Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
17278 (10)
1��2 _2� ----�---- C1TY OF DIAMOND BAR DEPARTFvfENT OF COMMUNITY&DEVELOPMENT SERVICES � 21825 E.Copley Drive (904)860-3195 Fax(909)861-3117 PRESS "'%»��� BUILDING PERMIT APPLICATION FIRMLY y JOBSITE 1126 Cle horn APPL�CATION fC-� j� � PERMIT P!C o ADDRESS_' g DATE r NUMBER � # �, ISSUE >S� y TYPE OCC APN LOT TRACT DATE �13 !� � CONST. GROUP 0 owNER �'ima�n (l�ks I HQA p ADDRESS (7'� W� �+'gg��-}i 1� R1 V�� �1��E ZONING SETBACKS Z CITY�i�ei�� ZIP_(3��-��� TEL. �G�(�—���� FRQNT qW ❑ � APPLIC N TEL._ REAR ❑ Z SIDE/SIDE STREET RW p ¢ CONTRACTOR ]�,O�Jgl Rf�Af�'Cl __ SIDE p ADDRESS_a��_���.��5�� o CITY ZIP,$��� TEL��1�_ PROPOSED USE TeHT' off wood akP� Install w ARCH/ � �z DESIGNER 7692 NO.DWEL. �e�NO}�}A�—s�}�s�gsNO. a ADDRESS � CITY ZIP TEL. UNITS STORIES �w� BEDROOMS � cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION � SFR/ADD/REM Q I HEREBY AFFIFM UNDER PENALTY OF PEflJURV THAT I AM EXEMPT FROM THE WNTRACTORS LI� Gaf8CJ6/CBfPOf1 W CENSELAWFORTHEFO�LOWINGREASON;SEC.7D37.SBUSINESSANDPROFESSIONSCODE:ANYCITYOR (n U COUNNWHICHREQUIRESAPERMITTOCONSTRUCT,ALTEfi.IMPROVE,DEMOLiSH.ORREPAIRANY5TRl1C� W PdilO/D@Ck W Tl1RE,PRIOF TO ITS ISSUANCE,ALSO REqUIRES THE APPLICANT FOR SUCH�ERMIT TO FIIE A SIGNED W STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF 7HE CONTRACTORS LI� � CENSE LAW(CHAPTER e(COMMENCMG WRH SECTION�000)OF DIVISION 3 OF TH'c BUSINESS AND PRO- � PooUSpa � FESSIONSCODE)ORTHATHEORSHEISEXEMPTTHEREFROMANDTHEBASISFORTHEALLEGEDEXEMP- (� V TION.ANVVIOLATIONOFSECTION7o31.5BYANVAPP;JCANTFORAPERMITSUBJECTSTHEAPPLICANTTO Z Re-Roaf � ACIVIL PENALTY OF NOT MORE THAN FIVE HU�'DRED DOLUPS(55Jo).): Z ❑I,ASOWNEROFTHEPROPERTY,OFiMYEMPLOYEESWITHWAGESASTHEIR50LECOMPENSPTION, � COl11f118ICIdI WILL DO THE WORK,NNO THE STRUCTUHE IS NOT INTEN�ED DR OFFEFED FOR SA'_E(SEC,7044,BUSI- J N NESS AND PFOFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OP = PROPERTY WHO BUILOS OR IMPROVES THEREON,AND WHO DOES SUCH WORN HIMSc'LF OR HERSELF OR CL THROUGHHISORHEfiOWNEMPLOVEES.PROVIDE�THATSUCHIMPROVEMENTSARENOTINTENDEDOR m Q OFFEREDFORSALEIF,HOWEVER,hIEBLILDINGORIMPR�VEMENTISSOLDWITHINONEYEAFOFCOMPLE Z TION,THE OWNER�9UILDER WILL HAVE THE Bt1R0EN OF PROVING THAT HE OR SHE DID NOT BUILD OR = IMPROVEFORTHEPURPOSEOFSALE). W ❑I,ASOWNEROFTHEPROPERTV,AMEXCLUSNELYCANTRACTINGWITHLICENSE�CONTRACTORS [[ TO CONSTRUCT 7HE PROJECT(SEC.7044,B:ISINESS AND PROFESSIONS COOE:THE CONTRACTORS LI� V81U0IIOf1 ADJ.AREA W CENSELAWDOESNOTAPPLYTOANOWNEROFAPflOPERTYWHODUILDSORIMPROVESTHEREON,AN� — � WHOCONTRACi5FOR5UCH7ROJECTSWITHACONTR0.CTOR(5)UCENSEDPURSU0.NTTOTHECONTRAG QUANTITY DESCRIPTION FEE Y TORS LICENSE LAW.). � ❑I AM EXEMPT UNDER SEC. B.8 P.0.FOR THIS REASON Q � U LL � DATE OWNER � Z W � UCENSED CONTRACTOFiS DECLARATION W ¢ � I HEREBYAFFIflM UNDER PENALTVOF PERJURV THAT IAM LICENSED UNDEF PFOVISIONS OF CHRPTER � d 9(COMMENCINGWITHSECTION7000�OFDIVISION30FTHE6USINESSANDPROFESSIONSCADE,AN� Z 'X MY LICENSE IS IN FULL FORCE ANO EFFECT. m � IICENSECUISS�—'�_���LIC.NO. (Flz`���� � U DATE CONTPACTOR d W • � WORKERS'COMPENSATION DECLARATION Q � IHEREBYAFFIRMUNDERPENALTYOFPERJURYONEOFTHEFOLLOWING�ECLARATIONS: Z Z _IHAVEANOWILLMAINTAINACERTIFICATEOFCONSENiTOSELF-INSUREFORWORKERS' _ ¢ COMPENSA?ION,AS PROVIDE�BY SECTION 37�OOFTHE LABOR CODE,FOR THE PEqFORMANCE U Q OFTHE WOfiK FOR WHICH THIS PERMIT IS ISSUED. � w t HAVE AND WILL MAINTAIN WORNERS'COMPeNSATION INSURANCE,AS REOUIRED BY SECT�ON Q �X37oo OF THE LA90R CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ��` �� ISSUEO.MY WORKERS'COMPENSATION INSURANCE CAqRiER AND POLICY NUMBER ARE: CONSTRUCTION � � CARRIER Superior National PLAN REVIEW Z POLICVNUMBER L7�T�„g��l(]_A ELECTRIC Q 0 (iHIS5ECT1qNNEmNDTBE�tdPLETEDOFTHEPERMITISFORONEHUNDREDLOUAFSISt00)ORlESS). PLUMBING � z I CEflTIFYTHAT IN THE PERfORMANCE OF THE WORK FOF WHICH THIS PERMIT IS ISSUED,I MECHANICAL � SHALLNOTEMPLOVANVPERSONINANYMANNERSOASTOBECOMESUBJECTTOTHE �/j WORKEFS'COMPENSATIONlAW50FCALIFORNIA,ANDAGREETHATIFISHOIJLDBECOME INSPECTIONFEE � SUBJECTTOTHEWORKERS'GOMPENSATIONPROVISIONSOFSECTION37000FTHELABOR � CO�E,I SHALL FORTNWITH COMPLY WITH THOSE PROVISIONS. ISSUANCE � SMIP p �ATE: APPLICANT: � WARNING:FAILURETO SECURE WORKERS'COMPENSATION COVLRAGE IS 11NLAWFUL,AND SHALLBE ENERGY P/C ....___ � SUBJECTANEMPLOYERTOCii1MINALPENALTIESANOCWILFINESUPTOONEHUNDRE�THOUSAN� ENERGYPERMIT OOLLARS(5100,000�.IN ADDI710N TO THE COST OF GOMPENSATION,DAMAGES AS PROVIOEO FOq IN � SECTION 3708 OF THE LA60R CODE,IMEREST,ANO ATTORNEY'S FEES. RETENTION FEE: d CONSTRUCTION LENDING AGENCY PRE•ALT FEE: O � I HEflEBVAFFIftM UNDEfl PENALTV OF PERIURV THATTFERE IS ACON3Tfll1CTION LENDING AGENCY FORTHE PERFORMA4CE OFTHE WOFK FOF WHICH THIS PEFMIT IS ISSUED�SEC.3os],CIV.C.�. Z w --- j LENDER'S NAME � H LENDER'SAD�RESS � TOTAL FEES I � - �+U � I CERTIFY THAT I HAVE REA�THIS APPLICATION AND STATE THAT TH[ABOVF INFORMATION IS CORRECT. � I AGREE TO COMPLY WITH ALL CITY AND�l.'NTY ORDINANCES AND STATE LAWS RELATING TO BUILOING � CONSTRUCTION,ANDMEREBVAUTHORIZEREPRESENTA7IVESOFTHISCOUNNiOENTERUPONTHE Z ABOVE�MENTION PROPERTY FOR INSPECTION PURPOSES. COMMENTS � J � m PEFMI �y C� � � U"� � V,� � SIGNATURE OF PERMI EE DATE = RECPT.NO. PAID BY VALIDATION ~ WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—Fi�e Copy,GREEN—Applicanfs Copy � �� � �:,�.w r ..�,.�.:,,,, .._, . ,. .. .,.,. .. :, q...• ;..rs�_ ,x�3�..,IMwr,i. �,. �,v�7a�•r,h-.��m:�wv "t•ik^:R:i,tr)w,m>.,� .v , � . ::,:s* ..., � . .� .,µ-.. . cM. u, .a,�;.�.. ,..a�, '�... � p �qg �.�� ,�.::� z��t.,-���%. ��.: �:�"�:�s. �� ,�'� �` '��,�� ;�;� � ��"�'�� "'�" �� .�d7�.�:� �� "�a�,a,�a.� .:n �'"�'�si�::.�Rgp `�' '����g� � '�:,� �..�.:. � :-��ka��.��+� �����..� ���a�� ��� ���� ::.�:a���5.. � �.. - ����� .�-a���� � - "��'�. � �k 'm.�"�� y,y"` a ��. � �,�� �'� � A^�'� � �'i I`� �� � � ��'` ��. . �am. .- g C� ... m,�+�m �P ..TMk fi� -�,.�'a��d �m � } "�, � $ �"� ��"a' �a � .� �� � �� d'� � F .`�^�,� ��� `� ����-.n�t'..,�..:�a ,:.�.�� ���s':;�"`,.�xi ���� e �� -���� ��an�,�,�as. ..�`.��*:_�..�r�" ��-�,�e��,:�: �`.�€�tt;`�% �����,�. �:' ... �"�.m �<_.; a� +. � a� ��ce�::� �� €��'... � � _ � i ` ¢ � ... .._ .. ._.. . _ ....... ._.... ._. __.t�,3w. .�... ....... ...... . . . ..w..�.... ............. ........ ..........�.�.__._� __ � �' ,6.-€� �..d� :�`�.3 `,�6 i L � ��i_!}i � �� " ...�.............._r................._._� .�_.�.... ... ..._....._......... ..._. .......__.,........._r_.i..,....._..... T,.__..«....,�......._ , . ..... .....___...... . ....__...�..._..... ... .. , f._............... .,.�.,. � ...... .. �{ . t t"e r ��.E C... �"� � '� ...�.. .._ � .... _ ...' � �_ �. t :_m .. __ . . _._._ _.._._.._ ... . ._._ � ._ . _ ....... _. y�;-�� �l'a . j .F,,t� i I s.,�..t� ' �=�.€ t�.' ' i� '€ .._.. ._.. _,_ ...._. _. ..._ ._... .... . ...._� _........._._.. ..._... _�... .. ,._ _.. ._ _� . .......__ .._.,... . ..__...... ..�._...__ � � �_;-;,� �;.�.a��.,:: � ..�7 7 r- C'(ita �4 4 7�.`Ti� .... I.... _ ............�.�.._.........._..............._,_...._.._-;_..._._......_. _.._._...... ............._.__._...._._..__ � . ' �.. ...... ..... ..._ ....... :_ ........ . ...... .._......__.._... ......__."'._......__........�__................. � {�..�xf d f.«�.4p.•_e: � � ::-WI 1..��� -��. Y"" ,,e ta� tJ .-.F g �-..... > F _ ...... �� 1 l ,m ... .._ ...._. .,...... _ ..__-_ __.___.._ ..........._.._____._....._ . ... .. . _.,..._. ........................�... .....,.,...,......_........_..___.... ....'" ...... ;..ti T � � f,; � € �d3£ = . �zits ��r a�tt;rr� _:¥ x €...._. ....._...__... �...__. .....�._....... ..._.---- :( � � � ""� /�. _-_........ .....6.,....._..._ ..� . .. �"'t� ;-,-5;'?'�t�-� I/���IP`�F.f �€ �.��__�_ ,_4 � �Ss %��t.'' ... _ ___.�_ . � .. �i p � .'';'i€} €'�i ��.p a S �gi3 z� �' E E ......... . � -., .... ... . _�_. .............. .... . __ �I pa€ .i`��.? S""�N �� 3 ._ .. ..... .._ .../'...._.._--¢ . .__.,.__ . . . . - F .. �..:�s �" �s�'r- _ ` 1/,' € �,� �.a�� C�tB ,�! :... . .� x . : .. .�(�J/�'_Z �.�_._ . .. . . .. ......... .... .__ ..... .... _......_ ......,.........�_.....,.... ...__ � i . i -w�e.�f � ¢-y:..?tTt�p-, � � ( � e.:`' a i��d�� .a � � t } .__v._ __. ...__.... .__ . ... . _ .__ .... _ . . ....._. [ ........ .. _......._ __.. {( � `" °a.,�`..1F %-a c_ "" � �' � i � €:l�t p t _f,� S 5 .�; . [ ' ! 0 9 . ... . ... . .._ ._. .. .......... ...... y. � ..... ..... .. . ._..� I .....__ ....._..._..�_.__ ...._.._. ....�... � i.j4 Y �.i. S --..x ... . 7 ..�I f� �.,'Z""� E[ SSb;,�: .�.. ._.....�.»_ � __................�...____._— __.w_...._. .T � �*�..�1'L�dt r � ¢�� -... . .... ....... ..._...._ .. ?�°�,*.,�' ��_I f �.. '"__ ._... ... ' 3 -_:�. ���..... .._ ..... .._ . .,._ p-.. _ � g . .. .... . .. . ._ __..._. _ ..__ ... .. ........-- -- ' �t; 7 g��'�� ai � I'"� f I �' �t P�� ,_. .; � d - .... . .._._ _".____............ ..�___....__....... _.__..._..__..____ .:.._... _ .. _... _. . .. ..__.__. .._...,._.� .w.�_ ..._..,,_...._._....._.......� ._ ) a z �E.t �1" s'..r � �a�:°�i ' � � rn4 ,-ror� �-��;€t-tg �i i � ' ..__.._�._ ..__.___. __.,__�� t__� _�.... __. �.�..� .___. ..____W._._..._.,_..._ ___ �_ _.l � , ..€��.;. t��a.'�s�..�::�'s4�;•� :��. ,"'� �{:�r .�. , � n. _ _ _...... _... . � t ' ��, � , a� �.r� � �R r�� � . _ _. 3 _ _ ___ � ._.. __ _ � .� ._ }._._.__M.._.__,.�__... _ j ` �,�� ��. �. � Sp� t �-.i - � ....-_..-�,....._�....._._n..._..,,...._....,.... ....._... _........... ....... ..m.�.. _.. ... .... .... .. �... .. . . ...�.�� .�........�......_.... --( � �.�4"�.ta €t-:bFyi i � - [ :..r�€L �.€._i� _�1.a::�g .. _..._.� . ._.._ .._..__._...___......._...._ ._._....�.._._.__._...r.w..._..._.._.__ .—._..... � . .......... . --___....__. ..� � '"��.d'' �''�a..�� ..._ ._ . � _ ....._ _.,- � C6�� ��n ..... .... ._. � s .._ �_'.a._:...e..____............._.__...................,.._.�...,....._.... ....._.__......_._...._._...__. _;.. .. .._.. ...a.. ....__..........�. __ . .......�. .............__...._...__........._.._..,..._._....._..._...�,. �.��:��'.a.�` i2 !�.�.�,::�" . € ( �=;i.�.F.�'��,e u ,.�v� � p ' .._..... .... .......___.... __'_.___........._.... ._i._.__......_.._...___......_.......... .._...:......._ .€ _. � ..... ._.__..__ _...._,__._._._._._..._____� ..__..._..._......�......._.....�..._.___.. ......_..._.. _...� �;� ,h � �""€€w=-F.�.�..�:,_s::. ; � �:t'" } �.:,- � :... ,m. � � _....._ .... .._.___. ., .___..__ . ....____ __.._ .._---_._ _-__—__ . .._ . �.�...._._. __._.__..... ___.. .....________ __.___ _��_ �._._. .___..� ..� _�,.._ .. �. ., . �. � � €til�.� t.t S � E f�� r-i , a � i �r.. ( C. _ _ . __ . _ _.........�.�._._---._... .._. . _...d � ��: -...^,�.,��.�'.a� r��,; - .� . _. .... - �..)�-� F-�-. a:,- : � . ....._.._.__.�_...._.._.w.. ...�w. .._.________. . . .�._ � _._._...............:�._............�.._._.._._. .�......_......_..__......._�.....__.._ _...�.. .._..___.� "__.:�__. ._.�....�.�._ ,_..._...... . j � ) � €�"��'sa ,a ��s�'� il,,,.,..__.. ! F.":�?�r -,� � ( �.,._...�_._ .........,.. � ....... _.:._....__...._..._.�_.._ �._.__......._.......,...._._..._.__...___...._...�......_...�...,...._.,........_._..,_._,_...._..._._.___..................._..,._.___. . �. ........___.... � ....._�.._.._._..___......_._.... ... � [. `.._.�,._ .. ....� . _ ..... .......___�_� . ��.�:"� �z«.r �a�'��^' , �. ... ___ ..__.__ ....._ __.�.._.� � € ...�.m_._ _....._ ...._._..... _ . � � __ & . _ .__v.._.___ .._�.....,...�....__....._..�._._..,....__ ,—___��.�......_..�_.n..,_.._...�_...__--'__�'��:,�:���,";.'�.�,.��'�.�3'�� . . .�.� _ � .-. ".._ . . ._ �. ..._ � � � � �'� �§� ��^'� - ..e.._..�n..._.. ..._.._.__.,.._� -.n.,»�a:.��..r&��t t�s ......__........._..._._.........�...__.__...______V.,...,.... . ....�..___.__.�_'-' 1 a �s . -' : ..._'____"'........_..._ ,.._............... .__........�..._.............._.........�...,,.�..,.._ � .::. .._.. ._.�..._..___,........��..__.._.... _... d S �.�s.,...»-......___ .�._..._.n........ ......._ ._._.___.._.�._...n.n.........._............___._............ .......... ...._.._........._ _ _-__ _j [ � .. ._.........._ ...,.........._._._._..._...__._..._.........,............................_..-,......... ._._.._..._.._...-,.............._..... ,._........__..._..__..___,......_......_.___._...__ __._._..... . ._.._.._......__...�._�__._.............._.. ..__....,.,,........_.._..._-,...__.__..._.....-..�., ...._._.,. €, � o- � � 3._....____._. __....._..__ ...._.....__.-........ ,.. .___,__.�.__........._�.....___ .._.._...._._.._...,........_...................._ ._......_.........______.___...._..._._..._... ....__.. .._.�....._........... ._..,,........._ ...._........_......'_.._."_"_._.._..._.. 3 ...... ..,...._............_.__..... _"''.. . _...! _ � �"'.�_,e........_.._.._..�...........�..........-.,__,.,,.�.,.... ..._....,.___,.. __" —___ '_ _ ,._ ..__,_.._.____ _ . � _ _ �'.._:�_.�.�_�._.e�............_....__.__._.......,_..___,.._.._........m.._...-_.........._,._...............�._._�_._.._....,.............. ....w,.. ......_.�_.......__._.,.._._. . ....._�..__.._.,_._ ...__.........,�-_......__._.�.�_�..�.�.. ._...... . ..._._.._'� > i 1'' [ ��,.__....�..._..... .............__....._.__..____......_..__..._.....�........_............... . ..__.__..._,...._..._._,._.._........._.__....,... �._...._...._.�._...... . .._....,___._._._._..__...,,...mw.,........._...._.�..._......._............._.___ � .. . ........�......_ . .. ....,._._._......._.._.....�.,._..� � +................�..........��._______.._......�.,.._._..._ .........._.__ _.._......_._.��._���___..,..._�,,...____ _.��____�__.._......W..........___...__ _._.,.._ ...... _......,_...............�._....__._......�___....q 9 � � ' ._.._...............,......�,...,,.................._.._ ._._�.�...._.........,.._,_ .............._........_........_....._.._,......................._..._......._.__.....«..,.......,....__._.._... ...._.._._«..................... _.. ......._.._ ..._____._.. ..............................«.'..............................�_ .................. ......_.........�: ;;-"Y ..2 ..'a�� I ��"�`t�..€�d �6� �.�"6 � � zYlT_ �'.:F_L. ..,..�.............................. 5�.:.b..€"" ��-f }"Yf ........_......_......................._....._....._ .............._._....,,.................,....................,._.,......___.....__.._..,,,.,,..,....,,,.. ............. _._.__.____..._.LL.........__........_,...,,.............,..,�....._,.. .� ..: .. ......._......._ __..f.___...,. �� .n..mn,«»� �t ,.. ,a-...-. �......................_..�..__....,.. � �.e: � ��..:: "" ...�......w.._ ............ . � .............................._...__........._.._....._..............._..... ................_...._. ..__...._._�._.�. ..........� � �:: � �. W..._..................,,.,,._.._... __._._...�......._�_....._......_.,....... � � �:: �: Y i � z � � � � .._....._.........,_.._._..........._._...,. ..._....._............................................................._..._..._.�.�.,.____.., ...............,,...... �.._..__._.�.._.�______.__...__�.......... . � � ..� �..: . -:. _........ .._._.� � �� , � � � � �� �' �� ._.._ �..__.._.._.�_ — --- __— _ ___ _..____m_.___._....___. � � F � � � � � ' . _ _ _ __. _ � = � �� �.. -- _ _ � � _ .. �:� � � � � "� ��-�'������ _ ..._.._.�._...___ � _....._. ..__� ��, __._._._ ..._._. .._. �.... .....___. ..... ...._. ___ ...._._____ ._.___..____� .._ __. n � � � a � � r � � ����� a � ,.� � _____...__ _____ _._—__ ___-----___ --__-_._____._.�_..�.._.._..._� .__�._�.__ �_....._ ____ _____._._. __�__a. � ,.. _ �� ; � � �: , �, r•� ,.��.._ . ;.�.��� _ �._..�_...� __ _._ _._..___ �__ ___ _... _.� _.� __._w�w..