HomeMy WebLinkAbout14-3854 ..�,'�'� � � I C1TY OF DIAMOND BAR � �,��` i
I � *_ _If'i i DEPARTMENT OF COMMUNITY&DEVELOPM�NT SERVICES �
�III,� - � '' 21810 Copley Drivc,Diamond Bar,CA 91765 ESS
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,,,,.� (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 FIRMLY
""'�"- BUILDINGPERMITAPPLICATION
wJOB SITE ADDRESS �'1"� 1� APPLICATION DATE: � � P/Cq �
z APN LOT TRACT ISSUE DATE: " �` � PERMIT# ryr� �/ L/
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o OWNER TYPE CONST. OCC GROUP:
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N ADDRESS
y CITY ZIP TEL. ZONING F ONT KS qW ❑
o APPLICANT TEL. REAR
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a CONTRACTOR �t" ^� SIDE/SIDE STREET RW ❑
i o SIDE ❑
� ADDRESS�
PROPOSED USE � LSr'
� CITY ZIP TEL.
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o ARCWENG/DESIGNER �e7� 1 �
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o ADDRESS
H DWEL.UNITS #STORIES p BEDROOMS
z CITY ZIP TEL.
� DESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREANALUATION
OWNER-BUILDER DECLAflATION
o I hereby aflirm under penatty of perjury that I am exempt hom the Contractar's State License Law for the reasan(s) SFR/ADD/FtEM
p inaicated bebw by the checkmark�s),I have placed next to the aDD���ble item(s)[Section 70315,Buslness and Gerage/Carport
o Professions Cotle:My city or county that requires a permi[lo construct,alter,improve,demolish,w repair,any
z strucNre,pHor to Its fssuance,also requires the applicant for the Dermit to file a signed stalement that he ar she � Patio/Deck
Nis licertsed pursuanl to ihe proWsions of ihe CaMraclor's State License Law(Chapter 9)Commencing with Section W
� 7000 of Uiviston 3 of the Business and Prafessions Code]w that he w she is exempt hom Ilcensure antl Uce basis for � P�USpa
N the alleged ezemplion.My viWafion of Section 70.31.5 by any applicant iw a permit sub(ects the applicant to a civil perolry C�
N of not more ihan live huntlred tlollars($500). Z Re-Roof
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o U I,as owner at the property,or my employees with wages as thelr sole compensatlon,wfll do(�all ot or(.,)portions 9 Commercial
� of ihe work,and the sWcture is not intertded a offered lor sale(Sec[lon 7044,Business and Rofessions Code:The �
� Contractnrs'State License Law dces not appty to an ovmer of property who,thmugh employees'or perso�al eflort,build5 m
u77 a imprwes ihe property,provided that ihe Imprrnements are rrot intended or oftered lor sale.It however,the building or
� Improvemen�Is sold wiU�in one year af compleUon,Ne Owner-Builder will have ihe burden of proWng ttiat it was rrot Ouilt
pa imprmed for the purpose of sale.).
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F U I,as owner of the properry,am exGusivety cantractlng wilh Iicensed Convactors to construct the project(Section
0 7044,Business aiM Profes5ions Co[le:The CoMractors'Slate License Law does not appty to an avmer of Droperry who Valuation: Adj.Area:
Z bulldsaimprovesmerean,andwhocontractsfortheprojectswimalicensedContractapursuanttotheContracrors'State pUANTIIY DESCRIPTION FEE
�
Y License LawJ.
o (�1 am exempt hom Ilce�ure under ihe Coniraclor's Stale License law lor ihe followl�reason(s): �
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By my signaturo below I acknowledge that,except fw my personal residence In which I mus[have resided for at least one �
o year prior fi completlon oi the improvemenfs covered by Nis permit,l canrrot legally sell a structure that t have built as an �
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� owner-builder it it has rrot been consUucted in Its ent'uety by licensed contractors.l understand that a capy of the epplipble
� law.Section 7044 of ihe Business and Professions Cotle is availahle upon request vfien ihis eppliption a submitted or at
� the follawing Web si[e:httpAvww.leginfo.q.gov/calaw.html. �
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o DATE: SIGN: � �
~ 110EN5ED COMRACTOH'S DECIARATION �
U d
w I hereby affirm under penalty of perJury that I am licensed under provisions oi Ghapter 9(commenci�with Section 7W0)
� of Division 3 ol the Business and Protessions Code,and my Ilcense is in full(orce and eMect.
� �� Q�.
v� ��N��� LIC.NO_�7� L� ¢
o DATE: CONTRACTOR:_` � ,
� WORKEl1'S COMP DE �
� I HFAEBY AFFIRM UNDER PENALTY OF PERJURY ONE OF 7HE FOLLOWING DECLARAl10NS: /�
ow � �r
I have and wiu malntsin a Certificate of Consent to Sen-Insure ta Worker's Canpensation,as pmvideu by CONSTRUCTION: y
� Section 370D of the Labw Code,for Ihe oerfarmance ol me work tor which this permit Is issued. p�,qN REVIEW:
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Q �have and will mairrtain Worker's Compensation Insurance,as requiretl by Sectian 3700 0l the Laba Code,fw ELECTRIC:
Z the pertormance of ihe work tor which this permit is issued.My Worker's Compensatlon Insurar�ce Carrier and
¢ PolicyNumbe�a���� e� PLUMBING:
� CARRIER 1
w MECHANICAL:
� roucv NUMs�
INSPECTION FEE:
o� (T}OS SEC�ON NEED NOT BE COMPIFfED IFT1�PERA4IT IS FpR ONE HINJDRFD DOLWiS($t(10)OR LESSj. ISSUANCE: ,f .�.�
I certify tlial in the performarce oi the�wrk fa wftich Ihis permit is'ssue0,I slv�ll nol empbY erry person in any manner so as to /' ��
o hecome subject to Ihe Waker9 Compeivation Laws ol Califomia.Md agree Ihat if I slrould hecome suqect W fhe Worker's SMIP:
� Comper�satim prwisbr�s ot Section 3700 0l the Laba Code,�shau rorthwith compry wi�ti tfrose pruvisiorrs, EN ERGY P/C:
'� �A�' ���' ENERGY PERMIT:
� WARNING:Failure to secure Wwker's Compensalion cmerage is unlawlul,and shall subJecf an employer to iriminal �` �
w penattles and civil fines uD to ona hundred thousand dollars($100,OD0),In adtlition to the cost of the compensallon, RETENTION FEE: «_
o damages as provided(or in section 3708 ot the�abor code,interest,and attomey's fees. PRE-ALT FEE:
d CONSTRUCTIONLENDINGAGENCY BSAF:_ , Da
w I hereby�rm under penaly of per�ury thal there is a Corrstruclion Lending Agency fa the perlamance ol ihe work fm
� which ihis permit Is kssuetl(Sec.3097,Civ.C.�.
� LENDER'S NAME
� IENDFA'SADORESS: �y 1 �
a I certity that t have read this application and state that me above informatlon Is conect i agree to campty with all city and TOTAL FEES
'� county adinances and state Wws relatlng m building conswceon,and hereby aumorize representatives of mis caunry to COMMENTS:
Z enter u n the above-mentioned ro p p poses,
p P� p perry for ins ection ur
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d PERM E E PRINn
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r SIGNA OF ITTEE DATE RECEIPT N_L��� PAID BY:��QC�VALJDATION:
WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—Fle Copy,GREEN—Applicant's Copy
CITY OF DIAMOND BAR :.,
INSPECTIOPI RECORD "
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'SETBAGK/LETTER �� '— F� � � �f .` v ' "��� � ' ��'``�� TRACT AND LEDGER
FOOTINGS�FORMS . � ' ' ' ° �� �'�,: { ��,_ ,.,�>J ;' SWITCH GEAR
- �' � ' '= ° ' COMMERCIAL HOOD
SLAB::'��, . � �
UG:PLUMBING- t :.` ,�- -- ` -_ `'`� '`:; T-BAR
+'�� �' "~- �< INTERCEPTER
'UG.ELECTRICAL f ...
UFER GROUND< ' '`,� �. '�`1'' - HOT MOP/SHOWERPAN
SEWER LATERAL SEPTIC/CESSPOOL.
MAIN WATER LINE HERS REPORT flECEIVED
SEWER CLFANOUT DEMOLITION
ROOF SHEATHING ROOF DRAINS
FLOOR SHEATHING ROUGH CONDUIT
- r` s ; 'POOL/SPA;- _ ` t'�
SHEAR'WA'LLS'EXTERIOR'.._ "� S� :: n ", , =
� � � ' � � RQUGH PIUMBING���s � � , , - ''
SHEAR WALLS�INTERIOR ��,� ��� ` y �� �- � �� ° �. � ' � �� �
�FRAMINGNENTING fi' �' ¢ ;`�� � ° _ ;rz`. � � , " ` �'. ,A��; RQUGH ELEGTRIGAL'; `! t } F _� �' F �� '�� s � f�ti
, � ,,, � +.� ,
ROUC�N.MECHANICAL�1��'"," +.�� � �` ": a ;�, T s ' 'S �`z'�`rr ROU61i MEPiHAN1CAl�,s'� 1 �i3 +"� :t � �;i' ` _ r � �r ,� �'
k � T, `g. -:, � ,�„��a; ,GASTESTy q { ::� � _ .�
ROUGW�ELECTRICAL W( ��j C( ) �;: ,, � �u ``
:ROUGH PLUMBING , � �` '� PRE GUNITE �' <; �� � � r
INSULATION WALL , °POOL'PRE DECK,BONDING , �. - �: f � - k N. r
, _,;r -
INSULATION CEILING P'�`P `� ^ � ' ' ' ' � '
DRYWALL �FENCE7GATFJtALQRM, .. -'-� "� � s ti `� � _- '.���
LATH(PRE)
FINALAOOL`.� ''j�;i,! r xS�:: � � �,:-� � ' �
LATH EXTERIOR WALLS:
LATH INTERIOR WALL FOOTING/STEEL �
GAS TEST WALL STEEL 1�T( )2ND( )LIFf
SCRATCH COAT WALL BOND BEAM
ELECTRIC METER RELEASE WALL ORAIN/SEAL
GAS METER RELEASE WALL FINAL
k,� � }��
SPECIAL INSPECTION � =RO:FRAl�IING�FIANNINGAPPROUAL � ���' r <r����f . '�; �'
� <ROUGH,FIREAPPROVAL :` �` � } `
FINAL BUILDING � �,r`/;y � ` � j
-FINAL,MECHANICAL ., , �:= �_ _, �;� � �,, , � �`� " : ��FINAL FIRE OEPARTMENT � "�- � - ! s ` ��
FINAL�ELECTRICAL, � � ' ` � :; FINAL PLANNING ,';; ' �
- � .� �
FINAL PCUMBING -:.j . `` } '' .. ' ` . F.INAL ENGINEERING/PW ;� ' ,r.
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' �� FINAL"COMMUNITY:�SERVICES � �� � ��
T.C.'of OCCUPANCY `'� ,, � '� - - - _ ,-? '=
CERT:of OCCUPANCY:��. . .� :% ,. �,�, , ��.':� ,.��.j" � "' � ,EINAL NEA%LTH DEPT �: r � ` " �
�,; �
'FINAL INDUSTRIl1L`WASTE��#� �''` h ', �i '" ;' ,�s�'
COMMENTS: