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Home My WebLink About10515 (5) EXPiRED f' CiTY t7F DiAMt]NI7 BAR Cf)MMLJI+IfTY L7EVELCIPMENT DEPA[tTMENT Af y� nq .;,,.;` 2L66U E.Caplry Drive Sui[e 19t� P`'�t �eT L�� PRESS (949)86(?-3195 Pax(409)961-3119 '�%^'� BUII�flI[VG PERMiT APPL[CATION ��R��-� �'� ,JOBSIT� ' � �1V J � QATEICA710N NUMA R (�.3�I3 �/C ADDRESS . � ISSUE 7'YPE OCC APN LOT ACT �� L1pTE CC}�iST.� tiRt}UP p OWNER ._�/} ��a� �,'�.�d d AbpPESS � ��, �, 20NING S�TBACKS � CITY � ZIP C_��j��EL. FR4NT RW � ❑ — APPLIGAN T��_ R�AR [a � S1E}EISIO£STfSEET RVtt ❑ � CONTRACTC7R �� SIDE . L _ ,� ADD � f ,_ PRQPOSED 1JSE Yf �'f ,�__ � CITY �d tir r7�£j. ZiP S �t'Et. oARGMtENGi u � ._ � DESIGNER NO.DWEL. NR�. NO. ri ADCtRE3S — UNii'S __�� ____ S7flR1ES W` 6EDRCN7MS � CITY_ Z1P TEL. ,n DESCRIFTIt)N SC}.FT. 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O F9L�cvt�kAMeEH Ad��__,��`_ �� ..��i'jJ� --_.�.--��`Y�.. � ELECTRIC .... ... . 4 d ONkssECTrxlh��Ar�TeEc�rTa70F7NEaF.RN7iSFoaavEfx.N�qEDmWIFis6loo)atL6sl PLIJMBING — '-�'�� Lll Z I CEATIFY THAT IN THE PERFORMqIVCE 6F THE 440RK FOR WMICH THIS PERMiT IS 155VE�,I MECHANICAL ,,,, [� St�Ai.L FpT�MPlOY ANY PEIiK7N 1N ANY MANh�fl 54 AS TCY 8EC4ME S�EGT TO THE 1NSPECTION FEE �j WOFKE'RS'GOMPENSATI[NILAwSUFCqLIFORNIA,ANDAGfIEETHA ISfiOUIP�EIX]ME = S{JB.lECT�OTNEINORKERS'COM¢ VISION OF5 57D0OFTHELAflOR �� fJ'A� CAOE FIAi.I F'RTMWITH COtAP W7TH E PROY ISSLIAM�'E ,.,_4'u ...� � a ,1 y - ' r—�----"—" SMIP p 6ATE: /� 1 APPI�A . .._ . �� . . .. . � ENERGY P!C , J WAi�UVIM4: N4URETOSECU11E4JORNEAB'COMPEN5AT1�N ' EAAGEISUNLAVJfUL,AN95MALLflE � su9,�Ecr nw€upiovea ro cm+�nivu�Nnu�5nrao clu� �s�'ro or�r+urxb�p rrrousuvo ENEflGY PEflMtT �OI.LARS{S�aa.GDU�,MIAOPiTN7NTOTMECOSTqFcaMPE SATION,9A�AK3E5ASPROV10EOFC5RIN � secrar+arm pF tr+e tAeon coae.�wiEaEsr,xNo nnor�n�rs�E6s. RETENTI�hI FE�: Q CONSTFaUCTI(7N i.ENDING AGENGY pRE-ALT FEE: .. d I HEHEBY AFFIRM UNOEA 7ENpLTYOF PERJl1RV TiUTTNERE�SACONSTRUCTION LENOING A66NCY _ 4- FOHTKE FERWRMAtME of THE WORl4 WR WH4G1 tk45 PEMIIT lSI�UED(SEC 30W,CtV.C.�. '�� Z W � LENGER'S NAkIE ...... F- LEN6EP'SA�ORESS � I CERT�FY THA71 HAYE REAp TWlS APPI.I[:A.TION,AhIo STA7E11M7 i/1EA90VE MiORMATN?N IS CORqECT. TLITf1L.��Ca7 �/7•�'�y � i hti,�E Tp�MPIY WITH Jt(.4 GTY ANP GiH1P1TY 4R�INANGES k1�Q STATE lAWS RELATING TO BUILfJING � CQHSTM1CTIqW,AI�FIERE6M M1TNOii12E REPRE�ENTATN$S OF TNIS CWNTM Tp ENTEii UPON itiE � /1B'CIYE� NTlpHEOFPAPEHTYFORINSPECTIONPURPOSES. L,QMMEN•�.$ � f..-' � � m P M1E IPRINn .. d , Ct} .�,,�q�.., T Vj 310NATU FpEflMI E � oA ,. �X �G �--ri --_��—��—� � RECPT.NP. �1�n�a av �''9 vauannoN�,. ~ WN�TE-0epartmenl Copy,VELLOW—Finance Cnpy,PINK—Ass9ssor Copy,GOLpENROD-Fila Copy,GREEN—llppikarn's Copy WNER-1f1"rl"• rnz EXPIRED CITY OF DIAA�TOND BAR COnInIiTNITi'DE�"ELOPnIENT DEPARTnIENT 21660 E. CGpley Drive S�ite 190 (909) 860-3195 Fax (909) 861- 3117 BiTILDIN(U PERATIT APPLICATION n-r.....APPLICATION C�I ISSUE o � oLOT'11"" L�� APN LOT'11""a- z a h h Q O D O Z O O tQ W O Z S 3 OWNER-BUILDER DECLARATION z d WO w h O Q Q Z Z G7 h wJ w d0 DI Cd Z UL a n C � DATE Urv-=-LICENSED CONTRACTORS DECLARATION �� I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I M1 LICENSED UNDER PROVISIONS OF � CHAPTER e (COMMENCING WITH SECTION 7WJ) OF ONIISK W 30F THE BUSINESS AND PROFESSIONS Court.AND MT LICENSE IS IN FU PCE ANO EFFECT Z ECIASB UC.NO. UCENB60 DATE 7 r CONTRACTOR WORKERS'COMPENSATION LARATION IHEPEB FIRMUNDEGPENALN OFPERURYdiEOFTHEFOLLOWNGDECSARATIONS: I HAVE MD.ILLMAINTAIN ACERTIRCATE OF C(xiSENT 70 EII INSURE FOR WORKERS' COMPENSIRNNI,AS PROVIDED BY SECTION 37G4 OF THE LA90R EGGS,FOR THE PERFORMANCE. OF TIE WORK FOR WHICH THIS PERMIT'.ISSUED -I HAVE AND WILL MAINTAIN WORKERS' COMPENSATION INSURANCE, AS REQUIRED BY BECTON 37COOF THE LABOR LOGE, FOR THE PER WRMANCE OF THE WORK FOR WHICH THIS PERMIT 15 ISSUE O.MYWORRK v7MPEINSVR DP.^INUMBER ARE 1011 CARRIER-I r'POLICY NUMBER-- (IHISSECroNNEOw7BEDXIPIFTIDOF7HEPERNT LS FW CNENYCPEDD7<1ARSRIw10R1ESSl I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I SHALL NOT EMPLOY ANY PERSON IN ANY MANNER BOAS TO BEWME SUBJECT TO TIE WORKERS'COMPENSATION LAWS OFCII1FORNIAANDAGREE 7HA ISHOULD BECOME IABOR SUBJECT TO THE WORKERS 'CMP ROVISION O FS 37WOFTHELARD LOGE HAI1F NTHW1THCdAP WTHTHO EPROV DATE:--APPLICA WARNING: PxURE705EWREKOMERS'CWPENSAT NERAGEISVNMWFUL,ANGSHULBE SUBJECT AN EMPLOYER TO CRIMINAL PENALTIESANOCIVIL ES UPTOONEHUNDRED THOUSAND R,LLARSISHO.IIWI.INADDITION TOTHECOST OFCOMPE SATIMI,OAMAGESASPROMDEOFORIN SECTION 37G3 OF THE LABOR CODE,INTEREST AND ATTORNEYS FEES. CONSTRUCTION LENDWG AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY THATTHEREIS ACONSTRUCTION LENDING AGENCY FORTHE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.300,CIV.C I. LENDERSNAME LENDERS ADDRE55 I CERTIFY THAT I HAVE READ THIS APPUCATINi AND STATE THAT THE ABOVE INFORMATION IS AGREE TO COMPLY WITH ALL pN AND COUNN ORDWANCESAND STATE LAWS RELATING 1 L J K^';^' Zip 6ft&-17EL. CIT APPLICANI TE�. MAY 0 9 2003 PRESS coNTRACTo FIRMLY ADDP,E.�ia PERMIT /Os 1- P/C NOMBER k TYPE OCC CONST GROOP J/EL S � Z� ISSUE pT - RW 0 O �aceveNc RW L7 DESIGNE ADDRES CIT ZIP TEL ATE ONING ETB_ACKS �RONT NO.DWEL.UNITS Z STORIES BEDROOMS EAR IDFISIDE STREET DESCRIPI IDE ROPOSED OSE OWNER-BUILDER DECLARATION SFFVADDMI n Gamge/CarL L PatWDeok L 1POOVSpa Re Rcu[ Commercial m val�akan ADJAREA GUANIITY DESCRIPTION FE SEC._B.a PC.FOR THIS REASON fl I PM DATE Urv-=-LICENSED CONTRACTORS DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I M1 LICENSED UNDER PROVISIONS OF CHAPTER e (COMMENCING WITH SECTION 7WJ) OF ONIISK W 30F THE BUSINESS AND PROFESSIONS Court.AND MT LICENSE IS IN FU PCE ANO EFFECT Z ECIASB UC.NO. UCENB60 DATE 7 r CONTRACTOR WORKERS'COMPENSATION LARATION IHEPEB FIRMUNDEGPENALN OFPERURYdiEOFTHEFOLLOWNGDECSARATIONS: I HAVE MD.ILLMAINTAIN ACERTIRCATE OF C(xiSENT 70 EII INSURE FOR WORKERS' COMPENSIRNNI,AS PROVIDED BY SECTION 37G4 OF THE LA90R EGGS,FOR THE PERFORMANCE. OF TIE WORK FOR WHICH THIS PERMIT'.ISSUED -I HAVE AND WILL MAINTAIN WORKERS' COMPENSATION INSURANCE, AS REQUIRED BY BECTON 37COOF THE LABOR LOGE, FOR THE PER WRMANCE OF THE WORK FOR WHICH THIS PERMIT 15 ISSUE O.MYWORRK v7MPEINSVR DP.^INUMBER ARE 1011 CARRIER-I_POLICY NUMBER-- - CONSTRUCTION PLAN REVIEW_I.,.ELECTRIC (IHISSECroNNEOw7BEDXIPIFTIDOF7HEPERNT LS FW CNENYCPEDD7<1ARSRIw10R1ESSl I pLUMBING MECHANICAL INSPECTION FEE ISSUANCE SMIP CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I SHALL NOT EMPLOY ANY PERSON IN ANY MANNER BOAS TO BEWME ENERGY P/C ENERGY PERMIT RETENTION FEE:PRE-ALT FEE: SUBJECT TO TIE WORKERS'COMPENSATION LAWS OFCII1FORNIAANDAGREE 7HA ISHOULD BECOME IABOR SUBJECT TO THE WORKERS 'CMP ROVISION O FS 37WOFTHELARD LOGE HAI1F NTHW1THCdAP WTHTHO EPROV DATE:--APPLICA TOTAL FEES WARNING: PxURE705EWREKOMERS'CWPENSAT NERAGEISVNMWFUL,ANGSHULBE SUBJECT AN EMPLOYER TO CRIMINAL PENALTIESANOCIVIL ES UPTOONEHUNDRED THOUSAND R,LLARSISHO.IIWI.INADDITION TOTHECOST OFCOMPE SATIMI,OAMAGESASPROMDEOFORIN COMMENTS SECTION 37G3 OF THE LABOR CODE,INTEREST AND ATTORNEYS FEES. CONSTRUCTION LENDWG AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY THATTHEREIS ACONSTRUCTION LENDING AGENCY FORTHE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.300,CIV.C I. LENDERSNAME LENDERS ADDRE55 I CERTIFY THAT I HAVE READ THIS APPUCATINi AND STATE THAT THE ABOVE INFORMATION IS AGREE TO COMPLY WITH ALL pN AND COUNN ORDWANCESAND STATE LAWS RELATING 1 NO.ZO X10 PAIDBY