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HomeMy WebLinkAbout16048 (20) � CITY OF DIAMOND BAR �� ` - � — DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES �� 21660 S.Copiey Drive Suite 190 (909)86(�3195 Fax(909)861-3117 PRESS �;�°�� BUILDING PERMIT APPLICATION FIR N JOBSITE APPLICATION n �. PERMIT P!C � o ADDRESS �3�9� CD YDT� -r/�Q rw 6�f DATE � �-� � NUMBER � ,t�• ISSUE � TYPE OCC f � APN _ LOT TRACT__ DATE_ � � �� .��� CONST. GROUP � p OWNER �,% .�2�l.fHE.Q/� i p ADDRESS�3y 9� C�.40TF SPR iNb� ZONING SEfBACKS j oCITY ��/�...e..a 'BRQ ZIP Q/Z� TEL. X 6�'��3� FRONT RW_ ❑ � �� APPLICANT TEL. SIDE/SIDE STREET RW_._ ❑ � � SIDE _ ❑_ ! CONTRACTOR (1 dNN /9_ �/'rLQ_—_— � ADDRESS_ �('(y�n /4 TY ! PROPOSED USE DF � � OE ca.a S f � CITY ALTa �o.�.� ZIP C TEt. AQ �LZ T 9-e1 -.�—�. I�f��s G ^��K� ( o '"'_.`-' /..i ,e�u„_., �-,. i c�-o � �R-3'/� 9 w ARCH/ENG/ !73� �'T` E � DESIGNER _— NO.DWEL. � NO. NO. j Q ADDqESS .�—_ UNITS STORIES BEDROOMS - � CITY ZIP___ TEL. � y DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � Q OWNER-BUILDER DECLARATION SFR/ADD/REM O I NEREBY AFFIRM UNDEIi PENRLT/OF PERMJNY THAT I AM EXEMPT FROM TH[CONTflACTOF9 LI� G8f8Q8/Cefp�ff � W CENSEL4WFORTHEFOILOWINGqER50N(SEL'.703f.5BU31NESSANDPflOFES510NSCADE:ANVCITYOR (n _ C� COUNfVWHICHREOUIRESAPERMRTOCONSTRUC',ALTC-R,IMPROVE,DEMOLISH,ORREPA�RANYSTNUC �jJ pat10/DBCI( Z TURE,PRIOFl TO I75 ISSU0.NCE,AL50 NEOUIRES THE APPLICANT FOfl SUCH PERMIT TO FlLF A BIGNEO 1 «� STATEMEM THAT HE OR SF1E IS LJCENSEO PUHSUANT TU THE PIiOVI510N5 OF THE GOt�TRqCTOFiS LI� w � � CEN5E LqW�CHFPTER 9(COMMENCING WITH SECTION 7000)OF DIYISfON3 0F iHE 6USINESS AN�PRO� LL PooVSpa ' � FESSIONSCODE)ORTHATHEDRSHEISEXEMPTTHFfiEFROMANOTHEBASISFORTHEALLEGCDEXEAIP� (�J F �) TIWi.ANYYfOLAT10NOFSECTION7o91.56YANYAPVLICAN7FORAP[RAIITSU&IECTSTHEAPPUCANTTO Z Rg-R001 �' O b f � ACIVIL PENNLTY OF NOT MORE THAN FNE MUNDftED WLLAPS(5500).)' '- 0 ❑i,ASO1YNEROFTHEPROPERTY,ORMYEMPIOYEESWIiNWAGESASTHEIRSOLECOMPEN5AT10N, � Commercia! Z WILL DO THE WORK,AND THE S1RUCiURE IS NOT IMENDED OH OFFEREU FOR SALE(SEC.7C44,BU51� J - . NESS AND PflOFE55iON5 CODE:THE CONTRACTOR6 LICENSE UW�OES NOT APPLY TO AN OWNER OF � PROPERNV'M1IOBUILDSORIMPROVESTHEREIXJ,ANOWHODOESSt1CHWOpKH!MSELFORHERSELFOR � ' Q 7HRIX10HNISORNER�N'NEMaLOVEE3,PROV10EDTHATSUCHIMPROVEMENTSARENOTINTENDEDOF m ! QOFFER[OFOfiSALEIF,HOW�EFtTT7EBUILDINGORIMPROVEMENTI550LDWITMINONEVFAROGCOMP�E f � TION,THE OWNER$UIIDER WILL HAVE THE 6UROFN oF PROVING 7HA1"HE OR SHE DID NOT BUII.D OR i IMPROVE fOR THE PUHPOSE nF SALE). W I]I,ASOWNEROFTHEPROP6RTY,AMEkCU1SIVELYCOhTiipCTINGWITHUCE�SEDCONTRACTOR3 �j p � � TO CONSTNUCT THE PRO.IECT(SEC.iON,BUSIkE55 AND PFUFESSIOh'S COOE:THE CO�`fiflAGiOflS LI� a f10f1 Z�._y�.� AUJ.AREA_.,____ W CENSEIAWDOESNOTAPP�YTOANONMF.HOFAPROPERTYWHO�U!LOSOfl{MPfiOYESTHEflEON,AND ! � WFI000N7RACTSFORSUCHPRPIFCTSWITHACOPITRACTOR�S)LICENSEDPURSUANTIOTHEIX:NTRAG pUANTITY ^DESCRIPTION FEE Y TOR6 LICENSE LAW.). __ � ❑�qM EXEMPT 11N�ER SEG_ B.8 P.G FOR THIS NEASON Q � �i _- '_--____- � " � - LL OI1TE_ �_OWNEF ___ U � z — � W o LICENSED CONTRACTORS DECLhRATION W '�� � IHEREBYAFFIPMUNDENPENALTYOFPEWURYTNATIFAIUCENSEDUNDFRPROVISIONSOFCHAVTEq � � d 9(COMIAENCINGWITHSECTION1uoo)OF�IVISION30F7MEBlJSiNE55ANOPFOFE^u510N5GOf)E.A�O Z, �_ X �MY LICENSE IS IN FUIL FORCEANO EFFECT. � � � b Q LICENSE CLASS___V_�1_.�.��c.no.�I I y z_____ � � �j DATE. 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TQTAL�C�S '�•� ' � � IA(iRF.FTOCOMPLYWITHAI�_CITYANDCOUNT�ORDINANCESANDSTATELAWSNELAT�N,TOB:1ILOWG CONSTRUCTION,PNl]HCREBY AU7110f11ZE REPRESEYTATNES OF THIS COUNTY TO ENTEft UPON THE : ZAF30VE�MENTIONEO PROPERIY FOR INSPEGTION VURPOSES COMMENTS__.___ � _ �/f ----��— ---`�— � �.��l'L�J / / /�! � -•--- -----'–_ "'— � '--- --.. .----.� m PEFMIT( AMF:(FR iJ -- ¢ __"-"- -"_ � �—a G-_6_�__—_ � -�� C -- -- ---- ------- --- -- - � SIGN HE OF PER ITiEE DATE � -- .1 � RECPT.NO.�_�_PAID BY " � � _VALIDATION _,_ WHITE-Department Copy.YELLOW-Finance CWy,PINK-Assessor Copy,GOLDENROD--File Copy,GREEN-Applicant's Copy . .. ' � ' � � . .� . ... ; . i. � � ; i , . . � . . � j .. ' . : . .. . . , . , y ' � -� � - , . ' ' , . ., � . , . ' . _ i . � - i . . . . ' . . . ' . ' '� .. . . . . ... � . . - . . . � . - ., - -' . . ' � . . . . ' � i �� - . - . . ' I . . + � � , . . ' � " , , . � ' . , � � . �` � 1 . , - L , . � ' f i � . ' , . ° • i . . _ _ _ � ' . _, , - ` -. � i . i . , ' , f . . ' • . 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