HomeMy WebLinkAbout14-1214 (217) „,t�,� CITY OF DIAMfJN])13AR �
4[1��1_i ' � DEPt1RfiMENT OF COMMUNITY&DEVELOFMGNT SERVICES
�f4�p�„�:� 21$14 Copley Drive,Di<imond Bar,CA 42?55 � PRESS
����� � (909)839-7020 �'ax:(909)861-3117 Etuilding Inspcction Hotline(909)839-7027 ��R(�LY
"'��"'. � BUILDING PERNilfi APPI�ICATION
� APPLICATION DATE:�� '"� —P�C�—.. �� —
� � JdB SITE ADdRESS � � /"��r'��/ pERMIT#�_�.���+�
ISSUE DATE:
a APN l.OT TRAGT 7ypE CONS7 YP���____
o QWNER /7�1 OCC GROUP:
� AbDFj S Z(7NING SEfBACKS
� C� A/ i ' T . FRONT RW ❑
d APPLICANT TE ��R �
0 81DE/SIDE STREET RW �
Q CONTRACTOR � ''�/Y SIDE �
oro ADI7RESS � PROPOSED USE
s CITY ZI{`� TE .
0
” ARCH/ENG/DESIGNER
a
z ApDRESS #DWEL.UNfTS #STORIES #BEDROOMS
0
Q CITY ZIP TEL. DESGRIPTION SQ.F7. FACTOR PSF ADJ.AREANALUATIQN
� QWNER-9UIlDER 6ECtARA7tON gFR/ADD/REM �
°C I hera6y a�rm��er penatty of perjury Ihat I am�emp!trom the ConUactur's State License Law for the reason(s)
� � indicated bebw try the checkmark(sj,I have piaced nezt to ihe aDD»��e�tem(s)[Section 70315,Business and
o Garage/Carport
w p�p�����;pny q1y pr county that rcquires a permlt to censWcl,a!ler,improve,demolish,or repair,any
z stru¢Nre,prlor to tts issuance,aiso requires Ihe appticani far the pertnit iu flie a signed statement that he or she W Patio/Deck
a is tieensed parsuant to tha provisEons o!the Coatraeta's State Lice�e Law(Chapter 9)Commericing with Section LL p�USpa
� 7000 ot Division 3 0(the Business and Protessions Gode]or ihat he or she is exempt trpm iice�ure antl the basis(or
�
� the aile9ed exemptia�.Any violalion ot Section 7037.5 by any applicant fa a permit subjects the appltcaM to e civil penalty
`n of not more ihan five hundretl doliars(E500}. Z Re-Fioof
o t}i,as owner of thn property,ar my employees with wages as Neir solo cnmpensatfon,witk do(}aN o7 or{�portiorts � Commercial
0 01 the work,and the sWcture Is not intended a oflared fpr sale(Section 7Q44.Business and Professims Code:The �
w m
� Contrac?ors'Stato License law does raS appty ro an owner of properry who,UuougD empioyees'or persona!eftort,boilds
w w improves the�properry,Provided that the Improvements are not intended or oflered for sale.If however,the building or
� imRrovement Ss sotd within ona pear of comptetion,it�e Qwner-8uiltler wiA have tha bucden ot proving iha[it was rrot buitt
por improved fa the purpose ol sale.).
� i,as owner of the ra ty car�tractlo wFth Acensed Gonttactars to conshvci the pro ect{Sectbn
�} p perry,am rxdusive g � Valuation: Adj.Area:
o �pqq,Business and Rofessions Cutle:The CoMractors'Sta1e License l.aw dces irot appry to an mmer ot property who
Z buitAs a imD�4ves inerean,and rfio conuxss tar the pro�ects wtth a ttcer+seu Contrador Dursuani to the Contractors•State QUANTiTY DESCRIPTEC7N FEE
�
Y License Law.).
o �}i am exempt hom ticensure under the Contractnr's State Ucensa Iaw For ihe fotiowing reasort{s}: �
� ¢
�—` By my signature be�ow i ukrtowiedge ihat,except tor my personai residence in whicil i musf have resided for at ieast one �
Z yeer prior to complefiai of the ImprwemenCs cavered by this permit,t cannot legally sell a strucwre t�at I have huilt as an ,��,
0
� owner-buiideriiithasrrotbeenconsWciedinifsentiretybyikensedconlractors.iunderstanUthatacopyoiihesppiicabie
� law,Section 7044 of the 8usiness and Protesslons Code is availab�¢upan request when this application is submitted ur at
c7 '
X the fotlowing Web site:http7www.feginfo.ca.govlcataw.himL m t� 1 rV �
..._LV
�'-� DATE: SiGN: �
� IJCENSED CONTRACTOH'S�ECLAHATION �
v
w i hereby affirm untler penatty at periury that I am ticer�sed ander provisions ot Chapter 9(commencing wiih Section 7006}
� of Division 3 01 the Buslness and PrWessions Ca1e,and my ticense is in full forcE and eflect. �
n r' 2.- �
�, uceN c�{p��--f�zt- '�/�'.`,'�'' No Z
o T:�_,!_?c�/'",�ONTRACTOH:� �
¢ WORKER'S fAMPENSATlON DE IARATION � �
� I HEREBY AFflRM UNDER PENAL7Y OF PERJUflY qNE OF T}1E FOLLpWING DECI.ARATIONS:
w
oi have and wi�i maintain a Ceiliticate o1 Consent to SeN-insure tor Waker's Gnmpensatian,as providetl by CONSTRUCTION:
� SecUon 3740 0l ifie Labar Code.bt tha P�ormance at iha wnrk tar which It�is permit is issued. PIAN FiEViEW:
� ��I have and w�ll maintain Worker's Compensatlan Insu2nce,as repuired by Section 37p0 of the Labor Code,fa ELECTFiIC:
o ihe perf�rmance al the vrork fcu which this Oermii is issued.My Worker's Compensation t�urance Carrier antl
¢ PolicyNumberare: � PLUMBING:
o CAEtRiER C NiECHANiCAL:
w
Z POUCY NUMBER � INSPECTIdN FEE;
c7 ��'�
� (�F6SSECfIDNNEEDNOTBECAMR.ETEDF7HEPERMffISFORONEFMJDREDDDI.I.MS�S100)DRI..ESSr. ISSUANCE: � �=-�=�
oi certiiy that in the pertarmance oi i�e wark for wYuch�his perm3t ' .i sMii a�ry R����Y����to SM IP:
becarne su�ject to Ihe Worker's CampeivaUon Laws of .Antl t if su e Workefs
�u
� Com Uon prw at SeGion 3740 at ihe ' mpiy with those provis ENERGY PJC: .
J DA���APvuCANT: ENERGY PERMIT.
� WARNING:Failure lo secure Wwker' uniavAui,and s�ail subjeci an empbyer fo crimina� RETENTION FEE: ' �v
� pena4ties and civil fines�p to one reA thousarnl dolfars{$740,000),in addi5an ta Ihe cost ol tha comperr.�tion,
d damages as prw{ded�a in section 3708 af the labor cvde,iirterest,end atlomey's ises. PRE-ALT FEE:
a GONSTRUCTl6N I.ENDING AGENCY BSAF:
� 1 hereby affirm under penalty of perJury lhat there is a CortsUuction Lending Agency lor the perlan�ance of the work for
� whiCh fhis permit is issued tSec.3097,Gv.C.}.
� LENDER'S MAME
� LENDER'SADDRESS: s� �,r
� i certify ihat t have read fhis appiication and state that Vre abave informatlwr is cortect.i agree to compty wttl�ait ciry and TOTAI FEES �` ;!L
� county wdina�ces and s�ate laws relating N b�ildi cauUuction,a�d hereby authorize representatives of Nis counry to (� 7
z ng u GQMMENTS:
Q entar upon the a6vr me " ed property fw' pu
J ��
�
m
� P£RMlTSEE NAM {PRIt�IT) ��' n� J
ol ! / L
= Sif�NA7URE QATE i?ECEIPT tt PAID BY: /Z ✓ VAi.it?RTtON:
H
WHITE—Department Copy,YELLOW—Finance Capy,PiNK—Assessor Copy,GOLDENROD—Fle Gopy,GREEN—ApplicanYs Copy
CITY OF DIAMOIVD BAR
INSPECTION RECORD
� � , • ' � e � • '
SETBAGK/'LETTER ,i,�" r F' r ': ' = TRACTAND LEDGER
FOOTINGS FORMS �- �:-
�' ' "` �-; SWITCH GEAR
SLAB � `� ���' _ � " . �"�' ' `_ '.�-i� ` ,, �,� COMMERCIAL HOOD
UG.PLUMBING ` � � s��. � � ;� , -� T-BAR
UG.ELECTRICAL � �` - INTERCEPTER
,
UFER GROUND, . `i �: � � =` HOT MOP/SHOWERPAN
SEWER LATERAL SEPTIClCESSPOOL
MAIN WATER IINE HERS REPORT RECENED
SEWER CLEANOUT DEM�LITION
ROOF SHEATHING ROOF DRAINS
FLOOR SHEATHING ROUGH CONDUIT
� `' `POOL/SPA-; '-r '�"' '
SHEAR WALLS EXfERIOR`� , _- " "�
SHEAR;WALLS_fNTERIOR".. . - � � ROUGH'FLUMBIN6 -: `� � ` _"� rv
FflAMING/1(ENTING ` ' � '� s: r ;� '�: RQUGH ELECTflICAL: ; 3 � -' � �
ROUGM'MECHANICAL �� � ��` ;' ��: , �� ,�, �' t ROUGHMECHANICAL. �;k � � �` *' -� ���r{ �t� ���`
J � h �9 .� i�j -�d ��
ROUGB ELECTRICAL W(,�).C`,(�,) . „� _ , ;� " GASTEST—F¢ " �'- "'�- - - - ` �'��:
ROUGN•PLUMBING - ' ��� 3 .�;' PREGUNITE ' �� � ':: ' a � �
INSULATION WALL � � �POOL.PR�';DE�K BONDING¢ � y,�, �. `' r�'' � �'
P-TRAP - , 4;. ,, i�: j y t
INSULATION CEILING - �
DRYWALL FENCE�/GATFJ ALARM �'� ' � " � -
LATH(PRE)
FINA'L`POOL� =� ", ,-.� ti '.;:F _-
LATH EXTERIOR 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 FINAL
t}' 1
SPECIAL INSPECTION � R0.AiAMING PLANf�NGAPPROVAL r* °��'' �` r '
' �-�i .� . i � , r' ROUGH FtREAPPROVAL �r x �
FINAL�BUILDING ` � � � `'
F�NAL�MECHANICAL : ti �� � , ��� z � FINAL FIRE DEPART,MENT ,` '��� '������� � �
�FINAL.ELEGTRICAL � k �:,' - _ , ,',."' FINAL PLANNING���_� ?' , ' � , � ��� - ` ��� +� �,_`
FINAL PLUMBING, - ` �` "' FINAL ENGINEERitdG!PW 'r , ';' ' �`-�' �' F +�''
T.C:of OCCURANCY_ . °�i . ' FINAC�COMMUNITY';SfRVICES - -_ '` '�°
,�., . .
FINAL HEJ4LTH DEP7 ' r � ` �
CERT:of OCCUPANCY':;' , .' . : '� � .,,,�._; �,. , . ���: . ��� ...' ; � �: t ,
.. . . -.: . .�r . ,. u., t -r a i ..
FINALINDUSTRIAC-WASTE_:�� ''_�.. ; .='`k °- -`- --= �
COMMENTS: