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HomeMy WebLinkAbout1174 DEL SOL LN ^---��— CITY OF DIAMOND BAR 1 DEPAR"C[vtENT OF COMMUNITY 8c DEVELOPMENT SERVICES 21825 E.Copley Drive (909)�Fax(909)861-3117 8�• ��-�� . PRESS �""",� BUILDING PERMIT APPLICATION / FIRMLY o� JOBSfTE APPLICATION . PERMIT p/C ADDRESS ' ��� I � DATE NUMBER��� # � ISSUE TYPE p� � APN LOT TRACT r� DATE CONST. GROUP p OWNER t1• p ADD S 7 ZONING SETBACKS z CITY ZIP / E P � FRONT Ryy p o APPUCANT TEL. SIDE/SIDE STREET Ryy p � CONTRACTOR - SIDE p � ADDRESS � � CITY ZIP TEL PROPOSED USE . _ w ARCWENG/ � �. / z DESIGNER y��� w NO.DWEL. NO. a ADDRESS 4 EDROOMS� � CfTY ZIP TEL UNITS STORIES cn ' N DESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATIO p� OWNER-BUILDER DECLARATION SFR/ADD/REM .O Q I NEREBY AFFIRY UNDER PENALTV OF PEfLIURV THAT 1 AM D(ENPT FfqM THE CON7RACTORS L4 (jef8�C8fPOf� W CENSEUWFOR7HEFOlLOWUqREA50N�SEC.7031.6BtRINE55N0PROFESSqHgCppEM/yGRyOR (n Z COUNTYWHICNREIXIIRESAFERMfTTOWNSTRUCT.ALTEiLOAPROVE.DEMp(Jgy1.ORREPAIRMlYSTRW W PetIO�DBCk w 7URE,PRIDR TO ITS ISSUANCE,AL50 REOUIRES THE MPLICAPIT FOR SUpI PERMR TO FlLE A SIGNED W � STATEMEHf THAT HE OR SHE IS 110E1J5ED RIRSUANT TO THE PROVISIONS OF THE CONiRACTpRq�4 � CENSE UW(CHAPTER Y(COMMENGPlG WIT7 SECTION]000)OF ptyl5lpM 30F 7HE BUSPlE55 MD PR6 � POOV$p3 Q FESSIDNS COO�OR T1iAT HE OR SHE 15 IXENVT iHEREFqOM AND THE BAS15 FOR iHE Al1EOED EXEIIP- (� � V T10N.AHVVqLAT10NOF5ECTION7W1.68YAM'A7PLIGNTFpRAPEfA/RSUBJECTSTHEAPPLIGNTTO Z Re-Root • A CML VENALTY OF NOT UDRE iHAN FNE IAIIJDRED DOLLAHS(fsoo��: � ❑LASOWNEROF7HEPROVERT`/,ORUYEMPLOVEESYIITNWAGESASTXEIRSOIECOMPENSATION, � (�`pmm0fC10I � Z WILI DO iHE WOqI(.AND TME STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.)ou,BU54 J l � � NESSAND PROFESSIONS CODE:7NE CONTMCTORS LICENSE LAW DOES NOT MVLV TO AN OWNER OF � � PiIOPERTVNTqBU0.D50RIMPROVESTHEAEON,ANDWHODOESSUfJ1WORNHWSELFOqHE(iSELFOR '� THROUON MS OR HER ONTI EAIGIOYEES,PROVIDED THAT SUfl7 WVROVEMENTSARE NOT MENDED OR m � OFFEq�FONSALEIF.HDWEVERiHEBU¢.DPI�ORqiPfiOVEMENT1950LDWfiYYNONEVFAROFCOMPLE- Z TION.iHE OWNER�UILDER WILL HAVE 71fE BU{7DEH pF PROVINO THAT ME OR SHE D�NOT BUILD OR � WPi10VE FOR THE PURP0.5E OF SN.E� . (�J ❑4�ON�NEROFiHEPROPEHfY.AMIXCLUSNELVCONtRACTW(SN7THL�CENSEDCONTRA(,TORS � TO CONSTAVCT THE PROJECT(SEC.70N.BUSINE55 ANO PROFESSIONS COOE:TNE CONTMCTO{LS LL V8I118�IOf1 ' AUJ.AREA CENSE LAW DOES NOT APPIY TO AN ONINER OF A PROPEq7V Wlq gUILDS OR IM7ROVE5 TMEREON,AND � � cT Foa cTsvnn��corrrwicTows���cENseoauasuurrTon+eoarrw�c pUANTITY DESCRIPTION �E , pe. v.c.roa rws r�tisa� � ?� U � DATE � OWNEq F-¢- � LICE SED CONTAACTORS DECLARAT70N w � I HER[BY AFFIPoJ INDER PENALTY OF PER0./RY THAT IAY LICENSEO UNDER PROVISIDNS OF GIAPTER � ' d G(COAIMENCING WRH SEGTION 7000)OF DIVISION J OF THE BUSME55 MiD PROFESSIONS COOE,Mlp Z X W LICENSE IS N FULL FpRCE AND EFFECT. m LL � LICENSE CIASS LIC.NO. � V DATE coNiRAc70R � W � WORKEfiS'COMPENSATION DECLARATION . � � I HERFBY AFFIRN UI�DER PEWLLTY OF PERNRY ONE OF THE FOLLOWING DECURATqNS: U N . � Z . �Z 1 YUVE ANp WIIL YNNTAIN A CERTIFIGI7E OF CONSfM TO SELF-P19URE FpR ypq�(Eqs a Q = COMPEHSATpN,AS PRpVIpED BY SECipN 37000F THE LABOR CAOE,FOR 7HE 7ERFORYANCE U OF THE WORK FOR WHICH TH6 PERAOT IS ISSUED. w O � � _I HAVE AND VALL MAIHTAPI VYOR1(ERS'CO�IPENSATqN INSURANCE,0.5 REOUIRED BY SECTION QJ]m OF THE I.ABOfl COOE,FOH 7HE PERFORAV NCF OF THE WOW(FOR WMCH THIS 7ERMR IS � �)��� � ISSUED.NY WORKERS'CWIGENSATION IHSUWWCE CARqIEp/U.7p pp�ICy Ml�@Ep�qE C.�S�UCTION `J j �� PLAN REVIEW � POLICY M/MBER � ELECTRIC o (ness[crior+r�wTeeaor�rmoFnEv�rswaa+EMmnr�oa�uslsioo'iaq�ssy PLUMBING w Z 1 CEHTIFY7HAT QI THE PERFONMANCE OF 7HE WOAK FOR WHIGI TML$pERACT IS ISSUED,I MECHANICAL C} °SHALL NOT EMPLOV ANV PERSON W ANY Mµ1.7Ep$p A$70 BECOA/E SU&IECT TO THE (q WOPo(ERS'COAIPENSATIONLAWSOFCMJFORM/�ANDAGqEETHATIF15MOULpBECOME INSPECTIONFEE S SUBJECT TO THE WORKERS'COMPENSATqN PRpVISqNS OF SECTqN�7000F THE UBOfl , cooE,i s'uu coRrr�ni caaa�r vnn�nas¢aaansar+s. ISSUANCE O DA7E: APRICANT: SMIP W � WARNWO:FARURE TO SEQINE VXJfL(ERS'COMPENSATION COVERAOE IS UILAWFUI,µp 9HALL gE ENERGY P/C � �y SU&tECTANEAIPLOYERTOCROAINAI.PENALTIESANDGVILFWESUPTOOME/NNDREDTIK7U5AND ENERGYPERMR DOlLMS(5100,Oa0�.W ADDRION TO THE COST OF COMPENSATION,DMUGES AS PqONDED�Op W � SE�IION 3]oB OF 7HE IABOR CODE,WTEREST,ANDATTORNEV'3 FEES. � flETE�•jnON FEE: � �__ W O CONSTRUCTION LENDING AGENCV � PRE-ALT FEE: � i MEREBYAFFIHM UNDER PENK7V OF PERNRV THAT 7HERE IS A CONSTRUCTION LENDWO AOENCY • FOR TNE PERFORAIANCE OF THE WOflK FOR NT11G1 TMIS PEiWR IS ISSUED(SEC.]OD7.qV.CJ. Z W � lE1�Ef75NM1E 1— LENDERS�DDqE55 � TOTAL FEES � � �� ¢ I CEHTIFY THAT I/UVE READ THIS AFPLICATqN AND STATE THAT THE ABOVE @IFORM�TqN IS CORRECT. w IAOREETOCOIIPLVN7THALLCITYANDCOUNTYORDRlANCESA/�pSTATELAWSq9ATWpTpBUqpIN6 � � CONSTRUCTION,ANpHEREBV EREPRESENTATIVESOFTHISCOUNTYTOENTERUPONTHE � � ABOYE�ME ED VIqPERTV R INS CTqN W7qpp3E5. . • . Z � COMMENTS � � /G m ,�w., � h 7 b (n Q DAT � RECPT.NO. 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