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HomeMy WebLinkAbout10243 „_ - - - ; ExPiREo CTTY OF AIAMOND BAR I ; COMMUNITY DEVELOPMENT DEPARTMENT J�l O� .,.� 21660 E.CoPley Drive Suite 190 :' ” ' - 2OOZ PRESS (909)860��l95 Fsz(909)861-3117' ' '' ""'` BUILDING PERMIT APPLICATION FI RMLY JOBSITE•=,;•; i f� ,/OZ y� Q ADORESS � � / �,, ' / , � ; APPUCATION ' S/5r � NUMBEq X/C . o OATE � APN "' ' ' LOT T CT D TEE � �9 CONST. � GROUP. p OWNER � o ADDRE�S � - C '20NING SETBACKS , gCITY ti • ZIP �, P'' FRONT RW ❑ APPLICANT .JE�, —.2[�2� REAR p � SIDFJSIDESTREET RW ❑ a� CONTRACTOR� �l ^ �� SIOE ❑ � ADDRESS – -v � - p .PROPOSED USE CITY I ,,� ZIP 7 t"Z�SLTEL. o ARCWENG/ � DESIGNER NQ.DWEL NO. • NO. = C�DAESS Z�P TEL UNITS STORIES BEDRaOMS c�n DESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION p� OY'MER•BI:ILDER DECLARATION � SFRlADD�AEM � O I HEREBV AiFIRY�NpER PENALTY OF VEfUUFY TNAT I IW E](EMPT FROY iNE CONTMCiOfIS L4 Garapa�Cerport W CENSEUWFOHTMEFOLLOWttiUREASON(SEG7W7.SBUSINESSANDVROFESSIONSWOEANYGTYOR (n U COUNTYW111p/qE0U1RE5A0ERMRTOCONSTRUCLALTER�MPNOVE.DEL10LI5H2ORRERURANYBTRUC• � W pa�IdDeck - � TUqE,VRqR TO rt3�SSUANCE,AL30 REOUINES THE MpLIGNT FOR SUd1 VEIWIT TO FILE A 61GNE0 W BTATEMEM 7MA7 NE OR SHE IS LICENSEO PUfiSUAHf TO ME iROV1510N5 OF iHE COHTRACTORS l4 � .CENSEUW�C/UPTERY(p04MENCINOWIiH3ECTION7000)OFOIVISION]OFTHEBUSINE43ANOPflO� u- PocUSpa ' ' FESSqNS CODE)OH 1MATNE OH SHE IS EXEMPT TNEREFRGM ANO iNE BA515 iDR iMEAL1EfiED E%EMP- � TION.AN'IVIOU1710NOF6ECf10N7o71.68YANVAPVLIGWiFORAVERYITStJBJECTSMEMPLIGWTTO Z Re-float � � � AGVILPENAI.TYOFNOTA10ilETHANGIVEHUNORE0D0UAR9(isoo)): ' 0 OLASO�MIEqOFiHEPROCERTY,OR4VEMPLOVEESWITMWAOFSA5T11EtR60LECOMPENSATION, ', O (',pTRiefClel � � . � N1LL DO TNE WORK,M10 TME STFUCTUNE IS NOi IMENDED OR OFFENED FOR SALE(SEL.TOU.BUS6 J NESSAND iROFE55�ON5 COOE:THE CONTRAGTORS LICENSE UW DOES NOT AVPLY TO Ml OWNER OF� N PROPERTYNM1iOBUILDSORNIPqOVESiHEREOH.ANDNM1IODOESSUCHNORKHiMSELFOAHERSELFOR' � � THROUGHHISORHERONMEIAPLOYEES,VROVIDEDTMATSUdIMPqOVEMENTSARENOTMENDEDOR� m pOFFEHEDFONSALE�F.NOWEVERiMEBUIDiN(iORMAPiIOVEMEMI550lDWIiHINONEYEAflOFCOMPLE•� � � Z TION,THE OWNER�BUILOER WILL 11AVE iME BURDEN OF pROVM10 THAT ME OR SHE DID NOT BUttD OR� � WVROVEi011THEPURPOSEOFSALE�. W ❑LASOWNERDFiMEPRDPERTT,AME%CLUSIVELYCONTMCTNOWIiMULENSEDCONTMCTORS W CEN6ENUWDOESlqTAPVLYTOANOWNEROFA0R0 ERT'!�N'HDBUA.D40�14PHRpVEO9Trt11 pEON.AND V2N8t{pl AD.I.AREA � M?1000MRAGi5FOR5UCNVR61ECT5MATHACONTMCTOR(5)LICENSEOPURSl1MRTOiHEWNfRAG QUANTITY DESCRIPTION � FEE ' . � � fOR3UCENSEUw). . ' ' o � � O 11W E%EYPTUNDER SEC. 9.�V.F FOq iN15 REASON Q O . , 3 � � �S �'= DATE OYMER OZ W ._ �Q LIGENSED CONTRACTOfiS DECLAHATION W [L INEREBVALFIRMUNDERGENAL7YOFiERJURYT�NTIAIALICENSEDUNDEqVROVISIONSOFCHAPTEq Vr � d i(COMMENCIIJaWRHSFCTION7000)OFOIVISION�OFTHEBUS�NESSM10iPOfESSi0N5C00E,AN0 Z X NY UCENSE 6 W iULL FORCE MA EFFECt. / � UCENSE CUSS � LIC.NO. ��a S � �-". Jj V DATE � — CONTMCTOR' ` !' 0. W ,. . � WORKEHS'COMPENSATION DE AFiAT10 � � IHEHEB�AFFIpMUNpERVENALTYOFiER7URYDNEOFTHEFOLLOYViN40ECLAMTWNS: z . � _IHAVEANDIMLLMANJTNNACERTIFICATfOFCONSEMTOBEIi•WSUREFGIWORKERS' x COYOENSATqN,A3PROV10E08YSECilON�7000FTHElABORCODE.FOqTNEPEPFORYANCE �U OF TNE NRNiK FOR WNIOI THIS VERMIT 6155UED. � Q _I HAVE M1D WILL MAINTAW WORKERS'COMPENSATqN INSUfUNCE,AS itEOUIRED BY SECTION O l7000fTHEUBORCODE.FORh1E0EFFOPY�IJCEOFTHEWORKfORWMp/THISVERYITI3 ISSUED.M1'V�Oi1KER5COAIPENSATqNINSUfLWGECM�EHANDPOLICYNUdBEHARE: CANSTRUCTION ' � GIRRIER STLI rt Fv~ PLAN REV�EW � POLICV NUMBEH v $L r Z � L ELECTRIC 0 (�HssEcnonHEIDrureEoa.F1FTEDOFnEPERxisPoRaNE�tILX�EODa.tAiGRiaqoalEs51 LUMBI �� C^ i Z ICERTIFYTIIAYMlTHEPERFOR/A.WCEOFTMEWOi1KFORVMICHTIISPFR/ARISISSUED.1 ME ANICAL (•} SM�LLLNO7EIAPLOYANYiER50NNlINYYANNERSOASTOBECOMEbUBJECTiOTNE (n WOHKERS'COMPENSATIONNN50FCAlIFORNIA,ANDAOREETI/ATIFISHOlADBECOMF INSPECTIONFEE SUBJECTTOTHEMlOfiKERS'COMPENSATIONPRONsp�SOFSECTqN]7coOFTHE OR ,.t ocooe, sw�u ormiwm�coiar�rvnn�n+o EVr�dnsaN. � , ISSUANCE ���_ p pA7E:S APPLICMlT. µ ` ;� SMIP � WNWINO:FAILVRETOSEWFEWOFiKERS NSATqN �n,�cEistmuwcu.u+o e ENERGYPlC �y SUeJECTANEMPLOYERTOCiUUWALVfNALTI S CMLfINE4UPTO0NEMUNDRED ENERGYPERMIT DOLLAAS(f f OD,Om�,N ADOfiION TD TME COST OF COM7ENSATION.OAtlA0E4 AS VROYIDED � SE��DN]7oeOFiHELABOHO00E,WTEREST,ANOATTONNEY'SFEES. ' RETEMIONFEE: �� �-� a.. CONSTRUCTION LENDINGAGENCY PRE•ALT FEE: ' O � INEREBYAFiIqYU�UERGENAITYOFPERIUNYTNAT7MERE6ACON5iNUCT10NLFN01N611fiENCY " � " FOR TME►EH W RMANCE OF TNE M/OiiK PoP YAi1CFl TNI3 VERMIT IS ISSUED ISEC,�oii,qV.C,L , � � LENDERS ILWE � - - � LFNDER9AODRE55 - W ICENi1FYTMATIMAVEREAOlM141�PPLIGTpNA1mSTA7ETMATTNEABOVENFOfiIAATIONLSCORRECT. TOTAL FEES �� � ��J7 �' � IA�REETOCOAIFLYMATHALtCRYIWDWIMTYORDWANCESANOSTA7EUW5pEUTNUTOBUtLD�NO ' j � / �� �� E �� � CONSTNUCTION,/N�NEREBYAUT1qRREREPRESENTATNE50FTHISCCIAJTYTOEMERUPONTME � � ' � Z. A80VE-MEMqNEOiiqvERTYFORMSPECTIONVUpPO5E5. COMMENTS � � � � �� �/y � i 1. � � _.Q iEHAl1iTEE E(VRINfI ; - . � , �L. . . - . � - c� �i � J l � y SWWUU1iEOF N.IITiEE ' OATE ' - � RECP7:N0.Q3 3�VAID BY �AS jI '� �' � VALtDATION 1/ � WHITE—Depertme py,YELLOW—Fhance Copy.PINK—Asaesea Copy,GOLDENROD—File Copy,GREEN--AppudnCa Copy . . � � i ; . . z ... ~ CITY OF DIAMOND I3AR� :.��'- :i�.''�-��"� � � = '- . �,,... �� '1�, � , i� , r .•:, � :�, , .v�: '1'i �;:".t/.r��� �..:''..!'7t.;:�:;� '4, 4: . � �" _ ;.�. ���� INSPECTIOR! RECORD. .- , �;.� .:�;,:,�� __:��,; '{. . ',. �; ,,. . , . '" _, ' - ,. ���� .. . S� .,I,l,:I,'i' ., ]� 11�1 ,f �fl !�!�-��.��'�X� ►� •: '�'I]':,�1� �-�.� � 0 �, ;r,.,:'.,.;�, !�' ��a ►.M` ' ,. `�o ' I�� I���'���.�'' 'o R�g�' ��- .. ^_ \_ ` - , :F.LOOR JOIST-- _ ' . _ ' SETBACK-,-J- ---- ---- - -- T ----�- . �- •,:; � - �, , . ., - --.. . ------- -------- -- 1 �r.� -- FTGS/FOpMS/STEEL:------ i,.:�:.a.� .._ -`-�'-'.�,-_ __ ,FHA REQMTS - � _ ,.. � . - - ---- - . . . � . ELECTRIC GROUND �. . - '� �UNDER FLOOR DUCT �� ' • � . � �'• 4-.;i�,,;-, � � GROUND PLUMBING `: ' --- - --- --- --- - � `�� UNDER FLO�R CdNDUIT�= `: � � -•- -_.- �.� > � '' SLAB GRADE----- -_ ;y,', ---- ----.- --�:.= ,�: �r.�- ! ��; FIREPLACE FOUNLIATION�:: ":'_'__�''�_ :_'_''_----.---- -! ',, ?EMP POWER --- -__�--=�=- -=-_ _-__--_=- --= ---=_ �•FIREPL'ACE BOND BEAM- - � �-• •'- -=: `•-- _ _ .. :. � �:,r.;;-��r����:. WATERSERVICE._._ __ -- --- --------- - �_�:��;:c, :MIDHT.BONDB�AM ��.;..-:. ,-� --• -- --•--- -,n ` ROOF SHEATHiNG----� - -� �--- ` '-`- - 8 FT.BONb BEAM `_=-�- ''�:i,� ' FRAMINGNENTiLIATiON °'� ~'-' � �FINAL BOND-BEAM - - �- - -"-- ` �----�'-- '� �" "`" � _ ,. ,. . ROOF COVER ------- _-- _--- - ---�- -- -- PRE-GRADING- i_i� --- - ��,. -- - -- - -- �; �; 'ROUGH HEATING—=--- "` '"`� ' '' " ' --- - - -_--- --__. .-- -- ------ - --- ___-- ---- --r-- -=- " '_ ' 6ENCHING _ ..---- , .��.. „ - -ROUGH EtECTRIC-;-- ---- - - -- ---�- �'------ - ROUGH GRADING ,.. ,_. _.,,, -' ..,. ��; �• � ',`,'��r''',,,::.;'"'; . `_ ' �... -ROUGH PLUM6ING-;� __- --- -�------`---"--- _. ". . FINISH GRADWG :'. � - ,, . , .,, ,: , ..SHOWEF�/TUB TEST`-- - ------- ----,---- :�;- POOL ELECTFiIC. ,,. . , ,.�.. , :, ... � ��;�,:..-:.-,. -: EXT.-[ATH151DING- --- ------- ------- --- � . POOL FENCiNG , , ,,, '� ' :F _+�•�`::'.�, ,: � :,� , , WALL INSULATION ,. �,.. . POOL FINAL ' ' "' . .. � ,.� ;„ , ,,� .,; CEILING INSULATION aFF SITE'IMPS: „`, '' ' • � �; ;;,.,• :• , DRYWALL NAILING ` DEDICATIONS' . . ' , , ' ;;:;:" ' � ' SEWER--------- ��._.-----_� ----- - FINAL ENG. - ,;� , .. �, • . - -- --- , . . „. . , ' ...^ , ,.� ._..-. :. _. „ ;: �,.� , � �, ., SEPTIGTANK----__.-�:_ __^'�''`_:'',- __.:__.-�-_-:�-----� - ..LANDSCAPEIIRRIG. �, " ,� ... „ . , , �„ .��,� ; - --- - -..,_.:-�---�-�=,- - ON SITE IMPS. : , . , , �EEP_F1TlLL�I------ --- � GAS AIR TEST'-------- -- - ------���_� _r'��-'i�- " -FINALZONING �, : , , . �„ ,.., . _ � _ , - _ - FINA6 CONST.- ---.---- —------ --- --�i�j . :F1RE DEPT. FINAL , ,.., „ FINAtHEATING _�__ _-------_-------. HEALTH DEPT.FINAL -.;,;--- �- ---.__- --.--. _--------.- ---- ,._- - - ,rn:.-mt��;, -�.��i� � 'F1NAL-ELECTRiC--- -------�- -- -.._----- ._-- - -DEV. FEES PAID �,:„ : :, ,,_., �, .. , , , ,�. .,_„--•:...� , .� , , j -FINAlPLOMBING--- -------- ---- -- -- ----- -� "EDJERGY , I �:.. -,. �,,,,,,,;, ,; ; ,;•,, i :;. _ ' :J_` ` - -- '_ .....:. . ;., , - • . , � it :R '� r ,� h�_--=--:,-- -., ...�, , . , ' ' ' L, � f:.. ,,.C'�'�: - - ' _.� �]?.N„ :-n _'______._' _"_ ' __.._'._____ ..'--�—_---"___._ _ i, _ _ __`_______ -COMMENTS ° �,_ ..a� . , .,,.� �, ,. ,� . ,., ., ,_�, :,.:....,. - .,,, „ ----- ._._---- ----------------- - - , ,. . - �. ,�, . . ,.. — — ----__— -------------------- — - , � �, , :�:- ., .,'. ',: ;��-- . , . '��., -____�_-- - _-�------------------------------- . � . � , �.. ,,,.,.�� , , ,, �� � .I:' ' .. :},. ' .F�l. 11/].f: ."_ — "� �._'.._'__ '______—___"'_._'_. '__'_ " _' . 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Val l ey Vi sta Dr.i ve; .� . .. � cRoss s�EETGoI den Spri nc�s% ��-y �. STATE � ZiP - COUNTY �a ev�ay n r. r�ve Dianond Bar CA 9I765 Los Angeles �ESCRIBE WORK LOCATION Lnd F1 oor of bu i 1 d i n BUILDING SIZE(SQ FT) 17, 51 O , NUMBER OF FLOORS 2 BUILDING AGE(YEARS) 7 NUMBER OF DWELLING UNRS il/d PRESENT USE� Cow�tcuu. �"�0..PITW- �td�US7RIAL M�811V�EOUS PL6UCBl!)G• RES�ENCE �Gt1�OL SHIP UNN,COf.1.EGE VACA17i PR10R USE Ca�E�a� Ha�arrni lwus�tu� M�scatnHEous { �1 PueUc�.o�. REsm� ScHoa Swa Urnv�;ouFce V►c,wr �/ srrEow�vE�t Omni I Par�tnersr�ip ^���ss 1300 S. Valley Vista Drive . �� Diamond Bar. 'STA� CA � �P 91765 coNTACTJaycee Kin pH�$G1-384� REQUIRED BUILDiAI� ASBESTOS YES NO ASBESTOS YES NO ASBESTOS YES NO BUiLDING 70 BE YES NO � 1NFOFtb1A710t�1 , PRESENT? SURVEY? REMOVED? �,� o�+oust�? DEINOLRION DATES � STAFtT n�a END WORK SHiFf(atnlpm� I FIEMOVA[.DaTES START 4�28�,�� EtJD 4�28�97 �vowc sH�Fr�amlpm� ASBESTOS Al�iOUNf T�BE FRIABLE � CLASS 1 CL11SS II TOTAL REMOV"rA{add rou� RE�d10YED(nsquarefeet) n/a n/a �n/a � n/a ' ASBES70S REi10YE0 FROi9 SURFaCES ��a PIPES n�a COMPONEFJTS n/d DESCRIBE 7HElAATERlALS ACOUSTIC CEIUNG UNOIEUM INSULA710N FIRE PROOFING D11C71NG . STl1CC0 . MASTIC : FLoORTILES.(VA'� DRYWALL PLASTER TRANSttE ROOFING OTHER(desa�e) carpe � COKTRACTORINFOFiN[ATION CSLBUCENSE# n/a OSHAREG# n/d AQMD(O�t 11/d NAME . � ADDRESS CfTY STA�E ZIP SI7E SUP1lR ' ' - PhfONE WASTETRANSPORTERI�1 N�-� ���LL Sanitation �istricts of L.A. Count ADDFtESS � I ADDRESS n,125 Val l ey Bl vd. � CiTY STATE ZIP CITY pomona STAT�• CA Z1P 9178� i � • . � Ru1e 1403 and NESHAP/�sbesb�Noti6cation Fam REV 9601231403FR96:SV . Page 1 oi 2 �� ' . . • ' . . =Z WASTE TRANSPORTER#2 ' YYASTE STORAGE SITE • � ADDRESS • n�a � ADDRESS � • n a . CiTY. . STATF ZIP CfTY STATE ' Z1P I CONTROI.S: DESCRIBE WORK PRACTICES AND CONTROLS TO BE USED AT THE DEM�UTION AND RENaVATIaN SITE. FORASBESTOS REI�OVAL WORK,INDICATE RULE 1403 PROCEDURE#1.2,3,4 OR S OR COMBINA710NS OF PROCEDURES USED. FOR PROCEDURES 4 AND 5,SUBMIT PtANS FOR AQMD PR10R APPROVAL. PROCEDIJRE#: � . � , . � , n�a _ . ASBESTOS DETECTION PROCEDURE: QESCRIBE THE METHODS ANO PROCEDURES USED TO DETERMINE YVHE71iER ASBESTOS IS PRESEPITAT .TH�SfTE,INCLUDING THE MlA1.YTICAL MEfFiODS:� . _� � ' . • � : . �n/a . • FOR DE1dOLiT10f�S GNE THE COMPANY NAME AND DATES�F THE ASBESTOS REMOVAL: • n/a . FOR ORDERED DEMOLRION SEND A COPY OF THE ORDER AND GIVE`'iHE AGENCY NAME: � . �AU7HORIZING P�RSON: • TRLE . . DA7E OF ORDER n f a � DATE ORDERED TO BEGIN: n/a � . FOR EMERGENCY ASBES70S REMOYAL GNE THE NAME AND PHONE NUMBER OF 7HE PERSON DECIARINGIAUTHORIZING THE EMERGENCY, DATE , AND HOUR OF EMERGENCY AND D�SCRIBE THE SUDDEN,UNDCPECTED EVENT: • • � n/a � IXPWN NOW THE EVENT WOULD CAUSE UNSAFE CONQITIONS,EQUIPMENT DAMAGE OR UNREASOt�IABLE FINANCIAl.BURE3EN: . , n/a . . • 'CONTINGENCY PLAN: DESCRIBE ACTIONS AND PROCEDURES TO BE FOLLOWED IF UNc'�'ECTED ASBESTOS IS FOUND DURING DEMOt.tTION OR NO'JFRU�BI.E j ASBESTOS MATERIAL BEWME CRUMBLED,PULVERIZED,OR REDUCQ�TO POWDER. . • ! . .n/a . � 7RAINING CERTIFiCATfON: I CERTIFY THAT AN INDIVIDUALTRAINED IN THE PROVISIONS OF REC�I.ATION AQMD RULE 1403 AND NESHAP WILL BE ONSiTE DURING i THE REMOVAL AND EVIDENCE TNAT THE REQUIREO TRAINING HAS BEQJ ACCOMPLISFiED BY THIS PERSON WILL BE AVAILA6LE FOR IAlSPECTION DURING NOFthV+l. BIJSINESS HOURS. . PRINT NAME OF OV4NER/OPERATOR n�a • SIGNATURE OF OWNER/oPERATOR DATE .� INFORL1A710N CERTIFlCAT10Pl: I CERTIFY THAT Tt3E ABOV'E INFORA+fATION lS CORRECT AND 1 HAVE QJCLOSED ANY REQUIRED ATTACHMENTS. J.C. Kim, O��rner/Partner � � �,...{�,,� � PRINT W1ME OF OVUNER/OPERATOR I � �Tl1RE OF 0 OPERAl'OfT' DATE J l 1 �c�-� NOTIFICATIONS•ARE N07 ACCEPTED WfTHOUT THE REQUIRFD ASBESTOS FEE(AQMD Rule 301)_ REMdVAL LESS THAN 900 SQUARE FEEf ARE • DCEMPT FROM NOTIFICATION AND FEES. PLEASE MAKE CHECK PAYABLE TO'SCAQMD'. FEES ARF PEFt NOTIFICATION, NOT REFUNDABl.E,1WD VARY ACCORDING TO TNE ASBESTOS AMOUNT TO BE REMOVED. FEES ARE AS FOLLOWS: � FROM 100 701,000 SQ1JAfZE FEE? S 1020 DEMOLITIOt3S S 25b0 FROM 1,001 TO 5,000 SQUARE FEET . S 76.80 REVISIONS S 1020 FROM 5,OOt T010,000 SQUARE FEET 517920 ' CANCEII.ATIONS � S 00.p0 MORE THAN 10,000 SQUARE FEET 5281.60 ' PROCEDURE 4 OR 5 PLANS 5281.60 NOTE: STATE LAW REQUIRfS TNAT lf W GIVEA COPY OF DE►fOU710N NOTIFICJl7iONS TO YWR LOCI�L BWLDING 11ND SAFETY DFPARTNEliT,pLEASE KEEPA COPY. R1AIL OFtIG11�iAL TO:,SCAQMD,RULE 1403 ASB�STOS NOTIFlCA710NS,P.O.BOX 4950,DIAlIdOND BAR;CA 91T6r0950 • . ' TEL.EPHONE: (909)396-2336 FAX: �909)3963342 � . Ruie 1403 and NESHAP Psbestos Notifx;ation Fartn RE1/9607231403FR96:SV Page 2 of 2