HomeMy WebLinkAbout10308 C1TY OF DIAMOND BAR � � S
COMMUNTfY DEVELOPMENT DEPARTMENT 1
x�c�o�.cop��y n���s��«�90 PRESS
� (909)8b0-3195 Fax(909)861•3117
�'�^'. BUILDINGPERMITAPPLICATION FIRMLY
y JOB5ITE a APPUCATION �'/ PERMR P/C
o ADDRESS ���� ��6� �� / DATE � ` NUMBER � 1t
� ISSUE TYPE OCC
APN LOT TRACT ��"�St�r DATE CONST. GROUP
g OWNER �G IJb c` .
o ADDRES b /�7I L��-U ZONING SETHACKS
� CITY vG� ZIP��I TEL���=�Jf3� FRONT RW O
APPLICANT 7E�, REAR ❑
� SIDFJSIDE STREET RW O
CONTRACTOR �Y2y/L���1 SIDE ❑
ADDRESS
� CITY ZIP 7EL PROPOSED USE L�'� �^'�'
o ARCH/ENG/
� DD ESS NO.DWEL � N0. NO. �
UNITS 3 STORIES BEDROOMS
� C(TY ZIP TEL.
� OESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUAT70N
�
� OWNER�BL'ILDER DECLARATION SFRlADD/REM
O
p �NcaEev�mau trmFa vFr+atn or v¢wm nur i ua[xEuvi Fnou it+e c�rtfucrorts u GarapdCaipoR
W CENSEUwFORTHEFOLLOWR�N3REA50N(SEG7071.SBUSMESSNJDPROFESS�dlSCOOEAHYCIiVOq (n
C_� COIMfYNMIUIREOURESAVERMRTOLONSTAUCT./�1TER�P�NE.OE►10115H.ORREPNRAM/SiflUG W P91fG�D6Ck
� TURE.VR10R 70 RS t55Wu10E./1S0 NEW IRES TNE APPLIf'.AM FOH SUQI PEf WR TO FlLE A 3IGNED W . . . . .
STATFMENT iHAi HE ON SME IS UCENSEU PURSU�M TO THE PROVi5�ON9 OF iNE CONTRAC70R5 L4
� CENSE UW(CHhVTEN i(CO►WENCNO M�TM SECiqN 700C)Of DMSpN i OF 1HE BUSINE53 AND Piq- u' POOVSP7
� fE35qNSCO0�OR7WUHEOR5HE13E7(EMPTTHEREFRdAANDTHE9AS�SFOHTNE1LLlEGEDE%EMP-
TqN.ANYV10tAT10NOFSECT10N7071.6EYANVApPIICurt�ORAPEPI.�RSUBJECTSIHEAVPLICAMTO Z Ro-Roo1
� ApViLPENALTYOFNOTMORETHMlFIVEMMDREDDOl1ARSfilWolY
� D1,/30WNEROFTHEVROPEHiY.OR4YFMPLOYEESWITMW�OESIl4lNEIR50lECOMVEN51171pN, Q C����f�
YALL DO THE WDRK,AND THE STRUCiURE IS NOT IMENDED di OFFEpED idi SAIE(SE4 704.BU54 J
NE53 AND PROfES51d15 CODE:THE COMTMCTORS LICENSE UW DOES NOT APPLY TO IW ONMER OF
� VROGERTYYA108ULD90i140ROVESTHEREON,MAYrtpDOESSUQ1V/ORKMi45ElFORNERSElfOq =
� T11ROU�HIa50RHfAC�1MEYPLOVEE4,GROVIOEDTNATSUCJIwvaWEYFNTSARENOTIHfENDmOli m
OFFERED FORSALE.IF�FqWEVER7NE BUDINOOR IMMIOVEMENT IS SOIDMnTNM ONE YFAROFCO4PlE-
Z Tldl.THE ON�NEREUMER YALL HnVE TME BURDEN OF VROVMO TUT ME OR 5l/E DiD NDT BUM1D OR
� MPROVEFORTHEPVR70SEOFSIL�.
�l�3 ONMER OF TNE VROPERTY,M1 ExCLUSNEIY COMMCTNO N7TN IICENSED CbNfMCTORS
� Tp ppNSTRUCT TME PRO.IECT(SEG 70u.BUSINE55 AND PROFE5510NS WOE 1HE CdrtMCTOR3lF Vatuation ADJ.AREA
W CEHSEUwDOESNOT�PRYTOANOVMENOiAPROPERTYYlF108UILD30RIIAVROYESTHEREON,MA
Z� w�qcarrrucreronsua�ona�crsvnrH�cartrucwacsl��%���►+nroTMEca+ra� OUMITITY DESCRIPTION FEE
� TORS UCENSE IAw.G .
O 1 NA EXEIAPT lAlOER SEC. 8.�P.C.FORTMS REASON U
LL' DATE �I � OWNER � U
� LICENSED CONTF2ACTORS DEC ION W
� �HEREBV AFFRW UNDER PENIILTY OF PERRIRY 1/uT 1 M1 LICENSED UNDER VRONS�ONS OF CMAVTER � .
� •(COAIMENGMW N'RM SEGl10N foao)OF DN�S�DN f OF 711E BUSME54 AND PROFE3510N9 CODE�NU Z
�� YY UCEM3E IS N ML FORCE IJrD E�FECT. (
_- � '
.. __. . ... _'..............._ . ' - '
0 LICENSE CUISS ��•�• �
V DATE CONTiUCTC%i a
W
� WORKERS'COMPENSATION DECU�FiAT10N �
N U
N I HEHF91'JIFFIRM UAEH PENAITY OF VE0.RIRY dJE OF TiIE Pol10WeiO DECLAMTqNS: Z
� �I HAYE MA WILL MARlTAN A CfRTIflCATE OF CONSENT TO SE�i-M4UNE FOR YVJtMERS � . .
OOYOENS�TION,A9 iRDVDED BY SECTION 77000F T11E UBOii COOE.fOR TNE PEFPDRUANCE . W
pF 7HE�WRI(FOR WF11d1 THq PERM�T�4 i55UED. � . . .
0
W _IHAVEMIDNM1lURlTAWVMOPo�EN4'COMGENSAT�ONMSUAANCE./SREOUfREOBVSECTIDN _ . .
Q J7000F THE LPBOR CDDE FOR ME PERFORMAtKE OF TNE N'ORR iOR WHid/iM3 iERMR 14 '. �,-�.. - � . . .� '
155UEp,AlY WdtlCERSCd.��ENSATqN MSURANCE GRRIFR A1A VOLILY M11.lBEFJIRE CONSTAUCTION
� c.,wa'ER PLAN REVIEW
Z oaicvr�ER ELEC
4
o �Ss�cnor���rneEoor.s�tr�oFnEpar.trsraaor�r+�r�nnoatue(s+mloq�ssl UMBING
w CHAMCAI
Z I CERTIiYT1AT N iHE PERFdiM�NCE OF TME NVNK FOR MRlidl TNi4 PERMIT 13155UED.1
('J SHAI.1 NOT EMOLOY AN'/PERSON N ANY AIANNER 50 AS TO BECOME SUfl1ECT TO 7NE !�'�` �" �
� NORKER4COMVENSATIONUWSOFGLL�FORN1AµDAOREETMAT615H0ULDBECOME INSPECTIONFEE .'-J iIi !11�� n -
S Si191ECTTOTMEWaR1(ERSCd.��ENSATqNVRDVIS10N50FSECTION77000fiNEU�BOR �SSUANCE � `4� � �,�/�
COOE.I SFiALL FORTIM'I7H COMPIY WITH i1q5E DRONSqNS.
0 SM�P
p DATE: APPLICMIf:
�uuu...��� WMMN�FAILURETOSfG1rtEYARKEF50�1APENSAf10NCOVERA0EI5V1MWFULNASMAl18E ENERGYP/C MAV , �I A7
SUBJECT�NEMPIOVERTOCA��LPENAL7IESAN�CMIFMESUPTOONEHUNDRE01HIX151VID ENERGYPERMIT
� DOLLMS(f100.0001.IVADOfT10NTOTHECOSTOFCO�.�PENSATqN,D�GESIl9PROVqEDfORIN
�1 SEC7i0N17WOFiMEIOB�RGODE.rdTERE4T,kA�TTOHNEYSFEES R�NTIONFEE:
Q
� CONSTRUCTION LENDING AGENCY pRE•ALT FEE: �
� IHEREBVAFFlRYUNDff10ENKTfOFPENRIRYTHI�TTIIENEISACONSTRUCT10NlENOMOAGENCY
Z FOH iF1E PER�OFMANCE O�TNE YYOFK fOR MNICFI TM14 iER1A1T IS ISSUE�(SEG�007.CN.C.�.
W
� IENDER'9 NAA1E
� LFNDER'SPDOHESS l.�
'� i�a�ETo�%i"o�r�"'EwiN�T"arv°��,�ONimo�ev�u.�icT s�sr�r�eu�"vs`OR�rv�ON+nro�l`ra TOTAL FEES ✓ f �
n" CONSTRUC7qN,ANOHEREeYAUh10RREREPRESENTATNFSOFTdSCOIMTYTOEMERUPONTHE �
S� ABOVE�MEHlIONEO PROFERP/FOA INSiECTION PURPOSES. COMMENTS
`� ,�c(I G t%—
�
� PERYfTTEEN/WE(pN�NT) � � `��
� t�
� KiNANREOFVE E DATE
� qECPT.N PAIDBY VIWDA �
WMITE—Oepertment Copy,YELLOW—�mance Copy,P�NK—Asa�asor Copy,GOLDENRO ib Copy,GREEN—Apptku�Ya Copy
�. - I tn cn -- - � _; n i T T T i� � in �rn'cn o c>'�' rrl cn � i� i� a �, � < =� cn c� m cn �= ,
� m m ,� i ,z z z z a m m m � m y s o D O o � p y m � r � ; �;.
r ' � m� I I I �., O, r n r r m m ia � � � r. .�� o c c c o D o -� � � p m G� �
i�'0_I � - r, � r^ r- b -_i r. � CD n (f� �� �
� . 'y 'S� D m Z t'^ ,t � L� G� ?t � 'n m v C a7
; . .. � � �(� � � v m 2 C� � � n,D 7 � Z n m Y 2 2 n Z t!� D '0 G)�Z � ii A T�. ., � .
�� � �.r� r m � 1 '�� r Cn '� 'D m 2.O L7 Z fn O � p � O C] �.
� ��' 1 � C m T C: -�_'i T f� Z Z C = � f- r rn � � iTl m 2 D 'V n 37 111�
�1�. � � -�' C z '.� �� Z' -1 tn � (n � (`n � C m p m m D 37 m � r L� 's r^,:
. . .��� I � � '-1 I W � ^ -I .,..� C�-� T D C O m � t7 -_I �.Z -I < � rtt C � �
T',m� ' �p�� --{n:-- G�'� c� � ' � z � p � � � � Z � -i z m w �c -�i Ji
� -1 2 lmn � C� � i '� L7 � ,Z 2 m �1
. � , j� fNfl � ' . � � � � . i -1 . D . p rtl ''dk .
i � � i Z _ � � � ,
� i � I � � �I ' I
�-. ��!, I � _ �� ' ' i 4 i I I Z i - �', -
. , , i � ''�, ' � ��,, I I� i v I I c I
I I � � ; I I :�I� � � ��
� i I � I �
I y � � �-- � ' i i i i ; � �� ° {� �(
� = ��' � i - � -� i � � , � _ , .
_ �! � �,� � �� � I i � ��I � ' �'' � .-�I, �.
,� I � ' '' :
` I L
I I i
�� � I i -
N
�'
�
i
, i _ �- ;nr� _ .. .
. ' , `P - - - - ; - -
!f� I � I � ` `�� n
� i
' _' ' - ��'I� � ' I � - � I I I �r' V1 �
� ; _ � i i � : - m 'Q
. i _ . �', , ` . : � � -
1 _. � ; _ ,11Yi� m � ` O �D �T _. _ .
: I __ _ .. � ao -� � � vTvm �3�, m ; -,I�, c c „ -�, . �:O
. __ _ _- _ .__ ___� _ __ -.- _ O �._ � Z p Z Z r ..,
- - - - - - „ rn < r z i" � z o m � � � 0 L
' -- -._ _ ._ --- I � -— -- --I �' r:w; �. n = �II Q.I m � Z � m "ri1 O O"��= 2 7n'J rm-p�-Zi D'� �•7m.7 D JO] �._. .-..._5 �:
--- -- �- - - 1I � �I ��o
/i, ! . _ . - I � i• Cn O iF`? � .'rti L7 O � � ' n 9 p G7' O �Z p p n n �. r y p �} , R'f T ..
r,,'. -o � � 1'n i' r C) D � � Z m m � � -I fn�r,�,k : �
; ! _ I � -: io � � c� m � in � � � oo i� � mom �nc3'ocn -i �.} Q-C7
I oovz�
n; "n Y �_1 _ . �Tl D m
%� '' ' � �;r c�I � � � i i ? � ? o� `o �;I� 'J"' ` _ p-� :
�, � � 'r�� ; -' m ,.�.� p .i � r � �
i � ( � , f -� = I � � c r} - _
/ �� z � � -
; � I i _
t; 4 �r r - - -
/
�- 'v -
� ;
r �
I 'v
i , �.' i
V _ '
� c� �— - . . ' � ' ' "
_ �
. �, � � . ; <
� . �
.�
� / � ! i �" _a
r � . , - ' . :" h- � ''�� .
/� r �I. . _ - .f - i � I _
i� ✓r � �l I V�i I � %
:
�' ' ' , � ' � �;"� e
i ,r` r �� ; � � _ ' „ �' �'
, ,
f-_
.,�
� ;t,
� i -�.
`•^ - ' � `:
' - ` .
� - -- -'-- --- — - -- -- -... -- --— - - _ _