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HomeMy WebLinkAbout10254 .,: - CITY OF DIAMOND BAR f/� ���� COMMUNTfY DEVELOPMENT DEPARTMENT Y :r•C 2I660 E.Copley Drive Suitc 190 (909)860-3195 Fax(909)861-3117 / PRESS ^''"', BUILDING PERMITAPPLICATION FIRMLY N JOBSITE o ADDRESS�q��C�C1Y1'�MR � L/�� DATE�ATION .� _NUMB R O�� N� � APN LO TRACT u� S ISSUE 7yPE pCC p OWNER C/U�G 1 Lc%� DATE CONST. GROUP d p ADDRESS O L' ZONING SETHACKS �. z CITY 1:�=te:2'C�/ ZIP��/ TEL. Z REAR RW ❑ g APPLICANT � TEL ❑ � SIDEJSIDESTREET RW ❑ CONTRACTOR_Ci��- SIDE ❑ ADDRESS � CITY ZIP TEL. PROPOSED USE ' �,� o ARCFUENG/ � � � DESIGNER NO.DWEL. • NO. , N(}, a. ADDRESS � CRY ZIP TEL UNRS STORIES BEDROOMS � cn DESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREANALUATION p� OWNER•BL'ILDER DECLARATION SFR/ADD/REM O p 1 HEREBY AFFIRM UNDER PENALTY OF PERJURV T/AT 1 AA1 E%EMPT FiiDIA iHE CdlTMCTORS L4 Garaps�Carport W CEHSEUWFORTIIEFOLLOMRNGREASON(SEC.7a71.6BUSINE55AN�VROFE5510NSCl�OE�AMYCRYOR (n U CpUN7YN7/1CHRE0UIRE5ADERMtTTOCONSTNUCT,FLTER�PAOVE,OEMOUSKORRECARIANY57AUG W W TURE,GRqq TO RS ISSUANCE.ALSO fiEWIRES TME APPIICANT FOR SUC11 PERMIT TO F�LE A S�GNED w P9110IDlCk � S7A7EA1ENT TUT NE OR SHE IS 110ENSED PURSVAM TO THE PROVISIONS OF iME CONiMC70R9 LF � � CENSE LAW(CHAPTER Y(C0IAMENCN�N7M SEGTION 700a�OF DIVISqN]OF TME BUSINES&Alq Pfq POOUSpe iE55qN5000�ORiHA7HEORSMEISE%EMPi7HEREfROMANOTMEBASISfORTHEIJlFCEDE%EMV- (� TqN.ANYV10lAT10NOF5ECT10N70.71.S8YANYAPPLICANTFOflAiEPMITSUBJECTSTl1EMPLIGWTTO Z pe-Poof � ACMLPEN/LTYOFNOT►IORETUWFNEHUNDREDDOLURS�fsoo)): � OLASOVMEROFTHEPRODfR7Y,ORYVEMPLOvfESNnTNWAGESASTHE1RSOlECOMPENSATION, (',pmmBfClal YALL 00 iNE WORK AND THE STRUCTURE IS NOT IMENDEO OR OFLERE�FOq SALF ISEG.701�,BU51• � ��` � HE55 FHO VROFESSIONS COOE:TNE CONiMC70R5 LIGENSE Uw DOES NOT APGLY TO AN OWMEROF = .., • iROGERTYWMOBU0.DSORMPRpVESiMEREOH.ANDYMODOE55Up/Wt7iiNNIMSELFdiME0.5ElFON CL 7HROU6HHISIXiHERONMEMVLOYEES,VROVIDEDiHRiSUCMWPROVEMENTSARENOTNTENDEDOR m � OFFEREDiOR4ALEIF,HOWEVERTMEBU0.DINdORWPROVEMENTI55d,DWRHNONEYEAROFCOAIPLE- Z TION,TNE OWNER�BUIIDER WILL HAVE TME&1RDEN OF VpOVM10 TMAi NE OR SHE UD NOT BNLD OR = WDROVE FOR TNE DURPOSE OF SILE). O 4�OWNER OF THE PROPENTY,AM E%CLUSNELY CONTMCTINC WIiH LICENSED CONTMCTORS Q TO CONSTRUCT THE OR0.IECT(SEC.70a�,BUSINESS AND PROFESSi0N5 CODE:THE COHTRACTORS LI• Vl1118Ii0f1 � ' pDJ.AqEA W CENSEIAWDOESN0T/1PPLYTOANOMMEROFAFflOPEflT'WHOBULOSORMVROYE$iMEREON,Mq � 1M�OCONIMCTSFORSVQIGRQIECTSYnTHACONTMCTOR�S�UCENSEDPURSUMRTOMECONiMG QUANTITY DESCRIPTIOV roas ucENse uw.�. FEE � ❑11WE)(EUPTWDERSEC. B.IV.C.fORTH�SREASON Q 3 � V" DATE � OWNER = F- Z U ;:..'v� ��'. E,�;:..�: d� UCENSED CONTRACTORS CLA ION -W+ i;-� LLl ►� �"�t9��:::1�' [t IHfREBYAFFUIMUNDERPEWLLTVOFPE0.JURYTHATIMILICENSEDUNDEAFRONSWNSOFCNAPTER � d f(CWAYENCINO W17H SECTION 70001 a DIV1510N]OF THE BUSINESS AND 7ROFE95iONS CODE,AND Z X MYLIGENSEISNiIALFORCEANOfFFEGt m lL � � UCENSE CUSS UC.NO. � � V DATE CONTMCTOR 2 W � WORKERS'COMPENSATION DECLAFiATION Q � IHEfiEBVAFiIR4UNDERVENALTYOFPE0.IURVONEOFTHEiOLlANN1GDEQAMTi0N5: Z . .. � _INAVEAN�VnILMAWTAWACERTIFICATEOFWNSENTTOSELF•WSUREFORWORNERS' _ tOYPENSATION,ASPNOVIDEDBYSECTION]7000FTHEUBORCODE.FORiHEPERFOfYAANCE U Q OF THE WORK FOR YM�G1 TMiS VERUIT IS ISSUEU. � _I MAVE Ni�WILL W WTNN WORKERS COMPENSA7qN INSUFUNCE,Il5 REOUIRED 8Y SECf10N + � J700 OF THE LABOR COOE FOR THE PERFORMANCE OF iHE WORK FOR W11Id1 THIS PERIAIT IS %/ /!(j' J'�J� J ISSUED.A(YWOAKERSCOMPENSATIONWSURANCEGRPIERAHDOOLICYNUTABERARG CANSTRUCTION c�--/�S v� > e�aeA PLAN REVIEW � POIICYNUMBER � Z ELECTRIC ¢ � (nassEcrorrFmw7eEm.aFrmoFnevEaur6ioaa�Krnr�pal�saiaqoqtFssy PLUMBING Z I CERTIFY 7HAT IH THE PEFFOfiMANCE OF TXE WORK FOR WMICN iH15 PERMIT IS ISSUED.I MECHANICAL 'U SHALLNOTEMPLOYANYVERSONWANYMMmER50115TOBECOMESUBJECiTO7HE (J� WORKERS'NMPENSATpNUW50FCALIfORNU�ANDAGREETMATIFISNIXILDBECAIAE INSPECTIONFEE S SU&IECTTOTNEWORNERS'COMPENSATIONVROVISIONSOFSECTIOHl7aoOFTNEIABOR cooE,i siuu coanrvnrH coua�r win�nasE varnisiows. ISSUANCE O p OATE: APPL�GAxT: SMIP _ �- � I � ENERGY P/C —' WARNkW:iAR.URE TO SECURE WORKERS'[W PENSATION COVEMGE IS UMAM/iUL,AND SWLLL BE �y SUBJECTANEMPIOVERTOC/1lA1iNAL0ENALTIE5MIDCMLFINESUPTOOHEHUNDqEOiTqUSAND ENEFiGYPERMIT ¢ DOLURS pto0•0001.W�aT10N TO iHE COST OF COAIPENSATpN,DAMAGES AS PROVIDED FOR IN SECTiON77aeOFTHEUIBORCOOE,NTEREST,ANOATTOFNEY'SFEES. � RETENTIONFEE: � �Q OCONSTRUCTION LENDING AGENCY pRE•ALT FEE: � IHEREBYAFFliWUNDERPENALTlOFPERAJRYTHATTMEREISAWNSTMICTIONLENDNOAOENCY � Z FOH iME PERFOMIANCE OF TqE WORK FORMRIIG?f TH�S PERMIT IS ISSUED(SEC.]OP7.QV.G.). W � IENDEff5NA1AE � � LfHDEfFS�DDRE55 � TOTAL FEES w ICERTIFYTHATINAVEPEADTFIISAF7LICATIONANDSTATE7MATTHEABOVENFORMATIONISCORHECT. d IA�REETOfAYDLYWITH/LLCRYAHOCOUNT`/ORDtNANCE5ANO5T.lTEUWSPEU7tNt7TOBUILDIN� � CONSTRUCi10N,ANOHEREBYAUTMORREREPRESEMATNESOF71115COUNTYTOENTERUPONiHf ABC�E�MEMIONEO PROOERTY iOR WSPERION OURPOSES. �� COMMENTS � ��� �,,9,L� ��t 1 m v i Ew�we�rw� � � /� � � d � cn s • - y saruruaEocve f DATE � RECPT.NO. PND BY VALIOATION WHIT[—Dspsrtment Copy,YELLOW--Fnance Copy,PINK—Aseeua Capy,GOLDENRO�fik Gapy,GREEN— 's Copy ���"9i`�r• . ... ::°� .. ... ��•�=: - ; . •';1�=�, .,. '.�,. , . .e. ... .�":r,� .l.w �':. � 'P,.'�" , . . . �-. . ... . ._ .i.... ..w.. , . . .-. . +• ,`,I `.\ ' CITY O.F DIACt�Of�D G�,R•; ':.' '���:�.' - . , . �,. ; . : . ,...�. . 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TEt•.1P F'OVVER :...-: .: . F'1REPLACE BOPdD BEA��4 .��-i_,•:...� _ ._ .,, t ' . . � _..-(_---- - - ----- -- : � �VATER SERVICE �� � F�11D HT. BOND E3EAP.1 �::, - - ROOF SHEATHiNG '��j�,_`/�/�_ e FL E30ND BEAM • ' • _, � ; � � � , . -- . _... . FRAPAINGNENTILIATION FIPJAC.B�ND BEAF:1 -- � -� �- / _ . . . _ , � , . _� _...,� - - PRE-GRADIPJG .' , `T ; ROOF.�OVER ...-- --._.: _ _. ... _. _. .. . .. ��— . - - --- --- - -.. . ROUGIi HLATIP4u-..:..... . . .. .. . � .• . . . E3EI�CHING , .. . . , .,,. _ - -- �� . --- ---- RdUGH EL-ECTRIC � �-- - - - - �� � -- - � � -- � f�OUGH GRADING ,.. , , „ � '. — --- ------ ---- -- - -- ROUGFI PLUP�1f31MG � �.._ - - - - FINISH.GRAOWG - . . ' . . ; . SHOVVEFifTUE3 TEST. " - -- - . ._ -- - F'OOL ELECI RIC� � ; __ — . - , , .�. ; , EXT.L:ATH/SIDING - _. .. _ ... _ . � � p.00L FENCING ` � .. � V'JALL INSULATION � _ -- --- PJOL F�t�Jnt: � , , . , . CEIUNG INSULATION OFF SITE I"."PS. .' T� . 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