HomeMy WebLinkAbout13208 _�� CITY OF DIAMOND BAR �
DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES
21660 B.Copley Drive Suite 190
(909)860-3195 Fax(909)86I-3117 ' PRE$$
` �'�^'� BUQ.DING PERMIT APPLICATION FiRMLY
� JOBSITE 2
Q _�_��o o APPLICATION PERM�T P
< ADDFiESS_Js� .�tY� �E�i�C DATE fI'I J I� NUMBER M ���
$ ISSUE��— TYpE pCC
APN LOT TRACT DATE CONSI: GROUP
p OWNER __Q�t �1d�P�-�y
' o ADDRESS_S�F�v�e a� rl.Q.o�' ZONING SEfBACKS
W CITY�:+•••...t �3A2 ZIP Qt G FRONT RW ❑
� APPLICANT��12s..� n'�l/e:� TEL,7(q�1[7f,4/6S` 3
REAR ❑
� , SIDE/SIDE STREET RW p
CONTRACTOR�/N��r�.�rc .40n �rse.�s SIDE ❑
� ADDRESS S '� � PROPOSEDUSE P��oa�ta �CR¢a/g� /�•q.T/s F �t�.oSu s
� C�C �V/l�f�,. ZIP�' S3/ EL�14-R'11-9/bs Dp, 5.�4 SCJ.�T
� DESIGAER Lr•- �,�� T�S�t Cr
ADDRESSSv c VG{,.�� _, tvL�...�;.,� .{..��,+a-f UN1TS E� � STORIES 2- BEDROOMS
� CRY �of Si-.eY ZIP 1LZq�. TEL
� DESCFIPTION SQ.Ff. FACTOR PSF ADJ.AREAlVALUATION
� OVJNER-BUILDER DECtAAATiON SFR/ADD/REM
O
8 i MEREBY AFFIAY UNDEii iENKTY OF PE0.A/11Y iluT 1 Mi E%EMVT FROM 1ME CDNTMCTORS LL Gara�a/Carport ,
CFNSEUWFOqtNEFOLLOWMOpEASON(SEG70.t7.6BV5WE5SANOPROFE5SqN500DElVfYCT'OH (/�
� COUH(YMR1KMfiEOUlitE9R9ERMf�TOCON57RUCLKTERIMPRGVEDEMOL1410qREVUR/NYSTRUC• W P91idD9Ck
1WiE VR�OR TO ITS ISSUANCE,AL50 RFQUIqES iHE APPLICM/T FOq St1CH PEPM�7 TO FILE 1151GNE0 W
� 2�REMENT T/u1 NE IXi SME�3 IICEN5E9 PURSUANT TO THE�ROVISqN4 OF iHE tdJTRACTOqg t4 �
� CENSEUW(dfAPTER�(COMMENCRl01N7HSECT�d17000)OFDMSqN90FTHEBU51NE55ANDPRO- P��Pe ,
iESSqN4CDDElOqTHATHEOR5NEI3EXEMPTMEREFROMANOTIEBISI4FOATHEAIi£CEDEf(EfAP- (�
Tq1/.ANYVqlA710NOFSECT10N7VJ1.68YANYMPLICMfTFORAPEFMIT5UB1ECT5iHE117PLICAHTTO Z Re-Rool
� ACN4PENNAlTYOFNOT1.lORETH4NFNEMIMJREDDOLWi4(5500)l:
O ❑IASOVMEROFTMEPAOPER7Y.ONIdYFYPIOYEESMTNWAGE3A4THEtRSd.EC01ACENSATIdJ, 0 COmrtlBf�lal -
� �('1l1 D�i}tE N'OPoC�17D 7ME STFiI,'CTl1RE IS NOT IMENDEO Olf OFFERED FOR S/�lE(SEG 7oN.BUSF J
N NFSS/JDVRDFES510N4CDOETHECOMfRAROR4LICEN4EUWDOESNOTAG7LVT0 Al10WNEROF
PiqPERTYMhqBVIL.D30RMFqOVESTNEAEON,AND1NqDOE55UGIWORKHIMSELFOflNERSELFOq � .S�
� 1HIIOtAHMgOfiHEqON�NEMP�OYEE9,VROVIDECTTUTSUG1u.�FROVEMENfSARENOTNTENDEDOR m
OfFERED fOH SALE IF.lqWEVER TME B�iDtN(30Fi MPROVEIAENT B SOLDN4TMN ONE YEAq OFGOMPLE•
Z t10N.THE CAYrtER$UMER VNS HAVE IHE 9URD£N Of 7AOYP�O 1HAT NE OR SME DID NOT BVM1D Oq
� w17iqVEFOH7Y1EiURPO5E0�511LE1
� O1�30NNEROFiF1EPHOPERtY.NAIXQUSNELYCONTMCiNOWRi1LICEN5EDO0NTRACTON3
TO CON3TRUCT TNE GRO.IECT(SEG 70u,BUSINE54 MA PROFESSION4 C6�E TME CONTMCiOq$L4 V81U6tI0f1 �_ ADJAREA
� CE1i5ELAWDOEJNOTMV�YTOMIOYMEROFAPflOPERTTM'MOBUIL➢SOROAPRQYESTiEREON,IJA
�� N7qCOHfMCTSFOH",.l1pIFA0.1ECTSWITHACONiMCTOA(5)LICENSE9PUFSUnMTOlF�ECOHTMG OUANTITY DESCRIPTION �E
iORS UCENSE UW�.
�� O 1 W IXEI.ICT UAER SEC B.1 P.G fOq TH�S REASON Q / �
U
�—`' o�� ovvrrEn V ,
'�, w
�6 UCENSED CONTFiNCTORS DECURATION W
¢ IHEREBYAFFIPlAUNOEqPENkLTYOFCE0.NRYT11�T1�4lICEN5E0UrAEFPROViSqNSOFpUP7fq � +,n
s f(W W�ENCNO WfM SECTION 7000�OF Om5lON J OF iNE BUSiNE55 AtiD PROFESSioNS COOF,ANp Z q�
X W UCtNSE t3 N FlAl FORCE AND EiFECi m
o uc�se cuss � uc.�,�. S4/7 3 3 �
� w� � � �f 9 corrrRacroR qm��.�e �Q�t-rTh� a - �-
1
� N'ORKERSCOMPENSATION�ECLARATION ���� Q ��T ' • �t3Ax
� 1
yINEREBYAFFIIWUNDEHPENfLTYOF►EMIRVONEOFTHEfOLLDWW00ECLAM 5: Z UII.DTiVG AND Sr'+FETY
� �I HAVE A/A NML WIMANA CEFiTI�IGTE OF CONSENT TO SEIf.IN3UPE fOA NOANERS =
Op�PIX5�1qN.AqPHOWE68YSECTI�N�7WOf7HEU&MCOOf.TORTMEPER�ORM �U
Q OF tME W01M(FOR Nkl�dl THi4 CERMR iS ISSUED. �
_v IHAVEANDWIIL►UMTAMYlOPo(ER4'CqA7EN5ATqNINSURANCE.�5RE0UiREDBY5ECT10N
Q �` 3T900iT1fUBOqO00E,Wq1NEPFRPoRMANCFOfTMEWOflNFOAWH�C/1TMISPERM1T15 I /��1.,
ISSUm.MYNOPo(ER9'WiIPENSATqN MSVANOCE CARPoER ANO P0.1C'/MIMBEHME CONSTRUCTtON �� f %%-�J -
� CMPoER s � PLAN REVIEW /�
Z POI.IC`f NWBEA �j Q B�S� £ � ELECTRI(�, 'V•
¢
0 (rta5stcrnnrgIDrnreEm.nFrID6nfvEa.ri6wr�ar��awr�[n0ottuuls>»caiE..s� PLUMBING
Z ICERTIFYTHATNTHEPERFOiAIANCEDFTHEWORKfORVrtndfTHISPE��TI515SVED,I MECHANICAL
(.7 SHALINOTFMVIOYMIYPER50NNANYMANNERSOA370BE ' ' TOTHE
(/� MVM(ERSCOMVENSA1qNUW90FCNJfORMAAND114REE IIF15�101ii INSPECTIONFEE
S SUB.lECTTOTHEWWIKER4COuvENS�T�ONFROVI510NSOFSEC f7ooOfTHEU80R —
aooeiswuFomNvnnica.�rtrvnninasErnovisav � ISSUANCE �
O '
p DATE: � APRICANF. SMIP I•r D
� W1JmiNO�F��URETOSEWA£W`ORICER5COMOENSATKKiCOVEMCEISUNLAWfl1LAND5W�118E ENERGYPIC
�y SUBJECTNiEMPLOYERTOCRRI'NAIPENAL71E5NJOCNILFNESUPTDONfMJNDREDTHOUSAND �ERGYPERMIT
OOLLIR3(f I00,000).kl PDOITA7N i0 7HE W5T OF COM7ENSA7qN,DMIAGES AS PROVIDEO FOR IN
� SEGTqNiIoeOFT71ElABORCaOENTEREST,/JiDATTOiiNEY3(EES R�E������ � /r/
II!
O CONSTRUCTION LENDING AGENCY � .qLT�E� •
� IHEREBYAfF�iWUNOERiEN1LLTYOFPERNRYTNhT1HERE�SACONSTRUCTdiIENDINOAGENCY �y(�
d FOR[HEDERFORIAANCEOLTMEMfORKWRYM16171114VEPA17TI5155UED(SEC.]ovl,C1V.C). ��
�
� IENDER'9N�1ME
C LE/AERSADDRESS
� ICER7iFYTMATIHAYEREADTNISAVPLICnTqN/JAST�TETIATTMEABOYEwFOHMATiONISCORRECT. TOTAL FEES
� IA�REETOCOM7LYWIT1ALlCT'ANDCOUNT'ORDINANCESANDSTATEUNSRELATNKiTOBV4DiNQ h
� CONSTRUCTION.ANDMEREBYAUi110RIZEREPRESENTATIVE50FTHi5COVNTYTOEHTERUPON�� /A/
Z ABpyE-MEMqNEDPROPfRTVFORINSPFCf10NPURPO5E5. OMMENTS� v�
9 � �s1 /V i
m MIT7EEWWE(Pfu
Q �
y SM,1uNHEOFPERMIT7EE DATE RECPT.NO. PAIDBY VALIDATION
� WNITE—DepartmentCopy,YELLOW—FlnnncaCopy,PINK—AesessaCopy, OLDENFOD—FileCoQy, REEN—Applicen sCopy
__ _____. _.__� _ --�-
------- ---- , � ,
--, - � --- � -- �n :r� '_ i _ ' .' � � , � :`��,) � �',� �;'m a � .�m�cn1-� � � 'z;-,��� :�-+'��'m � � �.
� � r'f-� ir�m�T rl ylY. S.'O U � Oly � n �
m �tt l I r> I � I .r,�n� -a r r r- r+ O c�c c, o x =>�m 'v x O � � d ,= �
� ' .. �� � � � = 1 � �F-I� ry-'� y, �o -i R I Ir I<- �i �;IL� � =: ;n ]J C z '� � ;• , . •
i = i �� : ;, -c n't;-i c� �,I� c� �: i;I�� _. �In`i s c; ' co � � D�p O n ••1.
� , � 'U£� _ � � r r T-� t� '� -� � - cn = � ro tn I=�C G� 2 m o �- c
�< z> ' n S
1,� � I � � �I'.{ m�'_ n -- inc �nccn �i< � !nymp -ro ��.- ��
E x � " I : ` ' �� c� r- ;- `nc � � n � � � ={ <_ 9mc - v; ��,
�11.Y� � .. C:.f. ;'j " --1 w J ' --I � • � � O ¢7 � Z -i S n � O fn ,.,i ,
, ln'� . � ��� n - � O ' m z � G� r_ z m m c � uk.
. � � '�, N C!) _ � I f7 =� 7 �� � G� (7 �, G7 � m �:
. . ' ; fit� �` O "i —O �I� r'r'% _
k.l_..__.__.._._�1F...____.,�.._ I I S- �,'� .
_� — � - , � � ��I
' __ � i ��
-- - - ; � �i
� �_ _- `' J -i " �. _ i � '.� � �
�'0 1 f� ,,,�
'i -- �� "t - � T17 O
— — � � �1
� ,a':' � O 2 '?i T O � T�O O � � 'D �l 37 QI � ?1 ca 7 T T C C �l T � .
P mm � zZ Zm -� 000zom � Z o � nzZ = o .:_� 0 D
Y� , �ya m` < y m � � o � o � O O O � c � m a � _ � v � m � � =�; � S
/ �.:� � „ rioN -� cnma � _ � ? � o � r z� � n, �
-� i' �. ,h ; � 'E�„ ,.� m 2 v O m � � m a tn rm- G� � z D O,Z m n.�c� � � p p �� � � �.
, ,.,y v� � -i Z � v G� O - D z m �l 9 � � zD•O.z rtT tn p p � � ��i � �
� "' - :-1 D -i Z G� � � � �n r Z � Z � � m:m � p O 9 � � � 'S'�. �
`' �' '''�r�ti � -n a SJ � C7 � Z D ��,� Z CZ C7 0 �� � D
,j: _ � _ n �;� 9 z r � � - �.. s� ni b Z n �- d �1 I
- � - i�"'! 5 �. � � �
- � � � r � � �;o � i
� � � � �' �
s �� � _ �=-� -
, �� _;
'' _ , T�r� ��Fi � .
.� j : i., ' � �
I��� �n � ( il���
, 7 �..
1 r/ L�. ; _—�_ — — _ _ �
'j�\ 7'1' _ '
��. r� � :1', .
'� '� \ - - .5� ' ���'�,
, I . _ - l '. '.�F.,.
. �,. .-�' ��� �.
�
i''-" I _ o �
t I �'I
�'.I / _ - _'' I"- . „ II