Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
13470 (14)
� � CITY OF DIAMOND BAR ; �,�r:� _---� � ; DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21660 E.Copley Drive Suite 190 (909)860-3195 Fax(909)861-3112 PRE$$ �°� BUII.DING PERMIT APPLICATION FIRMLY ¢ DDRES � �I ,'��s ' DATEICATION �. �• � - NUMBER # ��♦1� #/C `� ,-- � �� o ��'�?�--��'� ' c� ISSUE � G TYPE OCC o APN_�_ LO e��. TRACT DATE � ' ��' � � CONST. GROUP OWNER : / � LL- ADDR SS � ' �' ZONING SEfBACKS z CITY f ( TEL� e= ,,,j , FRONT RW ❑ g APPLI ANT ' 'TE�sd` > ' `"'P� REAR ❑ � SIDElSIQE STREET RW C] CONTRACT '�'�+f ���� :��'''' r SIDE ❑ ADDR S � t-� �' � C� � �F- , �TE o � PROPOSED USE w ARCHlENG/ . ,1 z DESIGNER G����`�`J-��•''y NO.DN1EL. NO. . NO. a- ADDRE S ' � � � UNITS STORIES BEDROOMS �; CITY � ZIP TEL .` ' � DESCRIPTION Q.FT FACTOR PSF ADJ.ARErWALUATION � �` O NER-BUILDER DECLARATION SFRlADD/REM O' p 1 HEPEBY AFFlRM UNDER PENALT/OF PERRJRY THAT 1 M1 EREMPT iROM THE CONTMCTORS LI- G8f8fJBJCd1p0ll -W' CENSELAWfORTHEFOILOWINGREA50N(SEC.7031.58USINESSANDPROFESSIONSC9De:ANYCINOR - {n . --U�-__ COUNTYWHICHREUUIflESADERMITTOCONSTRUCT,/LLTEtL6APROVE.DEAiOLISH,ORflEPAIRANYS7AlIC- W Patio/Deck - NRE,PRIOR TO ITS ISSUANCE,ALSO REQUIRES THE AFPLICANT FOft SUCH PERMI7 TO FILE A StGNED W 5 - -_.�_� STATEMENT THAT HE OR SNE IS IICENSEU PUR5UANT TO lHE PflOYSIONS OF TriE CONfRACTOFS ll- � CENSEUW(CHAPTERD�q61MENCINGWITHSECTfOY70D0�OFO1VI510N30FTHEBUSINESSANDPftO- - � POOUSpB . ._�-.- FE591ONSCODE)ORTNATHEORSHEISE%EMPTTHEREFflOMANDTHEBA515FORTHEALLEGEOEXEMP- - TION.ANYVKKATIONOFSECTION70.41.SBYANYAPPLICANTFCRAPERMiTSU&lECTSTHEAPPLICANTYO �Z R@-ROD� _�_ ACIVILPENN.TYOFNOTMOHETHANFlVEk11NOREDDOLLARS(5500).): ❑I,ASOWNEROFTNEPROPEFTV,ORMYEMPLOYEESWITHWAGESASTHEIRSOLECOMPENSATION, � (`qmmefdal - ��- WILL 00 THE WORK,Ml�THE SYfiUCTURE IS NOT IMTENDED OR OFFERED FOR SALE(SEC.�o4a,BUSI- .J _ NESSAND PROFESSIDNS COOE THE CONTMCiORS LICENSE LflW DOES NOT APPLYTO AN OWNER OF � �-��: PROPERTYWVIOBUILDSOHIMPROVESTHEREON.ANDWHO�OESSIiCHWORXH!MSELFORHERSELFOfl _ m [[.: iHIqUCaMHi50RNEROWNEMPLOYEES,PROVIDFATHATSUCHIMPROVQAENTSARENOTINTENDEDOfl _g ._.WQ- OFFEREDW0.5ALEIF,HOWEVER7MEBUIIAB�'GORIMPftOYEMENTI550t➢WITHINPYEYFAROECOMPLE- -TION,THE OWNER-BUILDER WILL NAVE 7HE-eUH�EN OF VqWING THAT HE OFi$NE DID NOT BUILD OR- --Z��. IMPROVE WR THE PURPOSE OF a'ALE). - --_` ❑LASOYMEqOFTHEPROPEFiTY,AMEXCLU5IVELYCONiRACTIN6YIITNLICEkSEDCOMflAC70R5 -W(�� TO C6NSTRUCT THE PRQIECT(SEC.70�4,BUSI�ESS ANO PROFESSIONS�D'c.THE CONTRACTOflS LI- 8ltl8llOf1 A�J.AREA - :-llle- CENSEUWDOESNOTAPPLYTORNOWt1EflOFAPROPERTYYIHOBUfL�SOflIMPROVEe'THEREON,AND �_'_-- WFIOCONTflACT5FOR5UCMPft0.1ECTSWITHA00NTRACiOR(5)LICENSEDPURSUANTTOTMECDNTFAG Q(),QNTITY DESCfi1PT10N FEE - :Yi- xoasucENssuw). �, -� _:Q: O 1 Ftd EXEMPT UNDER SEC. B.8 P.G.FOH THIS flEA50N '. � .`I �� - ..�� �� ��'j. I. O [� � � -- ,� ,l .d>�G L �/.l; '� � /. 4 3 _ -LL": OATE OWNER � � � z. w �:L�=i.f�i�• i� ���� 3� � -Q-- LICENSED CONTRACTORS DECLARATION -. W ' � - - '�) � � -�� IHEREBYAFFIRiAUYDEFP'eNAITVOFPERJURYTHATIAMLICENSEDUNOERPROVISiON50fCHAPTER � ' � :�' 9(COMMENqNGWITHSECTIDN7000)OFDIVISION30�THEBUSINESSANDPROFESSIOhSCCDE.MD . Z � x AIYLICENSE IS IN fULI FOFlCEMI�EFFECT. � LLf: /p'_ y� ��. _� r�: IICENSE LA9�/ �✓ I LIC.N . : __ � � s e s _1 , ` � � , _:.V. UATE�..•�•',�CONTItACTO .. . / a , �- ._< s .. uJ.� T� � � � 3 ^ s �� . � .,ti �r� + ydr� .d -_-� _� - WORKERS'COMPENSATION DEC- FiAT10N ��i f - � - {a`� � � � . - - - � �, a } ..�:.- lHEAFBVAFF!AMl1NDF.RPEN�LTYOFPERJURYONEOFTHEFOLIOWiNGDECLARAT10Y5: � K. .4 � ��.� _INAYEANDWILIMAINTAlNACERTIFIGnTEOFGCNSENTT03ElF-INSUREFORYi9RKER�'' e = - ' -' ,_�___ COMPENSATICP7,AS PROVIDED BY SECTIqY 3�oJ OF THE LA60R CC�E.FOfl TNE PERFOflMANCE W� - ,� -- OFiT7EK'ONKFOflWHICHT115PERMITISISStIED. � ^ W. �i HAVEAND WILL MAIMAIN WORKEflS'COMPENSATIDU INSURANCE,AS ReQU1RE�BV SFCTIOhi -� � lJ��} � /'j _O$_ 37000FTHELABOACODE.FOftTHEPEflFORMANCcOFTHc'WORKFOftWH HTMISPEHMITIS f����"7 � � ISSUED.MYWORKERS' E�„��NSUAANCj�A11RIERANDPOLICV UNBENARE: - CONSTRUCTION � ��� � « _�, caaniEA � � ���� PLAN REVIEW : -a" Pa�cYVUMeER r' � � � � � � �"' � ELECTRIG _'_� . �e 4E _� ,:__W, {rwss����rvoreE�FnoF'n�aEawr�src,aon:Ewr.nnEooat�nAs�siao)oat�ss} PLUA101NG . --::Z_ I CERTIFVTHAT INTHE PERF�RMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSl1E0,I MECHANICAL " "(�" -SHALL NOT EMFLOY ANY PEHSON IN ANY MANNEH SO AS TO BECOME SUB.IECT TO7H'c - �-N� WOHKEflS'GOMPENSATIONLttW50FGAL�FORNIAANDAGflEETHATIF' k{OULCB[COME INSPECTIONFEE c,•,�1-31tY1— . SUBJECTTO THE WORKERS'COMPENSA710N PR� 10NS OF 5 IC 3700 F THE UIBOR -.�-._ E.ISHRILF T THCOMPL OSE R VISIO�. .ISSUANCE o�. 9' . . . - _ _ �.. . - ` .-SMIP � . : . . �-p- DATE: � APPUCAN• -_- _ � - W- - ENEAGY P/C F '-J-. WMNING:FAILURETO.SEC FF_WOR 'C MPENSATIONCA flAGEISUNWWFUL,RNOSMALLBE ---'--"--"- ..� . ,_J . (` .. _�. SUBJECTANEMPIOYERTOCRIM:NAtPENAL ESANDCI`JILFWE wTooNEHUNoaeorxousallo ENERGYPERMIT DOLLARS(5100.OW),IN ADOITION TO THE CO OF fAMPENSATlO',DAMAQES AS PFiOVI�EO FOR IN .J SEC7ioNa�oeOF'fHELABORco�E.INTERESLANDATTORNEV'S E5. pETENTION FEE: �' -W�- CONSTRUCTIONLENDINGAGENCY P�E-^FE � 3 .�-d.�: �/ (1} ----- -- . � -�-CC IHEREBYAFFIPMUN�ERPENALTYOFPEHJURYTHATTHEHEISACONS7aUCTIONLENDINGAGENCY V � `� eJ 3 0-� FOR THE PERFOPM0.NCE GF THE WORN FOR WHIC1i THIS PERMIT IS ISSUE�(SEC.3a9�,C14.C.). �- z ���� � W �. �_ LENDEfl'SNAME _ F- LENOER'SAD�flE55 � � ����� ICERTIFYTHATIHAVEREADTHISAPPLICATIONANDSTATETHATTHEABOVEMFORMATIONISCAFRECT. TOTAL FEE�� 1 � / . . - �. � IA6HEE7nC�AAPLYWITHALLCITYANDCOUNTYOHDINANCE5ANO5TATELAWSRELATMGTOBUI:DINCi ���� . .._ � CDNSTRUCTION,ANDHEPEBVAUTHORIZEREPRESENTATIVESOFTHISCOUN E HE �J'�) ... Z ABOyEMENTKKJEDPROP�RTYFORIN�S!g,�1cTioNruArosEs. COMMENTS �■� D r�Q ,:.- � ./� , i+�'� • 1\ �i//�l� �J � Oti-1 - _ � M / � :.-:a PE NAME i�HINT) . �s � ✓� __" � -:. � oare � � PAID B VALIDATION _ _ _. �RECPT.N0. �� ` � ' ~ WHITE—Department Copy,YELLOW—Finence Copy.PINK—Assessor Copy,GOLOENROo--File CopY.GREEN—Applicant's Copy � __ _ ___ _ ___ _ __ _ ,., __.. _ _. �� � � � � _ � � � � � � � , � � � � N �� \ ; i � ' � � ' � "� w �~-�� � ' - _� � � ` � � ! �� `� � , J' ^-� I �� � � � � '� � � i � � �' � � { � , � ��' _ " � 3 : • ° . — � � � ; � � � � ��� � � , � �` e, �`.'� �� � _ ' I � I I 4 •.,. t. r, .F�„E __,� � F ;v - � - - , � - ��- ,� �.�� `__ �_ ,. � � �; �y , �' � � ���� � .� � � ��; _.. o ������ iV !W .d� _ ��" ' � , � � � � i ty�� 4 � � .+P � , ; ^ �� (.____. U V i ��._ �( � � ��� p , � �'} ± i , : I _ ' .\\\J/���. ` "+v ' ' � ,�. , t . � : ! � � ', � ,! , , ' � � i ; ; � ; , ; , � � ! , ,_ , . , � � i i � i ! ^fj!1� �` , � � ; ' , ` ; �� � i 3 r ! 3 .,,� S � � : I i '4 ' � E � �� I f � ` � � € ! �! E I F � � I . �� , � € 1 i �:�'� � � , � , . i r t i � ` ! `'� '� s i r 3- I 3 , , r ;� ��� �> , � � ! _ yr� ^ �. V^ - �- - —' -- �� � � � �� ; . i i `V : :".�1`�•� v� - ���-r i e � I� � — �!�,. *'�.� � . � � � `�. �. 2: ` � ' �". h� '���� -y (�..�' � ��� �' � � � f ���a _ x i � � � '� ' _ r , � � � '� � , - � �� �� �: ' F � � � _ � � �� i � �' d F ti �'= _ 1 ".k �'. . - f � . � � �. � € i i e.+3 : � �_ . � � �. �� 3 - � � _ _ � ��� ; � i, � � � �' �, ;� ;#.� � ��' � �`�� �� 7 � I � I ,�� i ��"� �. , . , , � . ' � ! �J , � . : p ; E — r � , , : -- • � �.� � � i i E � i �� — � E � i � , „ ! ; � !`,� ; i I- -� . � .��s; . ; E �� � ,-�i � i '� � � �re� ` - � � �� . ' '. � ' ; �� h: � �I � � � F z�- -- �- � --� —� _ �,"",- r-'-. -�-- �. . ' , � i� " , '� � � � � 3 �' �I , � . ' i � � � � I � , . ��a , � � � � � � - . i � , �_ , i � . tiJ � - � � , i ( �- . i _ � j i � � �., � � _ 3 i t� I � 1 j � � � � . . ' E i i � � � I � � .� i i i . � , i ( _ i I t 3 � i� �� . � , . :.i < <� . • �� � ` i � � '��� � � ; _ . ._�_._._._ _: , ..�.. � z�.._..<_....__ . � ` - .; . ._� .._ .__ ___.._�___ ....._ ,__ . , � _ ; �* .�.4 _ __ ._._. __._..._.,�_ . .-. �___.,. ��_�_.r.__ �._ .�...w_.__. , . . _