Loading...
HomeMy WebLinkAbout12663 (30) � � ,!� CITY OF DIAMOND BAR �"%-�� DEPARTMENT OF COMMLTNITY&DEVELOPMENT SERVICES; ,�-_`�`� 21660 E.Copley Drive Suite 19D 4t��-�'�' pRESS ��9%�'��w BUILDINGSPERMIT APPLYCATION FIRMLY N JOBSITE ��/ /� .� /� APPLICATION PERMIT P/C o ADDRESS�SCT? �SJ��C L��.S���`�� DATE �y��_�� NUMBER ����� # ISSUE t�.,... f j�4��� ONST. GROUP � APN LOT TRACT DATE � r ,p p OWNER OA-��c� � o ADDRESS �rYl�s ZONING SETBACKS � CITY ZIP TEL. FRONT RW ❑ � APPLICAN'f � �:�--�-'7�� fiEAR ❑ � � S4DEISiDE STREET RW ❑ �Z CONTRACTQR � SIDE G� ADDRESS c� � 14"f � PROPOSED USE �. �� • � �� ��� ��s CITY ZIP�z �Et. � P' d � f� ! p ARCHIE G! G�'' �'`c�__ D t�.dt Q/ W DESIGNER NO.DWEL. NO. NO. a ADDRESS 11NITS �� STORIES " z" BEDROOMS � CITY ZIP TEL. � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREA/VALUATiON � OWNER•BUILDEF�ECLARATION - � SFR/ADD/REM fl Q I MEflEBY AFflRM UNDER PENALTY OF PENUflY THAT I AM EXEMPT FflOM THE CONTRACTOflS U� �� � GaragelCa�port - W CENSEIAWFORTNEfOILOWNJGRFA50N�SEC.7031.58U51NE55ANDPROFE3S16W5CODE:ANYCITYOfl - U COUNTY}yMIGHqEpI11pE5pPERM1TTOCOhSTRUGT,ALTER,IMPROVE.DEM.OUSH.OflREPAiRANYSTRUG '� W patio/DeCk � TUflE,PRfOfl TO ITS ISSUANCE,ALSO HEIXIIRES THE APPLICANT FOfl SUGH PERMIT 70 FILE A SIGNED .� STATEMENT TNAT NE Ofl SNE IS tJCENSE�PURSl1ANT TO THE PROVISIONS OF THE GOYTflACTORS LI- ' �_� CENSELAW(CHNPTEfl9(CDMMENCINGWITNSECTION�Mn)OF�IVISION3DFTHEBlI51NE5SANDPft0. -�" P�OUSPB �� FESSpN5CO0E)ORTHATNEOFlSHEISEXEAIPTTHEREfROMAN�THEBA515FORTMEALLEGEOFJ(EMi• � - � TFDN.ANYYKKATIONOFSECTION7031.SBYANYAPPUCANTFORAPERMIiSUBJECTSTHEAPPLICANTTO Re-Roof '�2t�8� � ACIVILPENALTVOFNOTIAORETHANFNEHUN�REDOIX1aR5(SSao�.�� O ❑I,ASOYMEAOFTHEPROAERiV,ORMYEMPLOYEE5WITHWA6ESASTHEiR50LEOQ�IVENSATION, ':0 ommercial - [�_-. � WILL D�THE WORI(M1D THE STRUCNRE IS NOT INTENOEO oq OFFERE[l FOa SALE(SEG�aa0.BU51- -...J { � NE56 AND PROFESSIONS CODE:TNE CONTRACTOR$LICENSE LAW OOES NOT APPLY Rl AN OWNER oF - � PflOPERTY N9-10 BUILDS OR IMPNO�S THEREON,AND VhiO DOES SUCH WOHK HIMSELFOp HERSELFOq Q- iHROU6HHISORHEflOWNEMPLOYEES,PFlOVI�SDTHATSUCNIMPqOVEMEhTSARENOTINTEYOEDOfl :' �m � Q _OFFERE�FORSALEIF.HOWEVER7NE8UILDINGOqIMPROVEMENTISSOLDWfTHI40NEYEAROFCOMPLE- - �- TION,THE OWNER-BUILDER WILL HAVE THE BURDEN QF PROVING 7HAT HE OR SHE DID NOT BUILD OR 601PROVE FOR hiE PUHPOSE OF SALfl. uy ❑I,A$OWNEflOFTHEPROPEHfY.AMEXCLUSIVEIVCONTRACTINGWITHUCENSEDCONTRACTOAS (,'C 50 CONSTflUCT 7HE PRQIECT(SEC.70N,9USINESS AND PROFESSIONS CODE:THE CONTRACTORS Li=. �. VaIU8I10t1 ADJ.AREi� W- CENSEUWWESNOTAPPLVTOANOWNEROFAPqOPEHT'YMOBUILDSORIMPROVESTNEREON,AND�- -. � W}IOCONTR4CTSWNSUCHPROJEC75WITHACONTRACTOR(S�LICENSEUPURSUANT70THECONTiiAF -- pUANTITY DESCRIPTION FEE Y TORSUCQISEUW.). . . O. ❑IAMIXEGiPTUNDEflSEC. 9.SP.C.FOATHISREASON - � . �- '- - �� U . � - LL' 'DATE OWNER _:� V W -- ¢- LICENSEDCONTRACTORS DECLARATION �.-�j �C i HERBY.'.fFlf;hi lh1'DeR PENPLTY OF FERIURV THAi IAM UCENSED UNDER PAOVISIO450F CHA?T£A ._ � � t� e(CO�A4EkG;kO:MT715ECiKhY7000JOF�iYSION30FTHE6USINESSAN�PROFESS�ONSCODE,MlD . Z MY UCEN5E 5 IN FULL FORGE AND EPFECT. m � o�- UCENSEClASS// � LIC.ND. � ���� !�J U �ATE___�.��.�:�.+�rz_-�--��CONTMCTOIi �-- �`-d � liJ �;,_ WORKEFiS'COMPENSATION DECL4RATION ¢ �' IHEFEBYAFFIRMUNDERPENALNOFPEfLIURVONEOFTHE(OLLOWNJGDEGARATIONS: � U]- : Q 0- IHRVEANDWILLMAINTAINACEFTIFICATEOFCONSENT705ELF-INSUflEFORVJORKERS' - S � �j. - COAlPENSAT�ON.ASAROVIDEOBVSECTON37000FTHElA6OqWDE,FORTHEPFAFOflMANCE �_ `U ��� OF THE WORX FOR WHICH THIS PEAAi�T 131SSUED. .� �:. F- lIMRVERNDWiLLMAINTAINWORNEHS'COMPENSATIONINSURANCE,ASREflUIRE09Y5Eu'TION � - -Q 37ooOFTHEL460NCP�E,FOR7NEPEflWRMANCEOFTHEWORKFORWHICHiHISPERMITIS -- �� ISSUED.MYWOflKERS' �PENSATIONINSURANGECARRIERANO�tPOLyICY�NUMBERARE: -CONSTRUCT � - caaaiEa - ' L_�f'�D�� /�p�r/K j PLAN REVIEW > . ��"�i ��� --------�-- ---- Oz _- aoucrNun+aER ���� ` L�� � ELECTRIC _ _.___ � (iHts3ECT�7IJNE�NOT0E0Qw'LE�oF7tiEaEwNiISWRavE�NwREooawns(51m)atlEss} PLUMBING � �� w - MECHANICAL - - Z- �� 1 CEflTIGV THAT IN THE PEflFOflMANGE OFTHE WORK FOR WHICH THIS PERMIT IS ISSUED,I . �j - SNALLNOTEMPLOYANVPERSONINANYMANNERSOASTOBECOMESII&IECTT07HE --�NSPECTIONFEE -�- ' WOqKEflS'COIUPENSA:Y1NlAW50FCALIFOfl. NOA6flEETHATIFiSHOULOBECOME �pq -_ � . SUBJECTT07HEW�RKERS'WMPENSATIONP O IS OFSECTION97000FTHELtBOfl �� / COD ISHALIFOflTHN7TNCOMPLYWITNTHO E RO s 5. . ANCE �." '� � a,�^� p DATE�I�� APPUCANT: - �-='`� - � � ENEflGY P!C 'WARNING:FAIL�RETOSECUREN'ORKERS'COMPENS NGOVEflAGEISIlNLAWFUL.ANDSHALLBE � -SUBJECTMIEMPLOYERTOCflIMMALPENAL71E5AND I�FINESUP7�ONEHUNDREDTHOUSANU ENERGYPERMIT - - DOI.lARS(5100.OW�.INAOUITIONTDiHEGOSTOFCOMPEN5ATION.DAMAGESASPRONDEDFORIN - � SECTION3)OBOFTHELABORCODE,INTERFST,ANDATTORNEI"SFEES. - RETENTIONFEE: __ __ - � CONSTRUCTIONLENDINGAGENCY PRE-ALTFEE: _____ _. _ __ - . � .I HEREBYAFFIRIA UNDEfi PENALtt OF PEAJUflY TMAt TNEPE IS A GONSTflUC710N�ENDING AGENCY - . FOR THE PERFOHMANCE OFTHE WORK FOR WMICN THIS PEFMR IS ISSUED(SEG.�097,CIV.C.). Z - W _ z LENDEFTS NAME � . F- LENDER'SA90R555 . —.— �p TTTT�7 T{7�T p�7'}} �p V - � ICEHTIFYTHaiIHAVEFEADTHISAPPUCATIONANDSTATETHATh7[ABOVEMFORMAiIONISCORRECT �-- TOT/"lL rGLV G t11YU SAl'L'TS � � � � IAGREE7000MPLVWI7NALlCITVANOCOUNTYORDWANCESAN�5TA7ELAWSRELATINGTOBUILDING � � � -- � CONSTPUCTION.ANDHEPEBYAUTHOfl12EflEPRE3ENTATIVESOFTHISCOUNTYTOENTERUPONTHE . Z p60VE�MENTqNEDPROPERNFOPiNSPECTpNPUPPO$E5. COMMENTS �- �� � � J�� ��6 � m PEflM1TTEENAME( � /7� '^� ¢ !� C � /�-n�.n � Uj 51GNATUREOF E ITfEE DATE ''���iG�� � . - - = RECPT NO. PAIDBY / /�'`� VALl�AT10N_� � _' £ _ . - ~ WHITE-0epar6nent Copy,YELLOW--Finance Copy,PINK—Assessor Copy,GOWENROD--File Copy.GHEEN—Applicanfs Copy � � � � _ �.a� � ; �-'� �r- , �--� -�---P � , � ��`�� , � � � ������� � ' _ �.�a _ } z � "3 1 � � }�3t ;, � � 5 �. � �� � � � �� � � � � � � �� � � � j . i �_' � � � - � k� ����,7���� I �:, ; t j � �� � i :. t4,:+ �:a "y i _� a+ . d �����"�.-�,� i �s�.. � �j '; ! �� � i € � ! �n+ R y � �,�°���3�- i � �� � "���C„���' `: � , i z i i � .'� � I � .�:_��� - v - y� . '�'�, �,:,� ,u �3 L i ; , - �I _� ";� _ !i ° �a _ E �'�r ����� .�����5� �i i ' � ) � #�'� i � ��r ` � � y �_ � ��_� i ��i ���I � �. �� . � s i i ; � � � ���.�.���� ���'��� � � i i ° f � � � i j I ; E �� � � 't i v�'�> � �„� � ��-��.��2r�,a�` � -r � � j � � � I � � ' I � � . .� ! � ` "� . . � t ^ `�� 7 �,`��r�"� � 3 ; i � �__ �� , � . � ; � ! � - s � �-�s ���.������.�'� 7 i V � � i t i 3 � 1 _� _'�' ; - -r :-- i-i� r( ' � f � � , I t j � ; � i � � f ' �� � 1 � I � �� ' � 1 ; �� � � i � � � , i F � F � E 3 I i i' � -f� I i i� ��� . f . { , i ` � � I i � I� � � ; �� t � ;i I `.... � � . � '�A � I � � ' � � �V �� i '`� s , ' �s � ' ' i � ---i '� ;_ '-- j � �—t---i- ---C �--- � �- �� t � � � i � k � f 1- ! 3 � i � t ; 1 ! . � � .I � � � i � , i � I. .( � f i.� . 1 i , I � 3 ! � ; � � , j � �� ,. 6 , r � � `- � � - ! � , � � � � , ' � �` , ' i � , ' ; � � � , , � � ' �' � � � �� ; f ( � -� i ` i ': ; ' ', i " ' ! ; t � � � , � i � � k �.i � , { ��.. � t 1 � E I/��. I � � ' I i � ��� = x� . € � ` t ' � .. i = � � i i � I 1 � i -� �,�,s ="'s� . i I t t € � � �� � j 1 r � � � � ; . 3 i } ; � I i E � r � i � � � e� � � � ; j { ' : j ,i , ; � i ' � , � j f ; �k � � _� ! � f � � I ' "? �-�* # i i '. I t . i i � � � �. ��� ._I I . ` ..^ — �{. Ea�.. ""� -'�'Pi � � i j � - ; ; ( � f � � �� ..f -� € i r '-[� - � E,E V ,�_ - .-$ � . � { i i ;, ! � i . � � �x � i i 3 � .� ! , t' 1 ,,, �" 7['' � a��-e � =1 §�� � � 3 3- � i I i ` � � t I � � �� � � �� � ti _, _i.. I t � ,S �(�f� --t�� _ - � � �" I � � ` ! � ; ! :.�� 3 fi '�rt`,i :,e ��i� ��.:�t �> �" �''' � ,1 �P�. ."a. �� � � i � i� i�- � i ' ` � E { , '; ��� .,; � � ! `� i , ,(�, �� ,:, i�E� �I-�i� :I �'�= �� � ' _ i i � i � i I F ' i . � � r i� i � � �� ,vrl t; i �-€ -�� �C�I �� ,� � i . � , � � � t � � . i. 1 'l I�.n . � �i3 � I � ' f ' , ? � I ; ' �.. .�.. � ; t , i � i '�� I F. � C' �� � �, i I - � ; ' � i I � j I I ; , s.1� �� � � C 1 j I I . � .a y' �� ��,� = t i �. i 3 � ! r .. i i � � � : i � , � � : � i� , ...� � a . f � ' , E� � � , . � � � � � - i ` r' � � l ; i j � � ; � � � I � I � i � i ! �. ! 1 i i i � k � I � � � � i � � � ! �- l M r � - - ' - i i r 1_. � i, � ` r r ' �, -t i—�—,---J-' r j�t � + ; --r �:'—� �� l_ i i � I � i- ! . I f � ' � i i ` + i i I . � i . 'i�i � j.� �� � ' � : �� � s ;- { � ' ; ; ' � ; f { i I i I i R � � � � ' z� . � i ' I 3 � F � : � � . � � i � ! � ( � � ��� z 4 � � I � I � f. , � 1.- I � � % � . I i .i � � ; � � � I i ( . - � � �, f I i �t i 1 r � k .. i i I 1 �i i � -, � E � �---* }- 1�.�__:t..--+--t—,—.� _� J (-._ _� �!_,! � I � I t I i � I �" ) �.. z � , j � i f ! � - � � ; �:;, ( . � - . s � � I � � � i j i d_ I �` � i � i � i � ! 1 � � � � "��� � � t� ��� E I t i � I � i � � . f ' � � , i ( � I � �.. � � �_ 7 � i� i z � . i � � � 1 i d L � � _ � ' E i ! I � � ' R � I , � � � ,�' j J I- ( ! ! , � i j i - � � �s 1 ! 1 � I i : t , j � I ( ' 1 I , ! ( � i i i �'� F ; � �� � . . j 3 �� � t i '� � i � E i� i i ; E !_ I I , i �;#� i i � I � � _.__�-�.__._.�.__.�.___. � -�_ _>:_ � � �: i � ' , ; � . r � �� i i � i i � � t i � � � � . ' i i � I , ,� _ __._.. � ,.�—.e_! __,_ � >i._____ b___,_,. .z _.,_._ � . : ' ( � I 7 i �_ _ _�.__..�... _d._, _.. _...___y_ ,. _ !__ _.....�...... _._�...___ ._ . _.. �