HomeMy WebLinkAbout12-882 ^ �� CITY OF DIAMOND BAR ✓
DEPARTMENT OF CONIMUNITY&DEVELOPIVIENT SERVICES �
I 21810 Copley Drive,Diamond Bar,CA 91765
(909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS
��''"', BUILDING PERII�QT APPLICATION FIRMLY
�� JOBSITE �.� S�� D w APFLICATI PERMIT P/C
ADDRESS L DATE �I� � NUMBER ����#_�o`Z^SZ3�
� APN LOT TRACT �S$UE 7yPE �C
DATE CONST.�l7_ GROUP
p OWNER w11�� �dy
o ADDRESS L� t� a w ZONING SETBACKS
z CITY �('A'1"•or� IP�'L(�TEL. 6I� FRONT pyy p .
� APPLICANT ��.r��` �✓jjP�l.icaL TEL.�j '�/,taf`C�ft" REAR p
Q SIDE/SIDE STREET qV�l p
� CONTRACTOR i ye/t.�'-'��- SIDE p
ADDRESS T l " t 1) .
� CITY "l�--c� ZIP�,�(� TEL O 6S�"f� PROPOSED USE � �� l�-� Wt70�
w ARCH/ENG/ � cx �'�'"
z DESIGNER ��=='��
a ADDRESS NO.DWEL. NO. NO.
� CITY ZIP TEL UNITS STORIES BEDROOMS
�
� DESCRIPTION S�.Ff. FACTOR PSF ADJ.AREANALUATION
� �OWNER-BUILDER DECLARATION �
p � SFR/ADD/REM �
0 1 HER�V AFFlRM UN�ER PEtUL7Y.OF PERJURV TUT I AN E%EMVT FROM THE CAMRACTOR9 LL Garage/CarpoA. . . .
W CENSEUWFORTHEFOLLOWWOREASON(SEC.703t.68U5@IESSANDPROFESSIONSCOOE:ANYCfiYOR (n �
C-� COUNNWHICHREOUTAESAPERMITTOOONS7Al1C7,ALTEA,IMPROVE,OEAfOLISH,ORREPNRANYSTRUG PB,��
W TURE.PRIOR TO RS ISSUANCE,AL50 REpU1pES THE APPLICANT FOR SUGi PERA117 TO FILE A SIONED W
� STATEMEM THAT HE OR SHE IS UCENSED PURSUANT TO 7HE PHOVISION$pF 7}�E'COMMCTOR9 ll- , .
� CENSE LAW(qUPTER Y(COMMENpN(i WITH SECT70N 7000)OF DiVI4qN 3 OF THE BUSINE59 AND PRb . �'1' POOVSpB
, � FESSIONSCODE�ORTHATHEORSHEISEJ(EMFTTNEREFROMANDTHE9ASISFORTHEALLEOEDEXEMP• (}
TION.ANYVIOLATIONOFSECTION7071.6BYANYMRICANTFpqAPERMITSUBJEC73THEMPLICANTTO Z Re-Rool
� A CIVIL�EN�LTV OF NOT MORE TI/AN FIVE HUNDRED DOLURS(i60olJ: �.
0 ❑I,ASOWNEROFTHEPROVERTY,ORMYEMPLOYEESIY�7HlVAGESASTMEIRSOLECOMPENSATION, �' � C,pmm0fCI01
Z lNLL DO THE WORK AND 7HE STRUCTUfiE 19 NOT INTENDED.OR OFFERED FOR SALE(SEC.�ioa�.BU57- _J �
� NE55 AND PROFE5510NS CODE:THE CONTRAC7oR3 LICENSE�LAW DOES NOT MPLV 70 AN OWNER OF � � ��
P.ROPEHTY NM1iO BUq.D3 OR IMPROVES THEREON,M1D WHO DOES SUCH WORK HIMSELF OR HERSELF OR �
W THfl(K10HHISORHEROWNEMVLOVEES,PROVIDEDTHATSUCHII,IPROVEMFjJ{gARENOTPlTENDmOR � m - ,
Q oFFERmWR3ALEIF,MON�EYERTHEBULLDINOORIM7ROVEMENT1950lDWITHPIONEYEMOFCOA/FlE- .
z T�ON.7FfE ONTIER�BUILDER WILL HAVE TME BURDEN OF.PROVBd[3 7HAT HE OR SHE DID NOT BUpD OR ,
� IMPROVE FOR THE PURP0.SE OF SALE} ' . . . .
(yJ 04�OWNEROFTHEPROPERTV,AMIXCLUSNELYCONTRACTINOWfTH�ICENSEDCONTRACT00.5
¢ TO CONS7RUCT THE PRO.IECT(SEC.7M�,BUSINE55 AND PROFESSIONS CODE:7HE�CONTRACTOqS�L1- VelUetlOn� � ADJ.AREA� �
W CENSE LAW DOES NO7 APPLV 70AN dNNER OFA PROPERTY WHO BUILDS OR W PROVES THEREON,M1D '
� N7IDCANTfUCTSFORSUpiPROJECTSWfTViACONTRACTOR(S)LICENSEDpUR6UMlf70THECONiRAG ounrmTv � �oEscai�noN
TORS IJCENSE UW.). FEE �
� ❑1 AY E%EMPT UNDER SEC. B.8 P.C.FOR THIS REASON � I ���(�/�� g pi '�,�
� DATE OYMER �
Z U
� LICENSED CONTRACTORS DECLARATION � � - - �
� w
1 HEREBV AFFlRM UNDER?ENALTY OF PERIURV 7HAT IAM�LICENSED IMDER.P1iOVI510N9 Of CHAPTER � �
� D(COMMENCPIO WITH SECTION 7000)OF OMSION J OF THE BUSINESS AND PROFESSIONS CODE,MA Z '
�� MY LICEN9E 19 W FULL FORCE AND EFFEC7. m
� UCENSEC SS C Z� LIC.NO., ` ��� � -� .
V DATE • CONTRACTOR a . _ , .
W
� WOFiKERS'COMPENSATION DECLAR ION � � ��� ' � � � � -
� 1 HERFBV AFFIRIA UNDER PENALTY OF PERNRY ONE OF THE FOLLOW W6 DEQ.AMilONS: V - �
C� � � - . . . . Z . . .
� _�FUVE�AND WILL MNNiAIN A CEfiTIFlCATE OF CONSENT TO SEIF-WSURE FOR WOAKEqS' � �
COMPENSATION,A3 PROVIDm BV SECTION 37000F TFIE LABOR CODF,FOR THE PERf-0RMANCE U'
Q OF THE WORK FOR WHICH THIS PERMIT 19.ISSUED. � � � , . .
w _I HAVE AND WILL MAINTAIN WORKEqS�COMPENSATION WgUMNCE,'Ag pEpUtqED BV SECTION
Q 370o OF�THE LA60F CODE,FOR THE�PERFORMANCE�OF THE WORK FOR WMp/7HIS PERMR IS ��� �y .
ISSUED.MY WORKEcRSA COMPENSATION�NSURANCE CARRIER�AND.POLICY NUMBER ARE: CONSTRUCTION� �••���
jCARRIEH 71��� ��n, PLAN REVIEW .3
� VOLICY NUMBER . ��I O q(�j D . .
7d-. ELECTRIC 7
� fn-�sEcnorrn�IDrqreEoo�FrIDOFn+ev�rswaane�oatu�sK�roloa�ss� PLUMBING '
w
Z 1 CERTIFV THAT W hiE PERFORA/ANCE OF THE WOqK FOfi WHlpllji�g pER/A1T IS ISSUED,I AAECHANICAL �
C7 SHALLNOTEMPLOYANVPERSONMANYMANNERSOASTOBECOME'SU&IECTT07HE� � �
(/� WOAKERS'COMPENSATIONLAWSOiCALIFORNItiANDA(3REE �IF�SViOULDBECOME INSPECTIONFEE� '
SUBJECT TO THE K9HKERS'(bMFENSATqN PROVISIONS OF�SEC ON 3 00 OF THE LABOR '- - �
O i s Forrr�rn cour�r wi OSE PROVISIONS. ISSUANCE
1p onie: 1 \� Z n�icar7i: SMIP �i D
� ENERGY P/C
WARNINQ�FAILUpETOSECUREWORKERS'LOMPENSA COVEMGEISUNUWFUL,AND3HALL8E
�y SU&IECT AN EMPLOYER 70 CRIMMAL PENALTIES AND CIVIL FWES UP 700NE HUNDRED TFK)USANU ENERGY PERMIT
DOIUAS(f100.000),W ADDITION TO THE COST OF COMPENSATION,DANA6ES AS PROVIDED FOR IN -
J SECTION 370!OF 7HE LABOR COOE.W7EREST,ANDATfORNEY'$FEES. � � �
w RETENTION�FEE:
O , CONSTRUCTION�LENDINGAGENCY � �pq _ � �
ALT
� 1 HEREBY AFFlRM UNDER PENALTY OF PERIURY THAT THERE b^ACONSTRUCTION LENDWO AOENCY '/i��J
Z FOR TME PERFORMANCE OF THE WORK FOR WHICi/THIS PERMR IS ISSUEU(SEC:�3077,pV.C.� —h-f--
W '
��. LENDEft5NM1E . . . ._ . . _
� IENDERSAODRE55 '- � -
w I CERTIFY THAT 1 HAVE READ THIS APPLICATIDN AND STATE�THAT TiE ABOVE INFOfU/AT10N 19 ODRRECT. TOTAL FE ES ,�"'� '� 3LYU •�F �
� 1 A6REE 70 COMP�v N7iH ALL CRY AND COUNTY Oqp WiWCES AND STATE UWS PEUTPIO 70 BUILDINO � G
.� CONSTHUCTION,AND HEAEBYAUTFIORIZE REpqESEN7ATNE5 OF 7i/15 COUH7V 70 EMER UPON THE �
z ABOVE-MEMIONEDPROPERTY.FORINSPECTIONPURP0.5ES. COMMENTS �'
� �n1 V �(
m PE I77EE NAME(PRl ' .
a .7 �1 'P e \\b�4 `�4� \
� SIONATURE PERMfTTEE D 7E p M . . . .
� RECPT.NO. (� 1�✓ PAID BY VALIDATION
WHfTE-Depertment Copy,YELLOW—Flnarae Copy.PINK—Assessor Copy.GOLDENROD--FIIe Copy.GREEN—Appltcant'e Copy
CITY OF DIAMOtVD BAR
INSPECTION RECORD
� , � ,_ _ ,�
■ � .. � � ° ��o o � � p � . .{V, :.. o .0 0
SET BACK FLOOR JOIST
FTGS/FORMS/STEEL FHA REQMTS
ELECTRIC GROUND UNDER FlOOR DUCT
GROUND�PLUMBING UNDER FLOOR CONdUIT � '
SLAB GRADE FIREPL'ACE FOUNDATIOId '
TEMP POWER �FIREPLACE BOND BEAM'
WATER SERVICE • �MID HT.BOND BEAM
ROOF SHEATHING � 8 FT.BOND BEAM
FRAMING/VENTILATION FINAL BOND BEAM _____
ROOF COVER PRE-GRADiNG
ROUGH HEATING � BENCHIfdG
ROUGH ELECTRIC �ROUGH GRADING
ROUGH PLUMBING FINISH GRADING
SHOWER/TUBTEST PQOL ELECTRIC
EXT.LATH/SIDING I POOL FENCING
WALL INSUTATION POOL FINAL
CEILING INSULATION OFF SITE IMPS.
DRYWALL NAILItdG I pEDiCATI0N5
SEWER FINAL ENG_
SEPTICTANK • LANDSCAPE/IRRIG.
SEEP PIT/L.L. ON SITE IMPS.
GASAIRTEST � � � • • � FINALZONING
FINAL CONST. FIRE DEPT.FIIdAL
FINAL HEATING HEALTH DEPT.FINAL
FINAL ELECTRIC DEV.FEES PAID
FINAL PLUMBING �ENERGY
FINAL PLANIfdG �
FINAL ENGINEERING ' 0 e '
COMMENTS r '`�
.�"' �' ''�S� d•Z `l��w��
� � �.�� �z ,2c,,z ; -
SEPTICTANK SIZE
SEEP PITIU SIZE
��' � ;' ���'�� Ip � �
" � i i��
,
�