Loading...
HomeMy WebLinkAbout15618 C -� � ' � CITY OF DIAMOND BAR � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES ✓ � 21660 E.Copley Drive Suite 190 �� (409)860-3195 Faz(909)861-3117 PRE$S � 'µ'� BUQ.DING PERMIT APPLICATION FIRMLY oN JOBSITE � APPLICATION n /� f/J PERMR �Q� P/C AODRES DATE �/ U�` 1/ NUMBER U # $ ISSUE TYPE OCC APN LOT ACT DATE CONST. GROUP p OWNER` o ADDR S • ZONING SETBACKS w CITY - ZIP TEL FRONT RW ❑ � APPLCANT TEL REAR � � SIDEISIDESTFiEET RW O CONTRAC SIDE p r� ADDRES O � p �� Z�P / PROPOSED USE � g ARCHIENG/ � ,�, DESIGNER NO.DWEL NO. O. y CIDTDYRESS Z�P �L UNITS STORIES j BEDROOMS � �n DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � OWNER-BUILDER DECLAHATION SFRlADO/REM O � I NEREBYAFF6M UrAEH PEN�LTr OF VERIIIRY hUT 1 W EItEMPT FROM THE COHTR.ICTOR9 LL Gerega�Carport CENSEUWFORTHEPoLLONMMRFJ150N(SEQ70f1.SBUSWE34MIDVROFESSIOMSO00E:ANYCYTYOq (n Od1HTYWFIlQ/REOUTAESAPERMRTOCONSTRUCT,ALTER�NOVE.OEGOLI51l�RREPAIRANVSTRUC W Pata/Deck TURE VRiDR TO RS RSW�NCE,ILLSO REWIRES THE APPLK'!Ni f-0q SUCH PEAMIT TO FlLE A SIGNED W STATEYEHf 7)UT HE ON SHE LS 110ENSEO PU0.SUMR T01HE OROVIStdd4 OF TME CONTMCTOHS LF � cEr+se uw�auvrEq r�corauENceio mn�secrroN r000�oF omsan a ov n�eusn�ss r�rm vno- � PooVSpa FESSONS CODE)OR T11+1T ME OR SHE 19 EXEAIPT iNEREFHOM AND TME BASIS FOH 7ME Al1EGED E%EM0. TON.ANYVIOLATC7NOFSECfIONto]1.SBYANYIIDPLICANTFORAPEau115UBJECTSTNEA7PLICANTTO Z R&Rap} � ACN0.PENK7Y OF NOT MORE T1AH fIVE/AINDRE�DOLlARS p5o0).r � OL�30wNENOFTHEFROVERTY,ORM1'EMPLOYEESVf�7MWAGESASTNEIRSOlE00MPEN5ATqN, ❑ COmme�Gi31 - X61 DO 1HE N�DRK,AND T1E STil1CTURE IS NOT INTEN�ED OR OFFEAED fOR S+LLE(SEC.7ou,BU54 J � NFSSNAPROFE5510NSCODETHEWMTMCTORSLICENSEUwDOE3NOiMPtYiOANDVYNEROF ? PROPErt(Y WND BUlD9 Oq MPRONESTMEREON,AND Nllq DOES SUCI1Y�OfiK MMSEIF OR NENSRF Oq Q TNROUONH�SOfiHEROWNEMPL0YEE5,7ROViDEDTHAT5UG11MPROVEMEMSARENOtEYTENDEDOq Cd O OFifREDFORSAIEIF,/10NhYER1HEBUUMK70HMPROVEIAEMISSOtDVJI1MNONEYEAROfCOMPLE � T10H.hiE OVMEREURDER Y/ILL NAVE TME BVRDEN OF YROVv�O TMAT HE OR 511E DID NO7 BUM1D Oq MPHOVYE FOR TIE PVRPOSE OF SALE} �y,� ❑L1�90wNEROFTNEVfqFEHTY,M/IX0.U5NElY00NTMCTNOWfTNLiCENSEDCONTMCTORS � TO CONSTFtt1CT TME PfiWECf(SEC.)DN,BUSINE59 AND PROFF5910NS CODE T1E CONTMCTORS U- VaNation � ADJ.ARFJ1 CEMSE UW OOES NOTMPL1701W DYMER OF A YHOPEHTP W/q BV7D5 OR MPFpVES iHERCON,AND � NWCOHfRACTSi'ORStK}i0R0.1ECT5WfTNACONTMCTOR(5)LICENSEDVUR3UMlTTOTNECIXfTMG pU DESCRIPTION FEE � T0R4lKEN5E UW.} . ❑1 AII EXEYPT UNDEq 9EG 8.t V.G FOR T/MS REASON Q U u.. ¢ O�TE OvmER V � LICENSED CONTFACTORS�ECIARATiON W � �HEREBYAFFlPoAUNDERPEWLLiYOFPERNRYTTUTIAMLICENSEDUNDERPROVf5pN40FCHAiTER � (,� f(WMAIENCNUWfTHSEGTION70C010FOM510N7OfTHEBUSINE55MlDPAOFESSIONSCODE.AHD Z x W UCENSE�S N iULL FORCE.WO fFiECT. � p���S=z �--� ��,�ys ` S3 � J � WORKERS'CO!aPENSATION DECLARATIO Q NIHEREBYAFFiWAVlDFqPfW17YOFPfR7V�iYONEOCTHEFOLLOK�NGDEMRATqNS: z � _11UVEANOW�LLMAR/T/�MACEIRIFIGTEOFCONSENTRISELHNSUHEFOHNOFKERS = � ODYVENSATqN,A5PF10VIDE0BY3ECT10N7fo00FiMEUBORCOOE,FORiHEPERGOMAANCE W OF THE WONIC FOA NR11017H�3 GERMIT IS ISSVED. � _I NAVE FNO W41 W1NT71R7 WOi9(EFR'COMFENSATION INSUfUNCE.AS flEOInREU BY SEGTION � � �7000F1HE COOE,FOATHE7ERFpqMANCEOFTHEWORRFpRWHip/THISFERMRI4 � ISSUm.ttY E11 ISATION�M7CE GRPoE MA POLICY NUMBERME: CANSTRUCTION � GRPoER PLAN REVIEW � POIICY MlMOER� �� � / � ELECTRIC � �nassccnon�mrrneFan.�rmanEvesw+r�swaar+e�a�aenoatuss�s+aqoAtt� PLUMBING Z 1 CEATIFY TUT N h1E PERFORM/�f7CE OF iHE WOAK FOA WHICH TH�S PERMR I$ISSUED.I tJECHANICAL . (!3 SFNLL NOT FMPLOY J1I�Y VERSpN R1 ANY MMMER SO AY TO BECOME SUeJECT TO T11E _ .. _ . - - y WOPoCERSCd.�vEN5A7pNUw50�CAUWRM�I�NDACREE7W�TIFI5H0UlDeECd.�E INSPECTIONFEE "a10JECT TD TME vIORKEH3'COMPENSATION PROVISION9 OF SECTION 9700 OF THE U�BOR S woE i sruut Fonnn�nrn ca.��r wirn rrase rno�sar+s. ISSUANCE _ O p �ATE: APPLICANT: SMIP � -� � n n ..� i, n �! � WARNINO:F/ULUREiOSECUAEMVHKER5CO��PEN5AT10NCOYEMaEISUNUWFl1LAND5HALLBE ENERGYP/C �V ' v � �'l'�J''� � SLRJECTANEMPLOYEHTOCNIMmnLPEN1LLTIESMACNRFINESUPTOONE/M�DREDTM0U3ANO ENERGYPERMIT � �J���" � � � ��`�� � �� DOI.URS(f100.000).N�DDfT10NTOTNECOSTOFfY�IIVEN5�710N,DAAlAGESASGROVIDFOFONIN � ' ' � � SECTION]70tOFiMEUeORWOE,MEREST,AND�TTOfWEYSFEEA q�'EN'TiONfEE: �PTTT T�:l�f] �?.'�`� � -��/ a CONSTRUCTION LENDING AGENCY PRE•ALT FEE: O � IHEREBVAffiR1AVNDEFPEN/�LTVOFPERIURYTHATTFIEREISACON5TiR1CT10NLENDnafSAGENCY FOR h1E PERFOfUTANCE Of THE WORK FOR WHId1 TMS PERM1715155UED(SEG 70v/,CIV.G�. . Z W � LETAER'S NMIE C LEN�ER'SADDRESS /'� ¢ ICERTIFYIHATINAVEREADTH�SAVVUGTIONANDSTATETUTTiEABOVEWfORMATI0N14CORRECT. TOTAL FEES � '/�L //� w 1110REETOCOMpLYN7TH11LLCT'ANDCOlMfY0i7DMANCE5MlD5T�TEUWSREUTPWTOBUILDINO V � (/ � CONSTfri1CTiON,ANDNEREBYAUTNOFlIZEREGRESENTATNESOFTM5COU1+fYTOEMEHUPONTHE � /BOVE.YEIYTqNEDPR07ERTYiORINSPECfqNPURPOSEA COMMENTS � J � m E EE W �Mn � � vj SICHATUREOFVERMI E UATE � RECPT.N0. PAID BY VAUDATION WHITE--Department Copy,YELLOW—Finnnee Copy.PINK—Assessor Copy.GOLDENROD—File Copy,GREEN—ApplieanTs Copy .�.m..�-N N -- -- -- - - �..=� � :t-c� -n `r� � m m m � c) ,`L m cn 17 31 �i��-n"70 � _� cn G> m �1 2n • . t m m � � � >�= 7 Z =• m fn T 77 RI D X 2 O O O O 9 O y m r 77 r- -i fi1 I �'�. ���� �-� : fn"D �� �I'* T• �j D V7 I'n -o � -� r- r '� O C C C O b O -{ ` � O,n � -i �.� ,` . �� � ,�' �` i 'Dn � v m x c� � v c� � n c� z � m x x = � z cn � -o G� z A T a i � -1-I fil c m � O .� � Y r- zC = � rv � SOG7mmOy � n � � �� 7�}.. ��e ��, Cz ' � w A � .-�i ..�».� '•- x ' r c � o w � � -D+ � z -D+ < A i'' � � �' '� j , , cn T. Uj z G`� C � Z -i w � Z --� = c� s o in , � � ' N N : , � n z O O � � Z � � :r � m m Z m �`.�. . . ; m c� � � � . � o � m a � � o , . _--- �iB_ ��,_ z' o f�! ._-- �s ' I e :�I � !,C��i :t11i � � a � ��'J1 f �� V i�" ''� — n_ o f j "'� , � -G m o ' — � -n .3��gg m O 2 �n -n p � �n p O v �o v -n 77 w �a T m � T T C c -n -n -{ O �� z m m � z z z m -n O O o z o m 9 z � p � � Z z = p y� � Iy m < D m y � z q o "n O O O � c Z m n m m o o n � � r � r n (n r r r = � O � r � S � � m m �p O �:v�l Z � �n -i O -I (n S -i r r � 37 m � '� m 2 m N m n m D -1 T �t m 2 7,7 m O T'1 �? { fTl � p Z -i m Rl r ,n Z D O Z m D D •ii T O �- ',!� rc O ;rt� cn � --rZgvG� O DZna �n � ozpOmm � � � � :'L•J'�i Z � ,'r,y y � -*1 � � � � � � r Z -i p D z � m � � -n O O C�i� -�i ..�.�.� � ❑ i:9 z � • � cn 70 - � � W m o O � � �.�! . O 9'� o -nr � � � Gziz aDa' zcc� o ,�r Z7 W ' `n r � � � � s m � Q c�i ;�+ '� � . f r J , D � � � '� C ! � � 4 � {� �' � all� i' � . ' �.":'.f I .. �i • _ ^ i ' ��! - -, - - - 'tl�1' � ; f :;