HomeMy WebLinkAbout14-4147 (8) :�:''�_ CITY OF DIAMOND BAR " "
� � � DEPARTMENT OF COMMUNITY&DEVELOPMCNT SERVICES
� �lIII �;�- 21810 Coplcy Drivc,Diamond Bar,CA 91765 PRESS
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u,,,,,� (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 FIRMLY
���'�"'��� � BUILDINGPERMITAPPLICATION
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� p� � �� APPLICATION DATE: � �� P/Ctt
� JOB SITE ADDRESS 5�'��(�' a�77 � 'f7 �
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z APN LOT TRACT ISSUE DATE: L'— I� �t�D f / PERMIT# `�^�` ��7
oOWNER RN TYPE CONST. OCC GROUP:
� ADDRESS � �
� CITY � , ZIP TEL. ZONING F ONTCKS RW ❑
d APPLICANT� � TEL. ? � O^ � REAR
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a CONTRACTOR SIDE/SIDE STREEf RW ❑
o SIDE ❑
� ADDRESS PROPOSED USE � �7/� �Q /�G1
� CITY ZIP TEL. •
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o ARCH/ENG/DESIGNER
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o ADDRESS
ti DWEL.UNITS #STORIES #BEDROOMS
z CITY ZIP TEL.
� DESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION
OWNER-BUILDFA DECLAflAT10N
o I herehy aflirm under penalty ot perjury tha�I am exempt hom ihe Contractor's State License Law fw the reason(s) SFFUADD/REM
p fntlicatetl helow by the checkmark(s),I have placed ne#to the aDW�ble item(s)[Seclion 7031.5,Buslness and GarageJCarport
o Professions Code:Any city m county that requires a permit to construct,aller,improve,demolish,w reDair,any
z struclure,prior to fts issuance,also requires ihe applicant lor ihe permit to file a sfgned stalement that he or she � Patio/Deck
� is licensed pursuant to the provislons of the Cantractors Sfate License Law(Chapter 9)Commencing w(ih Sectlon w
� 7000 of DWlsion 3 of the Business antl Prafesslons Code]or that he or she is exempt hom Ilcensure and the basis for � PooVSpa
� N Me alleged exemption.My vidatbn of Section 7031.5 by any applicant fw a permit subjects Ne apDlicant ro a civil per�atty C7
N o�not mae�han five hundred dollars(5500). Z Re-Roof
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o (,I,as owner oi Ne property,or my employees wlth wages az thelr sole compensation,will tlo(�all of or(�portions � Commercial
, � ot the work,and ihfl strucNro Is not Intended a ottered for sale(Section 7044,Business and Proles5bns Code:The �
. � Contractnrs'State License Law does not a m
�ly to an owner al property vAio,ihraugh employees'or personal effort,huilds
w or imprmes the property,pmvided that ihe improvemenis are not intended or offered tor sale.II however,ihe building or
� improvement Is sold within one year ol completlon,Ne Owner-Builtler will have the burden of proving tt�at it was irot bultt
pa imprwed for the purpose of sale.�.
U
� (�I,es owner of the pmper[y,am exclusivety contracGng with Ilcensed ConVactors lo construct Ne proJecl(Sectbn
0 7044,Business and Professi0ns Code:The Coniractors'Slate License law does rwt appty to an awner W property w�o ValUation: Adj.Afea:
z builtls a improves Nereon,and who conhacts for ihe projecls wilh a licensed Contracta Dursuant to the Contractors'Stale QUANTIIY DESCRIPTI ON FEE
�
Y License Law.).
o U I am exempt hom licensure under ihe Coniractor's State License law for the tollowing reason(s): �
� ¢
''i By my signature below I acknowledge that,except tor my personal reside�e in which I must have resided for at least one �
o year prWr to comptetlon of the improvemenLs covered by this permit,l canrrot legalty sell a structure that 1 have buill as an w
Q owner-bull0er if it has not been constructed in its entirery by Iicensed contractors.I undersFand ttia[a copy of ihe apDlicable
� law,Section 7044 0l the 8usiness and Professions Code is availabi n request whe�this application is submitled w at
X mn roirov,�ny w s : Ieglnta.ca. v/calaw. _
o DATE � SIGN:� �
� LICENSED CONTAACTOH'S UECLARATION �
a
w I hereby aKrm under penalty oi perjury that I am lice�ed under provisioris oi Chapter 9(commencing wlth Section 7000)
� of Division 3 of ihe Business and Protessions Code,and my Ilcense is in full force and eflect.
�
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� UCENSE CLASS: LIC.NO.: a
z DATE: CONTfiACTOR: �
Q WORNER'S COMPENSATION DECLAqATION g
� I HEREBY AFFIRM UNOER PENALTY OF PERJURY ONE Of THE FOLLOWING DECLARATIONS:
o I have and will maintain a Cert�cate of Consent to Sett-Insure fm Worker's Compensation,as provided by CONSTRUCTION:
� Sectlon 3700 ot the Labw Code,far Ihe pertormance ot the work tor which this permft is issued. p�qN REVIEW:
� I have and will mainfain Worker's Comoensation Insurance,as requiretl 6y Section 3700 0l the Labor Code,tw �- O
Z the peAormance of the work for which this permit Is issued.My Worker's Compensatlon Insura�e Carrier and ELECTRIC:
¢ PoIi�yNumberare: PLUMBING:
� ��� MECHANICAL:
w
� POl1CY NUMBEA
INSPECTION FEE:
� (T}9S SECfION NffD NOT BE COMPLEfE�IFTHE PEAA�tfT IS FpFi ONE HUNDRED DOLLMS($1D0)OR LESS�.
� ISSUANCE: 3.f`\`d""�
o I cerlHy that in the perform�nce of the Hvrk for which Ihis permit is issuetl,I shall rrot employ arry person e�any manner so as to
o becortie subject tn the worker5 Compe�uaGon Laws of Califomia.Md agree lhat II I shadtl become subjecl m the Worker's SMIP:
� Cmnperaa pr ,or Sectiai 37pp m tne Labor o, sha�l�o i�h compry wilh those provisiars. ENERGY P/C:
LL DATE��,���apvuCaKr:X � ��� ENERGY PERMIT:
� WARNING: aiWre to secure Worker's Campen�sdtmn cmerage is uNawtul,and shall subject an employer to criminal D
o� RETENTION FEE:
w penattles and civil fines up to one hundred thousand dollars($100,000),in additlon b the cost of the crompensaUon, — 6�
o damages a;provided tar In sectlon 3706 01 the labor code,Interest,and attomey's tees. PRE-ALT FEE:
d CONSTRUCTION LENDING AGENCY BSAF:
w I hereby affirm under penalty oi per�ury that ihere is a Cor�sUuction Lending Agency ta Ihe perlorn�ance ol Ne work for
= which ihis permit{s issued(Sec.3097,Clv.CJ.
�
r LENDER'S NAME
� LENDER'SADDRESS: — — �7
a I certify Uat I have read this application and state that the above informafion is cortecL I agree to compty with all city and TOTAL FEES
� counry wdinances and state laws relating ro building consvucuon,and hereby author¢e representatives ol mis counry ro COMMENTS:
z
o enter upo�a�tioned�tw inspection purposes.
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a •�,/Rrn�EtaAt�H�
� SIG�NATl1RE0�PERMfrfFE �� �pp /� /� RECEIPTN �11/a'.I�� PAIDBY: � �"VJ VAL.IDATION: �
WHITE—Department Copy,YEILOW—Finence Copy,PINK—Assessor Copy,GOLAENROD—File Copy,GREEN—ApplicanYs Copy
CITY OF DIAt�JiOPVC� �AR
INSPECTION RECORD
s � � • - • s � • '
SEfBQ�K/LETTER � `� { '�` � " `F '� TRACT AND LEDGER
} ;,:
FOO7INGS F,ORMS . .,.;,`_` '� i ^�,;� - ` SWITCH GEAR
S�yg��� _ ; ' ' � :' � r�; '�a���� �'; COMMERCIAL HOOD
�:
UG.PLUMBING�,-: . - `"=- r<�.�. � T-BAR
UG.ELECTRICAL 'f � `< ` ;� ; ' ; '��;�`�'3 INTERCEPTER
UFER�GROUND;���; . ���, < < :'� ' � � `�` ,"�;� HOT MOP/SHOWERPAN
SEWER LATERAL SEPTIC/CESSPOOL
MAIN WATER LINE HERS REPORT RECENED
SEWER CLEANOUT DEMOLITION
ROOF SHEATHING ROOF DRAINS
FLOOR SHEATHING ROUGH CONDUIT ,
� 7�, - ° - ' t'� �
SHEAfiWALLS'EXTERIOR; ' _ ". ROOLlSPA.- '_ - _ �
� �� x v ;, 'ROU,GH�PLUlVIBINGF,= � -: 3 '
SHEAR WALCS INTERIOR;; " �. _ -
FRAMINGNENTING �, ii. _ �' _ .u:' : �r RQUGH ELECTRICAL: ' " '�`` ' -
' � t.� ! K .ti i '
ROUGM MECHANICAL '.'= � � �� � �� ;� � '.� r 7 „� r� ����` ROUGH MEGHEWICAG � � '3 r
ROUGIi ELECTRICAL W(,'.)C( ) L � = �"":f; �''�; GA51TEST''.=� '? `� , -� " � �� � � �
ROUCH PLUMBING x • ^ � � �� � °
_�, ; , � , , REtE GUNITE ,i � � ,
INSULATION WALL POOL`PRE DECK BONDING�_;'� ' �' ``� , � �° ��,r� ` l .� } f _
- INSULATION CEILING P'TRt1P � t�-__°'� � '- '� '� s� � � � `
DRYWALL �FfEJCEI GATE/`AfAAM +� :; � � � '`� : �'�'�,,�'� ,� � �', �� •��
LATH(PR� FI,NAL POOL r,...', , - -1 '" _ � " -
LATH EXTERIOR WALLS:
IATH INTERIOR WALL FOOTING/STEEL
GAS TEST WALL STEEL 15T( )2"0( )LIFf
SCRATCH COAT WALL BOND BEAM
ELECTRIC METER RELEASE 7 % i� WALL DRAIN/SEAL
GAS METER RELEASE WAIL FINAL
SPECIALINSPECTION RO FRAMINGPI�WMNGAPPROVAL = - - ~ � �� -
FINAL BUILQING -'{� ' a -_ '.ROUGH.FIREAPPROVAL ' ' �' r 1 "'
FINAL'MECHANICAL " ���. �� . 5 `� ti r , -` ` , 'FINAL FIRE UEPARTMENT t�� t � -
FINAL ELECIRICAL.-�,''' ,?Fd�'T �'7/I ��`' ',.� F.INAL PLANNING,�'. ,� k .7; h 3 l�
EINAL'PLUMBING ` � ''` � ' ' FINAL ENGINEERING/PW ' �:� r
�-, - ,_
. ,� '
, �� � � � r�, .��. , , . r_;� �, i�� ..
:f 4 �.`� ;FINAL COMMUNIT.Y SERVICES = �a�
� —. � , � ..
�,
,T.C.:of OCCUPANCY :;. . � �. �. ' t,;, �
CERT;�of'OCCUPANCY;;,. ,,, ,�.; ,�;_s;: ,> - . FINALHEALTHDEP,T ; r = "?
FINAL INDUS7RIAL�WASTE�=' ` `r � r , ti ;• '� , ;.
COMMENTS: