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Home My WebLink About14-5055 ��'"� CITY OF DIAMOND BAR `` �lb�� . € � DEPARTMENT OE'COMMUNITY&DEVELOPMENT SERVICES ' � - G . 21810 Copley Drive,Diamond Bar,CA 91765 PRESS \, p�,,,�y (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 FIRMLY '''�n°' BUILDING PERMIT APPLICATION ' APPLICATION DATE: P/C# i JOB SITE ADDRESS Z � f ��/�_pERMIT# I� �-�1 V�� i ISSUE DATE: � ✓�� = APN LOT TRACT � OWNE^��:y 4�'� TYPE CONST. OCC GROUP: n ADD�SS ZONING SEfBACKS � CITY l�^�aLGb _ZIP TEL. � FRONT RW � APPLICANT TEL. REAR � � SIDE/SIDE STREEf RW � a CONTRACTOR �� C �" � SIDE � � � ADDRESS _ L 1 PROPOSED USE � CITY.�,(�1LI 1V� _ZIP�2L�J_2TEL. \`' i' ARCH/ENG/DESIGNER ��L � z ADDRESS #DWEL.UNITS�_ #S70RIES� #BEDROOMS 0 � CITY ZIP TEL. � DESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREANALUATION � OWNER-BURDEH OECLARATION ` ��y I = SFR/ADD/REM v = I hereby affirtn under penalty of perjury that I am exempt from the Contractor's Shate License Law for the reason(s) I � indicated below by the checkmarlc(s),I have placed ne#to the applicable ttem(s)[Secrion 70.71.5,Buslnass aM Garage/Carport �-' Professiare Code:My city or county tliat requires a pemdt Lo canstrud,atter,Improve,demolish,a reDalr,any � z struc4�re,prlor to fls issuance,also requires tlre aDP��M fir tlre Dermit to flta a signed sFetemerrt that he or she w Patio/Deck i Is Ilce�ed pursuairt to ttie provislo�of the Contractar's State License Law(Chapter 9)Commencing with Sectlon � pooVSpa n 7W0 ot Dlvlsfon 3 of tice Business a�Profassio�Cade]or that he or she fs exempi from Ilcensure and the basis for � the alleged exemption.Any vlolation of Sectlon 7031.5 6y any applicant for a permR subjects the applicant to a civil penalty Z Re-Roof n of nat more than five hundred doliars($500). � U I,as ovmer of the property,or my employees with wages as their sole compensation,will do U�I oi w U portions � Commercial I � af the work,antl the structure Is not ir�tended or ottered fw sale(Secfion 7044,Business and Professions Code:The m I � Contractors'St2te Ucense Law doas not apply to an owner of property vfio,through employees'or personal eNort,build5 L or Imprrnes the pmPerty,provided that the improvements are not Intentled or offered for sale.Ii however,ihe bullding or � I � Improvemerrt is sold wdhin one year bf completion,the Owner-Builder will have the hurden ot proving that ft was not built � or improved for Me purpose of sale.). � '� (]I,as owner af the property,am exclusivety contractlng with Ilcensed Contracrors to cansWct the project(Section � I � 7044,Business and Professions Gode:The Co�actors'State License Law does not apply to an owner of property who Valuation: � Adj.Area: Z buildsorimprovasthereon.andwhocontractsfortheDrojectswlthalicensedContractorpursuanttomeContracrors'State QUANTITY DESCRIPTION FEE n Y lJcense Law.). I � O I am ezempt trom licensure under the Contractor's Shate License!aw Mr the tollowing reason(s): � I � � y V I By my signaiure betow I ackrwvAedge that,except tor my personal residence in which I must have 2sided for at least one w Z year prior to completion of tha improvemer�Ts covered by this permtt,l cannot Iegaliy sell a structure that I have buitt as an w I ovmer-builder If tt has not been constructed In tts entirery by Ifcensed contractors.t understand that a copy of the applicable � law,Section 7044 of the Business and Professlons Code is avallable upon request when this applicatlan Is submitted or at � i the following Web site�httpNiww.leginfo.ca.gwlralaw.htrnl. z I � DATE: SIGN: `� � � � — LICENSED CONTRACTOfl'S DECLARATION � a I � I hereby affirm under penalry of perjury that I arn licensed undar provislons at Chapter 9(commencing with Sectlon 7000) L � of Divislon 3 of tha Buslness and Professlons Code,and my license Is in fu�ll lorce and effect. n � (7� LIC.NO.:�'-"��/ � I ;q LICENSE CLASS' `� 1r�,�� 6 � DATE: CONTRACTOR:.�i�_-_7_�v�� I �d WOHI�H'S COMP@lSATION DECLARATIOH � � � I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLAR4110NS: L � ¢ f have and wiii maiMafn a CertiFlcate oi Consent to Setl-Insure for Worker's Compensation,as prmided by CONSTRUCTION: �,�� Section 3700 of the Labor Code,fa the performance of the work for whlch this pertnd is issued. p Vo,N REVI EW: J � I have and wlll maintaln Worlcer's Compensation Insurance,as required by Section 3700 of the Labor Code,for ELECTRIC: � the pertormance of the worlc for which thls permit is Issued.My Worker's Compensation Insurance Carrier and Zd PoIi�yNumberare: PLUMBING: y �pqq��i,t� - �L�.�(�� MECHAN{CAL: .,Z� POLICY NUMBER U�' ��"'I�IS��S�i''�02_. INSPECTION FEE: � (IHIS SECTION NEED NOT BE COM%.EfED IFTHE PFAMR IS FOR ONE HUNDRFD DOLLARS(310�OR LESSI. ISSUANCE: n � I certify that in the pertortnance of Ne watc tor which this pertntt is'ssued.I shall not emplvy arry persun in any manrrer so as m SMIP: � ,x = becane sub�ect to the Workefs Compensation laws of Califomla And agree that if I should hecane suhject to the Waker's � � y Canpensatlon provrsro ot Section 3700 oF the Labw Code,I shall forthwim compy with m Islonpr� s. ENERGY P/C: � DATE: �• Z' APPLIGUdT:_�_�_ �b E�IS��t- ENERGY PERMIT: n � WARNING Fallura ro cure Worker's Compensatlon cove2ge is unlawlul,and shall subieci an employer to criminal RETENTION FEE: �• d// y penalties and clvll fines up to one hundred ttrousand dWlars($700,000�,In addition to the cost of the compensation, i damages as pmvided for In section 3708 ot tha labor code,Interest,and attomey's fees. PRE-ALT FEE: i CONSTFIUCTION LBJOING AGHICY BSAF: 1' z I hereby atfirm under penalty of perjury that there is a ConsWction Lending Agency for the performance of the work for y � which thls parmit is Issued(Sec.3097,Clv.C). LENDER'S NAME: — = LENDFA'SADDRESS: i I ceNty mat I have read this appiicatian and state that the above Information Is correct.I agree to comply wtlh aIi ciry and TOTAL FEES y?y�� courity ordinances and sfate laws relatlng to building constructlon,and hereby authorize rCpresentatives of this county to COMMENTS: Z eMer upon the abrne-mentloned Droperty iw inspecrion Du�. � � n a PERM E A � " - 2 - ^ n pp� RECEIPT# d�� PAID BY: VALIDATION:��__ = SIGNATUREOF MI WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,60LDENROD—File Copy,GREEN—ApplicanYs Copy ��'�� INSPECTDION RECU DR � � . • - • r + • ' ;SETBAGI</°LETfiER�t• '""�` ��' �� '`�� kW�' .�� TRACTAND LEDGER �FOOTINGS FORMS�' �..�'� . ��'� �� ,� � ��.� � `� SWITCH GEAR � �^ � �a �- � x��= �g�g:��; ��_ �� "" �� - ��` COMMERCIAI HOOD ��,�,. .�� s.,: � ' �� .�; UG.PLUMBING��. ,.�°'� � r_ -� �`,��.� -; � �=�°� � �_� T-BAR `:UG.ELECTRICAL� ��'° .�,��.....,��. .,�� ; � � ��~ �~ E � �� INTERCEPTER � '�- � � "�-� ';,,��'�� HOT MOP/SHOWERPAN � ,t1FEFi�G(�OUND'°� � �;��..� �"��°�_ �. , SEWER LATERAL SEPTIC/CESSPODL MAIN WATER LINE ' HERS REPORT RECEIVED SEWER CLEANOUT DEMOLITION � ROOF SHEATHING � ROOf DRAINS FLOOR SHEATHING G N T ROU H �� _ *�� `` .� P,UUi.lSP�� '��'" . �SHEAR WA�LS�EXTERIOFi� � ,.� �� _�'�� - a _` �, �'� �., �4 �,�_�` �� .��, �� "�' � � � � ��" �� ROUGH PLUMBING�' �� '� `` � � � � � �� jSHEAR WALLS INTERIOR � � � � �` '" ; � � �"�� 3��' a "�� "�� `� ^ ��an �RaUGHfELECTRIC,4L �' . �'� ��, �� FRA�IiNG/UENT(N� � � A��; ^� : r �`��_ � n ��'°� . � � �`"�` � � � �.°� >ROUGN ME�HANICAL��`� ;�� ' ' ��' � . �� Q r .��, ,�� ,� - .� � :`�� d. � � ROU�f�H MECHANICAE a , � . �- � � � � � z a �� x � ,�� ,.�-� �� ROU�H�EtECT�?lCAE�W(,_)�C�{.� �. ��_ � „� _�� GASTEST� � �4�� ° �� RCIUGH'Pl'llMR1NG .. - �� w � ..aE x � -:,��,�� .-� °PRE�GUNITE�`� �� `" � � � �� ° �� '��:�� ,�"__ �o,�;��. „ .. ; � _. . � ,PpO�.PRE�bECK BO,NDING � � ' � � � � �� INSULATION WALL � `�� z �y ., � �� „ s ;� +�� P�TRtIP �x � : � � �"�: 9�" �° �� INSUlATiON CEILWG - QRYWALL �FENCE/GAT�I ALARM �` ; " ;�� .�, � ��' � ��4�m ,��`.�,;�. �"��%�� =' � ,�a� LATH(PRE) �F7NAL��OOL_.�m� .,.��,... � .. : . - .�� LATH EXTERIOR �A�� LATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL 1s'( )2Ne( )LIFT SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELEASE WALL DRAIN/SEAL GAS METER RELEASE WALL FINAL SPECIAL INSPECTION =RO��AM�VG PLIWNINGAPPROVAL��"`, �e�� .� ��.,� +� � �'"�'�4 „ _....�� ,w� '�-�� a� � � � ",�. � ' � �"� �t�� "��fk4 Hr ��,. FINA��BUILOIN�fa ��` =_ �/ t' � I - ��°�� .t�OUGtI FIRE APPRflVA�� E " � ,fINAL�NIECHANICAL� .,��4� ��; ��0. �. �' '�"��, �� =�INAL�;FIRE DEPARTMENT�°��n,t''� �� `' � �� r 3 � _ �, ; .� "� ��„� �� '`�� r�'�r�� ,,-,,.�� - F �'«M �- � i=` � " � �FINAt ELECTRICIIL� � �, , � �, � �,6� q�IN�L PLANtdING�� _ � � � FINAC,PtUMBiNG,��,,,� '' '� �`�� ' � � ��',�� ,,, � FlW�AL��NGtNEERiNG/Fi�f�� , z�� -� "�`�� +T.G.g;ofiOCCUPANCY �� ,��^�� ._.-��^�� a�`,�r,,�:.�'�� . -„�� :FINAL COMMUNfT'Y�'SERVICES ,��'� :;�� ..��`'' "��-�� ``� •� GERT Qf�QGCUPANCY� .;��.�t� .��.`.` �a�ia .�� •x ��'�� ;� ,FINAL'NEALTH�DEP�T � � ° � `�'' `�`�� `,��• " _� . . � " �� .��_ � �_ . �, � . � , �� _ �tt �° ° �� r� -- �� ;�� _ ,�_ . �flIUALINDIIS�RIl1L>WAST��; �..� )�„, „�� :��,.�,. � ..�� .,� COMMENTS: