HomeMy WebLinkAbout11911 - "- � CTTY OF DIAMOND BAR � COMMUN[TY DEVELOPhfENT DEPARTMENT �: 21660 E Copley Drive Sui[e 190 (909)860-3195 Fu(909)861-3117 PRESS ""' BU]LDING PERMITAPPLICATION FIRMLY Q JOBSITE ��Z/ 2s� G��'t�� �� DATEICATlON�/t��d� PERMIT I P/C �� Q ADDRESS "LO-L� VT'�V �T � NUMBER g ISSUE 7YPE OCC ¢ APN LOT_,.,�,�ACT_ ��2� DATE � CONST.� GROUP p OWNEH Z �1VleS .�__`�-��J n � ADDA S CL L..._, ZONING SETBACKS o , z CITY � ZIP TEL��j�"L� 7 FRONT qyy � o APPUCANT v^ TE�„ REAR p � S�DE/SIDE STREET •� pyy p � CONTRACTO �y a�v� SIDE � Q C TM E S Zlp � W L PROPOSED USE SL ��Cl� w ARCWEN z DESIGNER SA-wl�, ` ' -� a ADDRESS NO.DWEL. ..NO.,. . NO. N C�n ZIP TEL UNITS ' �STORIES � BEDROOMS � �ESCRIPTION SQ.FT. FACTOfl PSF ADJ.AREANALUATION p� OWNER-BI;ILOER DECLARATION O SFRlADO�AEM � p I NEAEBY AFFWM UNDER PENALiV Of 7ERAIRV THAT i MI EXEMPT FROM THE CONTRACTORS L4 - W CENSEUWFORTrIEFOLLOwwOHFASq��SEC.To3�.6BU5wESSANDGROFE55lON5CODEANYGTYOq � Garoge/Carporc . __ �. � Z COUN7YWHIRIREOI�RESAVERMiTiOCONSTAlK7A1TER�PROVE,pEA1(yj5�{pqqEDNRANYSTAUG tiJ PaudDeck ' w TURE,ORq(i TO ITS ISSUANCE,AL50 REOUIRES THE ACPL�CANT FON SUCH PERAIIT TO FILE A S�GNED w � STATEMENT THA7HE Oq SHE IS IICCNSED PUHSU/WT TO THE PROVlSIONS OF THE CONTRACTORS LL � GENSE UN(QIAY7FA Y(CqA/MiNGWp W1iN SECTqN 7000)�W��'/3 0F TiIE 6U51�ES5 AhD FHO. LL POOVSpd � FESSqN5CO0E)ORTHATNEORSNEISEXEAIPTTHEREFROAAANOTMEBASISfORTHEAILEGEDEXEMP• (3 V TION.ANYVqLATipVOFSECTION7a11.58YANYAPP�ICANTFOqAPERMITSU&1EC75THEA7VLIGNTTO � z (�g.qpp� , � � AGMLVENALTYOFNOTAqRETWWFIVENUNOREODOlURS(f50011: � Ot�OWNEqOFiHEVRODERIV,OR4YEMPLOYEESMnTHWAGE5A5THEIR50LECOMPEN5ATION, Q Cp�me�G2I ' Z YnLL p0 TNE WORK AND THE STRUCNRE LS NOT wTENDfD OR OFFFFED FOR S�LE(SEG ibu.BU54 ,J � - N NESS/iN0 VROFESSIONS COOE:iME GONTMCTOfiS UCENSE UW DOES NOT MPLYTO AN OWNFAOF j . VfiOVEATI W110&1ROS OR W cfiDYFS TMfREON,AND NAip pp�5 S�ypLy(HIMSEIF Oq HEHSELF Oq w TNFqUGl1NISOfiHENOWNEAIPLOVEFS,PHONDEDTMAiSUCHY.1PROyEfAEh75AAEN07WTENpFppq C� O OFFEREDFOfiSKE1F.MOwEYER7MEBU1lDWGORu1PR�VEMEMISSqIDW�TMWpNEYEMOfCOAIPLE- . - � . Z TION.THE OWNER�9UILDEH W�LL MAVE T11E&1RDEN OF VRpYWO TMAT 11E pq SME�ID NOT BtAID DR � YAPROYE FOq ME PURPOSE OF SKE} . - �- - -��lL �I�OWNEFOFTMEiROFERN,AMEXCLU5IYELY�pMMCTWGN7THLICENSEDCONTMCTOR$ WTO COtiSTRUCT ME DRO,lECT(SEG 701�,BUSINESS AtiD VROFESSK�NS CDDB THE GONTRAL70q5 L!• V81U2210li G U w� - A[�J�� �� CENSEUWDOESNOTAGPIVTOANOWNEROFAVROGEqTYW1q8Up_p50RWPROYE4THEfiECN.M� � MRfOCONiRAGTSFOA5UG1PpOJECTSVMTHACONTRACTpR(5)LICENSW%1RSUANTTOTHECONTRAG p�pry7�Ty DESCRIPTION FEE T00.S 11LENSf LAW). � O I W EXEYPT UNOEH SEC. B.i P.C,FO1i TW5 REASpH Q d�,,l, U li" WiE ON'NEA f¢„ � SC..� �,�� . � UCENSED COMFiACTORS OECLAAA7lON ' w � IHEREBVAiFIRYUN�EqPENALttOFPE0.IURYTNATIAAILICENSEDUNDERGROYI510N50FGHAVTER 4. Y�WMMENCWONnTNSECiqN7000)OFDMSION70FTNEBUSi�E55.WOVROFESS10N5000E,ANp Z ' L� Z� X MY UGEl15E LS N FULL FpHCE/�ryp EFfEGT. m � LLI �e �r� ^� � UCENSECLASS•7��LQ LIC.NO. `-� 3� � � [ V OAtE t3�((���� CONiRACiOq � a W � WORKER$'COMPENSATION DECLAFUTION Q � � IHEpEBYKFIFUIUNDEAPFNALTYOFGFWURYONEOFTHEiOLLDYNiODFftARAT10NS V � Z � _INAVEANDN7LL�WNTAINACFRTIFICATEOFCONSENTTOSElFINSUREFOqWO{L(ERS' a Q COMVENSATqN,ASFWOViDE0BY5ECilON37o00FTF1EU1BOq000EFOfiTMEPEHFOMIANGE U Q �F THE WORK FOp WnKN THiS PEH1Ali IS ISSUED. � / w _111AVEANONtLLMA1N7AWWOFiCE0.S'COMPENSATqNINSUqANCE,ASREOUIREDBVSECTION Q a7oo OF 711E U80R COpE.FOR TME PERWRAIANGE OF THE WORK FOR YRi�GH TNIS PERNIT IS ♦ ISSUE0.MYYNFiK.E�P5yCOM�,V_ENSATqNINSURMiCECARFtiEHANDVOLICYNUTABEFARE: CONSTRUCTION � � GRFIER S i'l�fL r"Lw� PLAN REVIEW v � va�crraivaEa (`7,�'1 l� �z. �' ELECTRIC 0 (n+ssccrqnr�orroisEm.�rFnacnECEa�rswaa�KrnaEooaiuug�ao�aa�ss� PLUMBING �n .� w - Z 1 CER7IFYTHAT W TME vEPFORMANCE Of TME W�ORK FOR WNIq1TH15 pERMI71515SUE0.� MECHANICAL C'3 SH�LLNOTEIAPLOYANYPEFL^,ONWANVM.WNERSOASTOBECOMESU&1ECTTOTHE (q WORKFiiS'COMPENSATpN LAwS OF cN.IFOw��AND AGREF T1iAT tF I Sr�01�1D BECO�IE INSPECTION FEE S SUBJECTTOiMEWORKERS'COUPENSATqNPfd0y1510NSOFSECT10N�7000FTMEtA�3pp cooE i s�wti Fonnrnm+caea�r Hnn�rHosE aaowsaNs. ISSUANCE O p DATE MpL�c,wT. SMIP � � — ENERGY P/C WMNING:iAILURE TO SECURE NK)fiKERS'COMPENSATION COVERAGE IS UNIAWFUL,ANp$HAL�BE � �y„ SU&JEGTANEMPLOYERTOCRiMWALPENALTIESANOGNLFWESUPTOONEVAINDREDTMOUSANp ENERGYPEflM17 JOOLU0.S(il 00,000�,W ADD�i10N T07ME GOST OF COMPENSAi�pV,DAMAGESlS PROYIpfO fOR U/ SECTqN]7oeOF7HElABORCODE,PITEPEST,ANOAROqNEY5FEE5. � RETENTION FEE: � CONSTRUCTION LENOING AGENCY PRE-ALT fEE I. � IHEREBYAFFIqMUNDEFPENALTYOf0E0.tt1flYTHATTHEFE15ACON$THUCiIONIfN�WpAGENGY FOR T}1E PERFORMNKE OF THE WOW(FOR W1i1d1 THIS PERMIT IS ISSUEO(SEC]OW,qV,C.y Z W � LENDER'S WJAE � F-- LElI�EH'SAODRESS � � IACREETOCOMPlVW17�G'TVMIDCOUN OROWANCES OST�EUWSREUiA7WOTOB0.DN0 TOTAL FEES '�� f t� \Cl � COriSTRUCTKKi,AYDHEReBYAUT1qp4ERE7RESEMAtNESOFTHISCOUNTYTOENiERUPONTNF Z ABOVEJIEMqNEO PROPERTY FOR WSPECTION VURPO5E5. COMMENTS � � � � J � -a PEMI�TTEENAME WH � ` 3 /b g�i � SIGNA7 O I7T DAiE � RECPT.NO. PAID BY VALJDATION WHITE—Department Copy,YELLOW--Finance Gopy,pINK—Auessor Gopy,GOIDENROD--File Copy,GREEN—ApplicanCs Copy i � , ;. , _ _ . _ , M _ _ _ -_ - -- - - - - = - -- - - - - - - - - - � , . ; _ ; � , . , , _. � .. ,_ •;� ' - � � _ . _ . � . o ,, � : � ;_ ? o •� �:� : F a , .F � Q W J , . 4 � ' � :� oZOW � ¢ � c� JZ ; � m:0 � � QooCDwmc� oZQ � � � z � �' � '� F- u�' O ou- mom pF- z p. us ui � LL � ¢ ❑.C� cn r- O Owwz o ? ¢ Qv � � � Z u� az �- d � • � W . � � J JUVOozoc7 � ¢ wza OCJa � zH W tn � � Q LL L� Q Q fD Z p < Z �J �y. J W Z W F Z ¢ � 4. � {11 � ,.,^r'} � O �� . Q W Q CL J J � m (D Q = _ = W It LL F- Q W � F N W S W � �+ � - ' . O Li (7 U F- - - � W W a. n. = J C7 J J ...I (n J - J i.r� ' _ ' _ " _- _ . .. � U - ' a z � � Q � � ¢ � o �izwz = Z000u. oaZ � a wa > w '" _ - - -- -- - — _ - - -- - O J 2 Z Z Q W O O O O u- W Z Q Z Z 2 w W Z �`.� ' , � � u. u. > > u. LL � m u_ a m ¢ � a a a O o u. .� O � u. x ❑ w �,, - Ll,; (� � f0 o t ; � , Z �', i - (� — � ; �. - ;' I ,f � U', -- - - - � -,�, _ � � N . I —_ � �� � i � _ ; _ , ��7 .� p�, , '7 ' � � . I - z ;. I '� - � . .� W � Z -, Q �' . U, F- .� p i , � � N.�, ��.�' • H � [0 ' lll 2 "� C7 V Z W U` � !- Z � ,; ' � (} � Lll UJ O � � U = 1- 2 ¢ m F Z F .._ , U � � fA N- � ('3 J p W � Q W W Q W � 7 � J � a �� Y --� �•� Z F'�" m '� '. , z�� Y CL U 4" Q � W W Z � W J J � � Z Z Z J W Z !- U � Z . . Q 0 � O !n 2 C7 O 2 W n. Q F=.. ff7 J F¢- F- ~ O W � J W F- • �U O � tn z U 2 2 2 w Z C7 ¢ U x w a ,� '� � �' U.��, , ¢ t� z � a � ¢ r[ Ua - C � m cn U � m d W LL � �- (7 (7 c� � g � � W N a ¢ J J J J 'G ��d' W � J ¢ � W `XO ¢ 0000 �2XaW � WWWQZZ2Z �O aW - ; u� � w c� mF- 3 � � ¢ ¢ ¢ ¢ v> w3c� ocnv> �ncau. � u. u. U � cWnuWi' —