HomeMy WebLinkAbout14-4352 i5' CITY OF DIAMOND BAR
f I I I i ' � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES �i Z,O��'� r,'
��jl„�:;.�- rr� 21810 Copley Drivc,Diumond 13ur,CA 91765 � �01��\� PRESS �
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,,,,,� (909)839-7020 Fax: (909)861-3117 Building Inspection Hotline(909)839-7027 FIRMLY
��4'�"' . BUILDING PERMIT APPLICAT[ON ��
g ` �� S p APPLICATION DATE• - ��� l I P/C#
� JOB SITE ADDRESS O r
a ISSUE DATE: .��� PERMIT# ��� ��J �
z APN LOT TRACT
o OWNER S [2�`� bP 1YPE CONST. OCC GROUP:
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N ADDRESS S'
N CITY ZIP TEL. . � ZONING F ONT KS RW ❑
OAPPLICANT ��T�' U✓) TEL. ',RI�� 7-� 7Z7, REAR ❑
oN r�^������ ���L�`���S • SIDE SIDE STREET RW ❑❑
CONTRACTOR
oro ADDRESS d H •
o CITY d��' ZIP�` �TEL. ��� O.- � PROPOSED USE O O /N l`I
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o ARCH/ENG/DESIGNER _��f J ��' �
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o ADDRESS
o ri DWEL.UNITS k STORIES #BEDROOMS
z CITY ZIP TEL.
� DESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREANALUATION
OWNEfI-BUILDER OECLAl1ATI0N
� I hereby aKrm under penatly of perjury that I am exempt imm the Contracta's State License Law for the reason(s) SFR/ADD/REM
oIntlicated below by the checkmark(s),I have placed nent to the apDltcable item(s)(Section 7031.5,Buslness and
'-'-' Professions Code:M d m coun that Garege/Carport
o y ty ty requires a permft to consWct,alter,improve,demolish,or repair,any
w structure,Drior to tts issuance,also requires the applicant tor the permit to flle a signed statement that he or she � Patio/Deck
a Is licensed pursuant to the provisions of the Contraclor's State IJcense Law(Chapter 9)Commencing with SecUon w
� 7000 of Division 3 of ihe Buslness a�M Professio�x Cotle]or that he or she Is exempt hom Ilcensure and ihe basis for LL PooVSpa �
� Ne alleged exemption.My violation of Section 7031.5 by eny applica�for a permA subjec4s fhe aDDlicant to a civil perqlty Z Re-Roof
� ot rrot more than five huntlred dollars�$500). 0
� (,I,as owner af the property,or my employees with wages es thelr sole compensatlon,wfll do(_,)all oi m(,poNons � Commercial .
� ot ihe xrork,and the strucWre is not Intended or ottered Por sale(Section 7044,Business and Prufesslons Code:The m I
� Contractors'Stata License Law dces rot appty fi an avmer of property who,through employees'w persanal eflart,builds
u�7 m improves the propeity,proNded that the Imprwements are not intended m ottere0 lor sale.If Iwwever,ihe building or
� improvemenl is sold within one year oi completlon,the Owner-Builder will have the burden ol proving that it was nut huitt
por imprwed fw the purpose of sale.).
v I,as owner of the ro
0 (� p perty,am exGusively conVacti�wilh Iicensed CanVacrors to conshvct the project(Section Valuation: Adj.Area:
7044,Business and Professions Cale:The Contractors'Stale License Law does rwt apDN to an owner ol property wtw
Z builds a improves Ihereon,and who contrxts for the proJecis with a licersed ConVacta pursuant to the Contrxtors'State
v� QUANTITY DESCRIPTION FEE
License law.). T �II
o U I am ezempt hom licensure under the ConVactor's Sta�e Ilcense law for lhe lollowing reason(s): a
� U �
S
�—` By my signature betow I acknowledge that,except for rtry personal residence in which I must have resided lor at least one � �
o year prlor to completion of the fmprwements covered by this permit,l c2nnol legatly sell a sWCNre that 1 have built as an w
r— owner-builtler ff I�has rrot been canstructed in iis enlirely by licensed contractas.I understand ihat a copy ol the applicable I
� law,Section 7044 of ihe Business and ProfeSSlons Code Is available upon request when ihis applicaUon is submittetl or a! S l N �
X the follovnrg We�site:httplwww.leginfo.ca.gov/plaw.htrnt. '�
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p .DATE: SIGN: � LL
� LICENSED CONTflACTOfl'S DECLARATION � (nJ,
w I hereby affirm urMer penatty ot pehury ihat I am licensed under provisions of Chapter 9(commencing with Sec on 7
m of Division 3 ot the Business and Professions Code,and my Iicense Is in full force and effect. �
y UCENSE CLASS: � LIC.NO.: J�/ � �/� z
o DATE: ��� � ��1. CONTRACTOR: _
Z w
¢ WORI(EH'S COMPENSATION DECLAHATION � •
� I HEAE6Y AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLAA.4T10NS: .
oI have and will maintain a Certiflpte ot Consent to Self-Insure tor Worker's Compensati ,as provided hy CONSTRUCTION: � � �S
� SecUon 3700 of the Labor Code,lor the perfamance of the vrork for wh�h this permit is issued. p�qN REVIEW:
� I have and wJ1 mairttain Worker's Compensation Insurance,as requiretl by Sectio�3700 oi the Labor Code,tw '� p� I�'q
� permit is issued.My Worker's Compensation Insurance Carrier antl ELECTRIC:
ih¢peAwmance of ihe work fw which ihis J / XI f
a PolicyMumberare: PLUMBING: ��(� � 1
,� C[�aRiER —f ' MECHANICAL: M�a'�I
� PouCrruUrnBFn INSPECTION FEE
� (TFOS SECTION NffD N0T BE COMPLEfED IF THE PERMR 5 FOR ONE FRINDRED (5100�OR LESS).
� ISSUANCE: �`
o I certily that in the pertwmance of Ne vrork 1a vfiich Ihts permit Is iss�ietl.I shall rot emp � �manner so as to SM I P: � [�
o hernne sul�ect In Ihe WalcerS Comper5ation Laws of Calitomia.Md agree Ihat i1 I W s�bject to the Wmke�s
� Cmnpe ti �xw�pr�s or Section 3700 m tha labor Code,�shan tonhwilh can provisiara. ENERGY P/C:
LL DAlE: � I Y) qpp��: ENERGY PERMIT:
� WARNING:Failure to secure Workers Compensation coverage is unlawlul nd II subJect an employer to criminal REfENTION FEE: �-�da
w pena�ies and civil lines up to ane hundred thousand dollars(3100,000) atldi on to the cost of the compensaUon,
a darnages as provitled for in secUon 3708 of the labor code,interest,and at mey's fees. PRE-ALT FEE:
0
a CONSTRUCTION LENDING AGENCY BSAF: `�
w I hereby atfum under penalty oi perjury ihat there is a Construction Lending Ageiuy for Ihe perlormance ol the work lor
3 which thts permit is issued(Sec.3097,Cfv.C.).
� LENDER'S NAME
� LENDER'SADORESS: �
a I certify that I have read this application and shate that tlie above infirmatlon is correct.l agree ro compty vnth all ciry antl TOTAL FEES
Z counry wdinances and state laws relating ro huilmng conswcfion,end hereby authorize rcpresentatives of this county ro COM MENTS:
p enter upon the above-mentloned property for inspec�ian purposes.
m --�- �9-rd .
¢ PERMRTEE NA E(PRINn
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�
� SIGNATURE OF PERMRTEE DATE RECEIPT# � PAID BY: � a&��VALIDATION:
WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessw Copy.GOLDENROD—Fle Copy,GREEN—ApplicanYs Copy
CITY OF DIAMOND BAR
., INSPECTION RECORD
. � � . � • - s � � • '
.SETBACKL LET�ER � - �f'-.. ' ' TRACT AND LEDGER
FOOTINGS FORMS ,' �' ,,; '. .r� '' °��' '�,.. -.. �i� {': SWITCH GEAR
�
`' COMMERCIAL H000
SLAB"� �� r �s �t�-' i .? ^.,r ,� �4,,
UG:PLUMBING.•�;, 9 'rtVF ;� �>..r.r �` '� ' :F, :_. T-BAR
UG.ELECTRICAL;; , • � x ``�� r `" 4 =�° �": INTERCEPTER
UFER GROUND: `' — r � = r: 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 E'Xl'ERIOR,- � `" } � ' �� � �� � ��� ��� � � ' 3 �� � ��
4�i;. � ."„ �, � ,: POOUSPAzr: F ' r �, s � � ,;�`, �;
SHEFiR':WALL9INTERIOR s:; „�,r� `:� k � .,�r,i° >.' RQUGHPLU(±lIBINGi s.1 ;, � s` f ;, r :r} c �
FRAMINGNENTING ` � �-,2 ��?��, -'� ROUGHEL""EGTRICAL � ' _ ,x.�:� - '3 '� t � '�._
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ROUGH'INECHANICAL ,`1 " ' � '� ROUGH MEGHANICAL'; = f� ` ',,' ''��' � �? '� ,r4 `���r�
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ROUGH ELECTRI6F�L W( ):C{ } = r�'I- - -� . ,+' A � ' a�� GAS TEST ; ;• s �
.. • , . ' r�. ,, �� - + �F ,
ROUGH PLUMBING 1 �::. ' P,6E GUNITE; , -;. _ , ' - :
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INSULATION WALL POOL.PRE�D,EGK BQNDING,� _�� _ _ �;,,.. ,` �' ; � .. _{ r ��°
INSULATION CEILING !', P-TRAP,� �w, v �; ,< + ' � � � ��;- ; F� ;;
DRYWALL FENCE,/;6ATE!AIAFiM r "�� a` ' ' : ' ;4 `�
x. , �•
LATH(PR� � FINAL POOL=� v s_' _ a . - "� ,�' ,' �' ��. �
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 REIEASE WALL FINAL
SPECIAL INSPECTION RO FRAMING PIANNINGAPPROVAL ,.„ �� ,_;;;� 3 ,s,.`.�' ;' � i''�L` ,�i'
FINAC`BUILDING`,4 p pa�{.'0 ' ' "~ �` _ RUUGH FIREAPPflOVAL ��� `�� r '�'e
_- : ��'' �F � -
'FINAL MECHANICALz , �'�., "` � '�° .s�'%.1.� � ��-�, FINAI FlF1E DEPARTMENT �� '� ' 9; , "� � �`` r �� '4`�:
FINAL'ELECTRIGAL ` °,�;r "' ;F �' "' =� � � �; `' `� � FINAL PLAMNING� ' ;:;L ' >'+ k 1 ' � '� �' r *�,� J ;,i
FINAL'PLUMBING h.}�i. ' T { �' '` �': ,�'�,=�` FINAL ENGINEERING/PW , ';4 '� �`>t � T '���i �"�
T.C.,ofOCCUPANCY..,. , , ;� - _ ,FINALCOMMUNITY'SERUICES �.�'r � ' � 3- y � ` *
_ . �. ,
CERT.of OCCUPANCY;';;: ..,� - y�,�„ ,� �,;,,> t� ..: FINAL NEALTH DEP7. � � _ � � r � � ` =a . ril
< < �' !2, �`s '�;-
FINAL INUUSTRIAL_WASTE r:� r - '" _-:�' „ ��. .
COMMENTS: �
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