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HomeMy WebLinkAbout17759 (17) - - - " -� _ �._.�._ ---- -- - . _. _ ..---------- ------------------------ -----__-___ . __�_ ., J� CITY OF DIAMOND BAR � DEPARTMENT OF CONIIvfUA1ITY&DEVELOPMENT 5ERVICES �1 � 21825 E.Coplry Drive (909)860.3195 Fax(909)861-3 t i� � PR E SS �����' BUILDINGPERMITAPPLICATION " ; FIRMLY } JOBSRE S'�J,`1O0 APPUCATIQ N ' PERMIT � n/R(«j P/C O'1�� ' A ADDRESS DATE Z//�dZ NUMBER��1� ► x (y� $ �ssue �, . e-�� TYPE occ � � APN LOT TRACT DATE `,"] 1_ ��c►�CONST.,] -�,L_N GROUP I -? p OWNER Q QtA S (,fJEST CoV1 r� in V1 "' A�DRESS�f1Z0 (.��. M�� S� ROO ZONING SETBACKS gCITY I r.i�nc ZIP�� TEL.7�lGi-G'22-2l7 FRONT RW ❑ APPLICANT ' 7E4.4c16-y2.�1-/�l SID SIDE STREET RW O � CONTRACTOfl OPIA��.�ES� ' ' SIDE ❑ a ADDRESS � � CITY ZIP TEL. PROP�SED USE � - � i w ARCH/ENG/ '� �`�' < < `?-�� � DESIGNEfl �D�tGCS � NO.DWEL NO. NO. a ADDRESS �Q'� _7_ _MAG Y Ur / O • �L N GITY �YV 1 N C'� Zlp� TEI..�j�l�i�7Zy= UNITS STORIES BEDROOMS rn DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION Q -0WNER-BUILDER DECLARATION SFR/ADD/REM O 1 NEREBY AFFlPM UNDER PENALiY OF PERAIHY THAi I AM EXEMPT FROM THE CONiMCTORS LI• GEt89B/CBrpOR W CENSELAWFORTH6FOLLOWP76REASON(SEC.70.71.6BUSWESSANDPqOFESSipJSCODE:ANYCITYOR (n V COtMfYWT11qIRE0UIRESAPERM�TTOGONSTRUCT,ILLTER,IMPROVE,DEMOLISM,OqREPAIRANYSTRUG W PetfO/DgCk � TURE,GRIOR TO ITS ISSUANCE.ALSO REOUIRES THE APOUCANi FOR SUCH 7ERMIT TO FIIE A SICNED W STATEMENT 7HAT HE OR SHE IS UCENSED VURSUMfT TO THE P{lOV1510NS OF THE CONiRACTORS lb � CENSEUW(QIMTENY�COMMENCWaWI7H5EGT10N7000)OFDIVISION70FTMEBUS�NESSANDPR0. LL' PooUSpa FESSIONSCODEJORTHATHEORSHEISE7tEMPTTHEREFR0IAANDTHEBASISFORTNEALLEGEOEXEIAP- (� g TION.AMlVIOLATIONOf9ECTION70�1.5BYANYAPP�ICMITFORAVERMIT5U8JECT5iHEAPP�IGAryTTO Z Ra•Rool . F, ACMLPENALTYOFHOTMOREhVNFIVEIIUNDREDDOlUR5�f500).} ' O OlA50WNEROFTHEPROPERiV.ORNYEMPLOYEESYNTNWACESA5TME1R50LECOMPfNSATqN, � Commerda� � Z WILL D07ME WOR1C,AND THE STRUCTURE IS NOT IMENDEO OR OFFERED FOR SKE(SEG.70��,BVSI• J � NESS Ml�PROFESSIONS COOE:THE CON7RACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF ? PROPEAiV N'HO BUILDS OR IMPROVES THGREON.AN�MrtiO DOES SUpt M/ORK HIMSELF OR MERSELFOR Q THROUGH WS OR XER OWN EMPLOYEES,PFIONDED iHAT SUCM MPflOVEMENTSARE N07 WTENDEDOR m QOfFERE0FOR5ALEIF,HOWEVER,THE8UIL�INOORIAIPROVEMENTISSOtDVrtiHiNOflEYEAROFCOIAPLE• � TION,TIE OWNERAUIIDEH VALL HAYE TME BURDEN OF PROVNO TH�T HE OR SHE DIp NOT BUILD OR � W PROYE FOR THE PURPOSE OF S�LL.EI O lA4 ONMER OF THf VROPERTV,AM E%CLUSNELY CANTMCTINO WITH UCENSED CONTMCTORS Q TO CONSTRUCT THE PRO.IECT(SEC.70��,BUSINE55 AND CROFESSIONS CODE:THE CONTRACTOflS U� VBIIIa�I0f1 ADJ.AREA '" W CENSEUWDOESNO7AVPLYTOANOYMEROFAPHOPER7YWNOBUILD90Hu.IPROVE5T7EREON,ANO � NnqCONTMCf5FOR5UQIPqOJECTSMATHACONTAACTON(5)UCENSEDOURSUANTTOTHECONTMG QUAMITY DESCRIPTION FEE � TORS UCENSELAW.�. � Q OIAMIXEMMUNOERSEC. B.1P.C.iORTHiSREASON a ?i V — , U. � DATE OWNER V � �s[ UCENSED CONTRACTORS DECLARATION W [L I HEREBV AiFIRAI UN�ER VENALTY OF VE0.IURV THAT I A1A UCENSED WDER PROVISqNS OF CHAPTEN Ur . p„ y(COYMENCWOWITHSECiqN70W)OFDIYIS O�l/FME55ANDPROFE5510N5�JDE.IWD Z �X MY LICENSE IS IN iULI FORCEAND EFFECT �� � D� m ,� LICENSECUSS UC.NO. __ � F J V DATE CONTRACTOR a � `�'� � ORK 'COMPENSATtON DECIARATION 4 = U � INEREBYAFFIRMUNOERPENALNOFPE0.IUMONEOFTHE�OLLOYANODEq.AilAilONS: Z � _IHAVEANDWILLAIAMTAINACEpTIFICATEOFCONSENTTOSELFdNSUHEFORWORKERS � � _ . COMPENSA7IDN.ASPROVIDEDBVSECTION970oOFTHEUeORCOOE.FOR7MEPEHFORMIINCE �U OFlHEWORKFORMM1/1CHTMISPERMITISISSVED. - � - � .� � " • W �IHMEANDWILLMAINTAINWORKERS'COMPENSATIONINSUMNCE.A$REOUIREDBYSECTION /'� � Q i7ooOFTHEIABORCODE.FORTHEPERWRMANCEOF7MEWORKFOflWMK7/TH15PERMRIS 1 ��,'�O LSSVED.MY WOW(ENS'Cf1A/{� SAT N I U CE ARqiER ND POL�CV NUI/a R�R�E,:�, a CONSTRUCTION �ti � � CARRIER •'�' PLAN REVIEW �" � POIICV N e � • ELECTRIC �OO � � ���_ � �twssE iee oFnfrEaMrtswaart�oat�sR+�IOAtFss1 PLUMBING '��.'�\7 w !� r� Z ICEHiIFYTHATNTHECEPFORMANCEOF7HEN'ONCFORYMICHTHISPERMITISISSUED,1 MECHANICAL 2 � t.-1 .C7� � U' SHALLNOTENPLOYIWYFERSONNANYMANNERSOASTOBECOMESUBIECTTOTHE � N WOpKERS'LOMDENSAiIONLAWSOFCALIFORNI0.AND11CREET1UTIfISHOULOBECOME INSPECTIONFEE SU&IECT TO THE 1MDiU(ERS'COMPENSATION PflOY1510N5 OF SEC7�ON]700 OF ME UBOR ' cooe,�sw�u ram`rvn'ni eauP�r win�JJJy��os vr�nsiorrs. ISSUANCE pOATE:����APR�CnNi: �� M�'C'�.(�J'� SMIP �O r ENER �1 � WARNINO:fNLURE TO SE411HE WORKERS'WA�PENSATqN COVERA�E IS UNUWFUL,AN�SNALI BE � �� Q� �y SU&IECTIWEMVLOVERTOCRIMINALPENPLTIESANOCMLFINESUPTOONEMUNDREDTHOUSIWD ENERGYPEFiMIT � DOLt/V13 ptaa.000l.IN AD�ITION TO TME COST OF COMPENSATION,DAMAGES 11S PROVIDED FOR IN � SECTqN]70e OF TNE LABOR CODE.INTEREST,ANDATfORNEYS FEFS. RETENT�ON FEE: pW.., CONSTRUCTION LENDING AGENCY PqE-ALT FEE O � IHEREBYAFfIFiMUNDEHPENAL7YOFPERRIRYTM�TTMERE�SACONSTRUCTIONLENDWO�CENCY _ .� n- FORTHE DERFORAIANCE OF THE WORK FORNMICH TMIS VEfiMIT IS ISSUED(SEC.�097,CIV.C.). � � 1 LENDEH'S W�ME � LENDER'SADDRE55 ^ p. � 1 CERTIFY TNAT I HAVE READ 7HIS AVPUCA710N AND STATE THAi TME ABOVE NFORA1A710N IS CONRECf. TOTAL F E ES� n � ��V,�, - ��VI o� W IAGREE 70 COAIPLV WI7HALLCfTYAND CdJNTY ORDINANCES AND STATE UWS REUTINO TO BU0.DINa O U � CONSTRUCTION,ANDXEREBYAUT1qFQEREPRESENTAiNE50FTMISCOUNTYTOENTERUPONTHE �I^ r � ABOVE�MENTIONEOPROPEHTYFOFiWSFECf10NPVRPO5E5. COMMENTS � J � m VERIA17 E (PWNn 4 O� � � iG EOFPERMiTTEE TE � RECPT.N0. PA�D BY VALIDATION WHITE—Oepartment Copy,YELLOW—Finance Copy.PINK—AesessorCopy.GOLOENROD—File Copy,GREEN—ApplicanYs Copy _. _ , .. . . .___ . . _ ... . ._ . , . _ _ _�-- - , . , _ . _ :.... - --- .— r� . . . . . - ClTI' C�F DlAMOf�D BAR lt,��F�EG�iON f�ECORD � �- o � !`;—� .,�.� �, a�� .�. C� a� � ..._ . , ---� ,� r� ��.��.�' � ,���"�� ,�!1 F � ' r,�1 r� . . . 'll�.�i��.�, �.�1�� � ����� � �� �. _..��� �_.���. .��_.�_._ .__ �____...._._�.. �- - - - =...`���__,_�.��'� . � i� 5ET BACKL� � ' FLOOR J�15T� FTGSIFORMS/STEEL �! 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FEES PAID � FWAL PLUMBIfJG � { ; ENERGY I a,v{�'VS _�,,�,1.�3"(3�021 � i.��9i ��`T���4. i 3_2/1`oi � � ' I o^..1�4 <'�'-"�`'`��ei�o � ' .._._; . • ' p COMPJIENTS as't-��R�Yt�a-c, o.(�-Ex�-`9��a4$X A� °�`���C��— _ - _ ._.�v��tc� � t��_p�Sj�,c.. ot,�e_o�- '� , -i}�_�W�kk�J'a-fl---���^� .—.. _..._ . .__ _. ; -- - jl�lo� o�i�"�����.c�a�c .Qc.y�r�.c.11__._' _ __ o�_._ _ . l �1_,•o-i -P,�L e(� . . : i SEP71C TANK SIZE � SEEP PIT/U SIZE I��i' . ._ _ . ,, . .. � . ...._ _., i ,. . ! ' .i .. a���� ��: . . _. __ � , . � . . , , _ • , ;, � i ` , . �_ . - • ., � ,_ .; _ ' - • ., � — .