HomeMy WebLinkAbout13954 �
��. CITY OF DIAMOND BAR E��' �
DEPARTMENT OF COMMUNTTY&DEVEL M
OP ENT SERVICES
' �� ^ ' 21660 E.Coplcy Drive Suitc 190
• �y (909)860-3195 Faz(909)861-3117 PRESS
�'*"f � BUII.DING PERMTf APPLICATION FIRMLY
¢ ADDRIESS �•` �� G / � �a G APPLICATION ERMfT P!C
o DATE � UMBE � M
$ ISSUE TYPE OCC
APN LO TRACT DATE CONST. GROUP
p OWNER T
o ADDRESS �1 ZONING SETBACKS
W CITY ZIP TEL V - FRONT RW ❑ -
� APPLICANT TEL SIDE/SIDE STREET RW ❑
� CONTRACTOR ' SIDE ❑
ADDRESS
� CIiY ZIP TEL PROPOSED USE
.Pi ARCH/ENG/
DESIGNER
L�Ii NO.DWEL NO. NO.
= CDDRESS Z�P TEL UNITS STORIES BEDRdOMS
�
� DESCRIPTION S�.FT. - FACTOR PSF ADJ.AREANALUATION
p� OWNER-BUILDER DECLARATION SFR/ADDlREM
O
0 I HERE9Y AFFli0,1 IMDER PENALT'OF OERA/RV iHAT 1/JJ EXEIADT iRdA THE CONTRAGTORS LF '� G91H99/C81pOR
W CENSEIAWFOA7T1EfOl10WINOpEl�40N�5EC.7071.68U5ME54ANOCROiE5510N5CODEANI'CRYOR (f�
G7 ���}�qEpUIRE511PERMRTOGONSTi1UCT.J�LTE0.MVilOVE.DEMO�ISH,OqREDA1RANY4Tf1UC•
tZ 1URE,P�qR TO R4155VANCE,AL50 qEal1IRE3 THE�PPlICM7T FOq SUCH PERMIT TO iriE A SN3NED W PEliO/DBCk
� STRTEMEHT 7HAT HE Op SME IS LiCENSED PURSUAHT TO T11E 7qOV15iONS OF 7HE CONiRACTORS LJ•
CENSE UW(CfUPTFR�(COM/AENCRq MnTH SECTION 7000)Oi DMSION�OF THE BUS�NE55 ANO PRO. �- PooVSpa
FESSIDNSCOOEJORi/4tTMEONSHEIgE%EAIPTTNEREFROAIANDTHEBAS�SFORTHEALLEOEDEXEMP- ('
T1J1lANYV10lAT10NOF5ECT10N7o7t.eBYN1YAiPLICuiTFORl1iERMi75U61ECTS7HEAVPIIC�NTN Z Re-Roof
� A CIVIL PENALTY OF NOT MOFtE 751AN FNE HUNDREO DOIUM lis�%.}. .. ._. .
� ❑4�SOwNEROFTIEPPOPERTY,OqYVEMPLOYEE5WI7MwACE5A5THEIR50tELOMPEN5A7pN, � COmmOfCldl � - - '
MIILL OO 71iE MCIRIC/N�7NE STPAICTUNE iS NOT NREND�OR OFFERED FOp S.LLE ISfC.701t,BUSI� J
� NE55 NA PROiE33qN9 COOE TNE CONTMCTORS LICENSE UW�OES NOt APPLY TO/N OWNER OF ,
PIqPERfYMTiOBUlD40RMGqOVE3THEREdyMANM1qppE55UCMWORNXIYSELFORNERSELFOR� _
� TNROUGHMSORNEHOWNEM�LOYEES,FRdVIpEDTHATSUGIMPROVEMEMSARENO'fRVTENDEDOq CO
Q OFiFREOFORSAIE�F,/1�wEVEFlT1E&11LdN00RMPqOVEMEN714SOlDwrtHMONEVFAROFWMPLE•
Z TX)H,TNE OWNER9UlDER WM1L MAYE�Y1E BUFOEH OG PROVWO THAT HE Oq SHE DID NOT BUttD OR
� 4PKNE FOR THE PURPOSE OF SALE} . . .
W 04�SOYMEROFTHEPROPEHTY,AMIXClUSNELYCONTRACT4qYrtRILICENSEDCUrtFUGTOR3
� ro oor+sTnucr n�vNo.iECT�sEc�a.,susiuEss u+o vnorFssior+s caoE nrE coerta,�cTORs u- Valuatbn ADJ.AREA
CENSE lAW DOE9 NOTA7PlY TpAN ONHEH OF A PROVERTV WHO BUADS Oq MFROVE57HEREON,MA
� wHomNrucrsFoasuaoaaecrswinr�mna�cTo�s���Nsmnunwurrmn�Ecarrrua pUANTIIY DESCRIPTION FEE .
� TORS UCEN^E UW}
� OIIAIO(EAIPTUNDERSE4 B.lP.4FORiHtSREASON � �
� U
LL ` _ . _.. . .. .. . . .
OATE OWNER . U . . � � .. .
� LICENSED CONTRACTORS DECLAf1AT10N W �
OC IHEREBYhFf�RtIIMDERPENFLTVOFPEIWRYTHATIWIiCENSEDUNDEflPROVI5qN50FGV1VTER Vr •
� �(Gq1YEHClqWITN5ECT10N700o)OFDMSqN10FiME8USWES4AN7VROFESSpNSCOOE,AND z
W LICENSE�S N ML fORCE EFFECT. � m .
0 110ENSE CU LIC.N0. j
V OATE CONTRACipq d
W
� WORKERS'COMPENSATION OECIARAl10N Q
� IHEREBY/�FilfatUNpERPEKA�TYOFPEfWRYONEOFTHEFOtION'INODECLAMTION4: � Z
� �_IIUVEflAWIILMAMTAR/ACERTIFICATEOiCONSEMTOSEIF•INSUREFOqWOR!(ERS' _ _
COMPENSATqN,A3�f10VIDEp9YSECT10N71MOFT/EIABORCQDEFORTHEPERFbRMANCE W
Q OF TNc wOPo(fOR WNICfI TMS FFitl�,nT 14155UED. �
� ��HAVEMAw7LLMAXJfAMYVp�fERSCWPENSIRIONtttSURANCE,A5t1ECUIREDBYSECTION - .
4 ]7o00FTHElABORC�DE,FORTHEPER�ORI.IANCEOFTHEWORKPoRWHidIT1iSVERMRI4
�35Um.MYWORKE 5COMP IS IONtt15URANCE AFqt[ /JI Ol I�)MBfRME: CONSTRUCTION
� CAqPoER �! .� PLAN REVIEW
z aaieruix�eER _ ELEC
4
0 (MSSECf1�NNEIDNoiBEm�siETIDOFnEP[mm.�TBtana+EHt�pA�DaliM5R��10AlEss1 PL MBING t
Z I CERTIFT iHl1T M THE PEFFORMMICE OF THE 150RK FOR WHIG1 THIS PERMR 15155UED,1 MECMANICAL � : -�
- L'f SIULL NOT EIAPLOY I�NY PERSON N ANV 1AINNEq SO AS TO BECOME SUBJECT TO TME �;'r`,��.�
� WORKERSCOMPENSATIONUN50FCALIFORM1MlO/�GFEETWlTIF1511qADBECOME INSPECTIONFEE
S - SV&IECT7CIT}1ENq1KERS'OdAPEN5AT10NPROV1510NSOF5ECTpN�7000fT1/EUBOR - �-� .
�E sN�y� eaev�rvnn�nasE s�q+s. ISSUANCE l
0 oA�: � �vPl�c�rrr �.�iLLlC..��1 - SMIP �n r .n r�
� ENERGY PIC �V �' �'� '
WMNiNQFAILURET SECIIREVKNiKERSCOMPENS�TqNCOVEMGEISUNUwFU1.,ANDSHALLBE 7��
� � SUB,lECT1JJEA1%AVfRTOCRIEIMA�VENALTIE4MIDCMLFWE$UPT�ONEHIXlDREDTIOUS�f70 ENERGYPERM�T �11 I �T'T'�nT�tr'' �
WLLAR4(f 100.Oa0),rti AODiT10N TOTIE COST OF COMPEN4AT10H,ON.UGES AS PROY�DED FOR IN '
. J SfCTIDNf70lOF1NELABORCODE,MTfREST,ANDATTORNEY'SFEES. T �•�• � �
aErErmoN�e: _B 1I�T`,T�:C; �•
oCONSTRUCTION LENDINO AGENCY PRE-ALT FEE:
� INEREBY/iF�FIRMtRAERPENILLT'OFFEFWRYiHATTNEREI3ACONSTPUCT10NtENDWO�CENCY - -
FOR TNE VER W A4ANCE OC TFIE WORK iOR WHICII THi9 PERMIT IS ISSUEO(SEG]097,CN.G.).
�
-- � LENDER'SNIWE . ._
� � lEN0ER7IDDRE33
� icEa�vnunw�venEr,nnns�vruunor+urosr►Tenurn�e�aovEMcoaurnor�isconaect TOTALFEES /�Lj- 9O
� IAOREETC1CddPLYWIMKLIXTYANOCOIMTYORDININCE9AND3TA7EUWSREUTMOTOBULDINp Q��
� CONSTRUCTI0ILANOHEREBVIUTHORIZEREDRESEM4TNESOFT1/15COUNTYTOEMERUPONTHE _ ,
Z Il80VEdAENT�ONFOPROFERTI'f-0RINSVECTIJNPUFPOSE3.
9 I/ COMMENTS
� K
°� vew�mee ww
4 /_
� - . . . ��-L LLJ � .�7 /'7� � �
� SKiN�TUREOFPEFu11TTEE OATE �Tr/ ( �/�� �
� - . _ RECPT.NO. PAID BY VJ / VLL10�7iaN
WHITE—Depertment Copy,YELLOW—fk�ence Coqy,PINK—Asaessa Copy.GOLDENRO�Fi1e Copy,GREEN--Applicant's Copy -
!1 n A
i�\� ����..�G
�� ' (7 � T T T � � � � a n � m � � � � � � � g � � � m � �
� m m i z z z z a m m m � m D x o 0 0 0 � o a m � r
m� �� a n a n � m v � � m � �
'p-i � r r, r r y '� � m �- � • O C C C O D O -� � �p O n �
� Z _ gc� c� c� �, � �, m � � � � m
-�'n - � vm2c� � -ac» a � Z � mxxxnzm � -o � Z � �na
r r m p � :.{ r [n � � v m 2 O G� x cn O p o O C�
� �D m � n � Z m � Z Z Z C � r r- R7 � z fn m � D -p C] � � •
'. + ��; (n T� : '-I � � � Z ;i -�i � T` D C � O QJ � � � 77 Z = � � m C 37 � �r
; N� (/�, � nf�, z � O � mz � {,Zj r�-- Zm m �C -�I �� m �
? m N �. � O Z � � n D � ' Z Z m .i
m Z -� G� o r .
} OZ -
11. _`j •
� -
i - .
- • i
�
, I � ro �r
. � � � � . � � ' '�� ' . � ��
_ _ • mpS ?t �t0 � "npOv 'vv 'n7� WVTmyT � Cc -n �t
_ t� z mm � Zz zm -n000zom �oz � � zzs r
" � � -rlo '_ � � rD- � � 00o = � � L7r �px -ma � m m � 9 z �:
� mxmr� ma � � -nm x = m -ir � � m
"� { mo � Omaz � mZmr � � zno � mD � -n -nD � �7 O
�+ a -� �' z � � � Z � � � -n+ oD � z � m � m � o oc�n o n �
�. -na � � � � � � � Zz � ma m � 0 � �n Q �
z � � � c� � �-Do.zc � . � 7Q b
� �'� mDz n � �7
D � o -i - -
c
� . � � Z � � . :
'i
- i � .
' I
a� `
_ - - _ � ,
_ .. _ - r
- ,;