Loading...
HomeMy WebLinkAbout10670 (5) �J'_7 - - C1TY OF DIAMOND BAR . COMMUNITY DEVELOPMENT DEPARTM`rENT �,.� 21660 E.Copley Drive Suite 190 PRESS (909)86b3195 Fax(909)861-3117 �'��'� BUILDING PERM[T APPLICATION FIRMLY ;:oN JOBSITE ��it_lv� �/J„�`� Jj��,� � APPLICATION � '�,� PERMIT I /C ADDRESS �� � �^'� { DATE NllMBERy� # � IS5UE TYPE OCC APN LOT TRACT DATE CONST. GROUP p OWNER p ADDR S, � �� �I�'�/�-� Q.L(/� ZONING SETBACKS Z ITY 1 �h+� �- ZIP /7�S TEL. FRONT RW CI_ p APPLICAN TEIS� SID�IDE STREET RW ❑ z ¢ CONTRACTO C- SIDE ❑_ �: ADDRESS • PROPOSED USE � CITY1�bhL t�C1d. ZIP4rtic� �e ' o: ARCHlENG/ iz DESIGNER � NO.DWEL. NO. NO. 0.. ADDRESS � UNITS STORIES BEOROOMS `�' CITY ZIP TEL. _...�.. �n: DESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREANALUATION � p�� OWNER-BCILDER DECLARATION � SFWADD/REM O I HEREBY AFFIqM UNDER PENALTV OF PERJURV THAT I AM EXF.MPT FqOM THE CONIRACTORS L��" G8f8Q6/CBfPOR T µ W��' CENSEUWFOp7HEFOLLOWINGREASON(SEC.703t.sBUSINESSANDPROFESSIONSCO�E:ANYCITVOR' (n U� CWNTYWHICHHEOl11RE5AVEflMITTOWNSTRUCT,A1.TEfi.�MPFiOVE,DEMOUSH,ORflEP41RANYSTRUG � (JJ patio/Deck ��� 111flE,PRIOR TO ITS ISSUpNCE,ALSO NE�l11RE5 THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED'� STATEMENT THAY HE OR SHE IS UCENSED PURSIIANT TO TME PflOVI510N5 OF THE CONTPACTOFS LI�' W y " CENSE LAW(CXAPTEfl 9(COMMENCING W�TH SECTtON 7000)OF DIVISION 9 OF THE BUSINE33 AND�RO�.. �� Pool/Spa ;;., � ' '�;�. FESSIONSCODE70RTHATHEORSHEISEXEMPTTHEflEFflOMANDTHEBASISFORTHEALLEGEDEXEMP-. (�J b.; V, TION.ANYVIOLATIONOFSECTION7031.SBVANYAPPLICANTFORAPERIAIiSU&IECTSTHEAPPLICANTTO' Z He-Raof ��:: A CIVIL PENALTV OF NOT AIORE THAN FIVE HUNDRED DOLIARS(S5o0).): ���� �. OI.ASOWNEROFTHEPROPERTV,ORAIV[MPIOVEESWITHWAGESASTHEIRSOLECOMPENSATION, 0 COfIIRIBfC10I Z�:' WILL 00 THE WOPK,AND TME STRl1CTlIRE IS NOT INTENOE�OR OFfEflE�fOR SALE(SEC.]oaa,BU56 J ��. NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NOT APPIY TO AN OWNER OF � � PflOPER7YWHOBUILD50RIMPROYESTHEREON,ANUWHODOESSUCHWORKHIMSELFORHER3ELfOfl � ' CC;} THROUGHHISORHEROWNEMPLOVEES,GROYIOEDTHATSUCHIMPROVEMENTSARENOTINTENOEOOH m W:! OFFEREDFORSKE.If,HOWEVER.7HE8UIlAINGOHIMPqOVEMENTISSOI.DWITHINONEVEAROFCOMPIE- -��'�^ TION,THE OWNERBUILDER WILL HAVE THE BUR�EN OF PROVING THAT HE OR SNE�ID NOT BWLO OR Z" IAIPROVE FOR YHE PURPOSE OF SAIE�. _'� ❑1,ASOWNEROFTHEPROPERTY,AMEXCLUSNELVCONTflACTING,WITHLICENSEOCONTNICTORS W'' �%• TO CON4TRUGT TME Pq0.1ECT(SEC,70q6,BUSINE55 AND PROFESSIONS CODE:THE CONTRACTOR5ll� V8i11811011 ADJ.AREA W'�, CENSEUWDDESNOTAPPLYTOANOWNEROFAPR07EFlTYWHOBUILDSORIMPHOYESTNEHEON,AND -- — '�" WHOCOMRACiSFORSUCHPRQIECTSWITHACONTRACTOR(S�LICENSEDPURSU�NT70THECONTflA0. QUANTITY DESCRIPTION FEE �- TORS IICENSF LAW.�. Q.:'. /� ��/�q J., Q.. C:i i AM E%EMPT UN�Efl SEC.__,__ .__B.8 P.C.FOfl THIS REp50N U �J+ L./{/1f.1 �/`�1�iP j �; ------- -- ---� o� 2 Lbr� �d `.S' �(0 �-� DATE __ OWNER___, F' z' W � / Yv .tl vt�,K- e ��� LICENSE�CONTRACTORSDECIARATION W .S^ � �C d• ��` 1 HEflEBYAFFIRlA UNDER PENALTY�PF.RAURY TNAT IAA7 LICENSED UNOEfl 7ROVISIONS OF CHAPTEfl � �d� e(COMMENCIN6 WITH SECTION 7000)OF D�VISION 30F TH[BUSINE55 AND PROFESSIONS CODE,AND Z X�� MY LICENSE IS IN FULL FORCE M7�EFFECT. +� Q. LICENS C SS ��� _, LIC.NO.�✓����� � �-- —�_ _ _ � , . ~ DATE� �� � CONTRAC� �� r�t.�'� a w': -�'--- '�� ��i WORKERS'COMPENSATION DECLARATION ( �„�{•�G U 1 yl "/G" ( � IHEREBYAFFIqMUNDERPENALNOFPER.IUHVOkEOFTHEWLLOWW6DECLARATKKJS� � ' Z � ^INAVEANDWILLMAINTAINACERTIFICATEDFCONSENTTOSELF�INSUREFORWORKEflS' _ GOMPENSATION,A3 PflOVIDED BY SECTION 97000F THE LABOR CODE,FOR THE PERFORMANCE W yf THE WORK FOH WHICH TMIS PERMIT IS ISSUEO. � W % � IHAYEANOWILLMAINTAINWORKERS'COMPENSATIONINSl1RANCE,A5RE0UIREDBY9ECTION Q 37000FTHElABORCOOE.FORTHEPERFORMANCEOFTHEWOflNFORWMICHTHISPERMITIS ISSUED.M/Yy�gy�"1{E/pp,��CO PENSA/ye�•INSU�RA�NC�E CA/g�n I9p AND POLICV NUMBERARE: CONSTRUCTION � CARRIER`._F�i<<� \��°`� �"� PLAN REVIEW ! 0 POLICYNUMBERL�"�vJ 7�o�O � ' �/ '� , Z -f-"�- r£CECT � _ � ¢ (IHISSECTK)NNE�NDTBE�MPLE�EDOFTHE7EPo1YtLSFIXiCNEFANY%�E�OR�E�s1� PLUM9ING 0 V � ICERTIFYTHATINTHEPERFORIAANCEOFTHEWOPKFORWHIGI7HISPEflMITI5155UED,l MECHANICAL __, (,'} SNALLNOTEMPLOYANYVEfi50NINANYMANNERSOAST E ESUBJEGTTOTHE � WORKERS'�OMPENSATION LAWS O�CAllf NIA, A T IF 1 SHOULD BECOME INSPECTION FEE '_ � �_ = SU&IEC7TOTHEWOHKF.flS'COMPENSA7I PR I S F TION37000FTHEIABOfl GODE SHALL RTHWRHCOMPIVWIT NO P IS YSSUANCE ��__ ,J L p ��� p DATE�__� APPLI . _ SMIP .._ _ J WARNINO:FAILUflE TO SEGURE WORKERS'CO ENSATION COV AGE IS UNUWFUI„AND SHALL BE ENERGY P/C _ �y: SU&lECTANEMPLOYERTOCRIMINALPENALTIESANDCIVILFINE UPTOONEHUN�REDTHOUSAND ENERGYPERMIT DOLLARS(5100.000).IN ADDITION TO THE COST OF COMPENSATI pAMAGES AS PpOVIDED FOR IN � SECTION370BOFTHEUBORCODE,INTEREST,ANDATTORNEY'SFEES. RETENTIONFEE: _ a CONSTRUCTION LENDING AGENCY PRE-ALT FEE: ___ O � I HEREBV AFFIRM UN�Efi PENALTY OF PERJUflV THAT THERE�S ACONSTflUCT10N LENDING AGENCY __ . FOR THE PFRFOflMANCE OF THE W�FlK WF WHICH THIS PEFlMIT IS ISSUE��SEG 3097.CIV.G). Z W — � LENDEFi'6 NAME ___._ _._ __ _ F— LENDEF'SADDRESS_ __ a ICERTIFYTHATIMAVEREMTNISRPPIICATIONANDSTATETHATTHEABOVEINFORMATIONISCARRECT TOTAL FEES � Q IAGREETOCOMPLYWITHALLCITYANDCOUNTYORDINANCESANDSTATELAWSREUTINOTOBUILDING � CANSTRUC710N.ANDHEREBYAUTHOflIZEFiEPRESENTATIVE50F7HI5COUNTYTOENTERUPONTHE Z ABOVE-MENTIpNEDPpOPEflTYFO INSPECTIONPURPOS . Q ��� �� A� COMMENTS _ � ��V m PEFMI EE N I T) � � � �� IC flMf1T DAT � RECPT.NO. PAID BY VALIDATI � � WHITE—DepaAment Copy,YELLOW—Finance Copy,PINK—Assassor Copy,GOLDENROD--File Copy,GREEN—AppllcanPs Copy � � _ _ M_ __. _n ._. _m _.�i -`~� - _ f �� , 7.._. � � I ��` �� _,� � � �. � � � � , ..�,_ .. _ a: � � e ` � ( I I ..+ ', � i .I.,�. � '. . -.� . I � ��.,:r � K � � :.. .'I 1 �I I � .. � -j � I M1 I, � I � I�, � � � � :.4/t'I' � . i I � ? � ^ ! I � � ' � ; � ;� � j I ;:i •-F ° � � i � .� � , � � � � , I �.( � i i .! : 1 � I.. I ;:4.� I � I �' I ��... ' � a t :� i . E . ' ! . � � I` � � I � I "" � i'. 'I � �� .I i ��.� f: � _ -' j I� j_,� I _� - � 4 � r' � � ,! � . �� � � _--}-� = -� �- � �. � ' i 1 �c���_ i � { � � � ; � I, i` ' I � .� � � � � , i �� , � , � , , 4, � i � d � �� �:. ,1. ;' � i I - � i I � - �i ` a � , ,_ f ._ .. _ _ � _ � . I � , � �r � _ � , i � ;�� � � ��� , ��� �•' I 'i , � _. . 4n� �� �L � -- � � t j_ ��. I �� r{_ J � �.t . �� i � � �� � � �� � -�: �-�i F: �� � ��'� ! ..� I ����� ( i i � � gy 'I�IZ �{.: � � �� I --.� " � 1� �I!: . f '-_I .� ' � t .I '. I I - Iy,YI ! ��� � , ;��.,� '��,��� �. � '��� � �: I ��. ; .,� �.��; . , ..:i , �f 4 -� , ;: 7����` , �- ! A� � ' . I �G�� m �� I .: . ' . i ' S � 1 f �".� � � U�� o � � tii � � � �I � �ca:k ��'z � i :� ' 'I i ' � � i. � � � I }, �; � � I�2.�l�i�,� a w z�c� � : � I 1�i �c �.�a � � I ( �I _ i ,,1 � �.�, � icc�lT�p,ol w m c7{' io �i�iz� �vil�,4 ,a ���jl? �i� i, . � G: .� : � ; f � s r- o��a ,� mici m z ��o,;� :{�� i Iz � s i � � i f ' , I � � v_; a- �' �I o �� z cir n. � i � ��e o`* w ��bI� a_ o c7 � �wiz ¢ �it's c� � ��z�a.o u�i� { i ' �, � ' � ; i ' I �'9a� � O �I�V��{.� C? �i,'aI Z I(� � 7 � C.� -J tdJ I Z.L'al t_ �I� � .7 I � ?� �,a � '.�'� � � :. �:" ��� �I � � WIW � C�`�{ �� l7. `� Q i.L �I I ��i^- l._.�� I " ~ .�.. I I I..; .� ......� ,..� I . _ i � ols�z z _�clm ' � �I� z � � w z o�zl�i_ �' � .: i ; I , ` �.... I .. � � - ; I— � Q x w ��� �-- ¢ w .� � �� u_ � � u. � ��m y � JI�nJ � � � � � W,o�n�� c`i � ¢ wca'�Iui��a�a�0�I[a �i�lO�u.. � w wi;wi - i �.. �I i... � �. . i I i I Q 7 '� � � � I__ _ ��_�T ��-��� . I� . ( I; t I' � I- f ���' � ..-�I �...,e� j--r T � -1 � , � i � � � �"� - � i ��, 1 a ��: � � � � � � �" � ;� '�. � ='` , � 1 i' �; -� . � (' I � I ' - � � � � � I � � � L � � � ( 'I �. � � � � � � �� � I' I i � „ r -, � � i�.�' � � � I - � � , , ; , i I' ,_ � ; � , � � i � !I i � i. . I I2 �'-, F i� ' I� � � I� I � �. ` � �� ( � I I . 7 I 1 ; . � �: � ��� I: [ : ; ; � ; f , f � , ��� �� � + I � � +�. �'i 1 � ��� i � ���� � _ ��� I �� .�� �� __ �_ � : �,���� . ��_a � � � � � ��� �� ��� �! � , , � � � . � � � � i ;�� i I � , Ir , � i �� � � �i �� i � ` ` ,` � � a � � � . I �; { '� � �`� i � ,� �� I � ; a � � ; ��;; � � ' � o i z � � �� � i 1"' ' I � � w z z �� i . {� c�j� �z a t^� .(� �. �� i �'' ' � ^�w � - r � m , w�z ="� ���5 ��w�Zl� ¢ � ��' I �.;._� �(.��C71 � � I I' - ; � ���. lcnN mO � '� ' Ux `- Zrca �-�_ �I� � F,. ��Ic��z'd _I :9S i I�trn ¢'�I ' � �I� z s�FIU � m G � d Y� r'. �. ml 1 '4— I. I I � �. g C7�-� p�w � ¢ � u ¢�w � � ��;�ic� � .�{'' cnl-p�r--�G�� i 'i �� �� -' � I . B'? Y � �ia��'� u� w Z � w,�IJ � a �IJ a�d � � a �: �i� ;` t3.9 ! r� � Q C7 (A 2 O 2 11''1 Q ��4Z — �I F- �-- O"f.Li � 9 '� . ° Q O � � � �. � rn � c� .a:.�x x L" �I? � alccIU a!t� c� aIw al � � I, 1 f ' U a. F-� � t` u.�C7��C7�t7 �� -,-�I ��4F- a:l¢ JIJ�..s .rl ��� �,� I'. : F-2�. ' � � v � m'� r o ¢ o,� � � n� �� �i��`s � w rr a ¢ia a, w ;� .� e� gfu; �Io rz O�o o�ol,� �x�¢ u. s;us�w wid ���I���� � ��o.�n ` u� u. u c� �r!t- � �,� s;¢:� ¢ cn u� � c� �.cr, �r <n � o� u.i� u:i s� ; ;> �__!__�_._J__�. 1_�_�_�._�_�.�_.�.�.��_._�_�.�....__..��. e.�� -_ . _ _ .�__�-�.�.:�:—.�