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Home My WebLink About15917 �T":.. ,. � _�-- T-'! ;.�y�-("�f � ( /�.: �� CITY OF DIAMOND BAR �,- —{� ,L c� ( � DEPARTMENT OF COMMUNIT�$t DEVELOPMENT SERVICES � 21660 E.Copley Drive Suite 190 (909)860-3195 Fax(909)861-3117 PR ESS "9�'� BUILDING PERMIT APPLICATION FIRMLY � JOBSITE APPLICATION PERMIT P/C o ADDRESS �� Bridgegate Dr. DATE 12�27�� NUMBER 1591 # � APN LOT TRACT ISSUE TYPE �CC p OWNER The Trenton Group DATE CONST. GROUP o ADDRESS 5670 Wilshire B�VC�. ZONING SETBACKS �w CITY Los A�q�e�_ ZIP 9003�EL. �936i83 FRONT RW ❑_ APPLICANT I�c�" G reene TEL. REAR ❑_ � SIDE/SIDE STREET RW O_ CONTRACTOR KPRS SIDE ❑ ADDRESS �{J� am ert f� _li�tP �nn Foundation � CITY Brea ZIP 9282�TEL. 7��FFi72OgOO PROPOSEDUSE � ARCHlENG/ � DESIGNER�BWS/GOrdoll SnicP _ NO.DWEL. NO. No. ADDRESS 300 N I akP ,qYe u� UNITS STORIES BEDROOMS y cirv Pasadena ZIP TEL.__�4�� DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION Q OWNEF-BUILDER DECLARATION SFPJADD/REM O p I HEHEBY AFFlRM UNDER PENALTY OF PERtt1RY TMAT I AM E%EMPT FROM THE CANTRACTORS LI- G2f8JB/CBfPOR W CENSEIAWfONTHEFOLLOWMGREA50N(SEC.70.11.SBUSINESSAN�PROFESSIONSCODE:ANVCITYOR (n C7 COUNTYWNICHREWIRE:iA7EHMfTTOCONSTRUCT,ALTEH,IMPROVE,OEMOLISH,ORREPAIRANYS7RUG W TUR�PRIOR TO ITS ISSUANCE.AL50 REIXIIRES THE APPLICANT FOH SUCH PERMIT TO FI�E A SIGNED w Pa�io/Deck SiATEMENT 7HAT HE OR SNE IS LICENSEO PVRSUANT TO THE PROVISIONS OF THE CONTRACTOFS LI- '�� CENSE LAW(dIMTER D(COMMENCINO WIiH SECTION]000�OF DIVISION 3 OF THE BUSINESS AND PRO- � POOUSPB FESSIONSCODE)ORiHAiHEORSHEISEXEMPTTHEREFROIAANDTNEBA515FORTHEALLEGEDEXEMP� � V TqN.ANVVIOLATIONOFSEC�lON7031.5BVANVAPPLICANTFORAPERMITSU&IECTSTHEAPPLICANITO Z Re-Roaf � ACML PEWLL.7Y OF NOT MORE THAN FIVE HUNDRED DOl.URS(5500).): gMlILl DO THE WORK�MlDI7ME STRUC7 REM1IS NOT INTEN�DI OH OF ERECTFOR SAI.E(SC.7 O4�ABUSI� � CORIf11BfCiel ''L 9 O � NE55 AN�PiiOFE5510N5 CODE:THE CONTMCTORS LICENSE LAW DOES NOT APPIV?O AN OWNER DF � PROPERTY WFIO BUILDS bR IMPROVES THEREON,AND WHO DOES SUCN WORK HIMSELF OR HERSELF OR � THRIXIOH HIS OR HER OWN EMPLOYEES.PROVIDED TW�7 SUCH IMPROVEMENTS ARE NOT INTENDED OR C� QOFFEREOWRSALEIF,HOWEVERTHEBNLDINGORIAIPPOVEMEMISSOLDWITFIINONEVEARaFCOMP��- Z TION,THE OWNERAUILOL'R WILL HAVE THE BUqDEN OF PROVING THAT HE Ofl SNE�ID NOT BUIID OR � IM�ROVEFOqTHEPUFPOSEOFSILE). � w ❑I,ASOWNEROFTHEPFOPERTV,AME%GLUSNELYCANTRACTINGWITHLICENSEOCANTRAC70RS Q TO CONSTRUCT THE PROJECT(SEC.]0�4,BUSINESS AND PRnFES310N5 CODE:iNE CONTMGTOflS LI- V81U8I1Of1 Q� ADJ.AREA W CENSE LAW OOES NOT�PPLV TOAN OVMEN OF A PpOPEHTY WMO 6UILDS OP IMPROVES THEREON,AND � WFqCONTMGT5FOR5UCHFROJECTSWITHAGONTRACTOR(5)UCENSE�PURSUANTTUTHECANTRAG QUANTITV DESCRIPTION TORS LICENSE LAW.). FEE � ❑I AM EXEMPT UNDER SEC._. ______..__. . __8.8 P.C.FOR?HIS REASON Q 3 � LL --., — —_— � DATE oWNER___ F Z -- ` - U O W � i_ICENSED CONTRACTORS DECLARATION W � 1 HEREBYAFFIFM UNDEfl PENALTY OF PERJUHV TNAT 1 AM LIGENSED UNDEfl PROVISIqM1S OF CFAPTER � � Y(COMMENCWO YVITM SECTqN 70a0)OF DIVISION 3 OFTHE BUSINESSAND PROEESSIONS CODE,AND Z �X, MY LICENSE IS IN!ULL FORCE AND EFFECT m lll r, � LICENSE CLASS_C_�O _ LIG.NG. �F E 3 Y 3 3 j V DATE __ GONTqACTOR _.________ d W � YJORKERS'COMPENSATION GECLARATI6N Q � � I HEREBV AFFIRM UNDEP PENALN OF VERJURY ONE C:7HE FOLLOWING DECI�1PpTIONS� Z � I HAVE AND WIIL 1,1AINT�IN A CERTIfICAiE Of CONSENT TO SELF�IFiSURE FOR WOFKERS' a 2 Q COMPENSATION,�5 PHOVIDF.D BV SECTION 3]ao OF THE IPBOq CODE,FOR THE PERFORMANGE U OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. w � � W _I HAVE AND WILL 6AAINT�IN WORKFRS'CAMPENSATION INSURANCE,AS REQUIREDBY SECTION Q3]OU OF THE 1A90R CADE,FOR THE PERFORMANCE OF THF.WOiiK FOR WHICH THIS PEflM1T IS 'Q O�'� ISSUED.MV WOflRERS'COMPENSAI'ION INSUPANGE CMRIERAND POLIGY NUMBERARE: CONSTRUCTION � jc�aaiew__ __ _ PLANREVIEW Z PaICYNUMBEfl _ — ELECTRIC _ A Tn Q � (iH65EC?IONNE6lNC�TOEQY.4'A.EfIDOFTI-EPERfMISFL�RIXJEHUN]qEDGCl1PFU^(5100)OFLESS). PLUMBING _ _ Z I CERTIFY THAT IN THE PERFORMANGE OF THE'NORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL (J SHALL NOT E"MPLt>Y M!V PERSOfJ IN ANY MANNFR 50 AS TO BEGOME SUBJECt f0 iHE j — � wORKERS'COMPI=NSATION WWS OF CALIFORNIA,AND ACREE THAT IF I SHOULCI BECOME INSPEGTION FEE � SUBJECTTO THE WORNERS'CAMPENSATION PROV:SIONS OF SECTION 37oa OF THE LABOR y ~ +� � = CODE.ISHALLFOATHWI7MCOMPLI'WITHTHOSFPROVISIONS. ISSUANCE f iTV nL�i��n�anhm n Q ��K'-rflP- +�£3�i4F'£"" 0 onrE: __ naaicaNr: _ sMia RT t�r , � ..�� WWARNING FAILURE TO SEGURE WOHKERS'GOMPENSATION CAVERAGE IS UNLAWFUL,AND SHALL BE ENERGY P/C � SU&IECTANEMPLOVERIOCRIMINALPENALTIESAN�CIVILFINESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT ' OOLLARS(5700,000�.IN MDITION TO THE C0570F COMPENSATION,DAMAGES AS PflOVIDEO FOR IN � SECTION37080FTIEUHORCD�E,INTEREST.AN�ATTORNEY'SFEES. RETENTIONFEE: _ _ _ OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: � IHEREBVAFFIRMUNDERPENALTYOFPERJURVTHATTHEREISRCONSTRUCTIONLENDINGAGENCV � FOR THE PERFORMANGE DF 1HE WORI(FOR WHIGH THIS GERMITIS ISSUED(SEC.3oe7,GV C.). Z w � LENDER'S NAME__ H LENDER'SA�ORE55 Y W IGEfiTIFYTHATIHAVEfltA0iMI5APP�IGAiIONANDSTATE7MATTHEA60VEINFORMATKKJISCORRECT. TOTAL FEES ej�/- � d I AGREE TO WMPLY WITH ALL CITV ANO CWNTY OROINANCES AND STATE UWS REUTING TO BUILDING � v�/� ��7� � CONSTRUCTION,AND HENEBY AUTHORIZE ftEPRESENTATIVES OF THIS CWNTV TO ENTER UPON THE - Z ABOYE�MENTIONED PpUPERTV FOF INSPEGTION PURPOSES. COMMENTS 0 _ � �/ ,� '.� �� m MITT y (PRINT; V] �cy�l� �,�' .)� � SIGN FPERMITTEE D E � . RECPT.NO.J�� PAID 8Y �- VALIDATION WHITE—Department Copy,YEL W—Financa Copy,PINK—Assessa Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy �°��'�� .�� _'`�� .�s�=��, ��'�� e� ��. .a" �;�a>'-;. ., . . : �'� �::. �� @� � �' � �•' r a �, �� , � ��.� ""`��n� ��,"G: , � , � � �� ., � � „. . , �s ,. "* . .: .. _ � , ,�. � h .�, o. . . . . ' , „� - . . . . . _.. .... _ . . .. . , .. . '.. .. „ "> �, ". .... _. . .. .-- ___ .. . .. _�.. � . " d�3��''; . ... ._ ._. __... ....... _. ... .__._�.., . ... --- —.... � .�.... , � . , � �'��,�' ��_ .�C- ___ � _ : A.°: � '��n ,"�.�».`�»�:e' ._nti,._ . �.�3 a3 ��s� ��/� �� .��'/ _ - � '�� -��'� `._.`�.,�- _ _ _ _ _ _ _ _ _____ ____ _ _ _ _ _ _ _ � _ _ : �,� �a �� __ _ _ __ _ � � � �� a � fl �� ' �`� i y� _ a � � �* �s,T�i �' ��,. ..;s'�� ,� w�„"�;,� . as"C'�{5�"€ �`��`��*��° h �,'d�H$°��:�� .. .... . ..... .... .__ . . ._ ._. _. ...... . .. .. � ��o-+�t � ,. 5 t rs�� . ._. _ ._ .- . �, � �` a "`��. �3� ,,, _ _ _ ,m� t , �� , r y �. � � � � '�#�`'4t�°�'� '; �, rQ; ��t'��w„ w. . .. ... . .. .. . . . .... . . .... .. .. .. . .. .. _.. .... _.. ._. k,�ay ;,N � n; -Y��•�, {� . ,'� �-�': �: � � 1 , . s x� _� .... . ... ... ��y; k r�,b ,� ��S� � m, _ g,. x � _�5 w. t��.e rvdfm�� .4.P��;� ±��'��=ir'. ... ... . . .. . .. . . . . �; , . ,...� .. .... .. ........ . . -.. . .... .... . .._ CITY OF DIAMOND BAR�,_-;{��, L r t DEPARTMENT OF COMMUNIT� $t DEVELOPMENT SERVICES 21660 E.Copley Drive Suite 190 (909)860-3195 Fax(909)861-3117 BUILDING PERMIT APPLICATION JOBSITE ADDRESS 1440 Bridgegate Dr. APN LOT TRACT OWNER The Trenton Group ADDRESS 5670 Wilshire Blyd. CITY Los ZIP 900367EL. 39�6'i8� APPLICANT T�Greene TEL. CONTRACTOR K P R S ADDRESS 4�am ert d_t,�tP inn cITY Brea ZIP 92821TEL. 7146720800 ARCWENG/ DESIGNER LBWS/GOrdOn SnICP ADDRESS 300 N I akP qYe CITY Pasadena ZIP TEL._�;;��p_pp OWNER-BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM EXEMPT FROM THE CONTRACTORS LI- CENSE IAW FOR THE FOLLOWING REASON (SEC. 7037.5 BUSINESS AND PROFESSKNS CODE:ANV CITY OR COUNTY WHICH REOUIRE:iA PEHMCTTO CONSTRUCT,ALTER,IMPROVE,DEMOLISH,OR REPAIR ANV STRUC- TURE,PRIOR TO ITS ISSUANCE,AL50 REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI- CENSE LAW(CHAPTER Y(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- FESSIONS CODE)OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED EXEMP- TgN.ANV VKXATKKJ OF SECTION 7037.5 BV ANV APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO A CIVIL PEN/LLTY OF NOT MORE THAN FIVE HUNDRED DOLURS(f500).): ^ 1,AS OWNER OF TFIE PROPERTY,OR MV EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC. 7044,BUSI- NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF PROPERTY WHO BUILDS CIR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR THROUGH HIS OR HER OWN EMPLOYEES, PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR OFFERED FOR SALE IF, HOWEVER,THE BUILDING OR IMPROVEMENTIS SOLD WITHIN ONE VEAROFCOMPLE- TK7N,THE OWNERAUILDF_q WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR IMPROVE FOq THE PURPOSE OF SALE). ^I,AS OWNER OF THE PROPERTY,AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT(SEC. 7044,BUSINESS AND PROFESSIONS CADE: THE CONTRACTORS LI- CENSE LAW DOES NOT APPLY 70 AN OWNER OF A PROPERTY WHO GUILDS OR IMPROVES THEREON,AND WHO CONTRACTS FOR SUCH PROJECTS WITH A CIXJTRACTOR(S)LICENSED PURSUANT TO THE GONTRAG TORS UCENSE LAW.). ^I AM EXEMPT UNDER SEC. . B.8 P.C. FOR?HIS REASON DATE OWNER --- LICENSED CONTRACTORS DECLARATION 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY TNAT 1 AM LICENSED UNDER PROVISIONS OF CHAPTER 0(COMMENCING WITH SECTKNJ 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE,AND MY LICENSE IS IN FULL FORCE AND EFFECT LICENSE CLASS C_IU uc. N0.483433 DATE CONTRACTOR - YJORKERS'COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE CF THE FOLLOWING DECLARATIONS: I HAVE AND WILL AAINTAIN A CERTIFICATE OF CONSENT TO SELF-INSURE FOR WORKERS' CCMIPENSATKXJ,AS PHOVIDF.D BY SECTION 3700 OF THE LIBOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REQUIRED BV SECTION 37000E THE IABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. MV WORKERS'COMPENSATION INSURANCE CARRIER AND POLICY NUMBER ARE: CARRIER_ POLICY NUMBER (i}tIS SECTION NEED NC7T BE IX)A4'I.ETID OFTHE PERMT IS FOR ONE HUNDRED DOII.AHS(f/00)OH LESS). I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I SHALL NOT E"MPLOV ANV PERSON IN ANV MANNER SO AS TO BECOME SUBJECT TO THE WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AGREE THAT IF I SHOULCI BECOME SUBJECT TO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 3700 OF THE LABOR CODE,I SHALL FORTHWITH COMPLY WITH THOSE PROVISIONS. DATE:APPLICANT: WARNING FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL BE SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS(f 100,000),IN MDITION TO THE COS70F COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTK)N 3708 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF 1HE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC. 3087,CIV C.). LENDER'S NAME LENDER'S ADDRESS I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATKKJ IS CORRECT. I AGREE TO COMPLY WITH ALL CITY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION,AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE-MENTKNJED PROP ERN FOR INSPECTION PURPOSES. //'�� /^',v MITT( PR I N T; / Y y�r' �� SIGN F PERMITTEE D E WHITE-Department Copy,YELyOW-Finance Copy, PIN PRESS FIRMLY c c,e!-% -T,�,