HomeMy WebLinkAbout14-3002 �`��.._� C1TY OF DIAMOND BAR �E�� ���
� I I I i ' I DEPARTMENT OF'COMMUNITY&DEVELOPM�NT SERVICE
��. ��III�� �—� ' 21810 Copley Dridc,Diamond Bar,CA 9176� ������� P ESS
w .� (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-70 7 IRMLY
� ���'�"°��� BUILDING PERMITAPPLICATION
�
¢ JOB SITE ADDRESS �I��C��"�fJ✓�A.� �/✓ APPLICATION DATE: �1 �'�� P/Ctl
z APN LOT TRACT ISSUE DATE: ✓ �_PERMIT# /7 �� �(s(/`
cOWNER � �'�- �1�1i1 �I �(� TYPE CONST. OCC GROUP:
y ADDRESS_�� ��✓I v-cr rt �
J CITY P�q,✓ ZIP�TEL.9G �C/D O ZONING SEfBACKS
Q �' � FRONT RW ❑
o APPLICANT TEL. REAR ❑
} S - SIDE/SIDE STREET RW ❑
o CONTR,4CTOR �EVV/C-L �I q L�I i��'1 r SIDE ❑
c� ADDRESS Z��I_�(li( �UV1C/l1
o CITY V-L- ZIP��TEL.�I¢7�'II7 � PROPOSED USE C O /4-(� : C�
o ARCH/ENG/DESIGNER
w
a ADDRESS
#DWEL.UNITS #STORIES #BEDROOMS
z CITY ZIP TEL.
� DESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION
owrr�-suan�oecu�nnnox
o I hereby attirm under penatry of perjury Nat I am ezempt Irom the Conhactor's State License Law(or ihe reason�s) SFR/ADD/REM .
p intlicated below by the checkmark(s),I have Dlaced ne#to the aDDlicable item(s)[Secllon 70315,Buslness and Garege/Carpwt
o Professlons Code:Any city a county that requires a permlt ta construct,alter,improve,demolish,or repair,any
Z structure,prlor to I[s issuance,also requires ihe applicant fm the permit to file a sfgned statement ihal he m she � Patio/Deck
� is licensed Dursuant to ihe Drovisions ot ihe Contracta'S State License Law(Chapter 9)Commencing wiM Section w
� 7000 0l Divlsion 3 of the Business an0 Prolesslo�Cade]or that he or she is exempt hom licensure and Me basis(or LL Pool/Spa
� Ne alleged exemplian.My viWation of Section 7031.5 by any epDlicant for a perm0 subjects the aDPlipnt to a civil penaFty C7
� of not more than tive hundretl dollars($500). Z Re-Roof
¢
o (�1,as owner of ihe property,m my employees wi�h wages as their sole compensation,will do(,all of or U porlions � Commercial
� ot the work,and tlie strucNre is not intended a offered lor sale(Sectlon 7044,Business and Pralessions Code:The �
� Contractors'State License Law dces not a ro an owner al r m
pplY p opeRy vfio,through employees'or personal ettwt,builds
w w improves ihe property,provfdetl ihat�he fmprmements are not Intended a ottered tor sale.tt howeve{the building or
� impmvement is sotd within one year of complefion,Ne Owner-Builtler will have Ne burden of praving ihat It was rot buitt
pw imprweA for the purpose of sale.).
V I,as owner ot ihe ro
� U P ce�1Y�am exclusNety convacting with Ilcensed Contractors to construct ihe proJect(Section
0 7044,Business and Professions Cotle:The Contractors'State License Law does rrot appty to an ovmer ol Droperry who Valuation: ,_S Adj.Afea:
Z builds w improves mereon,and wlw contracts tor the projecls wiN a licensed Contrador pursuam to me ConVxtors'State QUANTITY DESCRIPTION FEE
�
Y u�ense LaW.,. r. 3 H 3 S —e�
o U���empt Irom licensure under the Contractw's State Llcense law tw ihe following reasort(s): �
LL � C 0 1 �
By my signature belaw I acWrowledge that,excepl fm my personal residence In whkh I mus[have resided iw at least one � �
o year prior to completim of the imp�ovements covered by this permit,l cannot legalty sell a strucwre that I have built as an �
w
� owner-builder if it has rwt been consiructed in its entirety by licensed contractws.I understand tlia[a copy al ihe applinble
law.Section 7044 0l ihe Business and Professions Code is available upon request when this application is submitted a at
X the following Web site:http/www.leginto.ca.gov/calaw.html. �
w ?
� DATE: SIGN: �
�"' LICENSED COMRACTOH'S DECLARATION � �
H �
w I hereby aftirm under penatty ot perjury that I am licensed under prmisior5 ot Chapter 9(comme�ing wiU Seclion 7000)
� ot DlNsion 3 0l the Business and Professions Code,and my lice�e Is in full Imce and eftect.
N �����: G� ��.No.:. 7�'9i 7a �
a
o DATE: CONTRACTOR: ✓ 0 T�. ( x
Z U
Q won�a�s coMv�sanoN oecwu N � �
w I HEAEBY AFFIRM UN�ER PENALTV OF PERJURY ONE OF THE FOLLOWING DECLARATIONS:
o I lu�ve and vAll malntain a Cert�pte ol Consent to Self-tnsure lor Wwker's Compensatbn,as provided by CONSTRUCTION:
� �on 3700 of the Labor Code,for ihe performance of ihe wak far which ihls permit is issued. p�,C,N REVIEW:
� I have and will malntain Worker's Compensation Insuranca,as required by Section 3700 0l the LaDor Code,for
Z ihe perfarmance ol the work fw hich lhis permd is issued.My Worker's Compensatlon Insurance Carrier and ELECTRIC:
¢ PolicyNumberare: PLUMBING:
� CARRIER . V-�� '
w MECHANICAL:
cZ.., roucv NUMs� - �
INSPECTION FEE:
y (T}US SECfION NEED NOT BE COMPLEfED IF TFf PERIv4T lS FpR ONE NDRED DOLLMS 1 OR
�� �' ISSUANCE: ?�S'
� I certity tlkit in the performance of the�wrk fa which this perrNt is issucd,I shall not em �
� becane su�ect to me WakerS Com �Y�Y Derson in any manner so as to SMIP:
p bl pensatlon laws of Calil Md agree that If I slroWd becane subjec��o llie Worker's
� Cwnpensatlon prwislons of Section 3700 a1 ihe Labor Cod 1 � comp witn tlbse provisiau. ENERGY P/C:
_� DATE: qPPL1f,pNT:
`i ENERGY PERMIT:
� WARNING:Failure to secure Worker's Campensa5on cove2ge� u awlui,end shail subject an employer to criminal RETENTION FEE: �Q�
„� penattles and Gvil fines uD�o ane hundred thousand dollars(310,OOOJ,in addition to ihe cost o11he compensation,
o damages a;prwided for in section 3708 ot the labor code,interest,and attomey's tees. PRE-ALT FEE:
d CONSTRUCTION LENDING AGENCY BSAF:
w I hereby amrm under penalry oi perjury thal ihere is a Constructton Lending Agenay tor Ihe perlwmance of ihe work for
= which this permit Is issuetl(Sec.3097,Gv.C.�.
3
F LENDER'S NAME
� LENDER'SADDRESS:
� I certify that I have reae this aDPlication and slate that the above intormation is cortect.I agree tn comply with all city and TOTAL FEES /]�,w
� counry wdinances and sfate laws relating to building construceon,and hereby autharze representatives of ihis county to V�`��
? COMMENTS: ` �
p enteruponthe above-mentianed propertyforinspectbn purposes.
m �/o �,v�-A
a PERMfTTEE NAME(P /J�
� ' I ' IA`
N l�
r 516NATURE OF PFAMfTTEE DATE �� RECEIPT q PAID BY:_� a Z�VALIDATION:�
WHITE—Department Copy,YELLOW—Fnance Copy,PINK—Assessor Copy,GOLDENROD—Fle Copy,GREEN—ApplicanYs Copy
������� ��'��� CfTY OF DIAMOND BAR
#�,, � ;�� � %�V...���� INSPECTION RECORD ,
��..-�t � ��; "�' ;�:;��:�� �
� , , • • - - • e � � • -
SETBAGK/.LETI;ER - - TRACTAND LEDGER
FOOTINGS F;ORMS F �:�°��� �" _ . .;,�-� _'`;: SWITCH GEAR
S�B�: - - �^�i` : COMMERGAL HOOD
UG.PLUMBING.' - �- � ��'� �_, =�- `� T-BAR
UG.ELECTRICAL� - � `�' fi ' '�'� �° INTERCEPTER
UFER GROUND ' �-;' � �'�: HOT MOP/SHOWERPAN
SEWER LATERAL SEPTICICESSPOOL
MAIN WATER LINE ''' HERS REPORT RECENED
SEWER CLEANOUT DEMOLITION
ROOF SHEATHING ROOF DRNNS
OR SHEATHING DUIT _
FLO ROU H
: ,,,:
SHEAR WALLS EXTERIOR:' .* �
- POOL/SPA;- - `; - ` �` �
SHEAR��WALLS�INTERIOR-�, �: . �_ � _ � ROUGH PLUMBIN� � e , � ;� , �;,� � r�;,
,FRAMINGNENTING�'. � �;.. `' '': r'`. ' ` UGH ELEGTRICAL<;' - ;' 1° �- �
RQ
, : . . . ;. � _ .��:., . r ;=LL x :��,, ROUGN MEGHANICAL; � ;'�,a A s - , x r � ` �
'ROUGH MECHANICAL ' fi "
� ,�=�s ���� b _ _ 'GAS�TEST�:�_l t� , ,� � � , t:� t
ROUGN�,ELECTRIGAL W(: )G( ) , > : � - - ;
ROUGH:PLUMBINC� . - ��`'`' _ - �PRE GUNITE.� 'r 'y� " ' �-��;
,�� :
PQOL'PRE QECK BONDING ��' '. �� ` " '� � , SY`
INSULATION WALL � '.
INSULATION CEILING P��P � � � ��1 i
DRYWALL FENCE/•GATEI�ALARM _ '�t � .+'�
LATH(PRE) FINAL POOL' � ' _ ",x''� '*=
LATH EXTERIOR � U WALLS:
LATH INTERIOR WALL FOOTING/STEEL �
GAS TEST � WALL STEEL 1�T( )2ND( )LIFT �"""
SCRATCH COAT WALL BOND BEAM
ELECTRIC METER RELEASE WALL DRAIN/SEAL
GAS METER RELEASE
WALL FI
SPECIALINSPECTION RO:FRAMINGPLANMNGAPPROVAL ;';:' , -� r `=` �
FINAL"BUILDING - �'� ROUGH'FIREAPPROVAL "' � '=� �`
t FINAL FIRE DEPARTMENT� ` t � y 4''
FINALMECHANICAL � - � � ' ' � `'
FINAL�ELECTRICAL �. F._INAL PLAPlNING ;���'�� x , r �. � � � ,a �' 3 '`
- '���` 7 : i '' F >-I
FINAL,PLUMBING , '�' ,i. a 'r � �` FINAL ENGINEERING/PW ,,'; � r' _ � ' ,' � "
LC.of OCCUPANCY '. ;, �;;' �,�,� ._ �. ",�. FINAL COMMUNItY;SERVICES �-.< � ,' � ' = '=
� ' ` '$ FINAL HEALTH DEPT `
, ;_- - , „ .
CERT.`of'OCCUPANCY',;;: , ,,�:,�..,. � a ,: ��� � ` `
fINAL"INDUSTRIAL INASTE�`_, � � ",
COMMENTS:
,
o .�w. -r -., �i: .. ,,,^+� •..ur M1� . � . .. r n r
�,�' r� � � . . . a �1.m r , ,� ,� �, t r . • �;. p. .,.
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i �' � � ".x�,'� C1TY•OF bIAM ND BAR � . � " .. ' � .
,. , .
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"'`' � � � � � DEPARTMENT OF CONIMUNITY&DEVELOPMENT SERVICES �
�� - �. r '
,��jj(,�. - 21810,Copley Drive,Diamond 13ar,CA 91765 �.. .. .-,�' � � .. ,: � P ESS
� ,,,,�,r.�� ..(909)839 7020 Fax (909)861-3117 Building InspectionHotl�ne�;(909)839 7027 ; � . �
�`'�B , BUILDINGPERIVIIT�APPLICATION ' � � . '. ,.. ,, ., ,: � � IRMLY��� .
, � , , _ . .. , h
� ' /�/� /` �, ,q�� t APPLICATION DATE ' �D''�A I P/Cq �. G
� JOB SITE ADDRESS �I�`T . 1 A�"7'D✓A ti L/✓ , �I1� `' ��!�+/4��, I
,�' . . . . • �,�-"'.��r/%� : ' .. - �./� �� �./G�/ �qa�hd;F . .
z APN. : ' LOT ` TRACT' .
ISSUE DATE <' a PERMIT�i�
o, /'� �. ..r, ... . _ . . �
'o OWNER.. �;k; ;W�1i1' �'1 R 6"I' TYPE CONST... : - ti.� OCC GROUP: ' �
. v~i' ,ADDRESS � � "1�►'1: Orot eq .:, L,� � ,, ,
-' CITY � :R�4� �' ZIP�toT TEL.�Q� (Qa � Q ZONING ;SEfBACKS , �� ,
� FRONT' � � RW ❑.
o APPLICANT � TEL REAR . ` p
_
� . N � ; r' ' , ,,. SIDFJSIDE BTREEI". . RW ':p' '
o:,.CONTRACTOR � ?.V✓(C-�. '.C�Q d�o��,�(LZI'D�9 � : ' � ; 'SIDE.
ADDRESS � X✓a�N h►l �LS'VIT�"1� � ' p' .
� . I���:. PROPOSED USE C O . �Ci. i� ,�:•,.
, o� CITY : �-{,: ZIP41f/�h,)Z� TEL:71'{j���7��1' �
.0 .� � i � . ; . ' ' , � ,1�� �T! . . . .
. �. �.1 . � •. . ,. .
�"' 'ARCH/ENG/DESIGNER ' ' ,'` ' ' '
S O � , . . . . .. , . -,.'
z �ADDRESS + ,
� ' " � liDWEL UNITS #.STORIES #.BEDROOMS �
Z: CI7Y ,' '.' ZIP • �,' . TEL. . � - . .'
::�., . �mw+�n-am�oea oEc�nnAnox� . � DESCRIPTION .. SQ.FT.� ' FACTOR PSF. ADJ.AREANALUATION '
' °C I here atfirm under. � � . : ,..� , �. � . , � , .� . ,,. � � ,. . �SFR/ADD/REM'� .�. � � ,.. ' , ,
o, bY penalty�.oi peryury that I�am exempt hom Me�C�iractor's Stale License Law fw the,reason(s) � � � � �
.�� `p InOicated helow�try the�checkmark(s);I have piaced nract to the�aDDlicable�item(s)[Section 7031.5,Bus�ness and � � Garege/Carport � � � �, i '
0
I •. �� .Professlons Code;'My dty ar county that requires�a permit lo co�Wct,alter;Unprove,demolish,or re0air,any , � ��- ' ;
• z •structure,pdor to i[s iswance,also requlres,the appflcaM'far tlie permit to file�a sigrted statement that he w she� �� ' � •Patio/Deck •
�� '.N..�is licensed Dursuanl to lhe provisions of the Contractor's State llcertse Ww(Chapter 9)Commeiicing witA Sectlon W� - , . . . . .
�,j�.N.;7000 of Uivision 3�of the Business antl Protessloris COAe]or tAat he or�she is exempt hom.licensure antl the basis tor .� !i� P�USpa � . . • , �� �
�, ihe�I,I��9�e,_d exemphon:My vidation�of Sechon�70.31.5 by any epplfqnt fa a permit sub�ects Me'applicant to a ciwl perqtly� '� C7 , . , , , , .
� ot,noF(�re than�five�tiuntlred dollars(5500) : Z Re-Roof..' � - ,
�� �,. � . • . , :. -. ..S i. '. . . :.. ._ ',... .'; �o... . • .
'�� U 4 as owner�of tl�e property,or,my-employees with wages as iheir,sole compensa4on�will do(�all 01 w�1 portions�� � � � Commerclal: ' • � - �
.,-:�� of Jhe;work,�and the structure is not�intendetl Or ottered for,sale(Section 7044;�.Business a�M�Professbns Cotle;The' . � � ' � � ��� �
-����� Contracturs'State lJcense Law�does imt a . . . . .m .. .. .
.� Z•... . PPh'to an own.er o1 property vfio,through:employees'.or persoria4eifort,bulld5� .. .
w �or improves tlie property„piuvided that ihe,improvertients are not intended or offered tor sale.If however,th2'bwlding or'; ' �� �� �
�� �-improvement Is soltl within one�year of completlon;ihe 04mer-8uilder will have tt�e burden oi prov'mg that it was�not buitt� � ' ' r_��'�� '
�� - . , . . . . tt . . ., . .
.�,c�. aimprweefwthepurposeotsale.).� : .-' .... ,�,. ��.,'... � . �. � . ',':� �. � . - � �' � :���• . ,: .,� ,
, ; : n '. ',
� o (�I,as owner ol the property am exclusivety conVicdrtg witli,lieensed Contraetors to coushuct Ne Droject jSgciwn.� � , �Valuation..� r���n� �Ad' Area
;7044�Business�arM Protessions�Cade:The COMractms'Shale License Law does notappty�to an�ovmer o1 Droperry who� � - � '�"� 1� '��• •
I iy bmldsorimpr'ovesmereon,andwnocormxbfmmeprqects.wimalicerisetlContrectorpur`suan�tomeConiracro�s�Sqte� . ,QUANTIIY' DESCRIPTION� ' `� �,FEE ,
Y.'��cen�tCaw.). :, , .� � ,, . . },i. ' 4 3 U y � �Q.$u i
���o, (�I art'LAieempt from licensure under the Cantractor�s State.License law for the following�reason(s)�� : � . .
�. . ,��,. , . ,. ., . �.a.� 0 .
�=. .�By my signaWre below I aclmowled e ihai.ezce t ta m � . . ' � . ¢ � �
g p, y personal residence In which I must liave resided for�;at least one � �i �
.�.z� . �. . . . .. � . .�� � . � ' . � . .
'r' owner bullUeclf R has no tieernlconsWG Y� � . �h'�II a striicture that I have bwit as 9n. '�w . . . . �h� � .0 ,.�f�f.��
,o Y. D� d , p . . nis covered b this, rtnit.l cannot leg
ed in its entirety by licensed contractors:I undersfand Nat a cop'y oi ihe applipble� � �-._' �
��'. ,.law.Section 7044 of the Busu�ss and Prufassians Code�s availzbie.upon reduest when�thts epplicatlon Is�submitled a.at � � � - y i
� �a�,�.fhe IWlowing Web site;httphvww.leginlo.ca gov/calaw.html. . .,� i . ' � . . � .
"' �.DATE�. i � ' � � . � ._F , . � . .
..H SIGN::!�-'•� ' �.;.� �� �g• . .,.
�• �. � � LICEHSED COMflACTOH'S�ECWIATION �. � � �, .
.I�here afflrinuntler nal'of'" �� � n' �
;' w� . bY,, pe ty perlurY Uiat I�am licensed�under provisions.ot Chapter.9lcommencing with Section 7000)� � - .. . . , ' - .
i ' i. :
m:� ot Dlvts�on3�ot Me Business antl Prafessions Code and,my I�cense�is in full foice and ettect. J , . . ,
�Ji /J �y
,N .LICFNSE CU\SS .. / :/�. I� � I � �
� G��` ���No �l /
f�o ��DpTE CONTRACTOR. .� . " - � . . �. . G y�� ,� � . � . I
i
(.�� � � • '.WORI(QI'SCOMPENSATION DECLAHA�ON� � . g � , �� � -, �� �.
..,0. . . . .. . . : . . . . � �' . .
W .1 HFREBY APRRM UNOER PENALtt OF PERJURY�ONE�OF THE F-0LLOYJING DECIARATIONS � '' ,' � � - �-�
� o� ' "�i'have and will'maintein�a Ceruficate m Consent to Sett-lnsuie�la workersComD�sauon,as providetl by �, CONSTRUCTION '�,' ' � �
�. Ilon 370D.o1 ihe Labor Code for Ihe D�amance of ihe work'for wh�h.ihls permit is issued.',�' ' ' � ���' � 'i,, ' �
PLAN REVIEW:
>�, �' . I have arid wdl matr�n Worker s Compensation Inswance,as requiredby Seition 3700 of Ne Labor Cade for`� � _ELECTRIC:�
� Z. , .�ihe perfamance af the work lor whxh this permd Is issued My Waker's Compensation Insurance Camer antl �
¢ Poli�yNumberare ' + PGUMBING ` '
,�� � � � .�CARRIER. �'� ��� �MECHANICAL. � �
. ,c.Z7 .'. � � ''POIJCY NUMBER .. .::� . / �/A/ , ... . . . � � , . '' . .i'.
' � ' ���.L �" • � �' ' .��'�INSPECTION'FEE � „ .
�`'.. ��.�(T}tlS SECfION NffD NOT Bf COMPLETED IF TFfr PFAMIT IS FOA ON.E HUNDRED DOI.INiS(S70�OR.IESS) ' ,� � � � � ' j.
�,.I�certifythat�intheperforrnanceo(ihework�fawhirhlhispermit'sissimd,IshallnotempbyanyDersonmarrymamiersoasto. ��� ISSUANCE:' ' . i . � ��� ���0 .
oo .hecane subject(o Ihe�WorkaS.Canperuation laws'o(Ca1H �And agree Ihat if I SwWd become sub�ect to the Warkers� �. SMIP:. � • . . �
,
�;•'Compensalion prwisians of Section 3700 of ihe laba�Cod f �ith com .witn those prov'siors ,, ENERGY P/C:-� � . ,
,� Dn7E , naPUCN�:�, ' ' ;. . � ENERGY P.ERMIT ' ".
���, .WARNING FaiNre to secure Worlcers Cumpensatlon�coverage'�s u aivtul.�and shall subject'an�employefto,cnminal��� � �,;�Q;� ������
.�w' penatlies and civil fines up'to�ane hundred.thousand�dollars($i ;000),'in atldition to,Uie cost ohthe compensatlon, , RETENTION FEE .
o uamages as prwiAed for in sectlon 3706 ot the lahor code;Intere"st,and attomey's feos: ; �PRE-ALT:FEE: � ' '��
'�.�a� � CONSTRUCTIONLENDINGAGENCY� � � � BSAF: � � � ' � � � � �
�.w �I hereby aff(rm untler�penalty oi��perJury Nal there is a Car�stri�ction�Lendmg Agenq fw Ihe perlormarxe of the work for . . � . . , . '�,' � •i���:
_� „which ihispermit is Issiied(Sec 3097;Gv:C� ��� • � �.
� .�' �LENDFR'S'NAME '� � �}• . , � . .�'S
— • � :�' � �.� �. �-,.. .: �:. : ., -
' �� LENDER'S'ADDRESS.� �� � . . .. , . � '
� � , � r ; ,� . `' ?OTAL FEES . :
a 'I certtly that I have read this application and state that.the above�intormatlon is correcP 1 agree'to compty wiN'all uty and � •' � � � ' � � � ��;�
. z. .county ordinances and�state laws relating�tn�ullding ionsWctlon,-and hereby auth6rfze representatives of Nis county to ' .�' �(�� .
o, enter upon the abave mentioned,'property for inspectan purpases� '�. . . COMMENTS �. ;,
��m� " ��V f�`� �v,4�V��'9N�, � � . , rM?��t:
¢� ��PERMITTEE�NAME(PRINTj ; . �. . , • ' '•�:
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