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Home My WebLink About14-5214 � O ,, ' r' ==!-: �_ � CITY OF DIAMOND BAR i DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES �_��r � 21810 Copley Drive,Diamond Bar,CA 91765 PRESS ,LL] (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 �''�¢'� BUILDINGPERMITAPPLICATION FIRMLY I � APPLICATION DATE: P/C# � I L JOB SITE ADDRESS /� �/� � � z APN LOT TRACT ISSUEDATE: �I/�J /4'V',��PERMII# ��I� � OWNER 1('4�(�� Q�e �^yI P�^'� TYPE CONST. OCC GROUP: n ADDRESS � l' � � �'I� � r < ZONING SEfBACKS � CITY Cvl' i' ZIP C,A TEL. `�C7�- iS(�C�-�S3� FRONT RW ❑ = APPLICANT c�l��r•} � �i�)(Pl TEL. �CaCc-S�h�O- I RuC REAR ❑ n SIDE/SIDE STREET RW ❑ � CONTRACTOR � /� SIDE ❑ � ADDREMSS � I1�N �� - j CITY I'�1(i!'✓�,e�-�'l ZIP�_TEL. �QC�.5��p�[U' PROPOSED USE. S ARCH/ENG/DESIGNER L 1Vr� -�� u� = ADDRESS � #DWEL.UNITS #STORIES #BEDROOMS z CITY ZIP TEL. ¢ DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION � OWNEfl-BUILDEH DECLAMTION = I hereby affirm under penalry of perjury that I am exempt from the Contractor's State License Law for the reason(s) SFFVADD/REM ' I L indicated below by the checkmark(s),I have placed next to the applicable item(s)[Section 7031.5,Business and Garage/Carport I � Professians Code:Any city or county that requires a permit to canshuct,alter,improve,demolish,ar repair,any � structure,prior to its issuance,also requlres llie applicant for the pertnit to file a signed sfatemeM ihat he or she � Patio/Deck I � is licensed pursuaM to the provisions of the Cantractnr's State License Law(Chapter 9)Commencing with Sectian w � 7000 of Division 3 of the Business and Professlons Code]or that he or she is ezempt fmm licensure and the basis for � Pool/Spa I � the alleged exemption.Any violation of Sedion 7031.5 by any applicant for a permit subjecLs the applicant to a civil penalty C7 I = of not more than five hundred dollars($500). ZQ Re-Roof � �1 I,as owner of the propertg or my employees with wages as their sole compensation,will do(�all of or(,portions � Commercial I y o(the work,and the structure is not intended or offered for sale(Section 7044,Business and Professions Code:The � I Z Contractors'State License Law does not apply to an owner of property who,through employees'or personal effort,builds m y or improves the property,provided that the improvements are not intended or oftered 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 � p p rty,am exclusively contrac[ing with licensed Contmctnrs to construct the project(Section (,I,as owner of the ro e Valuation: Adj.Area: I Z 7044,Business and Professions Code:The Contractors'Sta�License Law does not apply to an owner of property who � buildsorimprovesthereon,andwhocontractsfortheprojectswithalicensedContractorpursuanttotheContractors'State QUANTITY DESCRIPTION FEE j Y License law.). � L)I am exempt from licensure under the Contractor's State License law fir the following reason(s): � � �IG2- G � ¢ I 1 By my signature below I acknowledge that,except for my personal residence in which I must have resided for at least one c~.� I � year prior to completion of the improvements covered by this permit,l cannot legally sell a structure that I have built as an � awner-builder if it has not been construded in its entirety by licensed contractors.I understand that a copy of the applicable w I � law,Section 7044 of the Business and Professions Code is available upon reques[when this application is submitted or at I � the following Web site:http/www.leginfo.ca.gov/calaw.html. � � I � DATE: SIGN: � I — LICENSED CONTRACTOH'S DECLAHATION � I a I � I hereby affirm under penatty of perjury that I am licensed under provisions of Chapter 9(commencing with Sedion 7000) � of Division 3 of the Business and Professians Code,and my license is in full force and efted. ' � l' �r i a i n LICENSE CLASS:� ��L��. G�1.�0 LIC.NO.: ��U I 1� az I � DATE: CANTRACTOR: �.�y.y��tS'54��a 4 V w I z ¢ WOHI�H'S COMPENSATION DECLAHATION � I y I HEREBYAFFIRM UNDER PENALTY OF PERJURY ONE OFTHE FOLLOWING DECLARATIONS: � I have and will maintain a Certificate of Consent to Self-Insure for Worker's Compensation,as provided by CONSTRUCTION: —1 I � / Section 3700 of the Labor Code,for the pertormance of the work for which this permit is issued. p�qN REVIEW: /` � �� I have and will maintain Worker's Compensation Insurance,as required by Section 3700 of the Labor Code,for Z the pertormance of the work for which this permit is issued.My Worker's Compensation Insurance Carrier and ELECTRIC: f ¢ PolicyNum6er re: PLUMBING: � CARRIER .�� rLtv�� MECHANICAL: z POLICY NUMBER �GSS`�-/�Z�-�G/ '� INSPECTION FEE: n (THIS SECIION NEED NOT BE COMPLEfED IFhiE PFAMfT IS FOR ONE HUNDRFD DOLLARS($100)OR LESS). �� 1� ISSUANCE: = I certify that in the perfortnance of the work for which this permit is issued,I shall not employ any person in any manner so as tn ,l �y � become subject to the Worker's Compensation Laws of Califomia.Md ag2e mat if I should become subject to the Worker's � SMIP: � Compensation p visions of Section 3700 of the Labor Code,I shall fortiivdth comply with tt�ase provisions. ENERGY P/C: J J DATE: J" APPLICANT: 1 ENERGY PERMIT. � WARNING:F lure to secure Worker's Compensation coverage is unlawful,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: = damages as provided for in section 3708 of the labor code,interest,and attorney's tees. PRE-ALT FEE: i CONSTHUCTION LENDING AGENCY BSAF: J�p/1� = I hereby affirm under penalty of perjury that there is a Canstruction Lending Agency for the performance of the work for d � which this permit is issued(Sec.3097,Civ.C.). LENDER'S NAME: = LENDER'SADDRESS: TOTAL FEES � ` � 1 I cerGfy that I have read this application and state that the above information is correct.I agree to comply with all city and �- ,�+� �/1r��/ � county ordinances and state lavrs relating to building construction,and hereby authorize representatives of this county to COMM ENTS: V (� z � enter upon the a6ove-mentioned property for inspection purposes. J � b ¢ PERMITTEE NAME(PRINn � � � n = SIGNAlURE OF PERMITTEE DATE RECEIPT# PAID BY: �r �, VALIDATION: WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy _ l I ! ` CITY OF` DIAMOND BAF� INSPECTION RECORD . � s , . � s . � � . � � - `SETBACK/.LEfTER_ _r , �� a� � � � � � �_ TRACTAND LEDGER �« _ � FOOTINGS FO_RMS -� ,�-,� , � � , , � e SWITCH GEAR . � z s� a ,_ � ;S,IAB` P�„�. � ,, � ,� : � COMMERCIAL HOOD x _ , �, _, . � . ��_ UG.Ft�Ui1�HING . a,:°�� '.. �� .. �� T-BAR �. � _ . .� ,�. ��. ,UG:�ELECTRIGAL; �. ,, � � � „ �,.� �, ;. ` INTERCEPTER ,UF=ER�GROUN� ;� � � �,_ � � ,.� �, ,„ � ' HOT MOPISHOWERPAN SEWER LATERAL SEPTIC/CESSPOOL , MAIN WATER LINE � HERS REPORT RECEIVED � SEWER CLEANOUT �DEMOLITION ROOF SHEATHING ROOF DRAINS FLOQR SHEATHING ROUGH CONDUIT �SWFAR WALL�S EXTEFiIOR �, :� � _, � � � ,_ POOUSPA y � _ . � � ° �SHEARWALLS�INTER(OR � � �� ,,, � � ROUGH PLUMBING . � ,FRAMINGNENTING ` �: 9a� <. s- _<. �ROUGH ELECTRICAL � „� � � � �� ` I � �.. ;: .< a� �ROIJGN MECkIANIGAL - �, �,E�� x ,� � � >� _ ROUGH MECHANICAL � � � �� . � _ _ _ � _ _� n ,, R�U6N EL'EC�TRICA�W(�.}G�i�� -. ; -.� � �F �. � � � � �GAS TEST ROUGN FLUMBING : = �. �;. ��s:� ��' � � _ �� PRE GUNITE _. ; � , INSULATION WALL POOL PRE DECK BONDING � _ _ _ _ INSULATION CEILING P-TRAP DRYWALL FENCE I GATEIALARM LATH(PRE) FI�lAL,POOL � � LATH EXTERIOR WALLS: LATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL 1 sr� �2Ne� �LIFT SCRATCH CQAT WALL BOND BEAM ELECTRIC METER RELEASE / —/,!-/ WALI DRAINJ SEAL GAS METER RELEASE WALL FINAL SPECIALINSPEGTION flO.�FRAMINGPLANNINGAPPROVAL � ,r �� _._ ,_ . � � _ � FINAL BUILDING �: �' ''" - '-"l'S� :�� ' �;� � �. . ROUGH FIREAPPROVAL f b � �..� .,�_,. FIN11L MECFtAN3CAL ; ° � ��°' `� ��: ��r�'� s�� ° FINAL FIRE DEPARTMENT � � �, _ ' "`'-x � ` � '� ; � FINAL PLANNING � . �EIN�I.ELEGTRIC:4L� �' � ry,�—�,S '"Qy"� ,; � FIN�iCPLI�Blt�6�;, `.'`�' � �`�" " � = ,�� '�` '� � � FINAL ENGINEERING/PW � �T.'C�.�"of OCCUPANCY`� " �'`� � �� -` ° T � ' � �" �� FINAL GOMh�UNITY SERViCES- ��> � ,. �,�•, , . � ,��,.. �, �� ,�� a� �., ��" � � � � ` �" � FINAL HEALTH DEPT, „CERT.of Ot�UPANCI"�= � : � FINAL INQUSTRI'AL WASTE � COMMENTS: