HomeMy WebLinkAbout14-4488� - _-:__ _ •-- �—--t— --- - '�p`�
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� ,,,r;�`"w. C1TY OF DIAMOND I3AR � ��
� I I i ' ll DEPARTMEI�IT OF COA'iMUN[TY&DI:VELOPMCNT SERVICES
� .,''���u�,�=:. � ' 21810 Copley Drive,Diamond Bar,CA 91765 � PRESS
.�,,�•,,, .,,,:� (909)839-7020 �ax:(909)861-3117 Ruilding Inspt:ction Hotline(909)839-7027 FIRMLY
' '��+�'". BUILDING PERMIT APPLICATION
� � APPLICATION DATE:� Z � P/Ck
, w JOB SITE ADDRESS �� �' �$$UE DATE: Q �a I '8!/l�/ pERMIT# �Ll� —1 y0� -
a
zo APN �OT TRACT
o OWNER IYPE CONST. OCC GROUP:
N ADDRESS 3 � ZONING SETBACKS
,� CITY ZIP ��7 TEL. FRONT RW �
a APPLICANT 7EL. REAR �
�
o ( � � SIDE/SIDE STREEf RW
� ! f �` 1 O
Q CONTRACTOR Ir1�a�T C��S'^uLT��- A"�� e...��tl� SIDE
oro ADDRESS � t � ♦ G �:� PROPOSED USE
o C�r��Gt_!N}.a ! ZIP TEL. lT�i7 �1q�e �3 200
o ARCH/ENG/DESIGNER
z ADDRESS tt DWEL.UNITS #STORIES_�_ #BEDROOMS�
0
¢ CITY ZIP TEL. DESCRIPTION SO.Ff. FACTOR PSF ADJ.AREANALUATION
� OWNER•BUlLDFR DECLARATION
� SFR/ADD/REM
o I hereby attirm under penalty of perjury that I am exempt hom the ConUacta's Stale Llcense Law for the reason(s)
o indicaled below by the checkmark(s).I have placed next to Me applkable ilem�s)[Seclion 70315,Business and Garege/Carport
'-'� Professfons Code:Any city or county that requires a Dermit M construct,alter,Improve,demollsh,or reDatr,any
z struclure,pdor to ifs Issuance,also requires the applicant br Ihe permit to fiFe a signed statement lhat ha or she � PatioJDeck
a Is licensed pursuant to the provislons oT the Contrador's State Lk:ense Law(Chapter 9)Commencing wilA Settfon W
� 7000 0l Division 3 ot tlie Buslneu an0 Professla�s Code]or fhat he or she is ezempt hom�Icensure and Ihe basis tor � PootJSpa
�
� the alleged ezemD�ion.Any violatlon of Section 7031.5 by eny applicant t�a permit subjects the apD���t to a civil penalty Z Re-Roof
N of rwt more tnan five huntlretl dollars(5500). p
o (�I,as owner of Ne property,or my employees with wages as thelr sole compensatian,will do(�all 01 or(]portlons � Commercial
0 of the work,and the strucNre Is not intended a oftered lor sale(Sectlon 7044,Business and Pmfesslans Code:The m
� Contractnrs'State Llcense Law does not appry to an owner al Droperty who,[hrough employees'or personal effort,bullds
w or Improves the Droperty,Provltletl Inat the impmvements are not intended a oftered for sale.tt however,the building or
� improvement is soW v+ilhin one year of completion,the Owner-Bullder vnll have the burden of proving Nat it was not buitt
� or improved fw tl�e purpose o1 sale.).
O
� (]1,as ownar af lhe pmDert),am axdusNely contracting wlth Ilcensed ConVactors to construct the pro}ect(Section
0 7044,Business and Pro�essions Code:Tho Contractws'Stale License Law dces rrot appry to an owner ol properry who Valuation: � O d �Adj.ABa:
z buildsaimpmveslhereon,andw�oconhactsforlheprojectswithallcensedCantractorpursuanttotl�eConVactors'Stale pUANTIIY DESCRIPTION FEE
N
Y License Law.).
o U�am ra�empt hom licensure under tha Conlractnr's State Llcense law for Ne tollowinq reason�s): �
� �
LL By my signaNre below I aclmowledge 1hal,except la my personal residence in which I musl have resided Ior al Ieas�one �
Z year prior to completlon oi the Improvemen4 covered 6y this permll,l canrrot lepafty sell a sWcfure that I have buitt as an w
0
Qowner-Duilder i(it has not been conshucted in its enfirery by licensed contractors.I underslaM ttiat a copy of Ihe appllp6le
Q law,SecGon 7044 of the Business and Protessons Code is available upon request when this applicaUon ls submitted a at
�
a the follovnng Web slte:httplwvnv.leginfo.q.gov/calaw.htrnl. z
x m
w �ATE: SIGN: g
� LJCENSED CONTRACTOH'S DECLARATION �
a
c~..� �w!
w V hereby aflirm under penalty of perjury that I am Iicense0 under provisions ot Chapter 9(commenCing with Seclion 7000) •
� ot Division 3 01 the Business antl Professians Cade,a�my license is in fUll force and eflect. �
� �
v' ucErisE Q /' ��. 0.
v, c.No.: �7 t Z Z
�
o DATE: Z� CONTRACTOR:_r�i� I r.L w
zd WONNER'S COMPEHSATION�ECLARATION g -�-`O �N C�
� I HEREB FlRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: .
w ��'���n
a I have arM will malntain a Certincate of Consent to Seu-msure lor workei's Compensation,as providetl by CONSTRUCTION:
� SecGon 37�ol the Labor C�e,for the DeAormance af the wrnle for which Nls permit is issued.
� ' / PLAN REVIEW'
j V I have and will maiMain Waker's ComDensation Insurance,as reQuired 6y Secfion 3700 of the Labar Code,fw ELECTRIC: ��--
o the performance of t�e v+mfe for which th"s permit is issued.My Worker's Compensafion I�u2nce Carrier antl �
¢ PoiicyNumberare: PLUMBING: L���b�'�-
� CARRIER MECHANiCAL: `I��y 7
z POLICYNUMBEA INSPECTION FEE: ) �
N (iH15 SECfION NFFD MOT BE COMPLEfED IFl}iE PH1MfT IS FOR ONE FiUt�RED DOLLMS�10(n OR LESSI. ISSUANCE: !/��r�„
� I cerli(y tliat in the pertomcu�ce ot the vrorVe ta wttich 11tis permlt 6 issued.l st�all rol empby any P�in anY�����as to f r f�
vro k SMIP: �
o hecane ai�ject to the Worlcer's Compeivation Laws of Califomfa.Md egree thffi If I should ba.come subject to 1he Worke�s
u� Canpensali prw o 3700 01 theJ,ytgf Cade,I shall lort iUi can e prmrisi . ENERGY P/C:
LL DATE:���CN7T.�� ENERGY PERMIT: �tN
� WARNING:Failure t secure Workers Comperaation coverage is unlawlul�and shall sub mproyer to criminal RETENTION FEE: �-V V
w penattles and clvil fines up to ane hundred tfwusantl dollars($lo0,OD0�,In addition to tl�e cost of the comper�salian,
� damages as prwlded Iw In section 3708 ot the tabor code,interest,and attomey's fees. PRE-ALT FEE:
� CaNSTRUCTION LENDING qGENCY asAF: f•Gn
z I hereDy afflrm under penalry of perjury that there is a ConsWction Lending Agen�y(or the perlorm�nce of the work for
w
= whir.h�his permil is issuetl(Sec.3097.Civ.C.�.
3
F_ LENOER'S NAME:
� LENDER'S AD�RESS: -
a I certily ihat I have read tAis appllqtioo and s�ate that Ne above informalion is conect I agree to compty vdth all ary and TOTAL FEES
� county ortlinances antl state laws relatlng ro bullding construcfion,and hereby aumwlze representatives ot mis county ro COMMENTS:
z
o enter upon Me above-mentianed properry far inspection urpose..
J
m r ., N�
� PERMfTTEE NAME(PRIN —� t —/ �y�
= Sl6NATURE OF PER DATE RECEIPT k �O /�V PAID BY: ✓ � VALIDATION:�7-
H
WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Applicant's Copy �
CITY OF DIAMOND BA�
INSPECTION RECORD
�, . .
. � , . � • - • � � � -
�SETBACKl�ET;f,ER �� � '�r , , �.; r ,.v:i: ' `; TRACTAND LEDGER
POOTINGS FORMS - � -U7 e t �� � �' _ ` �: SWffCH GEAR
S�p,g,,�, , � �;' ,- COMMERCIALHOOD �
UG.PLUMBING _ " �''` T-BAR
;;
UG.ELECTRICAL � �:' `=- '='"' � " `� INTERCEPTER
UFER GROUND:'' Irr , '"r � ; � � " J �'� :; HOT MOP/SHOWERPAN
SEWER LATERAL SEPTIC/CESSPOOL
MAIN WATER LINE HERS REPORT RECEIVED
SEWER CLEANOUT DEMOLITION •
ROOF SHEATHING ROOF DRAINS
FLOOR SHEATHING ROUGH CONDUIT
t„ F:; g I., . 'u� t
SHEARWALLS�EXfERiOR '� ROOL/SPA^; �� ` �;` ,�<: �•�'
SHEAR�.VdQLLS INTERfOR��� , � , '' `� �' ` ��, � ROUGW PLUMBIN� _'� � �, : + ���` � Y x� �= •�� .
. �� �� �• - �
�FAAMINGNENTING ;�, � ° � t - �' ." r � � ` �� � ROUGH.ELEGTR�CAL`: � � - _ _ �' ��_ ��
� - �' �m. �h . �l f } �1 � .' �Y(`� ..
. � 1 3€. . ;( d,
ROU�iH MECHANICAL.� � ,'�� ,,�r , `�,; r ;�� � R(�UGH M�GHANICAL` > �,� � � �' �> t �
ROUGH EL-ECTRICAL W(��)C{ ,) _ x ��� � ' GAS TEST `x` - �'' ` �� ` � �' :� `� ��, �'
ROUGN PLUMBING �.:-` _ ``�� - PRE GUNITE ; '. � f, �; ,{;�
INSUlATION WALL ,P_OOL PRE.DECK BONDING „�:-i�, "r, � `L�i� N
INSULATION CEIUNG P�*T�P °�' �~ J F �' � ��'�r
DRYWALL �i FENCE.7GATElALARM r, �f r, . .*' � u�+� ",-� »;
LATH(PRE} ,FjNAL POOL ,t ' �' ,�` .- ry.4 F� ' -
LATH EXTFAIOR WALIS:
LATH INTERIOR WALL FOOTING/STEEL
GAS TEST WALL STEEL 1ST( )2N0( )L1FT
SCRATCH COAT WALL BOND BEAM
ELECTRIC METER RELEASE WALL DRAIW SEAL
GAS METER RELEASE WALL FINAL
SPECIALINSPECTION R0.`FRAMINGPL'ANMNGAPPROVAL �� xs�:`
ROUGH FIREAPPROVAL ^ �
'FINAL BUILQING " '� "� � �'; � - _ '
FINAL'MECHANICAL �:�-E FINAL FIRE DEPARTMENT ��� :E � � {
FINAL EL:ECTRICAL �`' <` ,,, � �FINAL PLANNING �`� ' E ' r'�x �° - � '�w
FINAL(''Ll1MBING '�, � ��� FINAL"ENGINEEfi{NG/PW T � ' - ° ��:� �+'� "
T.C.Of OCCUFANCY - i 4� ` FINAL�COMMUNITY�SERVICES �;� ��"' � r.;' - � r"
GERT.of OCCUPANCI' ;i , '� ' � ,,; ` � "� _
s EINAL HEALTH;DEPT �l ` > 7�'
�.FINAL'INDU5TRIAt;WASTE -�L` " �r�. _. _�' <<'4.. ,. ` '� � > "';;:
COMMENTS: