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HomeMy WebLinkAbout16122 (37) � v�`� � Q CITY OF DIAMOND BAR `�� �� - DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES � 21660�.Copley Drive Suite 190 „ � (909)86Q3195 Faa(909)861-3117 PRESS '��'� BUQ.DING PERMIT APPLICATTON • � � �� FIRMLY o ADD ESS 23 6I S� �'�o n ,1}S�� DATE CATION �_L„O I NUMBER I G 1 �����" � APN OT ' � ' O TRACT r7 ""�_ ISSUE TYPE OCC DATE CONST. GROUP ' � OWNER "' ADDRESS ZONING SETBACKS " • � CITY ZIP �(EL. REAR RW ❑ APPLICANT TEL. SIDElSIDE STAEET RW � � CONTAACTO SIDE ❑ � CfTY SS ZI � TEL PROPOSED USfi N J F� � ARCH/ENG/ � • . DESIGNER NO.DWEL NO. NO_ ADDRESS UNRS STORIES BEOROOMS � CITY � IP EL � y DESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION � Q OWYER•BVIIDER D[CLAAATION SFR/ADDIREM O p I HEREBY AFFIR4 UNOER 7ENALTY Oi VE0.AIRY TUT I/J�E%EA�CT FRdJ T11E L�OtlfRACTOHS LL �e�g���� l.+O. LL CQ/SEUwFpq7HEFOLLONMMiRFA50N(3EGi0.7t.68V5W[SSAN�CROFESSIONS�ODE:AHYCf7YOR (n � COUHTYMM1Cf1PE0UWESAFERYRTOWNSTRUCT,AITER�PHOVE.0EA10IJ5H.ONli[VAIRANY57RUO W Patio/Deck . 7URE,►RqR M 1T3ISBUANCE/�LSO FEW�RE9 iME APPL�CANT FOR SlK]I VERM�7 TO illE A SICNED w � STATEYENT THAT HE 01t SME IS 11fFN5ED PU0.5UANT TO TME CROYISIONS OF TNG CONTFUCiORSIF � CENSEUW�pUPTEPY�COM4ENCR10WITISECTqN7000)OFCIVI51ON10�TMEBUSINESSANDVNO- LL' PoollSpa fE5510N5WOE)OHTNATMEORSMEI9E%EUPTinEREFW061N+OTME8A515FORiM[�LLECEDEXENr• (7 TION.AN'/VIOLATIONOFSECTION7071.[BYANYAPVUCANTiOFAPEiW�TSUB.IECTSTMEMPLICANTTO Z FjB-ROOI F AQhLVENALi7 OF N07 MORE TMlJ1 FrvE MUNORED DOtLAftS({500).): � O��aM�EROFTMEPRO0ER7Y.ORMVEYvIAVEESWRHwAO[SA57NfIRSOIECOA1vENSA710N, ❑ C,pmmOfCiel ' W1LL DO TNE VYORIC/wD TME STftt1CTURE IS NOT INTENDED OR OFFERED FOR SALE(SEG 1u�.BU56 J N NESS MO iROFE5510N5 CODE T1E CONTNIICTORS I�CENSE UW�OES NOT APPLY 70 AN OWHER OF ? . ►ROPENf7 NFIO BULD9 O�i MPROVES THEREON,IWD W110 DOES SUCH N'ORK HIuSELF OR HERSELF OR [C THfIdIOHMI50RHEPOMMFMVLOYEES.PRD`AOCD7HATSUGl1MPROVEMCMSMENOTMTENDEDOR m , • • Ll� OFFEREDFOqSALE.6,110WEVERTMEBULdNGORIMPROVEMLNTISSOLDWRHNONEYEAROfCOMP�E- ZTION.7ME OYmER�BURDEH N'ILL H�VE TME BUROEN OF iROVINO iNAi ME OR SME OW NOT BURD qi � MPROVEFOR7NEPURPOSEOFBMF). W O4��MMEAOFiNEi1qCER7Y.AME%0.lJ5NElYCOHfMCTINON'RFILICENSEDCOHiMCTOR7 � TO CON^a1i7UCf THE Vi16.lEGT(SEC.7Wa.BUSMESS IND DROiE5S10N5 COUL iHE CONTRACTOR4 ll• V8IU8IiOfl ADJ.AREA CEHSE UW DpES NOT APPLY TO NI OWNER OF�iflOFERN IMNO BUILDS OR�APfqVES iHEREON,MA � waoamucrs�sucHvr�cTsvnnucarr�ucroa;siucENsovur+su�Ton+eoarra�c pUAN71TY DESCRIPTION FEE tais ucer+se uw�. J O I AM DcEUPT VIAER SEG B.l VC.DORT115 REASON Q � � OATF ONNER V �' � � LICENSED CONiFU1CTORS DECLARATION W � M , � IHEREBYI1FiliWU1�7ERPENALT70FVERAIRYTHATINALIGENSEDUNDERiROVi510NSOFCNAPTEF � _ � �(CpMfNCfHON7THSECfUN70o0)OFDMSION]OFTMEWSiNE55ANDPi10FES510NSCODE,M1� Z X MY LICENSE IS N ML FOfiCEAND EFFECT. � f � lL � LICENSE CLASS� LIC.N0. J ►�- �,/� V pATE �_.yZ�" �—GONTRAGTOR a ^ �r W ,�.1_ � � WORKERS'COMP[NSATION DECLAFiATION a / . � U N IM �AFiliWU1DERVEWLTVOFiERR.'RYONEOFiNEfOLLOvnNGDELLAMTiONS: Z a I� IFUVE/NOwiILW�NT�INACE�iT7F�GTEOFCONS[MTO6ElFaNSUREFOitN'ONKERS' _ .�1�J�J � COYPEHSATION,ASiNOY�DEDBYSECTpN77ooOFTHEU00RCODE.FOqTHEPEA�ON.w10E U NOY FRIf WORK FOR NM111CH TM�,S iEAUIT IS ISSUED. � , � � _I HA{IE AND WILL MAINTA�N WORNENS'COMPENSATqN MSUMNCE,AS REOt11RED BV SECTION � (} (� Q TOOOF TH[LABOR OODE,FOR THE 7EHfOHAUNCE OF 7HL WORK FON YaNiCM 711i5 PEFW R IS v�' \ � � ISSUED.GfYYAW(ERS'�PHSATKNWSUMNCECARRIERAMIPOL�CYNUMOERARE: CONSTRUCTION ' �5�� �� I, � �.� � �,�pyEq � _ PIAN REVIEW , � vaicrm�eER ELECTAIC •�� o �n.ss�cm,Ncmwrsca.aercnocncan.a�srrna+c�awrcnocuusa,amanusss PLUMBING ��' � + ;�'� �J' � I CEflTIFV THAT N THE PERFONAANCE O�TNE WOFK FOH WHIq1 TNIS OERUIT LS lS5UE0,I MECHANICAL , � SYWL NOT EUVLOT ANY VER50N iN ANY MANNCR SO AS TO BEODAIE SU0.IECT TO THE � vj YIORXERSCdAFENSATqNUW50FC+LLIFORNIAANOAGREETYUTIFISFqULDBEWME INSPECTIONFEE , � �^^�a SUOJEGTTOTMEY.Oi1KER5'COMPEHSATIONPROVIS�ONSOFSECTiON71ooOFTHEIABOR r'(�� �J UU I [,i s�wt vormMn+w cour�r vnn+nase vnovisans. ISSUANCE i � SMIP . Il' �.' �� � � DATE:��. APPLICANT: ENERGY P/C � � C A . WARN:Ib:FA0.UHE TO SECUHE WORKERS'COMVENSATION fAYERAGE IS UN.ANM1lII.AND 51ULL 9E �� � 5U&IECiM1EMR0'IERTOCRIMINALPENK71ESM1DCMLFNESUPTOOH[MUNDREOi110U5M1A ENERGYPERMIT DOIl/NS(!too.000l•W bDITqNTO T11E COST OF COUPENSATqN,DAGIACES AS VROVIDED FOR IN � SECTION7�0lOFTHELABORCO�E,INTEREST,ANDAT70W+EY'SFEES. RETENTIONFEE: d CONSTRUCTION LENDING AGENCY pRE•ALT FEE: � INEREflVACFlRIAUHOENVENALTYOFVEMIRYTNATTHEREIS�CONSTRUCTIONLENDINOAGENCY FOR THE 7ERFORMANGE OF TME WORK FOR WMICM TH�S VERMIT IS ISSUCO(SEC.]oYl,CN.G} � � ����-�� �C�_�SC[h�"O � � LEN�ER'S NAME � LENOERSADDRESS J�L //�� � IGE�li1'iHATIHAVEREl1[1TMISAPPIICATpNIVlDSTATETHATTNE�VEM�FOMIATIONISCOFiiECL TOTAL FEES : J���a�J1 � IAGREETOC�IPLVWITHALIUf`lANDCOUMVOROWANCESANDSTATEUNSREUTWOTOBUROING � CON5IRVCTIOH,MI'J HEREBY AUiNORRE REPRESENTATNES OF TNIS CWNTY TO ENTER UPON 1HE � � ABOVE�MEMIONEUVfqVERTYFOR�NSPECTqNVURPO5E5. 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