT WALL BOND BEAM
ELECTRIC METER RELEASE , WALL QRAIN/SEAL
GAS METER RELEASE ' WALL FINAL
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CITY OF DIAMOND BAR �� (
BUILDING&SAFETYDIVISIDN
21810 Copley Drive
Diamond Bar, CA 91765 .
� (909)839-7020 ,
SMOKE ALARM AND CARBON MONOXIDE CERTIFICATIO�V
In order to help assure the life and safety within existing dwellings, the 2013 California Residential Code (CRC)
Section R314 and R315, along with the California Building Code Section 420.5 and 420.6 requires existing
dwellings have smoke alarms and carbon monoxide alarms installed within the upper 12" of the ceiling when a
building permit is issued for, worked on or in a building that is valued at $1,000 or more. Generally, the alarms �
are required to be hard-wired, have battery back up and be interconnected.
Starting July 1, 2014 all smoke alarms including combination smoke alarms, that are solely battery
powered shall contain a non-replaceable, non-removable battery that is capable of powering the smoke
alarm for at least 10 years. �
The alarms are required to be installed in the following locations
❖ Smoke alarms in all sleeping"rooms. I
❖ CO alarms in all sleeping�rooms where fuel burning appliances are installed.
❖ Smoke alarm and CO alarm in hallways preceding sleeping rooms.
❖ Smoke alarm and CO alarms on each dwelling level including basements and habitable attic rooms.
The smoke and CO alarms are required to comply with the above when requesting a final inspection. Please
make sure an adult is present to allow the Inspector access to the home to verify compliance with the above
requirements. If no one will be available, you may opt to complete the Installation Certification below and leave
it with the job card.
INSTALLATION CERTIFICATION
For the property located at C 2' �� D�oD� ��� l���l L'"'1� �)�4-/� ,�l- 91765, f hereby certify that the 'i
required smoke alarms and carbon monoxide alarms have been installed as listed above.
(�T�-/' S• 1'�Cr-f-yf�I� �� 2' /
ig ature Print Name ate
Relationship to project (please check one): .
�Owner ❑ Agent for Owner ❑ Licensed Contractor ❑ Agent for Licensed Contractor I
If"Licensed Contractor" or"Agent for Licensed Gontractor" is checked, please complete the following:
` Cont�actor Contractor's State License Number