HomeMy WebLinkAbout11466 �
,• �
. _-� ' EXPIRED
E� C1TY OF DIAMOND BAR
COMMUNITY DEVELOPMENT DE
21660E.CopleyDriveSuitel90 ' OC� nq � PRESS
(909)8643195 Fax(909)861-3117 ' �J 71;00
"^' BUILDING PERMIT APPLICATION FIRM LY
� JOBSITE �f APPUCATION PERMIT P/C
o ADDRESS L ��r' �����G DATE _� �-�Lj�/ NUMBER I� #
o� ISSUE �-� TYPE OCC
APN LOT TRACT DATE CONST. GROUP
p OWNER • �
p ADDRESS 7�z/C �O� /�7��✓ • ZONING SETBACKS
' z CITY D. l�-�QylJ ZIP TEL. FRONT RW ❑
� APPUCANT TEL. REAR ❑
� 51DFJS�DESTREET RW ❑
� CONTRACTOR u v �.--- SIDE �
� CITI( E S Z P TELL3 77�//SL� PROPOSED USE L'� , ' /� ^ C
J
o ARCH/ENG/ . ' --
, iz DESIGNER NO.DWEL. NO. NO.
a ADDRESS UNITS STORIES BEDROOMS '
� CITY ZIP TEL - •-
� DESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION
�
� - OWNER-BCILDER DECLAHATION - � SFR/ADO,�REM �
O
1 HEREBY AFFIRY 11N0ER CENALIY OF DE0.AIHY iHAT I AA1 EXElAPT FROM THE CONTMCTORS L4 Garage/Carport
W CENSEIAWFORTHEFOILOwWOREASON(SEG703t.58U5WE5SANDGFOFE5510NSCODE:ANVGiYOq (n
U COUNTYWHIqIRE0U1RE5AVENAl17TOCONSTRUCT,ALTER�PROVE.DEMOL15FiOFiREPA1H/J:YSTRUG W PdI10/DBCK �
W NRE.GRIOR TO 1T5 ISSUANCE,AL50 REWIfiES THE AV7LIGWT FOR SUCH FEHMR TO FILE A SiGNED (L
� STATEMENT THAT NE OR SHE IS LICENSED PUFSUANT TO THE PROVISIONS OF THE CONIRACT00.5 L4� ,
� CENSE LMN(CMADTEH Y(COAIMENCWG N7iH SEGTqN 7000)OF DIYISqN a OF THe BUSIhc55 AhD PHO- � POOUSp2
FESSIONS COOE)«1 TMAi HE OR SHE IS EXFAIPT7MEREGROAI AND TME BASIS FOR TME/�LLfGED E1cEA�P-
VTION.ANYVqLATqNOFSECT10N7a7�.5BVANYAPPLIW�iFOFiAPERMIiSU&lELTSTNE�PiIICANiiO Z qe-poof
� AGVIIPEN�LL7YOFNOTMORfTWWFIVEMF�DREDDOLUAS(fsao)): -
� ❑4ASOWNEROFiME7ROPERTY.ORMYEMGIOYEESWITHWAGE51�5TMEIR50LEGOMPENSATqN, 0 COR1R18fC12I
Z WILL 00 THE WO{iK,ANO TME STRUCTURE IS NOT INTENDED OR OFFERED FOR SAIE(SEC.7oN,&15H J
NE55 ANO PROFESSIONS COOE:THE CONTRACTORS LICENSE LAW OOES NOT AVR�TO AN OWNEfl DF
N PiiOPERTYWHOBUILD50HudPROVESTMEREON,ANOVMO00ES5UG1wORKHiMSELFORMERSELFOR =
CL THqOUGHH150RMEROWNEMCLOVEES.�ROY�DEDTMATSUG/WPROYEIAENTSMENOTWTENDEDOR m
u1 OFFEREDFORSALEIF,110wEVERTMEeUItD�NGOf1u1PROVEMENTI550lDwiiwNONEYEAAOFCOMPLE- - - � �
0 TION.TNE OWNERbU1LDER YALL FfAVE iXE BUfiDEN OF VROVWO THAT NE Ofl SHE DID NOT BUILD Oli
Z YAPROVE FOR TNE%JfiP0.5E OF SALE4 "
= OI.AS�wNEROFTNEDRODERTv,AA1EXCLUSNELYCAN7RAC7WG1NiTNLiCENSEDCaNTFUCTORS_ . /�� -
Q TO GONSiRUGT TME PRO.JECT(SEG 70N.BUSINE55 AND GROFESSIONS COOE TME CONTMCTORS ll- YdIU2fi0f1 C/ ADJAREA
W �NSEU�NDOESNOTAPCLYTOMIOWNEHOFADROPERn'WMOBUqD50RWPqOVESTMEREON.IND
� WHOCOtiTMCTSFORSUCF1vqOJEC75M4THACPVTRACTOq(5)LICENSEDPURSWNTTOTHECONTXAG Q�J�Jj�'� DESCRIPiION _ � - FEE
Y TORSLICENSEUw.j. - - --'� - -
� J
� O 1/�!A EJIEMPT UNDEfi 5EG 8.8 P.C.FOFL TMIS R£ASON U
� ¢ '
� DATE OwNER � . ,
Z . W . _ .. _ ..
� LICENSEDGONTRACTORSDECUIRAT�ON ' W
' � IMEREBYAFFIflMUNDERFENAl7YOFVERNIRY7HATIAMLILEN5E0UNDEFPROV15lONSOFCNAPTER �r �
p„ 9(COMMENCWGWITHSECTION7o00�OFDMSI0N30FTHEBU51NE55ANDPPOFESSIONSCOOE,AND Z
uj MYLIGENSE�.SWFIRIFORCEMlDEFiECT.
o �A�3 PrZ �
ucEnse cuss uc.No, J �
V �ATE '` CONiRACTO /1f�G�rL�� d , ,
W J
' � WORKERS'COMPENSATION DECLARhTION Q
� U
� I HEREBYAFFItUA UNDER VENAITYOF PERIURY ONE 0i iME FOLIOW WO DECL�MTqNS:
� ZQ
� IHAVEANDW41rdAiNTNNACER7IFICA7EOFCONSENTiOSELF�INSUREFORVpHKERS' $ � -
Z COMPENSATIOH,ASPROVIDEDBYSEGTION77000FTXElA80RLO0E.FOfiTHEPERFORMAHGE U
¢ OFiTfEWORKFOHWNiC+�THISPERAUTISI55U"cD. , �
. G
W iHAYEANOWILLMAINTAINWORI(ERS'COMVENSATqNINSUR/JYCE./�,SREWIRE081'SECiqN
O 3/aoOFTHEV�80RCO0E,FORTHEPERFORMANCEOFTHEWORKFORWHIpiTNISPERM1i15 9D•�y�
ISSUED.MYWOP RS'COMPEN/S,TIONWSUa�u/�ECARNIENAN�GOI�CYNUI/BEA�E: CONSTRUCTION �L '^✓
• j �Eq �� L�%Z�/ PUW HEYIEW
Z vaicY r�uMBER_ � �L, ELECTFiC
¢
0 �ncssEcnwr�Wr,oTeFoo�wFTmoFn�r�arxrswaor�wanmoau�sg�m�aattss�. PLUMBlNG _
z 1 CERTIFYTNAT W THE�ERFOfiMANCE OF TME wORK FOR wHip1 THiS PEFlMiT IS ISSUED,1 MECHANICAL
(ry . SHALLNOT EMPLOYANY PERSON W ANY MANNEH SO+�S TO BECOME SUBJfGT TO THE .
� � WORKERS'COMVENSATIONUWSOFCALIFORNIAANDAGREETMAi1FI5HOULDBECOME INSPECTIONFEE � - - �
. � SU&IEL7TOTMEWORNEiiS'COMPENSATqNPpOV1510NSOF5EGTION]7000FTHEIPBOR
cooE` =oarHvnn�couv�vwin�nasEaao+nsiaas. ISSUANCE � „00
� SMIP .�a
p OATE: APPLICANT:
, � W,tANiN(3:FARUfiETOSEWREWORKEHS'COMPENSATqNfAVEMGEISUNUWFUI.ANOSw�LLBE ENERGYPlC e��
� SU6IECTANEMPIOYEATOCRIMWALPENPLTIESANOCMLFWESUPTOONEHUNDREDTHIXISAND ENERGYPERMIT �'_�� -
DOIURS(t100.000).W ADDITION 70 THE COST OF COMPENSATqN,DAAUGES AS PROYIDED FOR W
� SECTIDN�TaeOFTF1EU�b�RCODE,WiEREST,MIDATTORNEY5FEE5. RETENTIONFEE: ~
� CONSTRUCTION LENDING AGENCY PRE-ALT FEE: n('� 1 ^ ' �
¢ IHEREBYAFFIRMUNDER7ENALTYOFPE0.RIRVTNATTMERE1511CONSTRUCTIONIENDW4AGENCY AyK �I�
n- FOR THE PEHFORMANCE OF TME WORK iOA WMIGt 7H15 pE WAIT IS ISSUED(SEG DOY7,GY.C.� T-TZ— . ,
Z .. . _ _ .. . _
W
� LENDER'S NAME
F— LENDEfYSADDRE55
W ICERTIFYTMATIHAVER'r.MTH�SAPPIiUTbNANOSTATETHATTi1EABOVEWFORMATIONISCOaRECL TOTAL FEES_ _ ' ���D
. � IAGREETOfAM7LYWITrIKIGTYANDCOUNTYOf1DWINCE5ANO5TAiEUWSREUTWG708U4DING .
� CONSTpUCT10N,ANOHEAEeVAUTHOR2EREDRESENTATNE50FiHISCd1N7YTOENTERUPONiHE �
Z ABOYE�MENTqNEOPROPEHttFORiNSPECiqNPURPO5E5. . COMMENTS
o ����
_
m vc inc r.�ua wN-
� 1 � !' O
� s ti�r F P I DATE RECPT.NO. � PAID BY ��_VAUDATION
, �� WHITE—Department Copy,YELLOW--Finance Copy,PINK—Assessor Copy.GOLDENROD—File Copy,GftEEN—ApplicanCs Copy � . . -
. -
. � -
. :
. . ,,
i /
_ �
- � �
- ��-
z >
'' � O � '' ..
F- 0 E-' W ' J � �,
` a-fl �' • = = � zo ¢ � � � � z
�c :: o � � ZmaW zZ � �, � a � o �,
�' � � v� o o � m � m m Z � o � z a � � � � � a < .
' ^O U ` �n �- z o a � z u7az a •
0 oww � aoc� � w . �'�
, ,�'W ',;'.::' . p � J Jc�,c� oozoc� ¢ wza - ocria � z � v�
� d t i t L m z p ¢ z � � � w Z w F Z ¢ - O a � w .
� � � '' w 5 � om � = x w � � F- awv Wr.i W xw � . ,
�- - ' � ¢ W W n. d � m J C7 V C7 � J J J fn V J � � J O j Ll" ¢ ' - -
:. p a o o W w p ¢ W Z � O O O � o 't Z ¢ tu Q > W
�-'i. u=. » u. u. � � � am � LLaaaO � � ZZ � ww z
� O � � x o w
�" � N : -
� — _
,.
�
� �' n� �T
��' � , t,�✓. . �
� �.' ,. .
. . ' � 1! S.� ..
� � '
r, �_ : �
T �— � p U' , F- � �... z W
Z (7 y N
`--.- .... • � o � � � � z ¢ m ~ z � g � c� `—' z cn �N
�l cn [L 7 W ��> F Z ¢ F- U�2 m � F- � Q Y J ~ � z (L Cfl {- � X CA
� c7 � o W ¢ ¢ W w ¢ w � � � gv� Z z w � F= c~.> � Z Z
Y ¢ U Q � W W Z > Q�
�� .� o ¢ ocnxc70xwa � = � Z � FQ- H � Ow � � W F-F-
a � � Z � a � cnzUsxxwF"' ? � ¢ a� c� a � Uxw a � ' Ua
m u� U � mawu- � �- c7c7c73s � z wFa, ¢ JJJ J � 1=a
' �� � C7 w O g F O Q O > > > O F � -� � � a w v� ¢ ¢ a a � . 4 w
J ¢ gW `LO ¢ 0OOO2Xa W ¢ W W ¢ ZZZ Z 0 WW
m � wc� mt- � ¢ u. ¢ ¢ ¢ ¢ v� w3c� ov� v� v> c7u. u. � � U cnm