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Home My WebLink About14-5325 -�:,�T CITY OF DIAMOND BAR � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES � {-�"= — 21810 Copley Drive,Diamond Bar,CA 91765 ,(,-rj l�� PRESS �, (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 .� FIRMLY ��''�"� BUILDING PERMIT APPLICATION APPLICATION DATE:�2�'L'S I��{ P/C# I r JOB SITE ADDRESS i ISSUE DATE: PERMIT#��543�� z APN LOT TRACT � OWNER��(\SS� �.O TYPE CONST. OCC GROUP: � ADDRESS �� V�Q�A�'1�� p� ZONING SEfBACKS � CITY W��N U� ZIP qi�¢`� TEL.I�,�Lo.lt l(�-�l2ot C FRONT RW ❑ ¢ APPLICANT TEL. REAR ❑ s � � � SIDE/SIDE STREEf RW ❑ Q CONTRACTOR ��u'rG�} SIDE CL � ADDRESS 3��"s �-��rU1Ls.v w�✓� � CITY �n�.N�wAct.�+ Z�p��OZ 55•loS1� PROPOSED USE VEW S TEL. ��'� �221 Yvif� S � ARCH/ENG/DESIGNER hn n U `OL7 P� = ADDRESS #DWEL.UNITS #STORIES Z #BEDROOMS z CITY ZIP TEL. i ay DESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREANALUATION � Q OWNEN-BUILDEH DECLAflATION = I hereby attirm under penalty of perjury that I am ezempt from the Contrador's STate License Law for the reason(s) SFR/ADD/REM I indicated below 6y the checkmark s,I have laced nezt to the applicable item s Section 7031.5,Business and I � () D ()I Garage/Carport 1J Professians Code:Any ciTy or couMy ttiat requires a permit lo construct,alter,Improve,demolish,or repair,any z structure,prior M its issuance,also requires the applicant for the permit ta file a signed sfatement that he or she � Patio/Deck I i is Iicensed pursuantto the provisians of tlie Contractor's State License Law(Chapter 9)Commencing with Section W I � 7000 ot Oivisian 3 oT the Business and Professions Code]or that he or she is exempt from licensure and the basis for � PooVSpa n the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty Z Re-Roof I of not more than five hundred dollars($500). � I� (,I,as owner of the properTy,or my employees with wages as their sole compensation,will do(,all of or(�portions � Commercial y of the work,and the structure is not intended or 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 ettort,builds 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 o1 the property,am exclusively cont2cting with licensed Coniractnrs to consVuct the project(Section Z 7044,Business and Professions Code�The Contractors'State License law does not apply to an owner of property who Valuati 'k - Adj.Area: � n buildsorimprovesthereon,andwhocontract5formeprojectswithalicensedContractorpursuanttotheConuactors'State QUANTITY DESCRIPTION FEE I Y License Law.). 1 Q O I j (,I am exempt from licensure under the Contractor's State License law for the tallowing reason(s): � I �i 2 1 By my signature below I acknowledge that,except for my personal residence in which I must have resided Tor 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 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 su6mitted or at � I �- the following Web site:http/www.leginfo.ca.gov/calaw.html. Z � DATE: SIGN: m i � � � — LICENSED CONTMCTOH'S OECLAHATION � a ' I hereby affirm under penalTy of perjury that I am licensed under provisions of Chapter 9(commencing with Section 7000) I y � of Division 3 of the Business and Professions Code,and my license is in full force and effed. J I n LICENSE CLA S: � t� /'��".Na.: k�RK l D� a I Z DATE:�,�3��_�(Q_ CONTAACTOR: ��T�C�1 w I ¢ � WOHI�H'S COMPENSATION DECLAIiATION � I � 1 HEREBY AFFIRM UNOER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: �/ " a�3. � I have and will maintain a Certificate of Consent to Self-Insure for Worker's Compensation,as provided by CONSTRUCTION: �(O � Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. p�p,N REVIEW: a I have and will maintain Worker's Compensation Insumnce,as required by Section 3700 of the Labor Code,for ELECTRIC: � � � the pertormance of the work for which this permit is issued.My Worker's Compensation Insuance Carrier and ¢ PolicyNumberare: PLUMBING: � CARRIER MECHANICAL: i � Z POLICYNUMBER yZy O INSPECTION FEE: � 1i (THIS SECf10N NEED NOT BE COMPLETED IFTHE PFAMIT IS FOR ONE HUNDRED�OLLARS($100)OR LESS). - ISSUANCE: 7�� I certAy that in the pertormance of the work for which mis permit is issued,I shall not employ any person in any manner so as to � become subject to the Worker's Compensation Laws of Califomia.Md agree that if I should become subject to the Worker's SMIP: �� J� � Compen on p wsions of Secbon 3700 of the Lab , shall forthwith cc.mply with those provisions. ENERGY P/C: L J i DA7E: �- � APPUCAN7:— ENERGY PERMIT: � WARNING:Failure to secure Worker's Compensation coverage is unlawful,and shall subject an employer to criminal RETENTION FEE: ag-a� y penalties 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 af the labor code,interest,and attorney's fees. PRE-ALT FEE: � i CONSTHUCTION LENDING AGENCY BSAF: � y I he2by 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: Y LENDER'SADDfiESS: 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 Z county ordinances and state laws relating to building construction,and here6y authorize representatives of this counTy to COMM ENTS: � enter upon the above-mentioned property for inspection purposes. J � .S?�E Lr�vrl � �/��^� � ¢ PERMITTE :n _ .a.-✓0— 'li �-3 L b b = SIGNATUREOFPERMITfEE DA RECEIPT# �Sya PAIDBY:G�C_ VALIDATION: �7�� WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy . CITY OF DIAMOND BAR INSPECTION RECORD � � � � � � � � � � � s 0 � �5��'�ACIU LETTER d�� s - -- � z _ TRACTAND LEDGER �F�OTIt�GS FdRMS""�:��'��,. ,� � ,��,a � � ' ° , � � StNITCH GEAR � . ,, . � �� COMMERCIAL HOOD :SLAB�� ,��. a � � � . ._. UG:PIIiMBING '� . �.�� ` y �� . T-BAR UG.°,ELECTRICAL �"'� �" �� . ; e��.�. „ . ,��,��._ . � � > � �° � INTERCEPTER �UFER�6t�0UND� � � " �'�'�� ' � � � �� HOT MOPISHOWERPAN � , ��.� �..;. ��4�-� z SEWER LATERAL SEPTIC/CESSPOOL MAIN WATER LINE HERS REPORT RECEIVED SEWER CLEANOUT DEMOLITION ROOF SHEATHING ROOF DRAINS FLOOR SHEATHING ROUGH CONDUIT ��,. _ . �� - � ,SH�1R WALLS EXT�RIDR ; � � �,��*�� ` �� POOUSPA a � ._. � � � . . � ' � ` ; " _ u �. ; _ SHE�tR�WA�LLS.iNTER10��}� �� ° � ° ° �ROUGH I�LUMBING� � � � �� ° �` � � , . . �, _: ,_� ��.� „��.fl x _ _ . __ _ FRAMINGN�NTING � � � � � _ � � � � � ROUGH ELECTRICAL � � ` . �ROUGH�MECHANICAL �� < _ � � � � ` � ROUGH MECHANICAL � � _ _._ . __. _. _ �ROUGH EL€CTRICAL�W(�)C(��) _. ' �� - � � � � � � - GAS TEST � = n - � _ , � � et� �� o . . _ _ �ROUGH PLUMBING , �� , , , � , F �-� � � � � � � �PRE GUNITE < , � INSULATION WALL POOL PRE DECK BONDING INSULATION CEILING P-TRAP ` , ; . DRYWALL �FENCE I GATFJ ALARM � � � �� LATH(PRE) �FINAL POOL � ` � _ r _, LATH EXTERIOR WALLS: LATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEI 1 sr� �2Ne� ��FT SCR,QTCH COAT WALL BOND BEAM ELECTRIC METER RELEASE WALL DRAIN/SEAL GAS METER RELEASE WALL FINAL SPECIAL INSPECTION RO.FRAMING PIANNINGJ�'f'ROUAL 'FIN�II..�UILDING�'� �` � ��,� � ��J.T'� � < , � ` � ' ` • ROUGH FIRE APPRO1tAL , _ � � FINAL MECHI�KiCAL �� ; � � ,� � . �. . .� .� FINAL FIRE DEPAHTMENT a � , , � � �FIN;4L�ELECTRICI�C�"��< �� '.": �-xi�� ° . � '/-0 FINAI PLANNING � , � a . , FINaL�PLUMBING�_M; .; ` �,� � � "� � � � - � FINAL ENGINEERING/PW � �� < �. � ��, ==� �� -� , � T.�.=of30CGUPANCY'�"' _ , ; n . �� FINAL COIVIMUNITY SERVICES ' e a . CERT.of OCCUPAtdCY � � � ' � � � FINAL HEALTH DEPT. ' � FINAL fNQUSTRIAL WASTE COMMENTS: / �.'LQ'�d .S' ��,Q�Od� ;�� ,��-,�.�.»� .�/�