Loading...
HomeMy WebLinkAbout17225 (10) __� CTI'Y OF DIAMOND BAR � — –�`` - DEPARTIv1ENT OF COMMUNITY&DEVELOPMENT SERVICES I � _ 21825 E.Copley Drive " (909)860-3195 Fax(909)861-3117 PRESS "'%»�d'�� BUILDINGPERMITAPPLICATION FIRMLY o DDRIESS � ✓ V�r ���C� / DATE CATION � ,-_.����-��y NUMBER��#/C �,J � ISSUE TYPE OCC APN �7 LOT T ACT DATE CONST. GROUP a OWNE_R /V I lU��l� " ADDRES ZONING SETBACKS Z CITY ZIP TE � FRONT RW O � APPLICANT TEL. REAR O � SIDE/SIDE STREET RW ❑ z Q CONTRACTOR qPFLiANCE 1NSTALLERS INC. si�E ❑— � ADDRESS 2 II1 � CIN (akewnnd,�J�,�f1719 �y PROPOSED USE w ARCH/ENG! w DESIGNER NO.DWEL. NO. NO. a. ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION OOWNER-BUILDER DECLAAATION SFR/ADDlREM p I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT i AM EXEMPT FPOM THE CIXJTRACTORS LI- G8f89BIC2fFlOR W CENSEIAWFOqTHEFOLLONANGREASON(SEC.7o37.5811SINESSANDPROFES510NSCODE:ANVCITYOF (n U COUNTVWHICHREOUIflESAPEFMITTOCONSTRUCT,AITER,IMPROVE,DEMOLISH,ORREPAIRANYSTPUC� W patio/Deck W TURE,PRIOR TO ITS ISSUANCE.AL50 FEOUIRES 7HE APPLICANT FOR SUCH PERMIT To FIIE A SIGNEO � STATEMENT THAT HE OR SHE IS UCE�SED PURSUANT TO THE PPOVISIONS OF THE COMRACTORS LI� � CENSE LAW(CHAFTEfl 9�COMMENCING WITM SECTION 700a�OF DIVISION 3 OF TNE BUSINESS AND PRO� � PDOUSPO � FESSIONSCODEjORTHATHEORSHEISE%EMPTTHEREFROMANOTHE6ASISFORTHEALLEGEDE%EMP� (� V TION.ANYVIOLATIONOFSECTION7a3t.5BYANYAPPLICANTFORAPERMITSUBJECTSTHEAPPLICANTTO Z Re-Roof � ACIVILPENALTVOFNO?MORETHANFIVEHUNOREOOOLLARS(E500).)� � ❑I,ASOWNEflOFTHEPROPERTY,ORMYEMPLOYEESWITHWAGC5A5THEIRSOIECOMPENSATION, � COR1t11BfCI81 Z WI�L�O iHE WORN,AN�THE S7RlJCTURE IS NOT INTENDE�OR OFFERED FOR SALE(SEC.7044,0'J51- J NESS AND PROFESSIONS CODE THE CONTRACTORS LICENSE LAW DOES NOTAPPLV TO AN OWNER OF � PROPERTYWH00UIlO50RIMPROVESTHEFEON,ANOWHO�DE55UCHWORKHIMSELFORHERSELFOR � � THROUGHHISORHEROWNEMPLOVEES,PPOVIDEDTHATSIJCHIMPROVEMENTSAFENOTINTENDE00R m W OFFEFEDFORSALE.IF,HOWEVER,THEBUILDINGORIMPROVEMENTISSOLDWITHINONEYEAROFCOMPLE- Q 710N,THE OWNER�BUIL�ER WILL HAVE THE BUROEN OF PROVING THA7 HE OF SHE DID NOT BWLD OR Z IMPROVEFOFTHEPURPOSEOFSALE). �_ ❑I.ASOWNEROFTHEPFOPERTY.AMEXCLUSNELVCONTRRCTINGWITHLICENSEDCON7RACTORS TO CONSTRUCT THE PROJECT(SEC.7a44.BUSINESS AND PROFESSIONS CODE�,THE CANTRACTORS LI� VOIUH�1011 ADJ.AREA W CENSELAWDOESNOTAPPLYTOANOWNEFOFAPROPERTVWHOBU'LDSORIMPROVESTHEPEON,AND � WHOCONTilACTSFORSUCHGROJECTSWiTHACONTRACTOR(S)UCENSEOPURSUANTTOTHECANTRAG QUANTITY �ESCRIPTION FEE Y TORS LICENSE LAW.). � J 0 ❑I AM EXEMPT UNDER SEC. B.8 P.C,FOR THIS REASON � �i __ � W �ATE OWNER �"' � W � LICENSED CONTRACTORS DECLARATION i j � I HEREBY AFFIRM UN�ER PENALTY OF PERJURY THA71 AM�ICENSED UNDER PROVISIONS OF CHAP7ER � � � p_ 9(COMMENCING WITH S'cCT10N 7o00J OF DIVISION 3 OF THE BUSINESS AN�PROFESSIONS CODE,AN'� Z �X MY IICENSE IS IN FULL FORCE AND EFFECT. � Ay m � LICENSE S C LIC.NO.� e � D � , � J V DATE CONTRACTOR _,_ a W [�i WORKERS'COMPENSATION DECLARATION a = U � I HEREBYAFFIRM UNDEH PENALT'OF PERJl1RV ONEOFTHE FOLLOWING DE0.ARATIONS: � Z Q C� IHAVEANOWILLMAINiAINACERTIFICATEOFCONSENTTOSELF-INSUREFORWORNERS' 2 COMPENSATION,ASPHOVI�EDe�SEC710N9�ooOFTHELABOPCODE,GORTHEPE9FOPMANCE U ¢ OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. � � w _I HAYE AN�WILL MAINTAIN WORKERS'COMPENSATION INSURANCE AS REQUIRED 9Y SECTION Q 370o OF THE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS � ISSl1ED.MV RKERS'COMP SAT70N I URANCE CARRIEP AND POLICY NUMBERARE: CONSTRUCTION 4 I��T' � P�AN REVIEW � CAflRIER ,``` a C� Z POLICVNUMBEft �� VyN� / J ELECTRIC Q � (iTiI55ECTKKJNE�40T8EOJMPLEfEDOFiHEPEfihiR4SFORONEHUNDREDDIXIARS(b1C0)ORLESS7. PLUMBING � MECHANICAL Z I CERTIFI'?HAT IN THE PERFORMANGE Of THE WORK FOR W HICH THIS PERMIT IS ISSUED,I (n SHALL NOT EMPLOY ANV PERSON IN ANY MANNER SO AS TO BECOME SlJ6JECT TO TNE � WORKERS'COMPENSAT:ONLAWSOFCALIFORN�A,ANDAGREETNATIFISHOULDBECOME INSPECTIONFEE SUBJECTTO THE WORKERS'COMPENSATION P V I�ION 37000F THE U1BOR � GODE,ISHALLFORTHWITHCOMPLYWITHTH OVISIONS. ISSUANCE � SMIP p DATE: APPUCANT: --- � ENEFGY P/C J WARNING:FAI�URE TO SECURE WORKERS'GOMPENSATION COVERAGE IS UNLAWFlJL.AND SHALL�E � SU&IECTANEMPLOYERTOCRIMINALPENA'�TIESANDCIVIIFINESUPTOONEHUNOFEDTHOl15AND ENERGYPERMIT DOLLARS(5�00,000),IN ADOITION TO THE COST OF COMPENSATION.DAMAGES AS PROVI�ED FOR IN � SECTION37oBOFTHELA80RCODE.WTEFiEST,ANDATTORNEY'SFEES. RETENTIONFEE: '�U d CONSTRUCTION LENDING AGENCY PRE-ALT FEE: � IHEREBYAFFIRMUNDERPENALTVOFPERJURVTHATTHEREISACONSTRUCTIONLEN�INGAGENCY ' n- FORTHE PEFFOFMANCE OFTHE WOPK FOR'NHICHTHIS PERMIT IS ISSUED(SEC.3097,CIV.C.). Z W — S LENDER'S NPME � F= LENDER'SAD�RESS ��`�� � ICERTIFVTHATIHAYEREADTHISAPPLICATIONANDSTA7ETHATTHEABOVEINFORMATIONISCORRECT. TOTAL FEES w IAGREETOCOMPLVWITHALLCITVANDCAUNTVOFDINANCESANDSTATELAWSFELATINGTOBl11LDING � CONSTRUCTION,AN�HEREBYAUTHORREREPRESEM1TATIVESOfTHISCOUNTYTOENTERUPONTHE ZABOVE-MENTIONm PROPERTY FOfl INSPECTION PURPOSES. COMMENTS � l fJ m d PEFMITiEE NPME(P > 9 ,3a/oi (A � SIGNATURE OF PERMIT�EE DA7E = RECPT.NO. PAI�BY VALIDATION �' WHITE—Pepartment Gopy,YELLOW—Finance Copy,PINM—Assessor Copy,GOLDENROD—Fila Copy,GPEEN—ApplicanYs Copy - ..� . -... .i. �....�..��y:., ,,:!a.: �.,�:^�.;... ... .:� �t ;:q�.�f.y;,,_.�..m,.�, .. .. .. . r..., ..r. ., . . , ,�.}�:F:.c wn.�.:M1,-. .. ,��.....,:�l� . , ':-.d'� � � �� �y C Rt���y"�.'�'k k %�.d�'�:f"�� ��4' �k�y� wd�"��r "' Y �g� � �a v �'"s 5}���"��,.�'�" ' �' ��#� �.sa � ����°;����a.a a� ��--��� �m�� ma��• �r-� ` '°�'���'� �{�.e ^g a.. � �.:.�a;� � ��� ����¢`s�' *„p�' �s �',�� � .� �� �� `�� �"� �� � ���`�e ,� ���`�Fro�� y� �, �� � � °�# �� ����-��� �� � � �" � ��� � ���� .. � - � � � �� �' s � ���«�� � �� a� � ,�.:.�� a��'"��.� .� z r'� � ° . . . . . � �� � , 4 `"�, -t�.,�`,. � ! €_.�., t '_S ... yyj .. __ .d... .....__. ..__ .,._..... . ..__ .. _. ..... .."- . . k� €'t S^� ; ... ' �}� ��d € p �� . t... — '_ � _. _ — .,...�__.... ......... :.. _....... . ..�..._..,.,.,.....,....,,,... .... .......... ........ ._._ . 3.... ....... .__ _._._ _._... � �...� ..... �..�, . . � e�.� �W �..� ��..fJi� � � �.. .. .......... . __r. � '��_eL.�.6.J�A Y t�'' � Sl S�T I.. .. ....................._ _...._..._ ._.__._._�,,..,,.,.........._....... .. .._. .. _... .. 9 I � � � { I �` I...?€�'� ',, � ( ��t C��- � ... � ,E) �...°. ,,. ._....._M_._........... .. ........................_....___._....._..r„_ .........._ i � .. ........ ..__ .... ..,._. S ....._.. ._ _ __ � .. ._. . .._ �..., ' ��. .�("? ,. ... � ..... . ... � �-:44' f _�ii. � �a•' � �r t:��"i� . �. � § _ ._ ..._. .�_� . . . . _ ... __ ._ ._ .. _. . .. .. _ ._. .. ..........._ � q�s.a���14'4. ,� �. � F€-tr � €- ��� '� � ��� i ! � _ ._ ��.�. .____ ... ..... ._ _._. >.__ .__ � ___.. _ .. .. .______� --+ �� � �rn;a k^ `� � € � r�i � �. � s ,ja �:- �t � �_ �__ _ �_.. . . _._ _._ _.. .....___ ..____. _ .� ._ ... _. .__ ._ ._ E__ _ . ____ _w.__...�.._ .__._..._____ ._�_ _� _ E_ ��`;(� �* F:r 't _ � � I �� �t.t��a � �,°�°��'� � �� � . � ___ _ _ __ � . _ __ . _��v_.� ___ ... � "°R0. � � f : : � _'e CP� ,�?1 { �'}.�h� e... � _ �F'S SS . �. 1 € ¢< d 1 � : ......_--�..,..�,.._.:..... - � ..,_...., .. ._____. . ._...,,._..,._...._...., ... ......X ........�,_._... _.�...........� . ..._..... ! .. e... ; � ki� � �?r�'-i f � q"I � C ___�_�._aa_.....��..._�-_ ..._..___.____�.._._. __.. . .._-___.___..y_. _ e.. .m _ _ . �____w. 1 � __ ..� � _. � €"''L a a s . a"d 5.;:.� F.rA ,; I -.i, 'i( �. : � P C � � , c „ € S .,� _ . _ ...e....._..._....�-_.._. e._.._...___ . �.__... __.. ...... _ _ .. .� ...�.... . . ,_ ___ . . ° ,�,�5' r � � � i`" .r. ' ; � ., � 9 . r,�� : I t �x.9 '�: � � :. , , Ei 3' ._¢�$ t.1: � .m_._�__ � � .,. ._ . ,. �. ._. ... ..Y,. .. _. . ._____ . . a-- .,..�. . w. ... .. .... . . .._. .��._..__....___-___ _ ......... � r^ .i a : � y t€ .�� .�;r. c,��i ,��.-s y J-}(�I;a ....... . ' . �.�.�..._..�._.,... S. .._ . ..._ q_. .__.._ ......... __.._...�.. ,........ ____.V �.� .� :,...+° ,ri.'�.r� �� :,, . ',�p f". r�M�€ ���^ � � ....� t � __. .P.m..__....�..:._.__ __._. -a-..____ _._.._____..._.___... ... �_ .__..__................. _...._,__.___.. ___.._.__..�.�_..._ �_,... : .._,..-1...� __� � �x �,pe� '. ( � SR d .h3 � � a�.r.� �����,�a -rp�, rc i p �"�'�,'"i �'� a r,�-...,E a € . _.. .�...._ __._ . ..... .__.......... ,..____.�..__.._.__�.._.__Y.._.........._.... ....... ..._.__..___...__�....�.._._..._ �__.�...�.�.�.... _._......_......... � ���fi'":�.....,"��,�.i�.. a 4��.-� �� : :'�i..,c`�3 ;�'`d'-�i�. y - - .. ... ._...�.M....._..,._.._..., ..V._._n ' __,..,..._...... ..__..___._....._._._ _.......... __...._.......... .__.__. .__ _...__.._...,..,,._. ._w........ .__. .__ ;___��__�_, .. ___�--------� . —1 �y� , ;r�a: r, � �- a ra c�- � @ ?,1, Lr tha.r...€.e< .."�JC`V I . _ .,}`z"` . I " . _ ,......._.......... ......................__.............._«..,.._. ....... _.� 1 _ ..__._..�... ..,_ . .._ _ .._............._....-.,,.-.._ .... ._...,. . .. .. ...... ..... .. `$i F-1.€ d'3��[E E �:� �. ..._ a '.��'3"4j ,���% �`� a : g . _,_ ..._....__._._ � ....._....__.._.._......._.......,... ._._._......._.. .._,._, ... .......__.�..�_..._.._v_.._ <.,... . . .._...._ .. � .._..� _._�_� __ ''.7 .._. _.......... ...__`"_._, I C° -' d . : , ,a .,E �„'�� , � . L� , ..._.„...,..._._. '-'_ '� ._ -_ __ —- _._..__._________._... _......_.._ _.__ � �. � ._..._.._..., ..___ ..___......�...__........ ..._..a...._.......�.� . .__ _ __t.._ .... 'y' .:. ' � qq a '.¢ . i . �A.:,a���I t P?F`ti e"1 : ' -:_ �:_..��:E v 43�:.es...��.,i �e k's 4�..,a, ��, ) � g — --.__ :._ _._.._...... .w___. ._... __..._____. . .. �,k _ __,_..___.__._� ___—�� __._.......�.__.;...._ ____4___.___,�______ ___� �. . < , �- r ��� ::� � i�" _L '� ;r ��! »,,. �_ _._..__ �..:..__._�e ........ �..___._.,�__._w..�._........_ , ..... . _ _........_._...... .. �_.�.. _. . _..r._�_....._�......._._._— -- , _ �_.�� _.µ.._ � ,.,.�:a- ta�",.'� ' � -�',.`e_%:.�.sr ;�,�_ ; � __. ...._._.__ ___r__ __._.... _._.._._�.__ _w._ _...__._. _:m;, ______ _ _..__.__ _..�.. _�......_ . _ ___.._.� s ���,.„�; � �r;, � .. � � _.._ j...._ . � ; .._: r .. . . . � ��_' i .....�..�.�._ ......_...._....�.._,__._.._..,. ..,..._...___._ ...... ... ....�.. . .._ "____�..._.,,...._,..........___ . __....._.w___.______.._. _.__ .. .._._ _._ . ____. _,..._,..---'- �_ -;� r �, ��-'�•`q �' B F €'.��xr.»��ed'.Y.S,v�9 :i�':i�k.9�'� tm{d..i'.. }'" .�t�a. '� .�..._1 t � 6 . . . . . ; : _.`___.. ._..........__.._...._...,,....__....._........._..�_.._., _.._....__.:......._._�.............._.._E....,......_._.�_.....__..._. ._.. .. ._ ..._..�....,�......:........�.->..._,.., ...n....,........._._ .............._......_........_._._........ :q�: q .,..-r.�..��g. ' `_.-�.�..�I €.a.:°_' "Z?.:t,-= � { i E : � � , �.p."'}..,m��...�.?.. .- : ; _ ' . F', ` � 3 I ; „_ _ . �.�..._.� .. _. . — — - � �. € -� ��, ..�ra r� �' 'i � __�. ......c..,.__._..................._. �.. .�.,..., r. ._. . ..... _ _.....,. ... .. ... . _...__ . _ 3 AvS� ✓A'��-_. ;ie.1.33�t •��i� . _ _ . ___.____m _____. _. � � � �: � � �������,' � _..._ __.____.._._._____ ___.______�.____..._.�.__�.��..__.__ ______ � ��.��m ��R� :�. _��. .�: � i �.>P,� . � ���...�������..��� � __._.._.. . _�_( � � ______ _..____. _ ... . _..._�m__.. .. _—_---__ _ _.__�_� .. .._____. ..._._.w._ __._._..._.�__.__.__ __.____._.___.___._.�.. _.____..�. ._....... _._._� � � � ��__.._� _._,.�..�..._._ _ ...________._.____... ._____._. _ _.___ _._._._�_ ____._ _.�___.__.�._______..__ �__.____._�_ _______µ..�._._.. �_�....� � �...�.___..__ �_..__....___..........�..__._.........._._...m_� ___..� .__.�____...__.�.__._____...._._.____..__........___.___._�__..�..�.._._._____. _..�.�__...__w._�__.___.____—__--� a � i ` � ..�___,� _---- __ _ __. .._._,. . ..____..._.__.__..... �...,_.._._.._......_. _...�.._ . ..__...... ..._.m_____ _—__ __.______.._..__.__._._. _�_ .___..m. _.� � i 8 a..�,....,.-............................ ............................._....................,...._.,_....... _..._.._................._......-...._._..—.._�__............._._._..�._..._.._____.__...._...................,.,,................ ...................._.......... . .. .._...,........_.........__...._..............._...........�.,.........�......... f �....«....�..w.._..................__.........._�....,..................._. . ...._.._......,......_._............_ _..__............._..,.,,,...,.. ......__..........,,. . ...... ............_....._......,.,.......,..,,.,.. .............._.._..�.�__........__._........._..�.�_v.�.._. ........�_._'_'___... ...._.... ...._ � � �'.�___.�._._._•__.___ __.__ ..._.__._—" ______"__�.�.................................... _................_.. .............._......................� -..__._...._ _..,,,,............... .............._.... . .._....................,,......._._...............«......._�...............,...�..,..,........_ s _z ................. .............._�.� C E �;_"__._.,.............__.,.,.._. . ....e...___........._......__.._.._.._.,.__.__....__.__.__..___ ..........._............._......__.,..._._. .___........_...._._.._...�,.._......_. . ......._.... ...............__.._._....._.�...�...._._._..._..___..,,..�...._.__._............. _.. . ....._ : �:�`�,.�..,;� .. - .�.._.� .�.:.w °°o z,',;";�,_ ,..� :. . . t�L,; �.¢���af@ :,..;s:_�..:...' ...._.__�____.....---_ . I { �... . ..z , . ...._...�_._............._._...._.._.... _.__ .---__. .____.____.._._.._�.._.__�__....�.�__..�.__�.._.......�...._... ...__..__._._...�_._.--E � r q __....__..........._�.�..... �...k Y...ti�-�«� tl a a s`�:..^ �.$a„�..,.,. ,.__.____.__....._..__....... 4 �'�� ��',3 '"' ..........._.._..........�............ .................. ........._.............................. ......._............._._......«.............. . _....................._........ „ ._........r...�.....,_ ..e.....d......_..._....._�..«.............,...................._.......... -�--� 4 C ".�: i� " �':5. � 4 .:.. . .. � :.,. � .. � -. ..., ......, . _._... _.�....__. _......,_..._........ .. . .... . .. ...... ....._.__. ...... ._.,_....._...,,....�.....-r . . __._..� .._ E .€'�'�. �.� � x.m.� ' _.... .._. . ____......_._._. ..._..__ .,.._.__ _.............._.____..._......_...__...._..-.....µ..,......,. ..... _ _... ._.....__ ........__.,._ ".._.""_............. . ....:... ............. �:::...... ' ......'. �.€ `%? � .::�� .; � ......._.__..._.... ...............................,,..�.,..,,..... ._.............�_.............. _. .._.._.._._._.__..._._.__�.�.._..____,....._._...._i .... .. :: .........r........_,....,......__.............._.._....._._...__._.. __.._ ...... : I �.. : g +"-:; '��' . . j '� :.; � 9g � �_.: - .... .�.......____.._._..._.,..,�.w....,.__._..__._._.__..._......_..�....._...,_.._�..._._ m_____.-..__._—___..."_'—'_'._. ....._._....._... . . ._._. _-____._____'_"....._._..._..._...._.-j ��. �I �.': ,::: ..,. :_ _ �.,� _ ....._ .. ., ..... ._._ _ ._.... .. . .......... _. . .. .. ._. ... ._ ........... ....... . . .._ . r �x . �� ' �,.�.. ________.�__ ._�.�.__.. ._ . ....µ�