HomeMy WebLinkAbout14-5044 _-----_�
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.,,._.. ���r ...... . CITY OF DIAMOND BAR
� ' I ( ; DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES " F p��� ����
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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
s JOB SITE ADDRESS APPLICATION DATE: P/C#
i ISSUE DATE: � � I PERMIT# �y.�'dy�
z APN LOT TRACT
� OWNER i7c y:,vA�Dv D�J�A�',� TYPE CONST. OCC GROUP:
� ADDRESS I�2J� M• P/iVT�1D�� �/�• ZONING SEfBACKS
� CITY d/���N �'�� ZIP � � �EL. Pl�J� .PGI 'TP6L FRONT RW ❑
r APPLICANT �c`y�fIG.O� D/o/CNrlfEL. 9D'7 ��o� ''�`L REAR ❑
� SIDE/SIDE STREET RW ❑
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a CONTRACTOR SIDE ❑
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� ADDRESS PROPOSED USEt���G�r'�� G✓!ND/°.J c1�.9/�� J`/G ft�
= cirv ziP TEL. ��fa R���-r��.v� , /,9�ZrY
1 ARCH/ENG/DESIGNER (/E/U��;/1 �(�/.Ui
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� ADDRESS #DWEL.UNITS #STORIES #BEDROOMS
z CITY ZIP TEL.
¢ DESCRIPTION SQ.FL FACTOR PSF ADJ.AREANALUATION �
Q OWNEN-BUILDEH DECLAflATION I
s I SFR/ADD/REM
= I �ereby affirm under penalTy of peryury that I am exempt from the Contrador's State License Law for the reason(s�
� indicated below by the checkmark(s),I have placed ne#to the applicable item(s)[Section 7031.5,Business and Garage/Carport I
Protessions Code:Any city or couMy that requires a permit tn construct,alter,improve,demolish,or repair,any I
z; structure,prior to Its issuance,also reQuires the applicant far 1he pertnit to file a signed statement that he or she � Patio/Deck .
i is licensed pursuant to the provisions of Vie Cantractor's SYate License Law(Chapter 9)Commencinp with Section w I
� 7000 of Division 3 of the Business and Professions Code]or that he or she is exempt from licensure and the basis for � Pool/Spa �
� the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjecLs the applicant to a civil penalty Z Re-Roof I
of ot more than five hundred dollars(5500). �
� �I,as owner of the property,or my employees with wages as their sole compensation,will do(J all of or(J portions � Commercial I
y i of the�work,and the strudure is not intended or oifered for sale(Section 7044,Business and Professions Code:The m
Z Contractors'State License Law does not apply to an owner of property who,through employees'or personal effort,builds I
y 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 of completion,the Owner-Builder will have the burden of proving that it was not built
� or improved for the purpose of sale.). I
'� I,as owner of the property,am exclusively contrac[ing with licensed Cont2ctors to construct the project(Section
� 044,Business and Professions Code:The Contracinrs'State License Law does not apply to an owner of property who Valuation: • Adj.Area: I
Z buildsorimprovesthereon,andwhocontractsfortheprojectswithalicensedContracturpursuanttotheContractors'State pUANTITY DESCRIPTION FEE �
;q I
Y Lic se Law.�. I
a
j I am exempt from licensure under the Contractor's State License law tor the following reason(s): � I
�j 2
1 By my signature below I acknowledge that,ezcept for my personal residence in which I must have resided for at least one w I
j year prior to completion of the improvements covered by this permit,l cannot legally sell a strudure 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 applicable
� law,Section 7044 of the Business and Professions Code is available upon request when this application is submitted or at ' I
� the following eb sit�http/www.leginfo.ca.gov/calaw.html. � Z I
11 DAiE: � I SIGN: s' � i
= I
— LICENSED C CTOH'S DECLAPATION �
a
y I herehy attirm under penalty of perjury that I am licensed under provisions of Chapter 9(commencing with Section 7000) I
� of Division 3 ot the Business and Professions Code,and my license is in full force and effect. J I
n �
� LICENSE CLASS: L1C.NO.: Q I
� DATE: CONTRACTOR: = I
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¢ WOfll�fl'S COMPENSATION DECLAHATION � _ ._ . I ,
y I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OFTHE FOLLOWING DECLARATIONS: f r'J I�. Y�XI�
� I have and will maintain a Certificate of Consent to Self-Insure for Worker's Compensation,as provided by CONSTRUCTION:
� Sectlon 3700 ot the Labor Code,for the performance of the work for which this permit is issued. p�.qN REVIEW:
i I have and will maintain Worker's Compensation Insurance,as required by Section 3700 of the Labor Code,for ELECTRIC:
� the performance of the work for which this permit is issued.My Worker's Compensation Insurance Carrier and
¢ PoIi�yNumberare: PLUMBING:
� CARRIER MECHANICAL:
y
� POLICYNUMBER INSPECTION FEE:
n (IHIS SEC110N NEED NOT BE COMPLETED IFTHE PEAMfT IS F9R ONE HUNDRFD DOLLARS(3700)OR IESS�. 'r��•
ISSUANCE: �J _Y 7
� I certiTy ihat in me performance of the work for which tfiis pertnit is issued,I shall not employ any person in any manner so as to ���
� become subject to the Worker's Compensation Lavrs of Califomia.Md agree mat 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 provisions. ENERGY P/C:
i DATE: APPLICANT: ENERGY PERMIT:
� WARNING:Failure to secure Worker's Compensation coverage is unlawful,and shall subject an employer to criminal RETENTION FEE: �r�D
y penalties and civil fines up to one hundred thousand dollars(5100,000),in addition to the cos[oi the compensation,
i damages as provided far in section 3708 of the labor code,interest,and attorney's fees. PRE-ALT FEE:
7
= CONSTflUCTION LENDING AGENCY BSAF: I,d�
i
y I hereby affirm under penalty of perjury that there is a Construction Lending Agency for the pertormance of the work for
� which this permit is issued(Sec.3097,Civ.C.).
LENDER'S NAME:
� LENDER'SADDRESS: I
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 TOTAL FEES
� county ordinances and state laws relatlng to building construction,and he2by authorize representatives of this county to COMMENTS:
� enter upon the above-mentioned property for inspection purposes. •
� �Y�.Ac.�� D/�k�tJ'
¢ PERMITTEE NAME(PRINn
� `�''1�//� ,��/ �����/Z��'� /� .1
= SIGNAIUR�IPERMITfEE � DATE RECEIPT#��'7�O PAIDBY: J,Jr VALIDATION:
WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy
. • .
CITY OF DIAMOND BAR
INSPECTION RECORD _' � -�
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..
• • � l • - • � � , . � .
56TBAGKi"tEf7ER ` " ` ` _ _
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: , �_�� __ �_� � . � TRACTAND LEDGER
--
��OTINGS FORMS� � �� � � - � � z � ' � `� " " " ' SWITCH GEAR
a .� , ,
�Sl.A6' �„�.����� _� �� � � � � � � � COMMERCIAL HOOD
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e �
y �,r,� �� � � . � �° �: � _ .
,�1G�PLUMBIN6°��� � ��_���� , s � w � �. 5 ,� . T-BAR
UC�,ELECTHICAL� - � � � s � r �� �� � ���* " � � INTERCEPTER
r � �. ,
UfER GRQUNb�� _�� � . � � � '. . � g - � HOT MOP/SHOWERPAN
SEWER LATERAL SEPTIC/CESSPOOL
MAiN WATER LINE NERS REPORT RECEIVED
SEWER CLEANOUT DEMOUTION
RDOF SHEATHING ROOF DRAINS
FLOOR SHEATHING ROUGH CONDUIT
;SHFAR WALLS fXTER(�R- � � ', ; ,r e ; ` � •, � _ � POOUSPA� �� ," � � ` `
_ ._ ._ � a .
�!-IEARWALL�1NTERIOR. - ° � � �� ' °� ° � ` � " � �ROUGH PLUMBING — � � � , � . d
� � ¢ > -•
� , _ gr k, � �. , - ; � �� � � t , � ��
4 Y � � � � � ROUGH ELECTRICAL' -
�FRAMIN6/UENT[NG '� �� ,: �x � . w � m q _ ,. � .� . , �
ROUGH�MECWANICAL ` � � ��' 1 �'I � ' ` , � � ROUGH MECHANICAL �°� � � ° �` � � � .
s __ no — _ ;
ROI�GH,ELECTRiCAL.W( �)C( }� ./ � � � � �GASTEST � , -� � ��
, .
F{OUGN P�UMBING � �„„ �� � � � ��PRE GUNITE � �
����.
INSULATION 4NALL � POOL PRE DECK BONDING
INSJLATION CEILING P-TRAP
DRYWALL i FENGE/GATE/ALARM ° e `
LATH(PRE) � �FINAL POOL' � � � °
LATH EXTERIQR WALLS:
IATH INTERIOR WALL FOOTING/STEEL
6AS TEST � WALL STEEL 1 sr� �ZNoi ���FT
SCRATCH COAT WALL BOND BFAM
ELECTRIC METER RELEASE WALL DRAIN/SEAL
GAS METER RELEASE WALL FINAL
SPECIAL INSPECTION RO.FFiAMINGPLANNINGAPPfiOVAL °
FINAL BUILDING§ y � �,��t`'j�-` " . HOUGH FIRE APPROVAL e
FINAL MECHA.NICAL�, ,_ � - �. - � �. � a ^ _ � FINAL FIRE DEPARTMENT � .
__,
�IN1�L ELECTRICAL�':; �.. � � � �� � �` �.�,��� � , . . � , �. �
, � �� � � a FINAL PLANNING
�. �
FINA�.PLUMBING � ��� �s� � �� �; � ' � ` '�' � � � � _ F1NAL ENGINEERINGJ PW
� e „ �. �. �
TC.of�OG,CUPANCY ;�,p� � � � �-�� : � � _ � � FINAL COMMUNITY SERVICES � ` � �� �
�� a � � '� �.� � „ _ � > �
C�F�T,oi 4CCUPIINCY' � : � � ' , � � , FINAL HEALTH DEPT, .
_ , . _.,
FINAL INDUSTRIAL WASTE , � -
COMMENTS:
. . . ,� _
,
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� . ��tT:riNn�iUfi/ .
�a9�
CITY OF DIAMOND BAR
BUILDING&SAFETY➢IVISION
� 21$70 Coptey Drive �
DianxQnd Bar, Ct1 917�5
{909)839-7020
SMQK� �►ILAF2Nt AND CAR�QN �1Q�ICIXIC�E CERTIFICATItJN
In order to help assure the life and safety within existing dwellings, the 2013 Califarnia Residentiai Code {GRC)
Section R314 and R315, alang with the California Buiiding Code Section 420.5 and 42Q.6 requires existirtg
dwellings have smolte alarms ar�d 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. GeneraUy, the alarms
are required to be hard-wired, have battery back up and be intercannected.
Start'sng 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 pawering the smoke
alarm for at least 10 years.
The alarms are required ta be installed in the follawing locations:
•:- Smoke alarms in all sleeping raoms.
•:� CO aEarms in all sleeping rooms where fuel burning app(iances are installed.
•:- Sm�ke alarm and CQ alarm in hallways preceding sleeping rooms.
❖ Smoke ala�m and CO alarms on each dwel�ing level incl�ding basements and habitabls 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.
INSTALLATtON CERTIFiCATION
For the property located at (,�1� �3 �t�,,�1�-DT c�p�-tti;l� , I hereby certify that the
required smoke alarms and carbon manoxide alarms have been installed as listed above.
�,�'���',�-� �,�`f 1`.�A�LUO Dl a[G N+� � '` 2 � 'lS�
Signature Print Name Date
Re(ationship to project (please check one}: ,
LYJ Owner ❑ Agent for Owner ❑ Licensed Contractor � Agent far Licensed Contractor
If°Licensed Contractor" or °Agent for Licensed Contractor" is checked, please camplete the following:
Confractor Contractor's S#ate License Number