Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
17234 (40)
� — CITY OF DIAMOND BAR COMMUNITY DEVELOPI4IENT DEPARTMENT � ;,. 21660 E.Copley Drive S�ite 190 / PRESS (909)860-3I95 Fax(909)861-3117 � '""'� BUILDING PERMIT APPLICATION FIRMLY o ADDFiESS�'—F�� , ��%U��� 'Al�-�.�d,t� j�� APPLICATION �u �,�9 �3 j�UMB R��#,C,: DATE o� iSSUE � r sTYPE OCC APN L07 TRACT DATE � � �" CONST. GROUP p OWNER _I�`Y ADDRESS a I cl d'��'e K��Kkl.L !k Y'�-c2-�w �%� ZBNING SETBACKS y CITY 'D1f��M.i,�I.Gb f3/rti. ZIP (1ic+'� TEL. �,Fy�,1f�Gi'7 REART RW ❑❑ g 'APPLICANT?�it�l'1tx. i?id;l�.[+-t.-�aae��. TEL�i9Lj:�.7as� SIDEJSIDESTREE7 RW ❑, mCONTRACTOR E�4+1'fl�K. �'Vt�L�.--� @.e%YU� PtI�A:�j2��� SIDE ❑ Q ADDRESS �,�.7�' i<a h rs r1�-�• � CITY 15,P;�-tv..n� ZIP C�E�tS TEL.L�� � �(��;��# PROPOSEDUSE o ARCWENG/ W rDESIGNER NO.DWEL. NO. NO. � ADDRESS UNITS STORIES BEDpOOMS � CITY ZIP TEL. � DESCRIPTION Sd.FI: FACTOR PSF ADJ.AREANALUATION �. . OWNER•BCILDER DECLARA710N SFWADD/REM � � � ' � � � � 1 HEflEBV AFFIRM UNDER PENALTV OF PERJUpY THAT I AM EXEMPT FROIA THE CONTMCTOqS LI- �ygfB98(C3fpOlt ' '� � � W CENSELAWFOfiTHEFOLLOWINGREA50N(SEG7o31.58USINESSANDPROFESSIONSCODE:ANYCI7YOR (n U COVN7YWMICHREOUIRESAPEFiMITTOCONSTRUCT,ALTEft,IMPROVE,DEMOLISH,ORREPAIflANYSTqUC- W Pg�lO/DBCIC �� w' 'TUfiE,PRIOH-TO ITS ISSUANCE,�AL$O'RE�UINES THE APPIICANT FOR SUCH PEFVAIT TO FILE A SIGNED W ' ' ' �. 5TA7EMENT THAT HE OR SHE IS LICENSE�PURSUANT TO THE PqOVI5loN5 OF 7HE CONTRAC70R5!1• , . � , �' ,CENSE LAW(CHAPTER 9(CAMMENCMG WITH SECiION 7000)OF�IVISION 3 OF THE BUSINESS AND PRO- �'�' POOVSPB FESSIONSCODE)ORTHATHEORSHEISE%EMPTTHEREfROMAND7HEBA515FORTHEALLEGEDEXEAdP-. �J OTION.ANYVIOUITIONOFSECTION7031.SBVANYAPPLICANTFORAPERMITSUBJECTSTHEAPPLICANT70 Z RE-ROOf ' ' ' � .ACIVILPENALTYDFNOiMORETHANFIVEHUNDREODOLLAHS(55o0�J: - � � ❑I,A30WNEROFTHEPPOPEFiiV,ORMYEMPLOYEESWIiHWAGESASTHE1R50LECOMPENSATION. � COR1R1@fClfll � � Z� �WILL DO THE WORK,AND THE 6TRUCTURE IS NOT IMENDED OR OFFERED WR SALE(SEC.7044.BUSI- J ' NESSAND PflOFES510NS CODE:THE CONTRACTORS LICENSE LAW OOES NOi APPLY TO AN OWNER OF � � .�PROPERiYWF109UILDSORIMPROVE$THERE�N�M`DWHODOESSUCHWORKHIAISELFORHERSELFOR � ' ' ' �• THFi0UOl1 HIS OR HER OWN EMPLOYEES,PqOVIDED 7HAT SUCH IMPROVEMENTS ARE NOT INiENDED OR m � OFFEREDFORSALE.IF,HOWEVER,hIEBUILDINGORIMPROVEMENTISSOLDWITHINONEVEAROFCOAAPLE � Z�, �TION,THE�WNER-BIIILOER WILL HAVE THE OURDEN OF PROVING THAT HE OR SHE DID NOT BUtLO Ofl � IMPROVE FOR THE PURPOSE OF'.SAIE): � � w' ❑I,ASOWNEROFTHEPROPEFiT�;AMEXC�.USIVELYCONiPACTINGWITHUCENSEaCON7RACTORS . . ,. �� ;TO CONSTfiUCT THE PROJECT(SEC.7D64�,BUSME55 AN�PpOFE5510N5 CD�E:THE CONTRACTORS Lb V811J8t1Of1 ADJ.AREA W CENSELAWDOESNOTAPPLYTOANOWNEROfAPROP�flNWHOBUI�D&OPIMPROVESTHEREON,AND ' � : WHOCONTRACTSFOqSUCHPROJECTSWITHACONiRACTOR(S)LICENSEDPURSUANTTOTHECONiRAF QUANTITY DESCRIPTION � 'KEE � Y; TOqSLiCENSELAW.j. � � ❑I AM EXEMPT UNDER 9EG. B.&P.C.FOR THIS flEASON � �..�. ' . . " �. � � �.�A7E OWNER � U � �' , LICENSED CONTRACTORS DECLARATION W ' �� 'IHEREBYAFFIRMUNDERPENALTYOFPEFiJURY7HATiAAALICENSEDLINDERPHOVI510NSOFCHAPTER � � q� g,�.� ,�,p ' ' ' , .. d�., � 9(COMMENCINGWITHSECTIONYOOU)'OFOIYISION30FTHE8USINESSANDPROFESSIONSCADE,/WD Z � ��/b' �YZ� W'—���'IY— w�, MY LICENSE IS IN FULL FORCEAFID EFFECL m � , ��, , �' LICENSE GL45S ���" LIC.NO. �°'����'� j � � OATE .`���"'=5�—b�''� CONTqAC70R ��.%tZF�''�' At1A.�'�f'C�A�`s�' OJ. � LL � ��.�..��� � � � WORKERS'COMPENSATION DECLARATION ¢ - N I HEFEBYAFFIRM UNDER PENALTY OF PERJURV ONE OFTHE FOLLOWCJG DECLARATION&: � � VJ ¢ Z _IHAVEANDWILLMAINTAI'NACERTIFICA7EOFCANSENiTOSELF-INSUREFORWORKERS' _ CAMPENSATION,MSPRD�IOEDBYSECTION3]OOOFTHELABORCO�E,FOR7HEPEflFORMANCE U ¢ J OF THE WORK FOfl WHICH THIS,PERMIT IS ISSUEO. � �.,� f . , . , . e`r I HAVEAND WILL MAINTAIN WORKERS'GOMPEN3ATION INSURANCE,A3 REQUIRED BY SECTION Q `3tOpOF7HElABORGbD�.FOR'THEPERFORMANCEOFTHEWORKiORWHICHTHISPERMITIS ISSUED.MY WORKERS'COMPEN,S»ATION INSURANCE CARRIER AND POLICY NUA78ER AHE: CONSTFUCTION j CARRIEfl ,w��'W{,� k''��4'�� pLAN REVIEW � POLICYNUMBEfi �1�3`� '(7�� ELEC7RIC � . (iHISSECM7NNE�NOTBE�OCN?4E7EDOF7HEPEPhttSFORONEHIN�DFiED00LlAR3(S1o0)OIiLESS�. PLUMBING � � I CENTIFV THAT M THE PEI�FORlAANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL - �J SHALL NOT EMPLOV ANY VIERSON IN ANY MANNEq 50 AS TO BECOME SUBJECT TO 7HE (p WORKEflS'LOMPENSATION��LAWSOFCALIFOqH1A,ANDAGflEETMATIFISHOUL�BECOME INSPECTIONFEE _, SV&IECiTO THE WORKEHS'COMPENSATION PROVISIONS OF SECTION 37000F iHE LABOR CADE,I SHALL FORTHWITIi COMPLY WITH THOSE PPOVISIONS. y� ISSUANCE �b � 6 y� p DATE: Q�6D`�i`'`ua qPPUCANT.� 'g '$•��" SMIP 111 J WARNING:FAILUqE TO SEGUHE WORKERS'COMP SATbN COYERAGE 75 UNtAWFUL,ANU SNALL BE ENERGY P/C , � SU&IECTANEMPLO�ERTOCRIMINALPENALTIESAN�CIVILFINESUPTOONEHWJDFEDTHOUSANU ENERGYPERMIT DOLI.ARS�f700,o00�,IN ADDRION T�THE COSiOF COMPENSA7ION,DAMAGES AS PROVIDED FOR IN - � SECT�ON3708DF'INELABOFiCA�I,INiEREST,AN�ATTORNEV'SFEES. - �RETENTIONFEE: I ` d COI�STRUCTION LENDING AGENCY pRE-ALT FEE: � � IHEREBYqFFIRMUNOERPENALTV�OFPERJUpYTHAT7HEREISACONSTRUC710NLEN�INGAGENCV ' FOR THE PEFFORMANCE OF THE YJ6RK FOR WH�CN THIS PERMIT IS ISSUE�(SEC.3091.CIV.C.). , Z' W � LEN�ERSNAME ' � � � F+ LENOEH'SADDRESS ''"' ' � w� ICER7IFYTNATIHAVEpEMTHIS(�PPLICATIONANDSTATETHATTHEABOVEINFORMATIONISCORRECT, TOTA�FEES , ��r., � ' �: 1 AGREE TO COMPLY WITN ALL CI7`/IAND COUNTY OR�INANCES ANd STAiE LAWS RELATING TO BUILOING � �. CANSTR CTION,AND HEREBV AU'frtl IZE REPRESENTATNES OFTHIS COUNTY TO ENTER UPON THE . - � _ � Z., ABOVE� NTIONE OPERiV FO NSPfiCT10N PURP0.SE5. COMMENTS O',�, �,.�, . . . . . m' �PE NAME(PRIN � � . . . . . � �' ��'�.���c:� io r�� �I,Y' SIGN OFPERMITTEE ""' ' DATE - - ' -'� � � - y � FECPT.NO. PAID BY � � �� VALIDATION ~ �� WHITE—De artment Co YELLOW—Finance Co PINK—Assessor Co GOL�ENHpD—File Co GREEN— IicartPs Co � . � � � . P PY� PY. PX PY� P PY , , .� ;.., . .. : , .+:.�.t, :�,;r" 1..'-::.<. 4- 4.e.:i:'�' v..t..""�'"d � ,�j94�13.h � ]'*r..•.-.:+d. a r:�'.� - .. -.,. . . .. .� �;�'° �� ��`'��,����� ��� �������`�'��€� ����6�� � � -� , : � �' ��'�3 �,�,� 0 � ,� „°�� � f1 �'a � � g � �,, r���u� � s��� � , _ _ _. . ,._ ��T���4� � � � �� � �L^v£7�3.�4�l��' � � � �� ���e������Fs;���� j ; °-������;s _..__-�— ____� ��;i � ��F�i����C�"�tr��? ' ! , ����DEP3�E.f7f�;�'��:C:� i ', _,—�_ ___- ------ � — �--- - --- ____--_ �� ����9s�9�������'t�� � � � 4 �Ji�i�3�� �(����E'tRi��liT � - � � � {j , � _�___ �� � �'+��S���s�� i � � �� ��` �F����L����'��9'���,T��i� �� �M" � a - :; i, ' �'� , I ��'3��3� j ,� � �a-V�F� E L���� Y � �Fi�� ���°t3L�' � �� ������a�� �—� � ! �9��� �������� �����a e�s��'4���a� � f � ��-;�.C�C�.��s����fi �L�______- --4_______-�___.__---m-�.._.w "h � �rP`�r,�a�aP6u`��C`����8,I�.i��'���e �_ � _ _ � �6�Je�,��{.��t����'ait� � i �� � � F����D6��f�d��� � � i � ��F-a�����d�9a1� �--�--i, ..�.-- -- _� , s ��7����-t�����9� � i 3C�Cs c�d�:.a ---- - - �����,�3 �{,��,iy; � 1 i � R i �st��;��t���:���� _--____— _ _ ����a��1 �'L ����e��� ' - � i FE�@S���C31�1f� � :� ���.�4'C''��4Y.��1P'i�'�/C5.F�:dY . . I .. '., �'Ld'V�.��•'...�`V P'?'1l0� ' � - . , .. �,I � �25�" ��R'�?,��1�.�.E;e� � � i ;�a�,'C}���s�S�a,�a°.�'.� '���wL� B�.a�:s�� �� �?��L Fl��L �'�� � ����.�G�N�l���b+_A,i��Pi"�I ! s7��SRT����5�5. _���i i —_ � � � —__` i ��'��,���.�3�:6�l�C`a ( ��PJ�:,��6t��S ," � e r � ' �_� ih'�.�,'�?S,.���. - . _ - ., �„ � � �.���^"`E���.a�B�i{'�a � � S,_���J�.�'ir�d,�v%��.'�3�$f�, � �. . ... �-.. �,�' u����������. � .. ...� . � ; . S'��.;��G��Pb���. . . � .. ... . . � . u' ��u9�'^,��Y`�i � �z � � P-&�s�a��:1�����'.-�. � .. � � . ��4� '�`���4�'; � � � � � � �'��i�'t�3��� �a�St�� ��� � _`�.` — _ ���1+9�v3_��o��:��°z � � =���E�!?� �t��4. ���rP�.� � _''I; � ��s'°���.�L.����l;S:a� 4 v`�� ------ r��i''�i���?�l'�`"�e�� � -,_— 1�_�� �__ -i'� � ���_-----.___.— ': Y 3 -__.. -�, �' . � t � , � k i 4 I � � a�����m����� � _ _ ; � i � � ; „ — — — ---- , i � , i-- —------ — _---- — _--_—___ .��_._+ � ;� 'i ���y������3��_��. � ���� ��`:p�'��s�� _— � a v ��7��r � ��'�"�� z� �__ _ � ___ � s �a,' "��,� E , � � 1 _ ��_. � ____----�_��' t,. y F' T��� i�ti� '�'s -� . . � . i. �. �—�__ + i � ` a .N4'� �'�'�.,�,w .. .. .— "- .— �� d .l . \, ... � � i � - � � ' � � � - � - � � �� � �