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HomeMy WebLinkAbout16888 __ ...__i . . _ _ �� CITY OF DIAMOND BAR � � � ' '' � � - �F� - DEPARTMENT OF COMMUNITY 8c DEVELOPMENT SERVICES �, 2i�oE.coPi�ynri��s��i90 �5��-�- ] (� PRESS , (909)860-3195 Fa�c(909)861-3117• -. • - :F�RM�.Y . ;�•' . .BUD.DING PERMTT APPLICATION : .: . +' �' � JOBSITE �r � APPLICATION PERMR P/C �3 Q ADDRESS ��D �(�S��I� ��- ; DATE - l � ' D� NUMBERT_,M ��� � � .ISSUE •-_.,:-, 1YPE••:'�:� OCC � APN LOT Z TRACT��Zrn� ' DATE CONST. "' GROUP ' � OWNER PULTE H MES � � ZONING . SETBACKS ' � p ADDRESS 1804 VON KARMEN STE.� 200 •-� �r �,�, �,.,RW o "' CITY �� ZIP TEL Q A-'J 9']-4 , .FRONT----- -` . � �$�-.-��I� 9-�-�-a� 9 - REAR 0 APPUCANT TE� ' SIDE/SIDE STREET � RW ❑ � CONTRACTOR �41'�k�6�'n r . . SIDE ❑ . � CDDRESS ���_� TEL PROPOSED USE � ��'" \ ' .; � �` ,.. � ARCH/ENG! � ,d,n �� � tr-SI ��SSQ� � DESIGNER ��wti NO.DWEL~ NO. NO. ADDRESS ��c r� �� mj�C'�'��] �V�. G—r.R'�'—_-�4 UNITS STORIES� BEDROOMS � CRy ZIP. TEL��_9 . N DESCRIPTION� SQ.�FT. � FACTOR PSF ADJ.AREANALUATION � OWNER-BUILOERDECLARATION SFRlADWREM '� � � O _ . .1 HEREBY AFFlIW IMmEA PENALTY OF iER1URY TXAT 1 NA E%EMPT FR01�THE COHTfUCTORS LI• GAIeg6lCelpOfl �l Q CENSEU'NFOitTMEFOLLOW�NaREASOH(SEG70�1.6BUSWESSANOVROiESS�ONSC00E:ANYdTYOR : (JJ , �.� COUI(TYWHIpf11E0U1RE5APEfiMRTOCDNSTRUC'f.ALTE0.IMPRO�E.DEMOL�SFLOFIHEPAIRANY37RUC• W PdtfOJDOCk �'•� � �'�.- �. i : � 7UpE ypq�Tp�Tg/SSUANCE.ALSO PEOU�RES THE MVLiCANT FON SUCM VERIAIT TO RLE A SIGNED W ETATEMEHf TWii HE OR EHE IS UCENSW PUM1SUANT TO THE PFiDNS10N5 OF TNE CONTRACfOR3 LI- LL, POOUSpa � CENSE UW�QUPTER i(COMMENC7NO Wf7/1 SECTION 7000)OF DIVIS WN f OF THE BUSINf55 AND VRO- ~ fESS10N5 CODE)OR TNATHE OR SHE IS O(EMPTTHEFEFROM AND TME BASIS FOH iHE NIEGED E%EMP- jpN.ANYVK7lATIONOF8ECT10N7W1•68YANYAVPUCMfTFORAYERMITSUBJECTSTHEAPPLICANTTO Z Re-Rool � � A CML VEWLTY OF NOT►qRE TMAN FNE INPIDREU UOlURS(tsool t ' . . ... _.. ' � ❑I,ASOMMERDF1NEPfqVERTY.ORMYEMGLOYEE9WiTHWA(iESASTNEiR50LECOMPENSATION,� O �mmerelal � yI[,�pp THE WORK,A!A T11E STRUCTURE IS NOT INTENDE�ON OFFERED FOFl SALE(SEC.70N.BUSb J � NESS A/D OROFESSIONS COOE T1E CONTMCTORS LICENSE UW OOES NOT MPLY TO AN OWNER OF � .�FN /,2 �. PqppEqryWIiOBUILpSORNAPRONESTNEREON.ANDMAlO00E58UCHY�ORKNIMSEIFONMERSELFOR � m . . � T1qOU0NHISORHEiIOVMEMPLDYEE4.ORDV1DmTWUSUCHMPROVEMEMSARENOTNTEH�EDai ' ._ '`�;�.� OFFERED fORSALE1F.110M'EVER7I�E BU�D�NOOR MPROVEMENi�S SalDMrtfMN ONE YEA1iOF CdIDLE• Z �T10N,THE OWIVER�BURDER WILL H11YE T1E BUNDEN OF pROVINO THAT NE OR SHE DID NOT BURD OR� _ �.1Vf10VEFORiHEiURPOSEOFSALE} � OIASOMR�EHOFiHEGROPER7Y.AMEXCIUSNELYCOfRMCT71aMRT1�LICEN5EDO0NTRACTOR3 TO CONSTRUCT THE PROUECf ISEG 7W.BUSINE59 AND Pf10FE5S10N5 LODE:THE CONTMC70R5 Lt- VelUaliO�l DJ.AREA � CENSEUWDOESNOTMPLYTOANdV�7�EROFAPFiOPERTYMR10BU4DSORWPiqYE97HEREON.AND NkrOCOMMCf3FORSUCNVPO.tECT3W11HACONTRACTOR(S)l10EN5E0VUN5UhNTTDTMECONTMG p�qM�7y DESCRIP710N '� '� FEE� TdiS LICENSE UW.). � .S t1c �',.� � 0 O I IUI O(E1APT UNDER SEQ B.l P.G FOR THIS REASON U . __... . 3 � � 1 + LL' pAiE OWNER V .. -.. n .. „ ...�.. . h � lJ d LICENSED CONTRACTORS DECLAFiAT�ON W � a ' 2 INEREBVAFFWIJUNDERiEW�LTYOFPE0.RIRYTMATIAMLICEN5E0UN0ERYROV�510N50fCM�7TER � u ( - � � O., �{COM�IENCNO NniN SECTION)0001 OF OMSION 70f THE BUSINESSANO PROFESSIONS CO�E.IWD Z X A1Y UCENSE S W FUl FOFCE ANO EFGECT. � � , � . . LLI o ucENSE cuss � ��c.wo. S 1 7 S 9� J . � .. �/ ,�' .Q ti c„/' ' � p,�� n n �n n� corirraacraa nrir m� v a � o- . ri'-�-r�' �v o-� -rvmz�—+z8��- = WOfiKERS'COMPENSATION DECUIRATION a + r � � IHERE FWAUNDERVEWLLT/OFVERNRYONEOFTHEiOL10'MNODECLAMTIONS: 4 I }�r� � � IM�VEANDW�LLAWNTAINACEHTIFICATEOFCONSEMTOSEIHNSUREFORW01iKER5' - S - I '�TV OONPEN9ATION,ASPROVIOEDBYSECTION770oOFTNEU80RCODE,FONTiEGERFO1iMINCE U THE WOPK FOR WHICH THiS PFRMR 44�SSUED. � ' C � 1 NAVE IIN�M'iLL MMRNN WORKERS COMPENSATION INSURANCE,h5 PEWIRED BV SECTION �� Q 710oOFiHEU80RCO0EiORTHEVERFOfWAHCEOFTHEWONCFOHM'MICHiHISDEAMRIS � ISSUEO.WWORKEftS'CaMiENSATIONWSUMNCECMPoERAN0i01JGYMIYBERME: CONSTRUCTION � �('TFTC' FMpL.Oti'EE TNS_ CO PLANiiEVIEW t � . CAHPoER� . � �ZPOLICYMIIABER nr n�n� � o-�n r.vr� - G_1Li— E��7qIC 0 - � � —�dic�-s7v�'r—r'vr=—�zsr—.�—v-T ' � . Q �y_�ry��q7��p,p�TmpF7/EpEp,�TI6ibRpdEH1�Ui1EDpalARS(ftop)OqtE55y PLUMBING . , w MECHANICAL � /) � ICEAT�FYiMATNTMEPERFORM/110EOFTHEWORKfORWHId/TH15PERMRI515SUED,1 SWLLLNOT EMPLOYANY VERSON IN ANY MANNER 50 AS TO BECOME SUBJECT TO THE uJ WORKERS'COMGEN9ATION UWS OF CAL�FOAMA,IVA��PEE 71uT IF I SHOUID BECOME � INSPECTION FEE 1� � 6L91ECTTOTHEVYONKERS'COM7ENSATIONG110VISqNSOFSECTION77ooOFTMEIABOR IS$UANCE ocoos�sH,►��oan��eora�rvnn�nasEvaov�s�ULTE HOMES p DATE: APPLICANT: SMIP . , � � WAANIN4FAM1URETOSECUPEMIORI(ERSCOMPENS�ipNCOYENA4E15UNUN'FU4�NDSWLLLBE ENERGYP/C � [—y SUB,lECTANEMPIOYERTOCRIMWALPEt1ALTtESM10CMLFNESUPTOONEWNOREDTMOVSANO ENERGYPEFiMIT pOLU0.S(ft0o.000).NADDRIONTOTHECOSTOFCOIdVEN5AT10N,DNAAGE5A3PRWi0EDFORIN . i O J SECTION�7o�OFTHEU00ROODE.NTERE5T,MIDATTORNEYSFEES. .RETENTIONFEE: W p., CONSTRUCTION LENDING AGENCY PRE•ALT FEE: CL IHEREBVAGFlRAIUHOERPENKTYOFFEiWRYTH117MERE15ACON5TRUGiKK1lENDWOAOENGY n- FOfi iHE VERFORMANCE Df 1ME WORK WR WHICH iMIS PERMIT I5I55UE0(SEG]ov7,qV.G). . � • ' � . � ��Easr,�.,E NONE (..PULTE) � �'— � � LENDER'SADORE85 ' . . w �a�ro�,,;�,M;,,��mµo"�ORDTINANC SANDSTA�E/UWSRF�LATMl�'TOBLDINf1 TOTAL FEES . � L� ; '�c n" CONSTRUCiION.MlDHEREUYAUiHORIZEREPRESEN7A71VE50FiHISCOUI.TlTOEN1ERUPONTHE . � Z ABOVE�►IENTIONEOPROPER7YFORINSPECTIONPUNPOSES. COMMENTS � ' J � m PENMRTEE NAM_(PRIIln . � - ,_ ,5--/r--rJ/ , � siaru�u F PERIAITTEE OA1E RECPL NO. � PAID BY 'VAUDATION' � WHITE-0epartrnant Copy.YELLOW—Finence Copy.PINK—Aaussor Copy.GDLDENROD--File Copy.GREEN—HpplicanCs Copy ? ' � � . . y�.,w...r ..•�Yr'����. � . . r• . . . :y � , . . , . .., . . .. -. � , .. ... . ,. . . � . .. .. . .... � ^ �� CITY �F DIAMOND BAR , . � '��.• . -�� �, : � : ,�u�;n���r,_� `� _� ��-;�vsi:t;:;��:ih9SPECTIONiRECORD .-. r .��n�,:.t ��-�,� ;� -f '• l l ,)<,(•,;.; 1�1�_ .i ir.� •�._ �•:;, a �:'! � 1 �.J � �1 1k\> >"! . 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