HomeMy WebLinkAbout14-3967 ' ::,._. -•'� C1TY OF DIAMOND BAR
� ��� � � DEPARTMENT OF COMMUNITY&DEVELOPM�NT SERVICES
'��I I�`;='v�� ' 21810 Copley Drivc,Diamond Bar,CA 91765 � PRESS
,,,,.� (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 FIRMLY
`'`'L"°". BUILDING PERMIT APPLICAT[ON
� ����� ��QO���� � APPLICATION DATE: C�'�'�� P/C# ��� �9 D �
� JOB SITE ADDRESS
z APN LOT TRACT ISSUE DATE: �Ia'�I-) 1� PERMIT# P1Z \g-� 3�?�p�
0
o OWNER TYPE CONST. OCC GROUP:
� ADDRESS` �nOc�d
� CITY ( P \ �L��' Q�v�Q�,� ZONING F ONTCKS RW ❑
o APPLICANT TEL. REAR
❑
� M,,� � -� SIDFJSIDE STREET RW ❑
o CONTRACTOR 1'`Y� O � SIDE ❑
� ADD ES � [
o� CI ZIP9i`�i-rEL.Q�-i 59 Q�5-7J PROPOSED USE � �L
o x3 � `
o ARCH/ENG/DESIGNER ^ �
o ADDRESS � N �-5�'"' #DWEL.UNITS �STORIES #BEDROOMS
' a CITM��h�L~ ZI L ,�)�����1�� DESCRIPTION SO.FC FACTOR PSF ADJ.AREANALUATION
. � � OWNEfI-BUILDEfl DECLMATION
� o I hereby affirm under penatty of peryury that 1 am exempt hom the Contractor's State License Law for the reason(s) SFR/ADD/REM
p fntlicated 6elow by the checkmark�s),I have piaced next to the apDlicable item(s)[Section 7031.5,Business and Garage/Carpwt
, o Protesstons Cade:My ciry or county that requires a permit to co�truct,alter,improve,demolish,a repair,any
w structure,prior to its issuance,also requlres the applirant tor the permft to file a signed stalement Mat he or she � Patb/Deck
� fs licensed pursuant to ihe provlsions ot ihe Co�rtraclor'S State License Law(Chapter 9)Comme�ing wfih Sedion W �
� 7000 of Divfsion 3 of tha Business and Prolessiais Code]or ihat he w she is ezempt hom Ilcensure and Ne basis(w � P�uSpa �
N the alleged ezemption.My violation ol Section 7031.5 by any applicant for a permit subjecis the aDDlicant to a civil penatty C9
N of not more than five huntlretl dollars(3500). Z Re-Roof
� I,as ownerof the ro e �
U p p rty,m my employees wlth wages a5 Nelr sole comperrsation,will do()all ot or U porllorrs _ Commercial
0 ot the work,and the strucNre(s not intended w oflered for sale(Sectlon 7644,Business and Prolessiorts Code:The �
Cantractors'State License Law dces not appty ro an ovmer of property vfio,Mrough employees'or personal eflort,builds m
w or improves Ne property,provitletl ihat the imprwements are not intendetl a otfered tor sale.tt however,ihe builtling or
� impmvement{s sold within one year of completlon,Ne Owner-Builder vnll have ine burden of proving ihat It was not bultt
p or Improved for the purpose of sale.). .
0� U�,�o++�nu of the property,am exGusivety conUacUng wilh Iicensed CanVactors to cansUuct the proJect(Section
7044,Business and Professions Code:TAe Contractors'Sta�e License Law does rwt appty to an owner ol properry who Valuati ' Adj.Area:
z bulldswimprovesmereon,andwhocontrxtstatheprojectswithallcensedContradorpursuantlotheContrxtors'State QUANTITY DESCRIPTION FEE
�
Y License Law.). '2 �
� (�I am exempt from licensure under the Coniracinr's Stale Llcense law lor ihe Iollowln9 reason(s): �
LL � .
By my sigrature below I acknowledge that,except for rtry personal residence In wtvch 1 must have reslaed for at least one �
w
o year prior to completlon of the fmprovements covered by this permi4l cannot legalty sell a sWcture thai 1 have buitt as an --�
w
�¢ owner-builder Il lt has rrot been consWctetl ln its enGrety by licensed contractws.I understand ihat a copy of the applicable
oc �w,Sectim 7044 0l ihe Business and Professlons Code Is available upon request when this application is submitted or al
a Ne iWlovnng Web site:httplwv.w.lepinfo.ca.gov/plaw.hhnl. z
x
w DATE: SIGN: m
o � 1 �
~ LICENSED COMRACTOfl'S DECIARATION �
r a
w I hereby aNirm under penalty of perjury that I am licerrsed untler provisions of Chapter 9(commencim�with Section 7000)
� of Division 3 of the Business antl Rofessions Code,and my Ilcerrse is in full brce aiM effeci. J ,`,.., _ , e
� �t'tit r•„�
N �
cn LICENSE CLASS: L1C.NO.: _
x
o �ATE: CONiRACTOR � �
a WORNER'S COMPENSATION OECLARATION "'
� I HEAEBY AFFlRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARNTIONS:
oI have and will maintain a Certiflqte of Consent to Self-Insure lor Worker's Compensation,as provided hy CONSTRUCTION: S'�S �f.��
� Section 370D ot lhe Laba Code,for Ihe perfwmance of the work tor which this permit is issued. p�.,c,N REVIEW: �J �l'� L/y
� I have and will maintain waker's Compensatim Insura�e,as repuired hy Sectioa 3700 W the Labor Code,tw ELECTRIC: :,(� ��
Z the pertormance of ihe work fw which ihis Dermit is issued.My Worker's Compensatlon Insurance Carrier and .
¢ Poli�y Num6er arer•, _ � ���� PLUMBING: ' p. Oa
Z �R�� ����� MECHANICAL: (p�p ,
� POLICYNUMBFA ] � INSPECTION FEE� �
o� (T}OS SECTION NEED NOT BE C0�IF THE PQiMR IS FOR ONE FNNDRED DOLLMS($10�OR LESS). ISSUANC E: ��}-'a• a`g
I ceAiry that in the peAormvr,e o!ihe vmrk la which Utis permit Is issued,I sh�ll rol empby any person m arry manner so as to ' ^ . ��
hecome su ect to Ne Worker's Cqm eraation Laws o(Califomia.Md e SMIP: a�
p �1 P gree Ihat II 1 shaultl becane sut�ect fp the Worku's
� Comp�e�.a,ti.o�n p-�ovisi'o`ns�ot Section 37 ot t e t.abor Code.�shall lor�mvi�� N wilh those provisims. EN ERGY P/C:
J DATE:L4_-1a..CAPPLICANT: .
" ENERGY PERMIT:
� WARNING:Fallure to s cure Worker's Compensation co is unlawlW,and shall sub�ect an employer to criminal REfENTION FEE: (p. O�
w penatties and cfvil fines�p ro ane hundred thousand lars OO,OOOJ,in addition to the cost of the comperaaGon,
� damages as prmided tor in section 3708 of ine la6or code,irrterest,and attomey's tees. PRE-ALT FEE: ' q'1 ��
a CONSTRUCTION LENDING AGENCY BSAF: �, pp
= I hereby affirm untler penalry of perjury that there is a ConsVucQon Lending Ageiuy fa the perlwma�e ol�he work for
� which this permit is issuetl(Sec.3097,Civ.C.).
r LENDEA'S NAME
� LENDFA'SADDRESS: • V
ow- I cer6(y that 1 have read ihis application and state that the above informatlon is cortect.l agree fa compty with all dty and TOTAL FEES
Z counry wdinances aM state laws relatlng N building construction,end�ereby autliorize representatives of this county to COMMENTS:
o enter upon the above-mentioned property for Inspection purposes.
J
m �-���� ���
¢ PERI NAME(PR� �O�co� 3,"'1 Ira '�\
�
� SIG TUR RMfTTEE DATE RECEIPT N I�•D �� pAID BY:V ,�7 a� VALIDATION:
WHITE—Department Copy,YELLOW—Fnance Copy,PINK—Assessw Copy,GOLDENROD—Rle Copy,GREEN—ApplicanYs Copy
�--.�
CITY OF DIAMOMD BAR �. -ry
INSPECTION RECORD �.
• � � • ' ' • ' ' o
SETBACK/LETTER ' '` � ,: TRACTANDLEDGER
FOOTtPIGS FORMS �� ' ' � " � r-'•�"^ SWITCH GEAR
S�B. - � , :� _ � COMMERCIAL HOOD
UG.,P.LUMBING`-. � , �.�;� ` _ _ ;� T-BAR
� � ' ' �' INTERCEPTER
UG..ELECTRICAL . " � - - -
UFER GROUND_'�i =,.";� HOT MOP/SHOWERPAN
SEWER LATERAL SEPTIC/CESSPOOL
MAIN WATER LINE HERS REPORT RECEIVED
SEWER CLEANOUT DEMOLITION
ROOF SHEATHING ROOF DRAINS
FLOOR SHEATHING ROUGH CONDUIT
_ _- • _ - � � �, � � - _
SHEAR-WALLS��XfERIOR�: - PQ���PA� ' �
SHEAR WALLS�INTERIOR�' � � ROUGH PLU�MBING �^� �� '� -
FRAMINGNENTING ,;`,... ` r� , : � ; � z ,: - .k
- , ROUGH ELECTRICAL- �
� ' .
� F
� �: �= . :� 7 . . , .
.ROUGH:MECHANICAL •=t °.�,- ,� �;,� ��,� �P 'ROUGHaMECH{WICAL� z . �'- � rr � ��, �
, ;, � ,�
ROUGN ELECTR'ICAL W(.'�`�)C( ) ;; _ �' � GAS TEST,'' �` � �,� �1 � �,
PfiE GUNITE ' t` " ' 4
ROUGH�PLUMBING, - - ' ,,
`. 1 , � �.� ... �:� . ._: _ � �� .. , ,.?... , ::.;
INSULATION WALL FOOL�PRE'DECK BONDING ; , � � h
:F�t ': ��d-c y�i ' ¢� �'
r �
INSULATION CEILING 'P-TRAP :.'� d " n ''
DRYWALL FENCE 1 GATEf,ALARM � '�� � � � ' �� -�
y
LATH(PR� FINAL POOL r = � 4 �'`� ���
tATH EXTERIOR WALLS:
LATH INTERIOR WALL FOOTIN6/STEEL
GAS TEST WAIL STEEL 1sr� �2xo� ����
SCRATCH COAT WALL BOND BEAM
ELECTRIC METER RELEASE WALL DRAIN/SEAL
GAS METER RELEASE WALL FINAL _
, � _ � - , -. �� ��_ �,�
SPECIA�INSPECTION RO FRAMING PLANNINGAPPROVAL F Y
, ` ,'-:- ;z -�- ._ , � ;-,- . 'ROUGHFIREAPPROVAL `
FINAC Bl11LDING'. . ;J �
, . . . . ,. � _ �
FINAL FIRE UEPARTMENT . + ` '
FINAL MECHANICAL �'� �
°
FIN,41 ELECTRIGAL� � - �'r '� F._INAL PLANNING � �h �- � � '� � � s��""' �7 s�'�
+ � � - FINAL ENGINEERING/PW ` " 1 c ` F<
FINAL PLUMBING � '
T:C:of OCCUPANCY �� - �r s fINAL COMMUNITY SERVICES � � _ �� � r h .
CERL ofiOCCUPANCY,:-. - - � ` y ' ' r FINAL HEALTH DEPT c � ' r� �� r� r ���
; '. .. . ..: ' , -
FINAL IMDUSTRIAL WASTE-, '' � -r t: � �
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i.O M M E NTS: �:�iv 1�/��►�rci- °�../ �,.•-, E �
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