HomeMy WebLinkAbout10012 CTTY OF DIAMOND BAR �
COMMUNTfY DEVELOPMENT DEPARTMENT
21660 E.Coptey Drive Suite 190
(909)860�3195 Fax(909)66]•3t17 PRESS
'"". SUILDINGPERMITAPPLICATION FIRMLY
� �S� C � :� � APPLICATION PERMR _�I�„{� /P/C
< ADDRESS
o DATE NUMBER �(/,�// �1
$ ISSUE NPE OCC
APN LOT TRACT DATE CONST. GROUP
g OWNE�—b-►J�
� ADDRES G ' ZONING SEfBACKS
Z CITY : ZIP �i�'�cr TEL - 8L� �R � O
� APPLIC NT_�� � � ��. SIDE/SIDE STAEET RW O
� CONTRACTOR . SIDE ❑
ADDRESS
� CITY /V O ZIP TEL, 96j 7�6�5'"� PROPOSED USE
o ARCH/ENC�/ . '
� DES�GNER NO.DWEL NO. NO.
C�DRESS Z'P �L UNRS STORIES BEDROOFAS
�
cn DESCRIPTION SQ.Fi. FACTOR PSF ADJ.AREANALUA710N
Q OWNEq•BQILDER DECLAFiATION SFR/ADDIREM
O
1 HEREBY AfitlY tMOER PENi1tT'OF PERIURY THAT I AA1 E7(EIAPT FRORI TME CONTNACTORS ll GaaOolCerport
W CENSELAWFOqTHEFOLLDWRqRERSON(SEG70.11.SBUSNESSANOVROFESSqHlCOOEANVdTYOq (f�
� COUNTYNM1/IClIREWIRESAPENNTTOCONSTiR1CT,�LTE0.�PF10VEDEMOUSM.MiREFNRFNYSTRUG (L
� TURE.PNiON TO RS RSVANCE KSO REW UiE3 THE AYPIIGUYf Fpi SUCM PER1nT TO FILE A SKYJED W Patin�dc
.� STA7EMEHf iHAi HE Oq SHE IS UCENSED PURSUANT TO T11E VtqNSqNS Oi iHE OONTMCTORS LL �
� CENSE Uw(��pTEF f(Cd/�ENC+Ki WITN SECTION 7000)OF DMSqN]Of TNf BUSME49 ANO GRP � P00�$Q8
FESSqNS OWE)OR 7HATHE Oq Si1E 19 E%E7aPT THEREFROM AND TNE 8A515 fOR TNE ILLLEOED E7(EMP.
TION.ANN VIQATqN Of SECTION 7071.5 BYANY MPLKMlT FOq�PEiWIT 5U8.1ECT5 iHE APPLMJUR f0 Z a�(�pp�
� A CML PENAL7Y Oc NOT MOqE TNAN iNE HUMDRED DOLLAqS(t6o0}}
0 O�I450VMEROFTHEPPOPEFliY,0i1MYE1APLOVEESWITHWAGESA7THE1N50LEtOYPENSATION, Q (,`prRmlftill
Z WILL DO TNE VAqK PNO THE STiRJGfUqE R NOi artENDED OR OFiEHEp FOq SALE(SEG 7DN,BUSL J
� NESS/lA CFOFE5510N9 000E:T1E 00N7RACTOR4 LICENSE UW DOES NOT ACPLY TO AN OwNER OF j .
PiqPERTYNRIJ BUlDB OR MPNOVE47HEREON.ANO VAIOOOES SUdI WOHK HIMSEIF OR HERBftF Oq
� T�ROUGHMSONNEHONMEwDIOYEES,GROVI0WTU1T5ULlIMPROVEIIEMgMENOTMENDE00f1 m
oFCFaED roR SUE G,wWEVERn+E sUlDRlnoN uvROVEuoJf i4 sd.o WrtHINONE rEM oroouatE.
Z TION,iME OVINEREV6DER WILL HAVE TNE BUFipEN OC PNOVrK3 TF4T HE OR Si1E OW NOT BVM1.0 OR
= MiROVE FOR THE PURPOSE OF S/LLEF
.W OIASOMMEROF7HEPROPEHTV.NIE%ClU4NELYCOHTRACTNOWITHl10EN5EDtONTRACTOR9
¢ TO CONSTRIKT TT�PRO.lECT(SEG 7at BUSInE55 AND iFlOFF5510N4 CODE THE GOHfMCTORS LL V!lWUQI ADJ.AREA
W CENSEUWDOESNOTMVLYTONIOWNEROPAP110VERT'WMOBULD90t1MPiqVE9TMEREOH,Nq
�C vnacartn,icrsronsua�vno.�cnwin+�carrw�cTonts���+sEonunsuurtron�ecarrruc �UANTITY DESCRIPTION FEE
�a ucE/use uw�
� C�31.51 EI�MiT UNDER SEG B.�i.G i0A TNIS 11FASd! � . .
U
LL oArE owrvER F�-
O W
� UCENSED CONTRACTORS DECLARATION W
IHEREBVAFFIR4UNDERPENµ7YOfPER1URYTNATIMIIICENSEDUNDERPROVI5pN90FCHA►TER � . .
� i(COWENCWOWfT115ECT10N7ooa)OFDMSqN]OFTHE�IS�HESSA1qPROFF5510NSCO0E,AND Z
X IAY IICENSE l4 H FIAL FORCE 1WD EiFECT. m
� uc�+secuss C-2D uc.r+o. G s3 �
� wrE��ZS �97 corrtrucroA K a
w
� WORKERS'COMPENSATION DECLAFiAT10N �
� IHFHEBVAFfIPIAUNDEROENALiVOF0FRIUMONEOFTHfFOL10VnNOOECLARAT10N3; Z �
� _I1IAVEANDwqlWM1W�CEaTK'N'aTEOF[ONSEM705ELF-MSUFEFOAMOAICERS Q2
COY7ENSATI0N.A9PROV�DE�BYSECTIONAOOOFTNEUIBOHCOOF,FORTHEPERFOPo,WiLE �U
Q OF THE NOid(FOR N411C11 TIIIS iERMIT IS ISSUED. � � �
� _INAVEM9N7LLYARlTANNOFNERSCOMPEN5AT10NR15URANCEASREOUIREDBYSECTUN
Q770o OF TME VBOR CODE Wi1lHE GERPDRMJINCE OF TNE NVRK FOR VMidl T111S PEAWT IS ■
^ ISSUED.AIYWOfYCEASCpAVENSATIDNINSUHANCECARqI(p/1NpppllC'/MUMgERME: CONSTRUCTiON � A ■�
Q
� GwniER PLAN REVIEW
� POUCYMIMBER
Z ELECTRIC
Q
� �rw�r�raTeeav.aF�IDOFirfrenarRwna+e�.ra+�oat►�M�on�tss4 PLUMBtN(3 .• {
Z 1 CERTIFY iHAT N THE PERFORIAM/CE OF THE WORIC FOq WHIQi TH19 FERMR IS ISSUED,1 MECHANICAL 1!P'1 i 1 ��
C7 SHALL NOT EMPLOY ANY GERSON N/�NY WM7ER 50 AS 70 BECOME SUBJECT i0 TNE
� � NORKERS'OWCENSATpNlAW50FCAUFORMJIANDAC7REElNA7KI5i10lAD8EWIAE INSPECTIONFEE
SSU&IECTTOTMENORKEASCOMPEN9ATIONPRDVISIONSOFSECTION77o00FTMElA80R � - �_--_
O cao�,��"/}y��LL�Fo�qnrvnn�cour�rwin��r�QsEPRDVI5ari3,i ISSUANCE �
� DATE:� ��� L_ APPLICANT. ���// SMIP
WMMNaFMURETOSEWREWORKER4'CdAVENgATqNCOVEIUGEISUMAWFUL,MASIULLDE ENERGYP/C
� sue�cru+�urwrenroawwuP�nes�wnavR�swroa��mnEnnranum ENERGYPERMIT
DOlUR3(it W.DOo�,N MdT10NT0 TME COST OF COMPENSATION.DAMAGES AS PHOVIDEO FOH IN
J SECTON77WOFTNEUIBORCODE.IHfEREST,AND�TTOPNEY'9FEE3. A��ONFEE: �
�q� CONSTRUCTION LENDING A�ENCY
0 PREALT FEE
� �NEREBYI1iFlR4UNDEROENAL7YOF►EIWR'ITHATTHEREtSACONSTqUCTlONLENDN011QENCY
FOR THE VERFOHMANCE OF TNE M01a(fOR MTIICII TMS PERYI715 ISSUED(SEG 7ov1.C1V.G�.
� � /�
«�� -
� lENOERlADCRESS
� ICERTIFYTNAtIiUVENEADTMSAPRICAi1ONM1DSTl1TEiHATTFIEABOVER1FdWATqNI3CORRECT. TOTAL FEES
p. I A(iREE TO W►�PL1 wRM ALl Cff`/AND COUNIYORDSUNCE4Iw0 STATE UYIS RELATNO TO BULDINO
� CANST IbHEaE8Y�l1T��ZEAFORFSFM�TNE30CTn5CdJH7VTOEMTEAUPONTHE
��P�p �����EA COMMENTS
9 � h'l/1�CC11.�S'
�
� 'U'�' _ 3-z.�-�Z -
(A Sq1NTUNE OF PE OAiE
' RECPT.NO. AtD BY VALWAT1pN
� NRi1TE—Oopertment Copy.YELLOW—Finenca Copy,PINK—Awasor Cop�,GOLpENFOD—flle Copy.aREEN—Appl a Copy
._ . __ - -
. cncn - -- -- ; , n � -n „ „ c� incninoc� g''mcn �ii» � „ � � -� tnc� m � cn ,� �
� ',.mm � i ��., zZzzrmmm � my � xoo0o � oam � �7 r
^ ;;mv � , � aaaru� m .vt � r- . oc � coDo -� s o mG� � �
�._�� ��, �. �:' .r, r, r.- ,r y v -i m � z � � � G� � -n � � m ro � c � m m �' ..
t' ' , vc� : ; � v' mxc� � v_ cri � a � Z � mxxsc� zcn � vc� z � �nn � ,
'� � ;'�-I ,� � m�. � m y O � ti r � Z u� _ � v m x O G� 2 m � n � C7 � �
' _ �D � ' n -i t m � z Z � � r r m < Z m p o � S ; �� .
!,� ' , � � . !._.��- �3 � Cn C C m y m D m r L� 'r+'�
jtl ! � �y�� ' t,.;� '' :i �m � z -+ -�"i �' � a � � o m � � _+ p z z <.p m c � a' �!,
* � �,��` '�,m� i --Cn - - ��.� � G7 _.. .i i.. � � � � � Z � � i :� ��� i i � ,'s� o m .��,,i .
. �. �. . i ,N ' - ' i �, I p I � ,n � � D I �Z 0 m r �I' .
. � 'fll � � I _-z�_ . �j -{ ,1 i� � �','
i �I � � - - .. � � Z �i J ��. ' � �A �
r I�t� �� : .i � ; ; � ; . -.
� i i � I
�-� I �' � t � i , �
� i �.j � : :�" j �� � ; �i .
� . � � �I ,�:4 � h-� �� . i I�, � CI , , .
i� �' �' � �! 1 I I. �\,'� j i 1 i� .
_ I IF � 1 'V �I ' .
� �z'�-� � - -
i'
i: -
. �� � ( II I j f C;` '' j/�I �- � � � - — ' .
.I ,! I � I �I � "j i �� i �1` i I I � j ,I � � _ � -'�' .
I � �, �I �'� . � I ��
�� I i �i �.� �C' � I _ _I - � i I .
I !.- t� I j I', 'i , ���
i , i I i I I - r1 — (7
_ I� . - " - —
i - � -
- 'I Ii � -{
- e
� ,
_ - �
�
�
�
�
. I � -. - .. i . _ i I � i' I a,E '0_.-G
� � ; i
m�o
I
_ �
i , i
�-
c�
I: �
I� ' 1 _ .- r:l�-�Rl C) S T 'f1l� f" �"Tl Q Q 'D 1� � 'il � q bi'�7 c� � ?7 T C C'Ti T ' �'�
-- - -- - — � _ I_ - ��� _��.�m < D m j � Z y O � O O O Z �C Z m��D -i � m m O O Y O -, °..,A
-� --�- -- --� �- - - --� — - -`- --� -- ,�._.� T -r"-� pr � � ctjfnr_n.r.. = � = �_�_� � v �.�.�.mp �i`:•, Z''�a
ci . -< � n -i m r G7 z D � � � ;. �.��
i �; I ' .. �. m d -mp O - y Z D m Z T � 9 � D O �z m f� (7 �.� � O
- � ; � 1 y. cn � -+ z 5 -n L� o � � c� c� y 9 L) o zo o O m m p p'-�-i u� � . �:G
� � 1 ' _ ��' � ���,I . D .-�{ T � C�i� � :CLi� '9 . � � 4 a �� m m p W � O. O p7 -i �., ; �' .� j
� � i I �' o z � � � z � ma000 � � � � , 'G
i -,� � y � � � DS mpz n.o � G
. � ' ! _ . _ i';r. A '� - � � w � � n' �', � -- :�-� -
- - � ;� r m � p `-� i ! ���" ,
�I I � - � " � O � _ I .
i i . �i - . �
i,
, �I
� , �� I i i �' ii - i � - �
L I _ i' ��
i I � ;J � iii��
' � � � _ � I I i ��' � � � ,
� � , I � - � i � I r:
� ! - � ' I �.�
� • �� I _ ' I ; ;1 i �tt' ` -
1/�_ � i . . _ i , I ;I � c. _
� i . .r i . i I _ •
_ - I
' �,
I =� : . _ �� - . � . - - ' - �:i.
.__ __ __ _. _. _ .�_..__ . .�._ ... ._._ . _ .. - - __ - __ _'
. . . -,.� ,. . � i . -. .. - ,. '
... � . � .. .. .
, .
_ .. -.. ... � .. ,�. ._.�. _ � . . c .. _ ,.._,',. :�_ �. . .. . � � �.. : ir� �.., ,. .,, '�,` ., . . . ... ..: .�.: