HomeMy WebLinkAbout12201 (6) 1� CITY OF DIAMOND BAR • •
DEPARTMENT OF COMMUNITY 8c DEVELOPMENT SERVICES
.�c 21660 E.Copley Drive Suite 190
(909)860-3195 Fax(909)861-3117 PR ESS
. ��'�%�^�� BUILDING PERMIT APPLICATION FIRMLY
N JOBSITE p 1, APPLICATION � ERMIT 7' P/C
o ADDRESS Z�O I� G�'T��'U� DATE NUMBE '" � �►
c� 15SUE TYPE OCC
APN L T TflACT DATE CONST. GROUP
g OWNER � �� � M S
ADDRESS Z I I�- � ZONING SETBACKS
W CRy ON� I STEL, - f Z- y REAR Rw �
� APPUCANT � I TEL ��E SIDFJSIDE STREET RW O
� CONTRACTOR - SIDE ❑
� ADDRESS ROPOSED USE O�� � OV�. N
o CITY ZIP TEL
�� DESIGNER ^�� r NO.DWEL � NO. ' NO.`
ADDRESS UNITS_..�_, STORIES , 7 BEOROOMS
� CITY ZIP TEL
� DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
N -
O _ OYYFIER-BUILDER DECLAHATION SFFVADD/REM �
i r�r�er�rw ur+oea r�uTv oc veaunr nuT i��vr rs+oM n�e carrrucroas u GaragelCarport
8 CEMSEUWFON7HEFOLLOWINf1FEASON(SEG7IX11.6BVS�NESSANDPROFESSIONSCOOEANYCRYOq (n
Sy CDu1(ttMM101REd1WESAGEHMRTO00NSTRUCT,ALTE1lIMPROVEDEA10l19lORHEPA7fiMN5TRUG W -PBIiO/Dedc� .'" ' " � .
6 TJpF,pqpq 7p ITq RSU.MIL�AL50 REOUIRES T11E AVVUCANT WR SU(3�PERAIR TO FlLE A SIGNED W
� S?ATFMIXT 7HAT HE OR SME�LICENSED PUFiSUANT TO THE PRW�SIONS OF TNE C0IRMCTOR3 L4
� � cErtt�uw�aunr¢n r tcd+uewcx+o winr sEcrnra�000l oc oms�a oc n+e eusmEss�rro vrio. �- PooVSpa
FESSION9 WOkI ORM�T ME��7E IS IXEMPT TMEREfROM ANO 71iE BAS14 FOR TNE MLEGEU E%pAP-
TqN,/xYVIOIATtONOF5ECT10NM7f.6BY/iM'A7PLKJWT�ORI1iEi»n75U61ECTSTMEMPLrCNRTO Re-Roof ZGbS• .
� A Gvk iE7VhLT!OF NOT MOftE 7fuN FNE IM�onED DaUws(flaM L J .
� OlA90MIHFROFTHEpiIOPER7Y,OR1AYFi.�7LOYEESWITIWAGE9ASTME�RSOLELl�A1DEN5A710N, ('ipfllT9rClfll �
YY11001NE WOfYC MA THE SiRUC711NE i3 NOT RRENOED OR OfFERED FOA SnLE(SEG)ON.&15H J
NE59 AND PROFESS�ON9 CODE 7HE COHRUCT00.4 UCENSE UW DOES N0T AVPLV i0 AN OWNER OF
� PIqVEftTY1M108UlDSONMPROVESMEREON.N�D1N10DOE43UtlIriORKNMSELFORMEASElFOR m .
� TloqU0HM50RHEFOWN€MPLOVEE4.VROVIDED7HATSUG/uCROVEIJEMSARENOTRfTEH�EDOR
OFFEPFD FOR5RLE IF�IfOWEVE0.7HE 6UlDP�00R MGRO�E�AENT IS SOLD WIT1M1 ONE YEAROFC�DMPLE
, � �T1�N�TNE CMMERBUM1DER W�LL H4VE THE BUROEN OF VROVNO TUT HE OR 511E OD NOT BUND OR
YPRWE FORTME PURPOSE OF S1LLE7.
W O t A8 dMER OF 711E VMDErt1Y.AlA E7ftLU5NELY CONTRACTINQ WITH LICET7SED QDNTMCTORS
¢ TOOONSTpl1CTTMEif10.lECT(SEC.7Wt.BU5ME59/JJOPqOfE35KKi9000ETNECONTRAC10R5t1� Vatuetron ADJ.ARFi1
«r CENSEUWDOESNDTMRYTOANOWNENOiAVAOPERTVYAqBU NA7ROVF37HEREON.AND
� wwcartw�crsronsuwrna�crswrtH�oonrFuctoncs���cv+s ru urrron�ca+rruo pUANTITY DESCRIPTiON FEE
� masuc�uwE ,
O I MI EXEi/PT�1NDER SEC .t O.G FOR 7HIS REIISON U
�
"-- p„re O ow"En c~i
� �
LICENSEDCONTRACTORSDECLAFiA ION W
� 1��NFg��FFni1 UNpEq pENh1TY OF PE0.AMI TNAT I IUA I�CENSED UNDER PH0��510N5 OF C R V,
� � �(OAWENCfqN7TN5ECTIO�/7000�O�DN�5i0NJOiTHE8U5MESSIINDCROFES510NSCO0E Z
X F/Y 110ENSE�3 H F1A1 FOACE�EFFECT. m
LU �
, � t10EFAE CLASS LIC.NO. �
V DATE cONiFiACTOR a
W
� WORKER5 COMPENSATION DECLMATI �
N U
� IHEREBYAiFlRAIUNDERFENIITYOF0E0.A1RYONEOFlHE EClARAT10NS z
G �I W.VE NA WiLL WIMTAM A CERItFlCATf OC OONSEHTM JNSUHE FOR WORKEFS 2
� CONiEN5.4T10N.A9iROVmED91'SECilON77D0OFTNE COOEFOR7NEPER�ORMfHCE �U
OF THE wORK FOH NNId1 TTn3 PERMR q ISSUED. . � .
a Q
�IHAVEItF1DWILLYARRIUNNS7N(ERSCUA7ENS MSURANCE.�SREWIAEDBYSECTION ��I ! O
Q ]700 OF iHE LABOF ODDE FOR THE FERFDRv CE Of iME N'OR1C WA WNiCN 7Mi3 PE�T 19
�sy�u�o,r,�yvroac�asco+�vcksAnorrn+s CECARRiERANDDOLICYMIMB£RNiE CONSTRUCTION
jwn�nen^ PUw REMEw
Z va�crnuueEn ELECTRiC
6 ��efp�r�IDwrgE pFnfpas.�rs�oqp+��+trar�npcu,�fs�aqatt6sj PLUMBING
C
Z �c¢�ncr nwt r+ ERPoIM�NCF OF THE WOaC FOR WN�ClI TttlS OEWM�5 ISSUED,1 MECHANICAL
(3 51W1NOTE�PLO FERSONMANYMINNERSOASTOBEOOMESUBJECiTOTME _
- N WDR1cERSCOMV SATIONU��CAL�FONNLI��REETFu71�I5MDUlOBFCOIJE INSPECTIONFEE
S 5V0,1EC{Tp NOi»cERSCOMPENSATRXIPROV15lON50FSECilONa7o00F71�E1A80R - ISSUANCE V
COOEISH FOH7Hw�7NCOM7LYN77N7TlDSEPROVISlDNS.
O SMIP �
p DATE: APPLIWtlP. �
, � ENERGY P/C
W .fAlURETOSECURENdIKEQ5COu0EN5�710NCOVEMCEI3UMAWFUl.M7D5M�LL18E
� � TIWEMROYERTOCAPARULPENALT�ESM'OCN�lFNESUPTOONE�M1INLYREDTHW4MA ENERGYPERMIT�
JCT10Nl70lOFT/EUBOflCaDENTEH�EST,AND�I7DRNE'Y'9FFE8.�CES114PROY�DEUFORIN . .
� RETENTION FEE:
W CONSTRUCTION LENDING AGENCY PP6ALT FEE:
� �NEREBYAfFIiNUNDERPENILLiVOFOERNRVTMATINEREI4ACON5TRUCTIONtENDax7AGENLY ' �
FORTNECERiOfiMANCEOFTMEYVORKiOR�IQI7MSVERMITISISSUEOISER]o97.qV.Q�
� LENDERB NMIF /� - J-
� �ENDER'SADDFESS
�CEp7�FYTHAT�IUtyEq(/�p111�gJ1ppULATqN1NU5TATETUTi{IEIIBOVEMFORMAilONI4CORRECL TOTAL FEES � � �O
� ��6REETOCdAPLY�MNACRYANDCa1NTVORDa'V'�CESlNOSTATEUWSREIATRqi06UlDINO
fY7N5TM1CT1IX1 M1D MEREBY AU111DRRE REVRESENTATNES Of 7H�5 COUNTY TO EMEA UPON T}1E
� /�BOVE-MEHfqNED PROPERTY FOR INSPECTION puRPO5E5. COMMENTS
� �-S P� S
�
¢ veau�neE waae�vw�rtl � �-/a � - �/
N •`.' -.�: - � �
N �gpNANRE OF VER1diTEE• _ �� OAtE `.
x �- - . RECPT.NO. � vuioanor+ .
~ LYHITE—Oapartment COR�YELLOW--Ftneroe Copy,PINK—As»isd CopJr,GOLDENROD-fib Copy,GREEN—Applicant'a Copy - - - -
�,� (� i � TTT � � � � on � m � � � 9 � T � � a � � m � � ! .
_ 1 m m i z z z z a m m m 9 m y = o 0 0 0 � o a m � � m � �
I �77�� ; � O . D,D D D � 177 '0 `� r- r � O C C C�,p D� O -1 � O
'0-� � ��. � '�, r r- r r- y ro � fn � Z r � � G) � G)"-n� -n m � W C � � W j ,
v mxc� � � c� Aa � z � mxxxnzm � 'nG� z � T n
�C� I I � ' r r m O � -i '-' m � v m x O L7 S cn O D o O [� .
_-i �' ' �' R7 :' C rtl y Z -1 r D �, � Z C � � r r m G �,fTl fn � D -p C] 7q T.
' D Z ; � n � �, m . z � zo, v, � cmym a � mo r c� � r ,
:�I cZ � m -� z -{ -�'i � � '' nc � om � c» Ar" -i < Dm � ,� cn
> i V1 T. . � ,-(n ' -- . Z n L� � � � _'� Z -I m � Z . �� Z.m ' m �c � - o �
i fNii N • � ' ' � ,n O OZ �' fn ,� O � ' D.L�" -. Z O m ' .,I
-1 -i L� r
m z _ o _ _
z
' _-� I � � •'� I "
h h �
`0 �Q , ,
`- -j u _
b
.�,� � .p - - _ . • .
� -
- , � ' �,- _ -i - _ 4 .. �
-- i-- Z
� � 1 0 � -G
- - m o
t� �
" mox -n -np � � oOvvv � 7� m � � m � -n �nCC -n � -� �
� z mmAzz Zm -nOoozOm � z -r1 7o9z z = � O
- -- - - - -- - � - ;� rtt < D m y � Z y O -n O O O C Z m D y � m m O O D O �' .
' .. .. . : , - - � - - - -- - - _ . .> . 7� r r � r n (n r c. c C� ' r 2 v � m fn 37
� - - � -n -I O -1 U� -2 � S 'f� W -i r [-'� 37 3� Z �
'� frl 2 frl N rtl (� R1 � � ?1 'n R1 2 7J W p D D. � rtt . �� O
�� i ! . r '� m � O z � I'n z m r � z n O z m � p � .
p D Z m 77 � n C7 r r O (11�. .
i � fA m -1 2 � 'O � O D n y 7J fi) � Z O O m.m.p O � Cn z -
s / . y � -nz � C�T� � � r' Z � oo z � mpm`� OOrn -i n �
•� � z G) . � m G� �° Z Z 'n, m n m �.�-� � �� W �
� _ i... ��_ D � � n � � � � � � Z Q p , s ��.'D
_ r'i � "D D C � � �� ��
: '�.. _ �.� _{ -
_ �� - i �` ..,
i � , - "
_
I ;.i' � � --
_ � _ ,��, �
- - �
