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HomeMy WebLinkAbout14846 (19) �,����--�.� , ._,_., J,� CITY OF DIAMOND BAR DEPARTI?ZENT OF COMMUNl'I'Y&DEVELOPMENT SERVICES �l/�,j p� �� w , � 21660E.CopleyDrivc Suitc 190' �-�- (909)8G0-3195 Fax(909)861-3117 :�s=c_--�- P R ESS � `°�"� BUII,DING PERMIT APPLICATION ' FIRMLY _ . .. _ --- � JOBSITE ] J J')� ���/� /+� >- � APPLICATION PERMIT p/C o ADDRESS i t v ��'� ��� DATE NUMBER # $ ISSUE TYPE OCC APN LOT TRACT DATE CONST. GROUP p OWNER o ADDRESS ZONING SETBACKS W CITY ¢ t ` ZIP TEL. ) FRONT qy� 0 � APPLICANT TEL. REAR � z� SIDEISIDE STREET RW ❑ aa CON7RACTOR � SIDE ❑ ADDRESS � CIIY ZIP TEL. PROPOSED USE o ARCHJENG/ z DESIGNER w NO.DWEL. Np. Np, a ADDRESS � CITY ZfP TEL. UNITS STORIES BEDROOMS � N DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION Q OWNER-BUILOER DECLARATION SFR/ADp/REM O I HEREB�AFFlRM UNDEH PENAITV OF PERJURY THAT I AM EXEMP7 FROM TNE CONTFACTORS LI- Ga�a96/C8rp011 W CENSEUWPDHTMEFOLLOWINGREASON(SEC.7031.SBUSINESSANDPROFESSIONSCOOE:MIVCITVOH (J� � (.7 CaUN7rNMKxIREGUIRESAPENMITTOCONSTHUC7,ALTER,IMPROVE,DEM01J5H2ORREPAIRANYSTqUG W Pdtio/D6Gk � TURE PRIOq TO ITS 1$SIJMICE.11L50 REOUIRES THE APPLICANT FOR SUCFI PERMIT TO FILE A SIpNED w � STATEMENT THAT HE OR SHE 19 LICENSEO PURSUANT TO 7HE PHOVISIOHS OF THE CONTRACTORS L�- CEN9E LAW(CHAPTEq G(COMAIENCINO WITH SECTIIXJ 7000J OF DIVISION 30F 7HE BUSINESS AND PqD- � POOVSpB FESSIONS COD�OR THAT HE OFi SHE IS EXEMPT THEREFHOM ANO THE 911515 FOR THE ALlEOE�EXEMP• TION•AM'VIOL�T�ONbFSECTION7031.6BVANVAPPLIC/,NTFORAPERMITSU&IECTSTHEAPPLICANTTO z Re-ROOf � ACMLPENALTYOFNpTMORE7HANFNEHUN�REODOLLARS(S5o0J.)� � �I,ASOYMEROF7HEPROVERTY,ORMVEMPLOVEESWITFIWAGESA57HEIRSOLEfAMPENSATION, L� Comm9fCiel -� WILL DO THE WORK,M10 THE STRUCTURE IS NOT INTENDED OR OFFEREO FOR SqLE(SEC.7oa4,BUSI- _.I N NESS AND PROFESSIONS CODE:TME CONTRACTORS LICENSE LAW DOES NOTAPPLY TO AN OWNER OF � PROPERTY WF108UILp5 OR IMVROVES TNEREON,AN�WHO DOES SUCH WONKHIMSELF OH HERSELF OR Q 7TiR0�JOHHISORHEROWNEMPLOYEES,PROVIDE�THATSUCHIMPROVEMENTSAqENOTINTENDEDOH m � OfFEREpWRSALEIF,HOWEVERTMEBVILDINGORiMPROVEMBJT15SOLDWITHINONEYEAROFCOMPI.E- �TION,IM1IE OWNER�ULDER WILL HAVE 7HE BURDEN OF PROVINO THAT HE Oq SHE DID NOT eUIIA Oq � p�IPHOYEFORTIEPUFIPOSEOFS�ILE). � ❑I,ASOWNEROFIHEPROPERTY,AMEXCLUSNELYCONTRACTINGWRHUCENSEDCONTRACTOqS � TO CONSTAUCT THE CRQIECT(SEG 704/,BUSINESS AND PROFESSIONS CODE:THE CON7RACTORS U- V81Ud110f1 ADJ.AREA W CENSEUWDOESNO7APPLYTbANOWNEROFqPROPEHTYWH09UiLDSORIMPROVESTMEflEON,ANO � WFIOCOMRACTSFORSUCHPRO./ECTSWITHACONTRACTOR(5)LICENSEDPl1RSUANTTOTHEODNTRAG QUANTITY OESCRIPTION FEE � TORSLICENSELAW.). O I AM EXEMPT UNDER S�C. B.B P,C.FOR THIS REASON J � U W a OATE OWNER U � W LICENSED CONTRACTORS DECLARATION -� � W 1 HEREBYAFFIRII UNOEA PENALTV OF PERJURV THAT i AM UCENSED UNOER PROVISIONS OFCHAPTER �^ � a(COMMENGNO WI7H SECTION�000)OF DINSKKJ 3 OF THE BUSiNE55AND PROFESSIONS CODE,AN� z � („� MY UCENSE IS IN FULL FORCEAND EFFECT. 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