Loading...
HomeMy WebLinkAbout17028 __. _. _._ _ __ _ _ , CITY OF DIAMOND BAR ` -�`` - DEPART[vIENT OF COMMUNITY�DEVELOPMENT SERVICES I 21825 E.Copley Drive (909)860-3195 Fa�c(9U9)86L3117 PRESS �%�%���� BUILAINGPERMITAPPLICATION FIRMLY � JOBSITE ^ G.� (� r, o ADDRESS�;���.J ✓'Ce ( APPLICATION C�, PERMIT P/C f � Q� DATE �-/ , � NUMBER�J?_o�# �` � ISSUE TYPE OCC '° `� APN LOT ���U�� �,,�TR CT �P� DATE CONST. GROUP p OWNEF��r a�Q-�P1Cl fi���S.tP� � rVl�r� p ADDRESS�.fi'�Yr ZONING SETBACKS z CITY�_ ZIP TEL. FRONT q�/�/ ❑ o APPLICANT . ��v Y3'l�7�i�y� TE�.� � 'pj. �j REAR ❑ z �- SIDE/SIQE STREET RW ❑ ¢ CONTRACTOR' � ^=i'S �i✓1 � �� SIDE p ADDRESS ' �'> '" � O ��n,��.,�i,G�-✓' 7�P -1 PROPOSED USE �f o �.,�� TEL. w ARCH/ENG/ z DESIGNER ~ � �jj � � i w NO.DWEL. NO. NO. � ADDRESS1�"J� _� .. G - UNITS STORIES BEDROOMS � CITY(�b�-'1✓FJ ZIP' l'� '?/ TE�.r � �ESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O p 1 HEFEBV AFFIFM UNDER PENALTY OF PERJURV THAT 1 AM EXEMPT FROM TNE CONTRAC70RS LI- GHfe9B/CefPOff W CENSELAWFORTHEFOLLOWMGREASON;SEC.7031.SBUSINESSANDPROFESSIONSCODE:AN�CITYOR (n U COUNTYWHICHREQUIRESA7ERMITTOCONSTRUCT.ALTER.IMPROVE.OEMOLISH,ORREPAIRANYSTRUC. Z TURE,PRIOR TO ITS ISSUANCE,ALSO REQUIRES THE A�PLICANT FOR SUCH PERMITTO FILE A SIGNED W PatiolDeck w STATEMENT THAT HE OR SHE IS LICENSED Pt1R5UANT TO THE GROVISIONS OF THE CONTRACTORS LI- W � CENSE LAW(CHAPTER e�COMMENCING WRH SECTION 70Do)OF�IVISION 3 0F TH_BUSINESS AND PRO- � POOI/SP8 � FESSIONSCODE)ORTHATHEORSHEISEXEMPTTHEREFROMANDTHEBASISFORTHEALLEGEOEXENP- � - U TION.ANYVIOLATIONOFSECTION7091.58YANVAPP�JCANTFORAPERMITSUBJECTSTHEAPPLICANTTO Z Re-Roat � ACIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED OOLLARS(SSoo).): Z ❑I,ASOWNEROFTHEPROPERTV,ORMVEMPLOYEESWITHWAGESASTHEIRSOLECOMPENSATION. � Commercial WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENGED OR OFFERED FOR SA'_E(SEC.7044,6USI- J N NESS AND PqOFE5510N5 CODE:THE CANTRACTORS IICENSE lAW DOES NOT APPLV TO AN OWNER OF � PROPERTY WHO BUIL�S OR IMPROVES THEREON,AND WHO DOES SUCH WORH HIMSELF OR HERSELF OR CC THROUGHHISORHEROWNEMPLOVEES.PROVIDEOTHATSUCHIMPFOVEMENTSARc'NOTINTENOEDOR m Q OFFEREDFORSALE.IF,HOWEVER,THEBL'ILDINGORIMPROVEMENTISSOLDWITHINONEYEAFOFCOMPLE- Z TION,THE OWNER-BUIIDER WILI HAVE THE BURDEN OF PFOVING THAT HE OF SHE DID NOT BUILO OP� � IMPROVE FOFTHE PUPPOSEOF SALE). w CI,ASON7JEROFTHEPROPERN,AMEXCLUSIVELYCONTRACTI�GWITHLICENSFDCONTRACTORS [[ TO CONSTRUCT THE PROJECT(SEC.�041,B�JSINE55 AND PROFESSIGNS COCE:THE CONTflACTOFS LI- V8IU8IIOf1 ADJ.AREA W CENSELAWDOESNOTpPPLVTOANOWNEROFAPRDPERTYWHOBUILD50RIMPROVESTHEREON,AN� � WHOCONTRACiSWRSUCHPPOJECTSWITHACONTRACTOq�S)LICENSEDPIIRSUANTTOTHECONTRAG QUANTITY DESCRIPTION FEE TORS UCENSE UW.). �{ � ❑I AM EXEMPT UNOER SEC. B.&P_C.FOR THIS REASON Q � lf �S � � � � � ��N � DATE OWNER 1- � � 4 e Z W T � LICENSED CONTRACTORS DECLARATION W Q Sl� Q l'y � I HEREBYAFFlPM UN�ER PENALTV OF PERJUflV TFAT IAM LICENSED UNDEF PROVISIONS OF CHAPTER � ( � 9(COMMENCING WI7H SECTION 7000�OF DIVI510N 3 0F TH_BUSINESSAND PROFESSIONS CODE,AND Z /� • X MY LICENSE IS IN FULL FOnRCE AND EFFECT. �LL' N _�dp,-,r I��� � � L� � LIGENSE CLASS L' LIC.NO. � ] V DATE CONTRACTOR�1� ��Lq�-K�7'6'� d � ` W � WORKERS'COMPENSATIONDECLARATION a � � � �Q � IHEREBVAFFIRMUNOERPENALTVOFPERJURYONEOFTHEFOLLOWINGOECLARA710NS: Z � A�� �C9 `�p a /'E"V O Z _I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT i0 EELF-INSURE FOR WORKERS' _ ¢ COMPENSATION,ASPROVIDEDBYSECTION37ooOFTHEIABORCODE,FORTHEPERFOflMANCE U C ��y �a Q OF THE WOFK FOR WHICH 7HI5 PERMIT IS ISSUED. � QW _I HAVE ANO WILLMAINTAIN WORKERS'COU�PENSATION INSURANCE,AS REat11RED BV SECTIDN 3700 OF 7HE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PEPMIT IS s��� . �� ISSUEO.MVWORKERS'COMPENSATIONINSUFiANCECARFIEqANDPOLICYNUMBERARE: CONSTRUCTION C j CARRIER PLAN REVIEW T'� �" POLICY NUMBER z ELECrRIC . , , r G� Q ,.� ..�q�,�,......�_."----._ � (MISSECTIONNEmNOTBEQNAPLEfE00FiHEPERMTISFORONENUPDRED0011ARS�E100)ORLESS). PLUMBING ���''^' ,°ra'`„�„�`:.\ I f �����];'y� � S C..� W '� . ... . „ � ^l Z �CERTIFYTHATINTHEPERFORMANCEOFTNEN'ORKFORWHICHTNISPERMITISISSUE�,I MECHANICAL V '(3' SHALLNOTEMPLOYANYPEFSONINANYMANNERSOASTOBECOMESUBJECTTOTHE [/� WORKERS'COMPENSATIONLAWSOFCALIFGRNIA,ANDAGREETMAT�FISHOUIDBECOME INSPECTIONFEE � SUBJEGTTOTHEWORKERS'COMPENSATIONPROVISIONSOFSECTION37000FTHELABDR � �(p CODE,I SHALL FORTHWITH COMPLY WITH THOSE PROVISIONS. ISSUANCE tJ� O p DATE: APPLICANT: SMIP ^ �'• w P-- r _ J ENERGY P/C _, .,... _.-...--�..,_-_,_,_:�yt:_-:...---�.._. WARNING:FAILURE TO SECUFE WORKERS'COMPENSATION COVERAGE IS UNLAW FUL,AND SHALL BE � SUBJECTANEMPLOYERTOCRIMINALPENAlTIESANDCIVILFINE5U7700NEMUNDREDTHOl15AN� ENERGYPERMIT OOLI/RS(5100A W�,IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROYIDED FOR IN J SECTION37080FTHELABOFCODE,INTERESTANDATTOPNEY'SFEES. Q RETENTION FEE: � .�(� OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: � IHEREBYAFFIRMUNDEflPENALTYOFPERJURYTHATTHEREISACONSTRUCTiONLENOINGAGENCV �-' FOR THE PERFORMANGEOFTHE WORK FOR WHIC�i THIS PERMIT IS ISSUEJ j5EC.3o9],CIV.C.). "- Z W � LENDER'S NAM= F- LENDER'S ADDRE55 �j W ICERTIFYTHATIHAVEREADTHISAPPLICATIONAN75TATETHATTHEABOVEIM1FORMATIONISCORRECT. TOTH��FEES ��V°�� � ��'%' ' �,��: ��+[f'�' �/' � IAGREETOCOMPLYWITMALLqTYANOCOUNTYORDIYANCESANDSTATELAWSFiELATINGT08UILDING� . '+� �� � CONSTRUCTION,ANDHEREBYAUTHORIZEREPflESEN�AiIVE50FTNISCOUNTYTOENTERUPONTHE ����'� [/ f� p / � � Z ABOVE�MENTIONED PflOPERTV FORINSPEC'IOM1 PUFIPOSES. COMMENTS t V` � � V t/ "' � �� y,, � m PERMITTEE NFME(PRINT) �l� Q ` (� �t � ? � SIGNATUFiEOFPERMITTEE DATE �. _ '���'^�2ECPT.NQ ` P.(D, Y C . VAUDATION ~ WHITE—Deparlment Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD--FiFe pplicanPs Copy . . t , . ... ,F ' .i� -� .. M '1 k �,{�� �'� ��� � !- _�,. ,,.. � ��,.A*�.� ;�.: � 1.,:�.�� ��k44s�Ac T���il'1G'.�. �/ r��.ffilil - .' ;�:.. .'� ,.....`:Ti M .) . ..-.:�;;: .�.�P�„�is�:' ,,.,.;:'.•:f. -. ,. . , r}:.Yt1;::d A�p:ld�yrn: . t. .� . . . ��, , .� . , � . . - - ;my..�o-.. �.. � � ,,�:. � r,.,.�u.a`"`���Y� �:,:c��ma� �`:'��"�:�'"� , .����� .,s,�� ���� �� v .���;�H � . � t S�' �* B.v. . �f;$ $ 9 '���'a d...V' � �-,.�-��m r�.��� ;�,�r.-�",� ��'� �'..�, "&t�a��'.;��� ,��.��� ��a�k�.�° �� �k'� ��'� ���Y'��'��s � ���'�`k���"�m�����,%'�•--� ��a �� � �`���y ��aaA i `�.�p�'�ht�� _ . .�.:'���€i� � ^a.�� ��,�a�� �.�� ��� � . � e ��1,� �r�'�� ���� � � �' �" � �� .,�`ro,��:'�.��` :��a �u�� �� "a•.�� �... � ; �� �_ ��� �,�:,.:: �' ��,�.. :���a� ��ae���������._� �a a��a���a����„ �� �;:_������� ���� �� �. ��,e. � , �,�� �e5�. .x , ����. �� x� ,��:e� ��� .. �. , � �, � � `C , 2 �; � � �.a_.W`.. _.._._____._-..�...._w_�... � ..._..... _.._w_ �..._...____.; __. , . ... ._.._....... __ ____ _ _ ..... i G." „3 .�s'�;�€ � � , : � �:::€', . ."'��'.f,a.``s ' i s ' �- � � . __._ _....__...... ......._... � ._ -. ._ _, �--- ._..�_.. ... � - _ � � �.:. s R � ` `' ���.� �fr� � � t r'��' r�9 t { ! a 3 1,:.. ....._ � _..� "� .. ...., ....... g . .. ... . . ... _ _ __ .... ...... .. .__ a �.��"-7 t -� r� ..��a � ��%�� �....�� "'_c` _� � �, I ? ° � i$ _.' ._�.� ..... .._......_... ...... ......... ...... .._.......__._.._.,.,. _ 1 � .. ._ ..... ..- . _. . .._ ...... .:... . _ a ...d��- c �'. f at : !.� a7j.'ipp �� ° �€ I 1...-tf,,�' �- t.��,€. .ri ._...- . _ . ........ ...�.........� ' ._._.""' ........w�..._. ..........�._�._.,._..__ � ...... _ __.___...... _...�.�..,. . ... .� ,._ ...... ...... .. .._ ._...... � ° -m,� .�{gx�a f: i i �:. '� �'B€ (,.04" c?,�;��:�� ��,```1� ...... _. ..._. g .: f.3__."�m......hti.. .. .................,�.-....._.,..._..._ _..._.:...,,. ... ..................._e._,.,......_ _..�....._.-........,,,.,�__..__... . .E_____��....___�_�_� _' __' _ __._........ ._..i.._.._,,._. � . : -- .....,..._..__._.._. . ._ � art.`:.��_� �r�� f j sr: ; � �r;€rz t-� �t,�"��7 � :�, l • _..__ _._ __._ . _ T__.w�..._. ;..._. __... _.__....,�....,... _._ .._.._ __ � — �_ _ ,:a � � E � sa �F"�� � f�o �t ��r � :. �" 3� i a � t . _____ .. _ _ ____. ... �__. .. . . __. __ � E ��-� ' �-�� � � _ _..__. _ ____ �_. _._ . ___ � �.��� .� � , �¢ �� � , �� � ..� _ - Y __ _ Y t" .S � ' d. 4 � I:; €^Q�g I€ S� � .._ ._ ... .................... ..«....... ........ ....,, . _... � ... . .. ..... .. ..._ ..... .......... . .. S `� � ��' ... . _.._..__.._...,. . .........�........... ._.._ ....e........... .....�..........._._.....__.....,..........5 � �'"� e 'a �` '`I 1...`�R� (1 - , . � �L.e�l 4 4 ... � .._f_�y/)�� .... ...... .... ''.. .. _ . E � g d^.I .!" � }„ l'"" P� ... / '/' .... . .. .__.. 7'1:. l I b l �6b t .,'d 7 .............. _ ._........�......_ .. ..,....._.._.�.._.,.,,.........,,._..........'___. ........., 1 � f :.. . v.r , 1 t ' �i ..i t i s ..' ' ! . .... _.... �:� � 9 ��i r�»� €�n'r f .... � �.. . �. ........... ......__...�.. _.. .__... ... ....._ ..._ ............��_� . . _�..__�.�...... ._.__ _. _..___..,....____._._._,....,.�........._ . .. .. . _;.._ _� _ .. _- �.. ..i- .. , : � �-:<"'t 5 r" -;a � - � @...;; y.,�..�..�.E ...:S 3 4.• � .� � � .. �t ' � _... .... _ _.... _.._. ..� � _ _ __... .. .. � �� ..... � ,� , �.� � �.. g , ° _ . .�� 5-dt _ ° . ..�____ _.__ __ �r:; � �� �. �� a� � r � , �t c ' � . � � 4 c� �-��� F f �� � � _ ._ __��_ _ � _ .� _� � -��� � �� �� � � F � � ��� � �. �{� � _ _ __ _ ____ __ � � _ ___ _ _� � , .. _ � �}���� � �� �� �� zf:�, �� , i��;� -� ,�� � __�_.._: .€ _ _ _ _ __ _ . ._ _ ___ ._ _ _ . _____ _.� ;_�°�:, �a : , ���'�=� ¢ '�'� ; ; _.�___.. ______.._ .. _.__ . _ . _ _ __ __ _; .. n � ,�,�, ;�- € g .,.:':�" �¢... .. �.$d E ' . � � �..�t 1 -. ""�}'"9 ', . S ... .....,.._.._._. _.......... ......._.._.......,......... .......................,.___...__._.,.�... __�.__.,,,... ...._....._.......___.........._.�.._ _..............___.....m._ _"...._ ........... .........._ � _,..... _.. ...� ...._....... �. . g 'X"i f ; y -� . ^}`v i i'�' F aa� x... ; .._... T.' F::.C, , . . __ - �.,�k � ,�. � ._ _ .i.__ ..___..._ _.�_....._... .,..___...__._..__..__�.� . _ . ._. ....._....._..., _ ....... ........._......._.,.._._ _... .__._....._..... . ........__.....�_�.__. ....:: .� £, .... ; , >:». .m.... . ..._ ...,..,..... ......;_._.. �.�< . .;'"s ......., ' :""�,�z�+,�..a.°uiE a ,�.._ _ b� ...,. ....._._. .. ..:......................... . ................._..,,:....�.... ............ . . ... ........... .... __._ . ................... .._............._._...��._..._�..._..__.......... .. -�'P..0 P, .: .. � ,._m � . � _.1�.`.i�,m �a..r�'i.«�:e. . . q.l€..,. L ..t � @ Ct.x... - 3 ..... . ,... ...._., .,... ... . �+ _.... .... . ........ .,. _ : ....... .. ._......... . ......._. ._. .. .. � ���p � <�' ' __i_p/ .._. ..%._.... _ ..... ... ...._ , i.1a..'S i t.3..e. ,'�.�'�� �� 1._...... —f _ 4 8 �1 �� t �� � � k � , d ��� � �C _ 4 _ ._. . . _._ �___.._. _._�.____ __.. �____.. _ __ � _ . _._ � �. E s �',.&@ � �� �� : 1'm � � �''i , .___.__._.. . ..�. � _. N.�_ ____-.. .... __,.w... _.----___-_.___._�_..,...... _._.....__-- --- � _. _�_ .� '_ _ __. _._ _ � � � ,� ^ � �� �. �� ���� _ ___,_....._ ___�... ._ _.._..._.__.. __ �... ._.,._.�. �� � J� .� ....."'�- .����"���������a�,�� �.�� .�� � �_ ; _ _ ._ � _ ---- ---- _.___.. ; � - ------ ._. _ _. t . �- , t .�.>„ z � �:� �'�� j � ..,,�1� F�, � � �� .__ __., . . .... _._.._ _ . �..�......�_...�..�.�..�.�_.._...�..____.._.______________�....._m_y �.... _- w_.___ ...._ /� f�j /c) r ��._ ���'�c�' � �._ riT�..L.� `���—rf��. ?�-�,� ' , � _ _ ___ . �. ___ � _ _�.--�._�___w _ _, . _��.. . � : yo� `� � ���,� � �����Q �,�� �,� �__ � � W...� _. _ �- �: _ __.. ___ . � _ _�'c a..��� '��,� __. _ .___ _. ___ ___... __ _ _�_ .______ . . .._____ _ � �...__ _ _. �__. .. � . . . .__ ..,.._ ._ , g f � .._...,�...................__..._..__....___........_.....__ ..... ...._........_._.......... �... x �� � € �... . .. . _.. _. ....., ._ .. . .. ........ -__. _._ . .. ._. _...... ._.. _._. ... ..... ........ .... . . . ...... � .......__.......«....._....,....._.._..e............_....,_... �...... ................ _ ......_ . ...�-.... ...._.�..,. ...,,....... .......... ....... . ._........ .._. ...,.......... ................,.._... ......_.«.........._....... .._,._....,.. ..._ ..,._ � � CJ ' '}` ��) _�_ ��__ .. _ __ ��:-�� .. _ ` �4 _. G a _ 3�:,-� .� ._ �_�_._�._..____.__ . _. _._____._ _.. _ ____ ___._._ _._..__�._. ._ _ _._ . _. _____; � m �— ��.'a?. � 'a �m. �---a :� � _ - Sc�ao`�t9�Y�� , _..___._.... . ..w ....... .__ ___...... __. _..._..... __ � _ ..� g'���" `F ,f� C � °��G.�._.._._. . - . � 'o ..... .._..... � �,.r�.�., , _ .. �,:: ....:. � ._._ .'_'.�._... .............._..................,........._...,,....____ ........ .._.....,_.... . .____"_ ""___"__ "____'___,_�.__.�__ _ ...._......_.._...._.�..__i jr . .. ...� �-�' ..:�u .�' .:.::� - ' ..__ . .... . ..__ _ � ..:::..... pq. .... ,.:... .:.,..'.- Y 3 ��.:. -� tl,.,..... ....: ._... .. ........._K ':.. � x;.:.....� ..._.._.....,.....__.,_...___. .._............e. � �.... ..,:. �, .� y,�......: ........___.........._.._..__._.......�.__..._.,�__.._..__.____....._.. ..........._...___....__......__....,..._..._...__._..._.___..""'___._. . � �.. k .. ..: .. . .�� � .. ` �.... �� ��.� � . :.� ..:�:�. __....._.._..._ _.m...,__ ,.....�.................,.._�.._. .._........_._. .._..__�._.._. ... .....�.._...�.___....,.-............_ ............ . ... .�.._......_.. .........w.._,._....._...,_ __.._.....�__..__.... ...._.......___._ . _..., . . .. .... � ..:... '�� € � �:., . :�::- ,; . � :.. _ ��. � � �:. �., _..._ _ .. ..._.._......_._.._.�.,.__._... , �.: :_ �-�- ._.....,._........ ,--_. ._........._......_...�,,,...., .... � .. ........ ......_ _..... __.. . . ... .._ s � a � , ; ' , ���',e§' . � .._...... ._.._.._..e _._......-.._...�....,,.,........ ...n........ ... ..._......_._.._......_ ..�...__..�.�...._._._.__.�_..._....._._,._.,._......_....._._... . ....._.._. ...m..'-'._.__�_........._.._.� � r ' 1 �' �� � �,� €�� ` __..._.... ......_—._....� �� _—__"__..__...._-..__.........r.,.. .._.�._.�._W.. ......P�...._._._.�.._.......___......_.._ ......m�.__�._.._......._.----- ------- .._.._ . ;:. � �_,-:.� �� � ....�.. ..... � 1 � � � � ..,�a.:> ...;:.�'4_ ..... .:� ��3 .:...:.... . , � ..::::.«...«.«�.a�....e.s�,:,..�,...,.._..�,.�.........,.s.e:�w�_..............�..�.,.....».»-.4,.w...._...�......,�.......e_.....__. .........-..... ,,....,.-_-._..m.__. _.,,.,......_...w.,F,e......._.._.,._......-.......�.:....«:««..»«2,..,:,,.....«.,.......x..�z.a..,..,.-_..,..,.....:,.:_,,.�._. .�W.....�....�...»....�esn._-»...:..... __ _ _ _ �