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Home My WebLink About14-4200 - C1TY OF DIAMOND BAR I � � D1:PARTMENT OF COMMUNITY&DEVELOPMCN'C SERVICE5 ��,- � �jlll��,. =` � " 21870 Copley Drivc,Diamond Bar,cA 9»�s PRESS ,,,,,� (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 FIRMLY �4'L"'� I3UILDING PERMIT APPLICATION � � JOBSITEADDRESS_ A��p✓ �� L?T/`�� APPLICATIONDATE ��`�' ��Y/� / P/Ctl � ISSUEDATE: ��- ��dr/��7 PERMIT# �-I' y}��/ z APN LOT TRACT 0 o OWNER�i�}'=�•y S(`o� TYPE CONST. OCC GROUP: � ADDRES�a �%� J CITY � C ZIP ^ TEL��C' � �� — Z�NING SETBACKS O APPLICANT C � '�[J7iQ=C_ ��REL�C�C V REqRT RW ❑ ❑ cn p SIDE/SIDE STREET RW ❑ o CONTRACTOR 9C �C�7`LZ(. f�7,k�s lj✓t� . SIDE 6 ❑ � ADDRESS /.��. �IT�� 6�� PROPOSED USE o ciTv l�,4-r��ul�A-� ziP_7��TEL�L-��57�`� o ARCH/ENG/DESIGNER w o ADDRESS #DWEL.UNITS M STORIES #BEDROOMS z CITY ZIP TEL. � DESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREANALUATION ow�+m-am�o�uecwwnoN � I hereby attirtn under penatty of perjury that I am exempt hom the Conhactar's State License Law tor the reason(s� SFR/ADD/REM 0 p indicated bebw by the checkmark(s),I have placed next to the applicable item(s)[Section 70315,Business and Garage/Carport o Professlwis Code:My city or county that requires a permit to construct,alter,Improve,demollsh,or repair,any �. w sWcLire,prior to i[s Issuance,also reqWres the applfcant for the pertnit to flle a signed statement Mat he or she � Patio/Deck N Is Iicensed pursuant to ihe provisions ot ihe Conhectw's State LJcertse Law(Chapter 9)Commencing with Sectlon w � 70W of Dirision 3 of ihe Business and Professions Cade]or that he or she is exempt hom licensure and the basis for LL Poo��Spa � the alleged ezemption.My viWation of Section 7031.5 by any applicant ta a De��sub�ects ihe aOD�icant to a civfl penalty N of nat more than five huntlred dollars(3500). Z Re-Root � o (,I,as owner of�he propeRy,or my employees with wages as ihefr sole compensation,will do()all of or(.�porUons � Commercial � of the work,and the structure is not Intended a ottered lor sale(Seclion 7044,Business and Profession.c Coda:The � � Conhactnrs'State License Law dces not a I to an owner of r e vfio,throu em I m Z PP Y p W�1Y gh p oyees'or persmal effort,builds w or imprwes the property,prmidetl Nat the Imprwements are not intendetl or offeretl for sale.If however,the building or � Improvement Is sold within one year of compteUon,the Owner-Builder will have the 6urden of proving that tt was rrot buUt pm Imprmed tm the purpose of sale.J. U � (..)�,as owner ol the propertg am exdusively conVacting wilh Iicensed Contractors to construct Ne proJect(Section 0 7044,Business a�M Prolesstons Code:The CoMractors'State License Law dces rwt appry to an owner o1 property wtro Valuation: Adj.Area: Z buildsorimprovesmereon,andwhocontrxtstortheprojeciswimaiicensedContractapursuantrotheContrxrors'State QUANTITY DESCRIPTION FEE � ucense LawJ. � I :s L R iLt��%itZC�JG �aZ✓ I o (�I am�empt from Iice�uura under the ConVactw's State License law tor the fWlowing reasoMs): � ' �' � !M��-� O o�-8"� /V `—`' By my signahue below I acWmwledge ttiat,except for my personat residence in which I must have reslded lor at least me � o year prbr to completlon of t�e imprwemenCs covered by Nis permit,l cannot legally sell a strucwre that I have built as an w � � � owner-bullder If it has not been cauWcted in its rntirery by licensed contractors.l undersfaml that a copy of the applicable � law,Sectbn 7044 of ihe Business and Professions Code is available upon request when this app6qtion is submttted ar at � Ne fdlmving Web site:httpAwfw.leginta.p.gov/Calaw.hhnl. � z o DATE: SIGN: g r IJCENSED CONTRACTOH�S DECLARATION � wI her a' eby affirm under penalty of perjury ihat 1 am licensed under provisions ot Chapter 9(cammencing wAh SeCtion 7000) � ol DMsion 3 01 the Business and Protessions Code,and my Ilcerrse is in full brce and etfect. J N� f � LICENS�E pCLASS: �'�4 LIC.NO.: �I�'�'B.l a oZ DATE:¢L �.�� CONTRACTOR: �C_ G_LPGT�12f.,j' �2�' /fii) 1fJl'. � ¢ WORKEp'S COMPENSATION�ECUlflATION g � I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FIX.LOWING DEqNWT10NS: o I have and will maintaln e Cert�cate ol Consent to Self-Insure for Worker's Compensation,as providetl hy CONSTRUCTION: SecOon 37�ol the Laba Code,tar the pertormance af the wak iw wh�h this permtt is issued. p�qN REVIEW: � I have and will maintain WorkePs Compensatfon Insurance,as re0uired by Secfion 3700 af the Labor Code,tor J p� Z the peAamance ol the work tor which this permit Is iuued.My Worker's Compensation liuurance Carrier antl ELECTRIC: ��V a PoIi�yNumberare: PLUMBING: � �R�� sr�-�- ��,�� POIJCv NUMBER �G/L.��l� ._ J � /G� MECHANICAL: INSPECTION FEE: � (f1�OSS[CfIONNffDNOTBECAMPLEfEDIF1}1EPERMITI$FQRONEMNJDREDDOLLARS�4,10(nORLESSJ. ISSUANCE: Jr oI cerlify ihat in the pertorm�nce ot the wark ta which�his permit is issueq i shall no�empoy arry perswi in arry mynn¢r so as ro SM IP: p become subject to the Workerh Compensatlon Laws o1 Calilornia.Md agree tliat if I st�aAU Uecome sibject to the Wwke�s � comver�sauon aw�i«�s a secson s�oo m u�e iano�code.i snau imr�m�comPN wan�nose a�o�s�ons. EN ERGY P/C: LL DATE_o�71%:�¢/!¢APPLICANT; Bf Fl2c.�Wi=i f"g��t�.�y �,�J�^. ENERGY PERMIT: � WARNING:IalNre to secure Workers CompensaUon crne2ge ts uNawlul,and shall subJect an employer to criminal ��m/� w penattles and cWil tines up to we hundred ttwusand dollars(5100,000),in addition to the cost of the compensation, REfENTION FEE: `i o damages as providea tw in sectron 3708 of ine iabor code,interest,and anomey's tees. PRE-ALT FEE: a CONSTRUCTION LENDING AGENCY BSAF: � I hereby affirm under penalry of per�ury that there is a ConsVuction lending Agen�y for Ihe perlormance ot the vrork fm � which ihis permit is issued(Sec.3097,Civ.C.�. � LENDFR'S NAME ` � LENDEA'SADORESS: ,J' � �I a I certify Nat I have read this applicatian and state that ihe above informatlon Is correct I aqree to compry with all city and TOTAL FEES Z counry adinances and state laws relatlng ro building construcfion,and hereby authorize representatives of this caunty ro COMMENTS: o enter upon ihe above-mentioned properry far inspecibn purposes. _ �?s�'�i`� C�-!�/� a PERMfTTEE � � �1�� ' �l/�4/ �� SIGNATURE OF PFA�AfTTEE DATE �— RECEIPT q��_ PAID BY: �-A P� VALIDATION:�_ WHITE—Department Copy,YELLOW—Fnance Copy,PINK—Assessor Copy,GOLDENROD—Fle Copy,GREEN—Applicant's Copy CITY OF DIAtVIOND� �AFi INSPECTION RECORD • � . a - s � � • - SETBAGK/LETTER, ' '� ` ' � �: TRACTAND LEDGER � x, - r _'r. FOOTINGSFORMS, .�" ,�-.:: ' = ti::'•.; SWITCHGEAR S�qg.:: �;;� _ - COMMERCIAL HOOD UG.P.,LUMBING.'� � `� ` �= �`� '- T-BAR � :�;� �,f a UG.ELECTRICAL+',�x_ � s;1'�� .,,'�,`� �"!`? �� _�` INTERCEPTER UFER;GRDUND ."�s� �� ,��:�� ..' �Y' �,,�� '; '� HOT MOPISHOWERPAN � � . . . .. ... __ .. . SEWER LATERAI SEPT�C/CESSPOOL MAIN WATER LINE HERS REPORT RECEIVED SEWER CLEANOUT DEMOLITION ROOF SHEATHING ROOF DRAINS FLOOR SHEATHING ROUGH CONDUIT SHEAR WALLS'EXTERIOR�_ ` POOL/SPA V;� '. ' SHEARVdALLS=INTERIOR ;-- ' _.. _��' .�.c - - ROUGH PLUMB�NG,..; ' _ { '� '�' FRAMWGNENTING � '� - - ' ROUGH;ELECTRICAL�: ' � �': - �, r- �� ' '' � � ' "c, ROUGH MECHANICAL ; ' �;� , �{ ;�'` F � - � ROUGH MEGFIANICAI�� ," + t :� "'� '� �; '' � �ROUC,H.ELECTRfGAL Wf�r-J�� ) -� � ,�. _ '' �" � �` '� GASTEST�� ,�' c �r '�-=�t � �:� s �u t' �` ROUGH PLUMBING S PRE GUN(TE, _ ' �'� ` ''� '�' _-� � �� ,..: '` �' , K ,�, INSULATION WALL POOC.BRE�DECK BONDING `�:�` _ ,� `�; ' , :' INSULATION CEILING P`T�P �� ` DRYWALL FENCE hGATEJ ALARM ' ` ` � r � .i,� ,2 7 k LATH(PRE) FINAL POOL` .�.��.- ��; ,��; ,� . LATH EXTERIOR WALLS: LATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL 1�T( )2ND( )LIFT SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELEASE � WALL ORAIN/SEAL GAS METER RELEASE WALL FINAL SPECIALINSPECTION RO�R�AMINGPl1WMNGAPPROVAL t' � � � '�� - ROUGH PIREAPP.ROVAL � '�'' � ' ` FINAC BUILDING � - _ ,: ,' ; . FINAL MECHANICAL .° ' " 4. �", ' FINAL FIRE DEPARTMENT "' , y F �r '�- z - FINAL PLANNING�%� �, � � { ' ��> FINAL ELECTRICAL , � . . - � ` FINAL'�PL'UMBING �� t' r, '_ �.`�� _ FINAL ENGINEERING/PW>� r'� � �' * � � '' ,^s" LC.�ofOCCUPANCY ' '� ` _ __- FINAL�COMMUNItY'SERYfGES ,.� �' � + �`._ = ' ° CERT:uf OCCUPANCII. ; `` - —.-,_�� , • FINAL HEALTH DEPT ,�� .., •.' _ .. _ . .;. ... - ;,. � �.,. . .. � _ . . .,. � , � tl ,:, r ;FINALJPIDUSTRIAL WASTE " �'�� ' -_ . = � _. ��- COMMENTS: