HomeMy WebLinkAbout14-3940 (219) �"�� CITY OF DIAMOND BAR
��_
r I�— L� I i ' DEPESRTMENT OF COMMUNITY&DEVELOPMENT SERVICES
���Illl��i+,; 21$10 Coplcy Drivc,Diumond l3ar,CA 91765 PRESS
� ' �� ��� (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 F�RM�Y
� �� BUILDINGPERMITAPPLICATION
!NY?'
� � 3/` , l/1/ 1G1u P,ca
APPLICATION DATE:��r��_—/ `,
wJOB SITE ADDRESS V ISSUE DATE:� /�O/ df/��I PERMIT#�." ,�.� 7 I,L�
a. •
z APN LOT. TRACT
TYPE CONST. � r OCC GROUP:
o OWNER
w
y ADD S � ZONING SEfBACKS
� C�Ty � Z{p TE FRONT RW ❑
� APPLICANT TEL. , REAR Q
o � SIDE/SIDE STREET RW �
o CONTRACTOR ./ SIDE �
o� ADDRESS � � ,,,r PROPOSED USE
¢ CITY
Z�p TE �
0
" ARCH/ENG/DESIGNER
0
o ADDRESS #DWEL.UNITS Ii STORIES #BEDROOMS
� C17y ZIP TEL. DESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREANALUATION
� ow►i�+•euaoErs oecw�nnoN
� I hereby amrm under penalty of Derjury that 1 am exempt from the Cantractor's State License Law for tho reason(s) SFR/ADD/REM
0
o indicated betaw by Ihe checkmark(s),I have D��ed next lo fhe apD����e item�s)[Seclion 703t.5,Business and Garage/Carport
w Protesslons Code:Any city or county that requires a permit to construc4 alter,improve,demolish,or repair,any
z structure,v��m 11s issuance,atso reqWres Iha aDP���nt tor the Dermtt lo file a s{gned statament that he or she w Patio/Deck �
d is licensed pursuant to ihe provlsions of tAe Contractor's State Lkense Law(Cltapter 9)Canmenc�n8 with Section LL p�I/Spa
� �OW ot�ivisfon 3 of the Business and PrMessiw�s Code)or ihat he or sfie is exemDt hom licensure and the basis for
N the alleged ezemption.My violation M Section 7031.5 by any applicant fa a permit sub�ec4 the apDlicant to a ch+il per�alty Z Re-Roof
� oi nof more Uan froe hunUretl tlollars 15500). '
0
o (J I,as owner of the property,or my employees with wages as their sole compensation,will do U�I of or(�porllons � Commercial
0 of ihe work,arM the strucNre is not intended a oflered for sale(Sec�on 7044,Business and Protessbns Code:The m �
w
� Conhactnrs'State License Law dces rwt 2ppty to an owner of property who,through employees'or personal eflort.�uilds
w or improves ihe property,providetl that ihe imprwements am not intended or offered for sale.It hownver,the building or
� impmvement is sold within one year o1 completion,No Owner-Builder will have Ne burden of proving Viat it was not 6ulit
por imprwed fw Ne purpose ol saie.).
V I,as owner o1 ihe ro ty conUacUn with Iicensed Contractors to canstruct tha ro ect{$ection
U p perry,arn exGushre g P � Valuation: Adj.Area:
0 1044,Business and Professiars Code:The CoMractors'S�ale License Law Aoes naI appty N an hwner o1 property wtw �
z builds a Imprmes thereon,and who cmtracts iw the Drojects with a liceraed Contractor pursuanl lo the Contracrors'Shate QUANTITY DESCRIPTION FEE
�
Y License law.).
o U�am e�eempt from Ilcensure under the Contractor's State Ucensa law tor Na lollowing reason(s): �
� �
`—` By my signature below I acknowledge Nat,except for my persa�al resldence in which I must have reslde0lor at least one �
Z year prior[o wmpletiai of the improvements covered by this pertnit,l cannot legalty sell a structure that I have built as an w
0
� owner-builder ii it has rrot been construcled in iis enHrery by Iicensed contractors.I understand fhat a copy ot the applipble .
� law,Section 7044 of ihe Business and Prolesslons Cafe is availabla upon request when thls application Is submitted w at
X the tollowing Web slte:http�Avvnv.leginlo.q.goWcalaw.html. m �
w DATE: SIGN: �
� ♦ I
� LICENSED CONTRACTOH'S�ECLARATION � ,
U
w I hereby affum untler penalty ol perjury Nat I am licensed wtler provisiw�s af Chapter 9(commenci�wiN SeCtion 7000)
� ot Division 3 of the Business and Rofessions Code,and my Ilcense is in full force and eflect. � •
� c`�.
� LICENSE CLA : LIC.NO.: �- _
�
oZ DATE: '�� COMRACTOR: w '
¢ WORI(ER'S COMPENSATION DECLARATION . �
� I HEREBY AFFlRM UN�ER PENALTY OF PERJURY ONE DF THE FOLLOWING DEq.ARATIONS:
w
¢ I have and wili mainialn a Certmpte of Consent tu Seli-Inwre for Wo�lcer's ComDensalion,as provided by CONSTRUCTION:
� Secuon 3700 of ihe labor Code.ror the perTamance af ihe work tor wh�h mis permil is issued. p�qN REVIEW:
�
j �L I have and will m�intain WorkePs Compensatfon Insurance,as reqmretl by Sac6on 3700 01 me LaOor Code,for ELECTRIC:
o fhe performance ot the work 1or which ihis permit Is issued.My Worker's Compensation Insurance Carrier antl ��
¢ Poliq N e: y PLUMBING:
� CARRIER /'" ' MECHANICAL:
z POUCVNUMBEA � INSPECTION FEE:
c�
� (T}OSSECiIONNEFDNOTBECOMPLETEDIFT}EPERMfT FOR E N DOW�ASl�t00jORLESS). ISSUANCE: � ��
oI certify fhal in tice performarr.e ot ihe wak for wldch ihis permil is isa�etl.I sliall nol employ any person in arry manner so as to SM IP:
0 6ecane subject to the WaleerS Comperaalion Laws of Calltomia.Md agree t�at If 1 stqWtl becane subject ro Ne Worker's
u� Cmnpensaiim provisiorrs ot Section 3700 or the L�or Code,I shan torViwith canpry wiln those provisiau. ENERGY P/C:
� DA7E: APPLICANT: ENERGY PERMIT:
�
� WARNING Failure to secare worker's Compe�uat}on coverege is unfawlul.and sbatl subject an emproyer to cdminal REfENTION FEE: �'0
w penatties and civil tines up ro one hundred thmrsand dollars(5100,OD0),in addition to the c65t of Ihe compensatlon,
a damages as provided tor in seci'wn 3708 ot the�abor code,iMerest,and anomey's tees PRE-ALT FEE:
� CONSiAUCT10N LENDING AGENCY BSAF:
z �hereby a�firm under penalty of perjury Ihat there is a Construction Lending Agency fw the perlamance ol the work for
� which this permit is issuetl(Sec.3097,Clv.C.�. p
� LENOER'SNAME � �Y
� LENDER'SADORESS:
a I ceNty ihat I have read Nis applicatlon and state that the above intormation is corzecL 1 agree N compry with all ciry and TOTAL FEES
� counry wdinances and state iaws relatlng m building constructi�,and nereby authorixe representatives at this county ro COMMENTS:
z
0 enter apon ihe above-mentioned property far fns ion purposes. �
J
�
m �
¢ PERM�TTEE NAME(PRI - � ' /
cn �, r /�-
� SIGNATURE OF PEAMITTEE pA RECEIPT q �OQI 7 PAID BY: � ' � 7 �VALIDATION: T •
WHITE—Depariment Copy,YELLOW—Finance Copy,PINK—Assessw Copy,GOLDENROD—Fle Copy,GREEN—Applicant's Copy .
CITY OF DIAMOND BAR
INSPECTION RECORD
. � � . � s - • � � e '
SETBACK/LETCER`,; �" '��''` TRACTAND LEDGER
FDOTINGS FORMS � ' c, ,, ;= - �� SWITCH GEAR
SLAB';. M`: " ;� '' '� ` "ck COMMERCIAL HOOD
<�° � ��,�' T-BAR
UG.PLUMBING�.�, : � �� n,� --�= - - a, ��
UG.EIECTRICAL`:' ` � ;:; - INTERCEPTER
` " ' r` 5S HOT MOP/SHOWERPAN
_UFER GROUND;L. . = .�=ti_, �' �.=
SEWER LATERAL SEPTICICESSPOOL
MAIN WATER LINE HERS REPORT RECEIVED
SEWER CLEANOUT DEMOLITION
ROOF SHEATHING ROOF DRAINS
FLOOR SHEATHING ROUGH CONDUIT
SHEAR WAILS,EXTERIOR "�' � •_ '� ?- POOUSPA`�:; � � _ '" `=r ` ��'`�'
` f°, ''-
SHEAR WALL:S.INTERIOR tr. � �{ :ROUGH PLUMBING ,� , � u � , ,, �x � ^ ��
., .:.�_ :. ; '•, i:f. ,"' .s _�f ' / ., � J . )1-.I a
FRAMING/VENTING �- ROUGH ELECTRICAL`, - < - _ �
' 1F a � � '}.4 :.
ROUGH MECHANICAL .• �" k <; f < < ROUGH MECHANICAC ;' ,� � - ' �� ,�
ROUGH ELECTRICAL W( �)C( ) :t ; GAS TEST�F °" ` � ,� ' '� � � � ' �"� '�s'
ROUGH PLUMB�p�(�. : ` ' +`:, 3 1'RE GUNITE' , �„ , #` '� � ` ',� � , ' ��'?
IIYU , _...�' Y :.."�.�, .� ,„t -c�°:.� ._ . .-'_ 1 i ,i.`.i� .
�r ,
_, ... _ ..: .. . , . � . '�. 1.
INSUWTION WALL POOL'PRE�DECK BONDING,__�: � s+ �' �'�
INSULATION CEILING �P'�P �' ' -'� � �
DRYVJALL ,FENCE f�GATE/ALARM r , ;.�r � r r+"
�
LATH(PRE� FINAL POOL ',�, . ,a = + _' �'1 _ ' �
LATH EXTERIOR WALLS:
LATH INTERIOR WALL FOOTING/STEEL
GAS TEST WALL STEEL 1�( )2ND( )LIFf
SCRATCH COAT WALL BOND BEAM
ELECTRIC METER RELEASE WALL DRAIN/SEAL
GAS METER RELEASE WALL fINAL
SPECIAL INSPECTION RO FiiAMiNG PUW(�NG°APPROVAL � - 'r '-�_
FINAC BUILDING `' r � - : ROUGH FIRE APPROVAL _ >i =" i' �' "_:''r '
FINAL MECHANICAL ; °, � ' FINAL FIftE DEPARTMENT ��, °� i '� 'r
'a ;'
v �.�,� � ,,; - � .�- . � ' ,,; - NAL PCAPINING ' r,� ��,,: � ' TM' .
FINAL ELECTRICAL � , . FI x. : ,'� '
'FINAL PLUMBING � �� �., � �� � � ��� ''� '�� - �FIPIAL`-�ENGINEERINGI PW ;;` �=� >>�� �_ " �� � ���':
T.C.of OCCUPANCY � � FINAL COMMUNITY SERVICES _ _ �
CERT;of OCCUPANCII��;;� �,�, . ` ` ��'� fINAL HEdLTH�DEPT ° ,� '� �' �F`
fINAL7NUUSTRIAI�'-WA5TE§,' 1*a'1 'r -'" ��
h. . �.. � ,,...'. ,..1 t, , ,.. ' ""� t, . v
COMMENTS: �� �� a� ��"��