HomeMy WebLinkAbout13-01982 :,.`
CITY Or DIAMOND BAR
� I ,r I i ' � DEPARTiV1ENT OF COMMUNITY&DEVELONMENT SERVICES ,
��p,i� ,.*_� ` 21810 Coplcy Drivc,Diamond t3ar,cA 9»�s PRESS
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" •,:� (909)839-7020 Fax:(909)561-3117 Building Inspection Hotline(909)839-7027 FIRMLY
\�''�ri'' BUILDING PERM1T APPLICAT[ON
� APPLICATION DATE: P/C#T� �" D��i g Z �
� JOB SITE ADDRESS �� ' LN �
u�J ISSUE DATE:_� � l PERMIT# I �=�I�Q�Z'
z APN -OIU'(1 �OT--y�---TRACT �
o O W N E R 4-� Y ��� TYPE CONST. OCC GROUP:
N ADDF�ESS � ZONING SEfBACKS
N GT`f 0'J ZIP J TEL. ' d � 7 ' ro FRONT RW ❑
a APPLICANT TEL. � ��' � REAR �
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o SIDEISIDE STREET RW � --
Y CONTRAC70R � \�V +-� S� � SIDE �
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� ADDR S � � PROPOSED USE � ` _ /
¢ CITY i ZIP � TEL. — K/
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" ARCH/ENG/DESIGNER
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o ADDRESS #DWEL.UNITS #STORIES k BEDROOMS
Q CIIY ZIP TEL. DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
� owi+m-auao�+oscw+nnox
� I hereby amrm urMer penatty ol perjury that I am exempt hom Me Contractor's State Ucense Law for the reason(s) SFR/ADD/REM
� IrMicate0 below by the checkmark s,I have placed next to the aDD��ble ilem�s)(Section 7031.5,Buslness anA
o () Garage/Carpwt
w Professioas Code:My aty or county that requires a permit ta wnstrucl,alter,Improve,demolish,or repafr,any
z strucWre,D�or lo its lssuance,also requires the appltcant for Ihe permit to file a signed statement that he or sAe � Patio/Deck
� is Ifcensed Dursuant to the Drovislons ol the Contraclor's State lJcense Law(Chapter 9)Commenctng with Section W
� 7q10 of Divislon 3 of the 8usiness and Professfons Code]or ihat he or she is exempt hom Iicensure and ihe basis for � Pool/Spa
� the alleged exemDh���Y�rolation of Section 7031.5 by any appUcant for a permit subjecis ihe aDDlir,ant tn a clvil penatty Z Ra-Roof
� ot rwt rtwre than five huntlred tlollars�3500).
O
, o (�I,as owner of the property.or my empbyees wIU wages as thelr sale compensadon,will do(�all of or(J portions � Commercial
� of ihe work,arM the struclure is not Intended a offered for sale(Sectbn 7044,Business and Professbns Code:The m
� Contractors'Stato Licertse Law does rrot appry ro an avmer of property wfw,through employees'or Oersonal effort,builds
�w a imprmos ihe property,provided tha�ihe Imprrnements are no�intended w ottered tor sale.It however,tlie building or
� g Impmvement Is sold withln one year of complefion,Ne Owner-Bulltler will havo the burden af proving Ihat it was not bullt
� or improved for I�e purpose o�sale.).
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� O1,as owner ot Ihe property,am exGusively conVacting w4th Iicense0 Contractors tn tonstrucl the project(Section
o �pq4,Business and Professions Cale:The Controdors'Stale License Law dnes no�appty to an awner of properry wtro VaJuation: � Adj.Area:
z �uilAswimD«esNereon,andwhocontracts(ortheproJecl5w11he11censetlContraclorpursuanttotlieContractors'State OUANTITY DESCRIPTION FEE
N �
Y ucense Law.). �S(" .
o (,J I am exempt hom ticensure under tbe Contracinr's Stale Llce�e law tor Ihe following reason(5): .t�
� � v r
LL By my signaNre Defow I acknowledge mal,excep[lor my personal residence In which I must have resided for at least one � i' C..�
Z year prior to completlon of ihe Improvements cmered by Uiis pertnit,l pnnot legalty sell a sWcture that I have built as an W
0
Q owner-builtler il It has rrot been wnstructed in Its entirely by licensetl contractors.I undersfarM tliat a copy ot the aDPlicable
� law,Section 704d of the Business and Professions Code is available upon request when this apDliplion is submitled or at
� fhe following WeD site:httplwww.leginfo.ca.govlplaw.hhnl. z
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DATE: SIGN: �
f�-- LICENSED CONTRACTOR'S DECIARATION �
U
w i hereby attirm untler penaity ot perjury ihal 1 am Iker�ed untler provisions oi Ghapter 9 tcommencing with Seclion 7000)
� ot Divlsion 3 ot ihe Business and Professions Code,and my Ifcense is in(WI force and effecL �
� � 4u • � .
� UCENSE CLASS: �� uC.NO.: ������ a .
oZ DATE^7 � /� CONTRACTOR: U � ^� ��� '"'4- �
¢ WORI(EN'S COMPENSATION�ECLARATION �
� I HEREBY AFFIRM UNDER PENALTY OF PEfUURY ONE OF THE FOLLOWING DECIARATIONS: ��p b�
¢ I have and will mainlain a Certiflcete o1 Consent to Setl-Insure�or Worker's Compensation,as pmvidetl by CONS7RUCTION: � �
� Seclian 3700 of lhe Labor Code,for Ihe pertormance of the wark for which ihis permit Is issued. Q(n . �
� PLAN REVIEW:
� I have aiM will maintain waker's Compensation Insurance,as required 6y Sec6on 3700 of the Labor Code,for ELECTRIC: 5� • ��
o the peAorma�e of lhe work ta which this permit fs Issued.My Warker's Campensa8w��nsurance Camer antl • .
a Policy Number PLUMBING: � •
o �q�� ���L, "� „�r�N�'L MECHANICAL:
� POLICY NUMBER '�b � n�o'��""��""I I I INSPECTION FEE:
N (T}OS SECf10N NFf11 NOT BE COMPI.ETED IFTHE PEFVv1lT IS WR ONE HUNDRED DOLLM51$100)OR LESS). ISSUANCE: �� �
oI ceAify thal in tho Periormance ot the work ta vrtv�h Ihis P�it's issued,I stv�ll nol empby any persa�in anY manner so as la Ll , �Q
becwne subject to t�e WorkerS Compensation Laws ot ' ia,Md epree Ihst if I ma.�u_bjecl to the Waker's SMIP:
� Comce yy rwi' ot section 3700 ot 1he st with ltmse provisia�s. ENERGY PlC:
� DA7E�C�����APPLICANT: ENERGI'PERMIT: �1
� WARNINfi Failu to secure Workers Compensa4on coverage fs uNawful,and shall subject an employer to criminal RETENTION FEE: 0��
� penaAles and ch�l lines up to one hundred Nousand dolWrs($1�,000),in addiGon to the cost o1 the compensatlon,
w PRE-ALT FEE:
a tlamages as provided for In sectlon 3706 of ihe labor code,interest,end attomeys fees.
0
� CONSTRUCTION LENDING AGENCY BSAF: " ��
a
w I hereby alfirm under penalry oi perjury Nat there is a Coiuutruclion Lending Agem.y lar the peAormance of the work Iw
= which tNs permit is issued(Sec.3097,Civ.C.).
� LENDER'S NAME
� LENDER'SADORESS: �
a I certity that 1 have read this aDD�iption and state ttiat the aWve infortnatlon is cortecL I agree[o wmply wiN ell ciry and TOTAL FEES ��.�
� county oroinances and state�aws relating ro bulltling conswctlon,and hereby aumonze represenratives of mis county ro COMMENTS:
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9 enier upon the aDove-menfwned property for inspection purposes.
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= TU OF PERfutITTEE DA RECEIPT N\�T`S a PAID 8Y: 5 S��VALIORTION:
�
WHITE—Departmern Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—Fle Copy,GREEN—ApplicanYs Copy
CITY OF DIAMOND �AR j
INSPECTION FiECORD
• � , ' e ' ° ' ' � �
SETBACK/LETTER - - . TRACT AND LEDGER
FOOTINGS FORMS �• �`_°�''� - � SWITCH GEAR
SLAB
� �; - �ti � , ��+`• COMMERCIAL HOOD
`UG:PLUMBING°: � �� �_ T-BAR
UG:ECECTRICAL INTERCEPTER
UFER GRDUND "T .:ti.� � '_ HOT MOP/SHOWERPAN
SEWER LATERAL SEPTIC/CESSPOOL
MAIN WATER LINE HERS REPORT RECENED
SEWER CLEANOUT DEMOLITIaN �
ROOF SHEATHING ROOF DRAINS
FLOOR SHEATHING ROUGH CONDUIT
SHEAR�WALLS�EXTERIOR��_ _� _ � - � � ��� � ��'OOWSPA'� � � � - �`' ' _ `� �° �
j ROUGH PLUMBIN6 " �� �, ���• � f-
5HEAR WALLS INTERIOA, � ' � F - `� ' �
` ROUGHELECTRICAL� ` � rari ti , i"
FRAMING.NENTING - , - �
ROUGH�MECHANICAL _ �, - �:, :` '� ROUGH�MECHANICAL F � ` � £f' =�� �'
ROUGH ELECTRICAL W('_)C(, ) -- . ` '� ` _ - {,, i' ?
,
�� - � L�� � � °GA�TEST�a �
r�5; ;:
ROUGH PWMBING � u':�. .*, - � �'• - P,RE_GUNITE+ , ,; � �
INSULATION WALL ,POOL PRE'DECK BONDING �.�- ,�,-`� -�`��� �' � .' _ ���'" ��,
INSULATION CEIUNG p'=_T�p ,,_ _ x , s- �. =
DRYVJALL FENCE/G9TEl AtARM �' "� �;� �' ��
_ y _^ r :n { � �:;c -� _
LATH(PRE) FINAL POOC. - � ��F - - �',t:
LATH EXTERIOR WALLS:
LATH INTERIOR WALI.FOOTING/STEEL
GAS TEST WALL STEEL 1sr� �pNo� ����
SCRATCH COAT WALL BOND BFAM
ELECTRIC METER RELEASE WALL DRAIN/SEAL
GAS METER RELEASE WALL FINAL :
SPECIALINSPECTION �RO.FRt1MINGPL�WNIfVGAPP,ROVAL '= - � �' "�'f'=�A' `'' f "�
FINAL BUILDING `' i - ' ' ROUGH FIRE APPROUAL < �`` ' ._r � I`
�� �FINAL.FIRE OEPARTMENT ' - � � '��� ��� �
FINAL MEGHANICAL , - � �` � , , r .�, _ �� , , a��
FINAL ELECTRICAL . � �,� �- "�'�� � `EINAL PLANNING :':. � � �
FINAL�.PLUMBING ' '�"� s" �'� ��FINAL�ENGINEERI_NGl PW �; ``` ". ,;[ t ` `� � r � `` �
T:C:of OCGUPANCY- ; - � :, - '- -< • F ; > ., ; r
� ,: � , � . INAL COMMUNITY;SERVICES �
CERT of OCCUPANCX,...� - � � �FINAL HEALTN DEPT : � '. � >"
� .�;�. , "�. . � ,_.,. z� _- � � '
�FINAL 1NDU5TRIAC WA5TE'; ' �;�_. N `` -'��` � � � '� "
R � F� . �
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COMMENTS: ' � �
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