HomeMy WebLinkAbout14-3662 — '�'�_ CITY OF DIAMOND BAR
._ _.._; ,
� � _ � � � DEPARTMENT OF COMMUNITY&DGVELOPMCNT SERVICES
i ` 2181U Copley Drivc,Diamond Bar,CA 91765
������`�� PRESS
,,,,�� (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 F�RMLY
`�`�"'� BUILDING PERMIT APPLICAT[ON
�
� � APPLICATION DATE: P/C#
w JOB SITE ADDRESS � "a �
z APN �OT TRACT ISSUE DATE: � PERMIT#��'` �� �'
0
o OWNER h� �.� TYPE CONST. OCC GROUP:
� ADDRESS 2 0
—' CITY ZIP ��, ZONING SETBACKS
oAPPLICANT LrN'1`i TEL. �n.�"' O'(��� REART RW p
I ¢ CONTRACTOR �� SIDE/SIDE STREET RW ❑
o SIDE ❑
� ADDRESS ��b r r PROPOSED USE
o CITY��1�(�(��� ZIP EL. � Z, J
o ARCH/ENG/DESIGNEF
w
a ADDRESS
tl DWEL.UNITS #STORIES #BEDROOMS
a CITY ZIP TEL.
� ownen-emio�oecuwanoN
DESCRIPTION SO.Ff. FACTOR PSF ADJ.AREANALUATION
o I bereby attirm under penatly of perjury that I am exempt hom the Contractor's State License Law for the reason(s) SFR/ADD/REM
p fntlicated belaw by ihe checkmark(s�,I have placed next to the aDD��ble item(s)�SecUon 7031.5,Buslness end GaragPJCarport
o Professiom Code:My city m county Nat requires a permit to consUuct,alter,improve,demolish,a repalr,airy
z structure,prior to ils Issuance,also requlres ihe applirant for the permit to file a sigired sfatement that he or she y Patb/Deck
NIs licensed pursuant to the provisions ot the CaMractor's State Liceme Law(Chapter 9)Commencing with Seclion w
� 7000 of Division 3 of the Business and Prolesslons Code]or that he or she is exempt hom liCensure and the basis fw LL Pool/Spa
N the alleged exemption.My vrolation ol Section 7031.5 by any aDD���1 ta a pertnit sub�ects the aDDlkant to a civil�nalry C7
N of not more than five huntlred dollars(55D0). Z Re-Roof
o (J I,as owner of Me property,a my employees with wages as their sole compensation,wfll tlo(_J all oi or(J poNons � Commercial
� ot ihe work,and Ne struclure Is not Intendetl or olfered for sale(Seciion 7044,Business and Professions Code:The �
Contractors'State Llcense Law does nat a ro an avmer of r m
Ppty p aperty who,through employees'or persanai ettort,builds
w w improves Uie properry,provided ttiat the Imprmements are not intended or ottered for sale.II however,the building or
� Improvement is sold wfthin one year of compleUon,ihe Owner-Bullder will have ihe burden of proving ihat It was irot built
p a improred for the purpose of sale.).
U I,8$OWfICf O(�h0
r (� property,am ezcluslvety contracting with Ilcensed Cantractors to consiruct the proJect(Section
0 7044,Business and Professions Code:The Contradws'Sble License Law does nat appty to an ovmer of property who ValuatiOn: Adj.Ar'ea:
� builds a improves Ihereon,snd who contracts(or ihe proJecis wilh a�Icensetl Contractor pursuanl to the Contractors'Shate QUANTITY DESCRIPTION FEE
Y License Law.).
o (�I am exempt trom licensure untler the ConNactor's State Ucense law lor the Iollowing reasron(s): � '
� � s'1 Ll
BY my signature below 12clmawledge that,except tor my personal residence In which I must have resided for at least one �
o year prior to comptetion of the improvements covered by ttiis permit,l cannot lepalty sell a strucNre that I have built as an �
w
�- owner-bullder if it has rwt been conslructed in Its ent'uety by licertsed con6actors.I understand fhat a co{ry of Me appliqble �
� law,Sectbn 7044 of the Business and%ofesslons Code Is available upon request when this appliratlon is submittetl a at
a ihe following Web slte:httpAvvnv.leginfo.ca.gov/calaw.htrnl. _
x
"-� DATE: SIGN: m
O �
~ LICENSED CONTNACTOH'S DECLARATION �
� J
wI he2by aftirm untler pena of p p ( � � �
1ty perjury ihal I am IicenseA under rovisiwis ot Cha ter 9 wmmenci w{th Section 7000
� ol DiWsion 3 01 the Business and Professions Code,a�my license is in full farce aM ettect.
� ucerase � � �c.No �I 6�(a�'"� � ,
�Z DATE:�����I CONTRACTOR: f9 ^C�j CC� Q �
¢ WORI(EN'S COMPENSATION DECIAHATION �
� I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING OECUIRATIONS:
o I have and will malntain a Certrfinle ot Consent to Sett-Insure tar Worlcer's Compensatlon,as prov{ded by CONSTRUCTION:
� Secllon 3700 0l ihe Labw Code,for ihe pertormance ol ihe work for whirh ihis permit is issued. p�qN REVIEW:
> �I have and will maintain Worker's Compensation Insurance,as repuiretl hy Section 3700 of the Labor Code,lor
Z the pertormance of Vie work far which this permit(s issued,My Worker's Compensatlon liuurance Carrier and ELECTRIC:
¢ PolicyNumberare: PLUMBING:
� cnnRiEn S'�'cs.'r '�u v`�.
�'-' a MECHANICAL:
� POLICY NUMBER �1 �'I
� � INSPECTION FEE:
(THIS SECIION NFED NOT BE COMPLEfEp IFTHE PERA7R IS FOR ONE HUNDRED DOLWiS($10(q OR LESS). ISSUANCE:
o �certi(y tliat in th ormance ol the xork lor whkli ihis pertnit Is issued,I sh�V rot employ arry person in any manner so as to � `�
o becortie subject to e Worker`s Comperuation taws of Calllomia.Mtl agree Ihat il I slroWd becotne suaect�u tlte Wpker's SM IP:
� Com Iion oiSectimi3700oftheLabw e,Ishall1or11iv+itlicmnDlyNn�Lprovisiars. ENERGY P/C:
tim ,A
LL DATE: ' E'IAPPLICANT: /v\ �y�,\ (
TF� ENERGY PERMIT:
� WARNING: ilure ro secure Nbrkers Campensation cwerage is uNawful,and shall sWject an empbyer ro crimfnal �C,.�`
w penatties and chnl flnes up to one hundred ttrousand dollars($to0,OD0),in atlditlo�to ihe cost ot the campensation, RETENTION FEE: _t/
o damages as provided for in section 3708 ot the labor code,interest,and atlomey's fees. PRE-ALT FEE:
a CONSTRUCTIONLENDINGAGENCY BSAF: � � / ��
� I hereDy aKrm under penalty of per�ury ihat there is a Cortstruction Lending Agenq lor t�e peAormance of the work frn
� which this permit Is fssuetl(Sec.3097,Gv.C.). �
� LENDER'S NAME
� LENDER'SADDRESS:
a I certify that I have read this appllption a�state ihal ihe above IntormaUon is cortect I agree N wmpty with all city and TOTAL FEES ���O
z counry wdinances and sfate laws relating to building construc6on,and hereby authorize representatives of this counTy to COMMENTS:
p enter upon the abave-mentioned property for i spection purpases.
J
� `t�^Q,l..! r
m
¢ PERMfTTEE f
�
�
� F PERMfTTFE �ATE RECEIPT N PAID BY: VALIDATION:
WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessw Copy.GOLDENROD—Fle Copy,GREEN—ApplicanYs Copy
CITY OF DIAMOi�iD Be4R
INSPECTION RECORD
. � � . • - • � � � • -
�SETBAGKI,LET�TER ,:� ,.,. . � �:' } —. _ ��.a TRACTANDLEDGER
FOOTiNGS FORMS, _ - � � _ ,x'``:,, , r;-`�, . . . ,j-�`=' SWITCN GEAR
S�B' ,- , ?�:' ���,� COMMERCIAL H000
UG.PLUMBING " ` „ ��` � �" ��-��, ' ��- T-BAR
UG.ELECTRICAL , " 4�� �,.''` y INTERCEPTER
UFER GROUND a:. ". ° � "� '��"- � ` ' �i �' HOT MOP/SHOWERPAN
SEWER LATERAL SEPTIC/CESSPOOL
MAIN WATER UNE HERS REPORT RECEIVED
SEWER CLEANOUT DEMOLITION
fl00F SHEATHING RQOF DRAINS
FLOOR SHEATHING ROUGH CONDUIT
SHEAR��WALLS,EXTERIDRs � � �a POOUSPA;- � � ' " �' �� �' ��
� �
SHE,4R WALLS:�INT'ERIOFt�,� ,� �`-, '� '-�,_." " � �_ ` -'" �RDUGH PL'U�tI61NG . ` r � , � '�� "' '^ �
�FRAMINGNENTING t; � } : v ��' x � }°;'`� `Y � � - 1 RqUGH ELECTRICAL�` ' } - 'S '�_ ,
ROUGIi ME�IiQNICAL, :�jz x'"t � ` _ � �` ���,.: ,c,, ROUGIi.h/IECHANICAL' � r r � ` t#}� � rr�*�1 y
ROUGH E'LECTRICAL W(;-)C,(�•) :�� " °�# ` ' GASTEST ' ;` '� Y � . � • >_: *T ' �_
ROUGH fLUMBING � � :'' ''r �tiw%x, PRE GUNITE ,, > , ; z :`' - :� � '
INSULATION WALL POOL PRE DECK BONDING :�- �+ � � � '�'`y k � x �`�Y r'
�,'t� �,�"- :: �' • �,� � " �� � ��'� `'`�
INSULATION CEILING F=TRAPu ';; n. _ - <
DRYWALL FENCE!'GATE/ALARM ' rx" � � �� �, �: ��
LATH(PR� FI,NAL POOL ;;., � � .�:. - ',� • ._ '`�; -
LATH EXTERIOR WALLS:
LATH INTERIOR WALL FOOTING/STEEL
GAS TEST WALL STEEL 1�T( )2ND( )LIFT
SCRATCH COAT WALL BOND BEAM
ELECTRIC MEfER RELEASE WALL DRAIN/SEAL
GAS METER RELEASE WALL FINAL
SPECIAL INSPECTION ;RO FRAMING PLANMNGAPPROVAL - � ���-�
FINAL'BUILQING , ` � ROUGN fIREAPPROVAL ` ''' t r� ' ;
FINAL MECMANICAL .. . � ' "�' �` � FINAL.FIRE DEPARTMENT ;, ;,r� 7 '�`
FINAL'ELECTRICAL �,h;� x fj � ,� ' � k , T ;'i� FINALPI:AtdNING ':", r :- ; � " 5 y � t k
FINAL PLUMBING. , ' � FINAL EN6INEERING/PW , k� '" ; k,^'''� , J ' �- "
r'�
T.C.Of OCCUPAtdCY ` .- 'F ; F-INAL COMMUNITY'SERVICES `' r "
, �
CERT:of=OCCU�ANC11 �.� ' ,.�� "� „� � -' � ', �� ,F�, FINAL`HE�ILTH DEPT ,� � � k��, ��
,, F�.���� . _ . �.�:
, . , _ , � ; �
__ _ , . �.:, �
FINAL INDUSTRIAL-WASTE=;' - '
COMMENTS: