Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
10509 (5)
�r " CITY OF DIAMOND BAR �� COMMUNTfY DEVELOPMENT DEPARTMENT .:,,�; 2166o E.Cop►ey nrive Suite.t�o PRESS (909)860-3195 Fax(909)861-3117 �""°` BUILDINGPERMITAPPLICATION FIRMLY JOBSITE r��, APPLICATION/� / � :PERMIT j f� �/� P/C i o ADDRESS � d�� �L^��i r'''�J7�'- 1/`�^• DATE ( ` NUMBER /�� " # ; c� ISSUE TYPE �O OCC � APN LOT TRACT DATE CONST. GROUP p OWNER A�� � �.. �A tz-G.t �- i � ADDRESS ll'L� C^ir�g(r1��A �TZ--• ZONING SETBACKS � Z CITY�Q ZIP��TEL. �.�---A-��� ; FRONT RW ❑ � REAR p � p APPLICANT S„�� .�TEL.�t'��....�� , SIDE/SIDESTREET RW ❑ z a CONTRACTOR S�DE ❑ � � ADDRESS � ( � CITY ZIP TEL. PROPOSED USE '� ��� f� �Q� ��W� ' w• ARCHlENG/ `z DEStGMER � �` W NO.DWEL. NO. NO. � � a ADDRESS UNITS i STORIES �S BEDROOMS � CIN ZIP TEL. � DESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREANALUATION -p�: . OWNER-B�ILDER DECLARATION SFR/ADD/REM O ,0; 1 HERE9Y AFFINM UNDER PENALTY OF PERJURY THAT I AM EXEMPT FRDM THE COMRACTORS LI• G8f&96ICflf�WK ��.W-��, CENSELAWfORh1EWLLOWtNOREASON(SEC.7091.SBUSMESSANDPROiE5S10N5CODE:ANYCITVOR ; (f� �-U- COUNTYWHICHREOUIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE,OEMOLISH,ORPEPAIRANYSTpUP - -_�jJ patiolDedc �Z�: TURE;PRIOfl TO ITS ISSUMIGE,ALSO REIXJIflES THE APPUCANT FOR SUCH PEPMIT TO FILE A SIGNED - �-W' STATEMENT THAT HE OR 3HE IS LICENSEO DURSUANT TO THE PROVISIONS OF THE CONTqACTORS LI. �� W � _��� CENSE LAW[CHAPTER e(COMMENCMQ WITH 5ECT10N 7a0o)OF OIVI510N 3 0F THE BUS W ESS AND PR0- -'� PooVSpa _0.,_ FESSIONSCOOE)OqTHATHEOflSHEISEXEMPTTHEREF{iOMANDiHEBASISFORTHEALLEGEDEXEMP- � (� _V, TION.ANYVIOLATIONOFSECTION7031.5BYANYAPPLICANTFOflAPERMIiSUB.IECTSTHEAPPLiCANTTO :z {�g-ppp} � A CIVIL PENALTY OF!pT MOflE THAN FNE HUNDRED DOLLARS(i5o0).): - O l AS OWNEHOF THE Pi�PENTY.bR MY EMPLOVEES WITH WAGESAS THEIH SOLE CAM7ENSATiON, -p`- -n Commercial - ;Z: WILL 00 TME WOHK.PND 7HE SifiUCTUFE IS NOT tNTENDED OR OPFEPED iOR SALE(SEC.7044,BU51- e.J - - ' NESS ANO PROFESSIONS COOE:THE CONTRACTORS LICENSE LAW DOES NOT APPIV TO AN OWNEH OF- � ����` PPOPERTYWHOBUIL�SORIMPROVESiHEREON.ANDWHODOE55UCHWORKMIMSELFORNERSELFOR ' � - -'�;- THROU6HHISORHEROWNEMPIOYEES,PROVIDEDTHATSUCHIMPROVEMENTSARENOTINTEN�EDOR- �- m . �:W" OFFEREDFORSALEIF,HOWEYE0.lF7EBl11LDIN60RIMPPOVEMENTISSOI➢WITHINONEYEAROGCOMPLE ���� TION,iHE OWNER�BUILDEfl WILL HAVE TXE BUflDEN OF PftOViWp THAT ME OR SHE DID NOT BU�LD OR -Z�-�IMPIiOVEFORTHEPURVOSEOFSPIE). -_�' ❑I.ASOWNEflOFTHEPROPERTY.AMEXCLU5IVELYCONTRACTINGWITHLICENSEDWNTNACTORS ����; TO CONSTflUCT THE PPQIECT(SEC.7064,BUSW ESS AND PROFE5510NS CO�E:THE CONTpACTORS LI VaIU0Ii011 � e+m" ADJ.AREA -�Wi- CENSElAW00E5NOTAPPLYTOANOWNEROFl1PHOPEflTVWHO8U1LO50RIMPROVESTHEflEON,AND' - -_'�__' �WMOCONTMCTSiOR9UCHPROJECTSWITHACONTMCTOR(S)LICENSEOPUR3UMlTTOTHEWNTMG: . QUANTITY DESCRIPTION FEE TOHS LICENSE LAW.). Y �. J �- ❑1 AM EXEMPT UNDER 6EC. 8 P.Q FOR THIS qFASON ; Q .�.� �O 3 U - . �" �7 � .LL"- OATE � -i`P� OWNEfl � F Z� . W � �- LICENSED CONTRAC ORS DECLARh ION ' W .�: �HEHEBYAFFIRM 11NDER PENALTY OF PERIURYTHAT IPM LiCEN5E0 UNDEH PflOVISION50F CHAP7ER :,�-- � -pV. s(COMMENCiNOriITHSECilON7000)OFDIVISION3oiTHEBUSINESSAN�PROFESSIONS�DE.AND � Z x MY UCENSE IS IN FULL FORCE ANO EFiECT. - W� m �" UCENSECL4SS UC_NO. � � F, � ::-�.� '. -� . ,.V=; �ATE CONTRACTOR � a � W # •-�[ �: WORKERS'COMPENSATION DECLAFiATION ` -i -� U � 1 HEflEBYAFFIRM UNDER PENALTY OF PERIURV ONEOFTHE FOLlON7NG DECLARATIONS: � N`- Z �Q. _IHAYEANDWILlMA1NTAINACERTIFlCATEOFCON5EN7TOSELL��NSUREFOFWORKERS' �_ _ .-� Z'. COMPENSATION,ASPPOVIDEOBYSECTION37000FTHELA60RCOOE.FORTHEPERFOflMANCE - U - ¢ OFTHEWOpKFORNRIICHTHISPEHMITI3133UED. _ � _I--. -W 4.,,, .. j _IHAVEMIDWILLMAINTAINWORKEflS'COMPENSATIONINSURANCE,ASREOWRED9YSECTION y Ej r� i Q� 3'1000F7MELA80RCDUE,FORTHEPERWRMIWCEOFTHEWORKWqWHICNiHISPERMITiS I 1 1 �I; "�`- ' ISSUEO.MY WORKERS'COMPENSATION INSURANCE CARPIER hN�POUCY NUMBERARE: CONSTRUCTION �z � �� . t Q': �.. . CARflIEfl__ P�.N flEV�Ew o"- aoucv NuateEn E�ECTRIC �'�"t ._--D`' (IHISs[�itorvNE�r+o78EoohQLETmoFn+EaEaMffisfOFtoNEtRx�DaEooatnas(Stoo)oaLESS) PLUMB�NG �`" � :.-u�?� . W: I CERTIFYTHAT IN�HE PERFONAANCE OFTHE WORK FOR WHICH THIS PEflMIT I5155UED,l MECHANICAL '� _�:�. .. SHAILNOTEMPLOYANYPEHSONINANV:MANNERSOASTOBECOME5U8JECTTOTHE - �f=- -�(n: WORKERS'COMPENSATIONLAWSOFGALIFOflNIA,ANDAGREETNATIFISHOULD9EGOME - -�NSPECTIONFEE - �- " - - SU&lECTTOTHEWOIiKERS'CAMPENSATIONPROVISIONSOFSECTION3l0oOFTHELA80R '�-� ( _ Q' -~=� CWE,ISHp1LFORTHWITHCOMPLYWITHTNO5E7NOYISIONS. �SSUANCE �""°' " � _ 0= e � � `p' OATE: APPIICANT: SMIP -���� "J'.. WARNING:LAILURETOSECURENK7FKENS'COMPENSATIONCOVERAGEISUNLAWFUL.ANOSHALLBE ENERGYPlC --LL_:- -5U&IECTMIEMPLOVEHTOCRIMINALPENALTIESANDCIVILFINESUP700NEHUNDR�DTFIOUSAND __ -ENERGYPERMIT - � DOUARS[51oo.U00),INA�DITIONTOTHECOSTOFCOM�ENSATION,DAMAGESASPROVIDEOWRIN _ - -- - - "J- -SECTION3�OB�THELA60PWOE,INTEREST,ANOqTTOflNEV'SFEES. RETENTIONFEE: �• i�� CONSTRUCTION LENDING AGENCY PRE-ALT FEE: p€ ---�"" I HEREBV AFFIRM UNDEfl PENALTY OF PEflJURY THAT THERE�5 ACONSTRUCTION LENDING AGENCY -�`- FOHTHEPERWRMANCEOFTHEWORKFORWNICHTHISPERMITISISSUED(SEC.3007,CIV.C.). WT. TS LENDEq'SNAME_ - - - - }-: -1�` LENDER'SADORESS �� � �'�� ICERTIFVTHATIHAVEPE4DTHISAPPLICATIONANOSTATETHATTHEABOVEINFOflMATIONISGORRECT. ,� TOTAL FEES � _�y `-'0.' IAGREETOGOMP4YWITHPLLCITYANOCOt1NTYOflDINANCESANDSTATEUWSRELATINGTOBUIL�ING _ .. - -- CONSTRUCTION.ANOHEREBVAUTHORITEREPFESENTATIVESOFTHISCDUNTVTOENTERUPONTHE - �°Z" ABOVE-MENTIONED PROPERTY FOR INSPECTION PUHPoSES.. . - COMMENTS � 0= ��.tu� ��,_' �,,,7Z-C-� /y-'�"_' ;�' �m' PE TTE AME(OpINn � _ t Q: '. .�,. 7 �: "-�-:'�-- SIGNAYCfRE PEPMITTE DATE , - T RECPT.N . PAID 8Y VALIDATION -~. WHITE eparlment Copy.YELLOW--Pinance Copy.PINK—Assessor Copy,GOLDENROD—File Copy,aFiEEN—AppticaM's Copy - - . .,-_ i _ � li �i I m m . , � i -n -ri:-n is,� ;n c�,cn o � � m m ��a � � -n � �=tfv� �j�m cn � fn Ti � � 2 zl� zID tr Pn�m�� m D X S�Q O O O � O D m,r'��r � m F D �}3� D4 Pn m '0��:< 'r � O(C,C�C O �.D -i ��A O m � -i �n ~ I : � � � ��i�c}i� -�°o � �i� n z �'m(sli �>i�.� c�'r� � �!� zID � n �a-� t�i c ml,m�o :.� � r �cn y��i�i�l� o Gs x cls o l� o O n cD - c�iD�? m � �� zC Ia : r-l rn ¢ mrn ➢ �,n � R z � � ,_ � z zc��,- ��� I � �f I �i1� 1 cnr � C miDm� D � or es �` ✓%x � � �z �'G�s �� � � � � r�- -�i.g W �I�j� �j� -i � �Im c � �_ m N �' �;�`� z DIz,� m z��I�l {r�,�m a �c�� , T� , , ` � p mcic5�. � Gs Z zm � � � ;( .� ,� - z � -� , � � � � a � � � � � � ` I `� .F ��: � ;°�� — � ( � � �� ( j a � � �` .I � ( � - E , ; , � i , � ��,. � � I � i � y� �� ,� t i � ° � I I ;i � I ' i I � , �� � � ; �. I �,� � ; � ; — �� i ', '_ ; _ � � � i ` ! � ! I ;i� ,�' � :i � � , i I I I � � . I :I � , 1 ( ' ;) - - i , � � ; t � � _ ' ' i - � � � � � ' � � c� � � ` ' I ; ; � : � j ; v�.� , , � `� � `�` � ' , i_ ' . ' ' . � -�� � � . � ,, �I �: , : , ' : _ �: { �; � �� � � ��� ; . i�: � � j � �` 1 � ; _ � I � � � � � _ '� � _ � � �y .� � � _ � �� ' �_' I _� � � f ' I I :!. -- �rr+�a'i -n �n O �'o.0i� �..� �n�� miv,T m � -rt �, c �k�!-n � � � � -� _� ,� i � . . i !. � , z1m_M�m�z•Z D z o -n O d"O � Ti�D� -�'lai i-� z ( I � im� D D [n�zEY* I �Oi0�0 � OIZ '-z Z -� 77 ZiY:O f � �r rl �It- L��r rlr{C� _C)1 �' �'�m �10 � �� .I I `t � � r�ri,�- � �,�� ,n ;) _ �._ � r�m = � �- R'i`T�-zii�`� � �T� ( _ I I 5 I I ! � I1 --iRl! R� CS tT' ?�i��'�7 -r,.m (S: ,�� W p -ilr r-77i37 m 7� qq 5:1 f , � _ � � �� I t�;i.J 7��d -. D � -_S��m ��ITF 7- � f Z.i D w� Z I G7 A D� '7'1`�5 4� L �� a1d .� i i - � � � i� :d Z � ��5�, Ip� �7a.Z Tmi1113J��-�� �fQ O C1 C�. r-tr- � p �g . - .�i � = 9 , ��;,'O �4 Z 'D I4T �Zi� rIE7. -C}f�cD7.➢� Zia�� � �lm_� . � �� v� G -i cn � �'_� � p�T � � �: � I�7t�n ���iZ D� �i,��q p�0�0�0 O cn;-i � � � �, � 1 � r � � � ; � �e' zr' �°' � ' � c��czii •> � �n,����nol � � �„ 'V � �_, --i I � I � , � � I c� �oiz- � I � � � � ��� � �-� � � � s� b. � c � � � `'�' � :I ' '' � *�'— � ' � I �, � �m I�E i� � E ; : � � �, ,�� I � , i C � � � '� � ; � �: k �D'� g -�� : �� � -I � � � � ��� � �� � I-�a � i ,_;� � � ;<< � � � I � , ,� �- j ��� i� °�-+�. �:�'��\) � i i �( I l �] f [� ' I t i,;i i � �� � . �- �- �4 . .. � � -) � � I � a� � : ( �. I. � , ,- � l _ � �� ' _ � I � j � � � � j F� � — �. I � � � i � '� � � — �� � ' 1 `� � = 1 ��� 1 i �`� � �� � �,-` i _ ; � � �_ ( � � � � � �-� I� �, � ;, � , ; � �� - - _ ��� � � a >i �" —= ;I Y � � � ��� =f � f �' _ � � :� - ��. I - I { � ` ' i - ' - -� �= _ � - ' - � t : F C ''� ' I i � _ { _�? � t `�i � � E � f � ��� t � ..-- .. ' �- ; i ` I _: _f. � , ' =;� ,;._� � ;�� < ! L, . ° ., � �� �� � �� -_ � ; _' . � ` : - � ;� f ; ;I � ,{_ � : : ! ��� � ��- � f � , � � i , , � _._L .� _ __ �— ' ,_ __ _ �