Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
11691
� .�� � G���- C.�� �a� ��r�� �'� � �(�� + r � .- ° --��`�--� C1TY Or DIAMOND BAR �4 ` e �J(�/ �l��']�j Z� �� * �. � + I I COMMUNITY DEVELOPMENT DEPARTMENT �v � 21G60 L.Copley Drivc Suite 190 (909)R60-3195 Fax(90))861-3117 PRESS BUILDiNGPERMITAPPLiCATION � FIRMLY oN JOBSITE �O C� 6 J .�j�,I'2�f N '7 f= � S 7 . j � I` C /C !(J : ADDRESS 4 � DATE CATION~ NU BER 1��__� #__ °P APN LOT��_ TRACT_�-�G�C� � �SSUE � , �y TYPE OCC DATE �7 e7 CONST. ,_ GROUP � OWNER l"� � ' OO ��- '- p ADDRESS_t_,�,C��'te !t7 '�' 1�f�lA' G"v i'z 1�_ S7 t ZONING SETBACKS Z CITY_[�� ZIP���TEL.��6.0'74 3 FRONT RW C�---,----- p APPLICANT _ _ v " � ?� REAR � -- ❑ —---- Z x� SIDE/SIDE STREET_ __ RW {� ¢ CONTRACTOR--,--,-- �' Zt--�-�_-...____ SIDE __ �.i — ADDRESS______ � CITY ZIP_ TEL.— � ROPOSED USE Y��G I'��l.� ��L-j ;� " o i�� ! w ARCHlENG/ z DESIGNER_�� '� i71�j� N _ NO.DWEL. � NO. '���4Y—� NO. a ADDRESS I e r a..a��ts2 i�! � c 7—_ � , --a-r'-�'�-(� -�•�-�--�-rti--cCd �7 y � UNITS____�_ STORIES �'r' BEDROOMS�_ � CITYA�F��_....��„_ ZIP • 6_a_ TEL.7�-�_r�^��� cn �� ��� �� DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � p� OWNER-BI:ILDER DECLAF�A � SFR/ADD/REM O � 1 HEREBV�FI�IfiIA UNDeR PENAITY OF PfHJURY THAT I AM EXEMPT�ROM THC-CONTRACTORS LI- G3f89B/CBfPOfI W CENSELAWFORTHEFOILOWINf.flEASON�SEC_10315011SIN['SSANDPROFESSIONSCO[]f�ANYCITYOR (n � U COUNTYWIIICHREOl11R[SAPEFMI'fTOCONSTRUCT,ALTER,IMPROVE.bLN.OLISH,ORREPAIR11NY5TRUC- W PaliO/OBCk w TURE,PRIOR TO ITF ISSUANCf:,ALSO REQUIRES TME APPLICANT FOR SUCH PtRMIT TO FIL[A SICNE� W � STA1 EMENT THAT H[OR SHE IS UC�NSEU Pl1flSUANT TO THE PHOVISIONS OF THE COY fFlACTOHS 1.1- � � � CENSE LAW(CHAP7 EN 9(COMMENCING WITkISF.CTION 7000)OF DIVISION 3 Uf TFIE U1151NESSAND PRO� POOVSPe � � �ESSIONSCODE)ORTIIATVIEORSHEISE%EMPT711CREFAOMpNDTHEBASISFORTF1EAlL[GLDEXEMP� (f V TION.ANVVIOI.ATIONOfSECTIQN]031.5RYANVAPPLICMITFORAPERMITSUBJECTSTHEAPPLICANTTO 'Z Re-floo( F A CML PENA�TY OF NOI MOFl[THAN FlVE INNDRE�nOLLARS(5500).)- ¢ ❑I,AS OWNFfl OFTHE PHOPEfi I Y,OR MY FMPIOYEES W ITH WAGES AS THEIR SOLE COMPCNSATION, � Z WILLDO iHE'NORK.ANf1 THE STRUCTUFIE I.5 NOT IN7ENDED OR OFFEFlf"0 FOIi SALE(SEC.7044,6U51� � � COmf1lEfGldl NE55 AND PpOFES510N5 CO�E'THF.CONTRACTORS LICF.NSF LAW DOES NOi�PPLY'f0 MJ OWNER OF ; � Pfl0?ERTY WHO BUILDS OR�MPROVFS TNF,REON,AND WNO DOES SUC,H WORK HIMSEIFORHERSELf OH � Q TIIROUGHHISORHEROWNFMPLOVEES,PROVIDCDT1fATSUCHIMPftOVEMENTSAHENOTINTENDEDOq m � 0 OFFEREDFORSALE.IF,HOWEVEF,TH�BUIIDINGORIMPROVEMENTISSOI.DVJITHINONEYEAHOFC04PLE � Z TION,THE OWNER�BUIL�ER WILL FI�VE TVIE BUROEN OF PROVING THAT Hf:OR SHE DID NOT BUILU pR F � IMPHOV[FORTHEPUftPOS�OFSALEy : w CJI,ASOWNEROFTHEPROPERTY,AMEXCLUSNELYCONfHA(:TINGWITHLICENSEOCONTFiACI'ORS 1 � TO CONSTRUCT THE PROJECT(SEC.70q4,BUSI,NESS AN�PROFES510N5 CODE:THF.CANTRACTOflS LI- V01113ti0f1 U C'>J' �j qDJ.AREA W CENSEIAWDOESNOTpPPLVTOANOWNEROFAPROPEFlTYWHOBUILD50RIMPflOYESTHEREON,qND �-- � WHOCONTf1ACTSFORSUCHPROJECTSWITHACONTflACTOF(5)LICFNS[DPURSUANT70THECONTqAC- QUANTITY D S�RIPTION FEE Y TOHS LICENSE lAW�. �¢ f J IAM EXEMPT UkIIER SEC. El&P.C.FOR THI5 REASON � ' .}/�� � a� : "'_-" " • � � a ` i Qy `��� � �.'7j ' ---- - - - ---- - --...-— z �ATE-.. -..- .__.-OWNER _"- ' __""'-_'_ V [ 1,. `/! _— i O ��t �' �' • � LICENSED CONTRACTORS UECLARATION W Fj ¢ - f � I HEREBY AFFIHM 11N0ER PENAIN OF PERJURY ThIAT I AM LICENSED UNUEfi PROVISIONS OF CI I�PT[R � ' j � y Q� / h � 0(COM!AENCING YdITH 5EG110N 7aaoJ OF DIVI510N 30f TFIL BUSINE55 ANO PHOF[55!ONS CODF:,A�D ��V �.J � (J �X MY LICENSE IS IN FULI FORCEAND EFFECT, /� m � �Op��` - E /���/�'ry � ' , a � ' f � LICENSECLASS___..�__ LIC.NO �%�?,!=_l. -�_ � � �{ ¢' � p � k /1.� �° .0- -- "�� ����. w DATE_�1_�.�_y�__ GONTRAGTOR__�---�L211c a .�� 4 .t�(.: oc `, { !� � WORKEAS'COMPENSATION DECLARATION � Q � �� - v � � IH[flEBYAFFIRMUND[NGENALTYOFPERJLIRYOYEOFTHEFOLLOWINGOECLARATIONS: z C• Y �{6 : Q S`—`, t�t,�� v. t! i � IHAVEANDWILLMAINTAINACEHTI�ICA�F.�FCANSENTTOSELF-INSUREFOHWORKEFS' _ : CAMPENSATION,�SPFlOVIOEOBYSEGTION9]OOOFTHEL��ORCOD[,FOflTNEPERFORMANCE V `U � OF THE WORK FOR WHICH 7HI5 PERMIT IS ISSUED. }' � � • �• w __._IHAVEANDWILLMAINTAI,yWp�jKEPS'CQNVf�NSATIONINSUFANCE,A5HE0UiREDBVSECTION ` + ' /� € Q 3]OOOFTHELABORCOUE,�OflTHEPERW(iMANCEOFTHEWORKFORWHICHTHISPEFMITIS 1�Cy L ISSUE�.MY WOqKEflS'COMGFNSATION INSUFANCE CARRIER AND POLICY NUTAB[R ARE�. CONSTRUCTION � ./� _/ )� J � -i ��. J. J.7 � .. ✓ T ._..__"_"- r.._.�. d �T� ��_.�`_l�� _, PLANREVIEW ��-`' +--- ] CAHRIEFi—___' ,�, �- _...._""-_""'"" ""-_ _ � ¢ voucvNUMaEq���`=1__.C'.��._.a.���. ELECTRIC _,_.__._ . )y i 0 (MISSECipNN'cEDNOfB[O�MPLEfEDOFTHEPEPAVTIgFOHONE11U4bREDWYLV95(SICO�ORI.I;SS). PLUMBING _,_, _ ____ _ C � ` � W S Z If,[RTIFY7HATIN'fHEPf.RFORMA�C[OFTHEVJORKFOFWHICHTHISPEflMITISI55UED,l MECHANICAL p -""-__'.... "___- - (�7 SHALLNO�EMPLOVANVPEHSONINANYMANNEf1SOASTOBECOMESi/BJF.CT�OTHf + � WORKERS'COMPENSATIONUWSOfCALIFORMA.ANDAGHEETHATIFISHOULUl3ECOAAE INSPECTIONFEE ,__ (�! ._...__-.....__ ...._'_"�//' - SUOJECTTOTHEWORKERS'COMPENSATIONVROVISIONSOFSECTION3]OUOFIHELPEOR : � COUE,ISHALLFORTHWITI�COMPLVWn11iHo5EPpOVI5loN5. ISSl1ANCE t ( ___"'__""_ _"" "' � d � � p �ATE:_.._._'_'_ APFLICANT:-_._-.". __._ SMIP i _ . _.'_.._'-' � _- .--__ \ , � WARNING:GAIIURE TO SECUPE WOqKERS'COM7GNSATION CAVERAGE IS UNLAWFUL,AND SHAI.�BE ENERGY P/C _„___ _ ___ _ � � $UUJECT AN EMPLOVER TO CRIMINA�P[NAL.TIES AN�GIVIL FMES 11PTa ONE HUN�RED THOl/5AN0 ENERGY PERMIT > � DOLUR5�EIWUW),INAOOITIIXJTOTHECOSTOFGOMP[NSATION.l7AMAGESASPROVIDEOFORIN �-- �--- _._.___- �./_\ J SECTK]N3loeOFTHELA60HCODE,INTENEST,ANDATTORNEY'SFEL-S RETENTIONFEE' ___,_ � �. �U � _ _ '""__'_"_"'_ '_ ! d CONSTRUCTION LENOING AGENCY PRE-ALT FEE: � p -—�-- ---.....------�--- - t � IHGRCBYAFFIHMUNUERVENALTVOFPERJURVTHATTHCREISACONSTRUCfIONlEN01NGAGENCY __ ` FDH TH[PEPFOHAdANCE O�THE WORK FOR WNICH THIS PCRMIT IS ISSUEG(SEC.30B1,CIV.CJ. --' -�"-" -"---"'-- 4 � -' -' � -'" '-_ _.._._�_.__�_�. _ k LENUER'SNAM[ ' �' � '_'_ '_-""_ -... ., .. � ----- ------- .. . -- � .- ?1-- f- LE4DEH'SADDRE55 ___.___._.. - � :• � � �-"__'_ -` "__ . w ICEFTIFYTHATIHAVEHFADTHISAPPUCATIONANDSTA7E�HATfHENBOVEINFORMATIONISCOHRECi TOTAL FEES � S � � IAGREETOCOMPLYWITNALICITYqNDCOlIN1VORDINAIJCE5AYU5TATElAWSRELATINGTODUI�UING � 1 CONSTRUCTION,ANDHEREBYAUTNpf11ZEREPRESENTAT!VISOFTHISCOUNIVTOI:NIERUPONTHE �f ,'�J ?, ABOV�Ny`DRbPLRTVFORINSVE�NPU(R'PEOSES.-�� _ -- — COMMENTS�1���.�Z��Z�' .� — r c� �', � I L = -- - --. --. m PERMITTEE AME(VRINTJ + �qr I�'�r114 ', �¢ � , _.. O 5�': l� —--—�—s�--- � ----- — . � =n �-- , � —... - '' -- -- . SIGNAT FPERMITTE ,� DATE r�j � _ = RECPT.NO._ � __PAID BYC'i_ V I. VALIDATION ~ WHITE-Department Copy,YELLOW-Finance Copy,PINK-Assessor Copy,GOLDENROD-File Copy,GREEN-ApplicanYs Copy �,<<:.. _.. - .�. �'���� i .� ._ _ F _ _ ._... _ - . — --- - ---. ..i � �,._ ---- . ��'#��'� - ' _ i . . . i � . � , �.�: � \ �4 �. � � � i i � � � � . . ' � i � . � , , � � � - � - —� � � ' ' � ' j I � . � j { � � , � . . � ; �'\� I � � ��, ' t ! I � � ' � � ' . � � � � � � � � � i I � \� ; � I � � � i � i i i � ! i I . � � � �� �.�. � . � � . , ' � i � i � . . ' ' I i : � � - � ' � r �(� i � ; � � i ' � : i ! - i � . . � ; � : . i . ; � � � � . a : :� , I - ; - � i , , I - � • � '.� �,� _ ,a ¢; , i : . - I . . . � I � � : � � � 'i E ; � � � � i �. �„r� I I -__1 � ; _ i._ . - __I -I ! , _ A' _. ('_' .d _ _"_ " � I ��d . � � E � }3 - i � - . � . � . '� i ; � ' , � I . i , �� 1.�.-•�,� � i i ' � ; , . , ' i , ( � I � � , i I �., _ ' - + ! i /1 {� � .' �� I I i ' � ' I I i I i � ' i �*v r �-'� � s�£ a_.. _. __ � __ .i_ : _; ... I � � . � ���,�I � � ���? , � i 4 ��C it^�'� =. ' ' , i '� ' i ; . , � � ..�-�' _ � , ' i , .�'�'.'r �{+ i S �i 7� , i � i i �s�� I j , � ' ' I I : � ��. ' i ' ' � � i � ` ti��-� -�,,� � � r. i ,c i �y�. �. . ' . : i �,,��. � ' � _ � � � �� � ( 3{ ��.� � � � � � I ,� � ��7. � ; _ ` �' a� _ � ,tt , � C, n„�. Lr, . I i i -, � _ � -i ; � - � w � � ; � � [�" � � i t �. I `°i 4 � . ��C ; � �5� ( j ' ` � Y � �^ � . r . L , }' � � C� ^ ` ' J 1 `` f°� " l . -i.€' . _ . . . . t. `I". C I ",='� ; �;s# -� �i . - - . � � , ' ; i � � $ . �'' t1y�- � � . 1 t ' _. � _'_ _ . a� v l . i . : ; . . � � i _ i ; r � t __ � __� i � : �ja ' � � � ( ' .� , ; '� i .„� �= � � I i \ gl � � I i f � `%I ' � � �`�" � + r s: ,e .� i � : ; � i�� ! � ,-� ; � .� ; � � � i i �� � ' . , � , � , � " j (�,� � � x4�, � �a ; ; i : � � i ( � � � y � , zX�f�� : - ;I� �, � : � i :� � _ � � : � � , ; ' . T� 'C � . . k; I � � � ' i - � - : : ' � : ' �' r � ; : �' � � ; � � � � � , ; ; , � � � � .�} � � f � � E , J -��.j . t : � ( , I ; i � � ' : . � \t; . ...i .,.--_ .: . -- , � � � i ��� � \ � ' . � � - - � � ---�� ' i , ; � i ' I . � � . � { r't \ , ry\� '� . .\ . ' � � ' � i � � . J -� # . ( . i . . . ��{� � �\ i �n i � � � � � I � ' t ' � . . i E �fi�� �. �_o0 i � .. ,.�`�. ! - --- � .. ) � � i ° i ; ati'Y�+`�����-� i � � - i . � - '-.. t ; 'Ub, j i ; � '`,a .�, ���s- � � � � : ! � ?�,� � � � ' � � I � � � ! ' : � � _ � ` ' us I . � � , ,� , � : � � ���� �� . i 4, _ , , i ' �� .� � � t t; ' i 'i ; � � > � + � � : � � �' � � � � � � + ' .3i � � ;i , � ' � j,�a i � :: �^ � 1 #i- ' i , � E� i � ' � � ' f ' ; [ { t . �`rs�� � �..Z_ _. _ .. _ . ... . ... » .. , , , �_.i. � . -. . . .. f � . I[.. �: d�F�a5. ��xcF i6h`v�J';�.9s i , ` ..' _ _ .-. ._. � .. ,'. ... _ -- i. .�..._....___...{..... .....:_"__,:...... ._.,.I....'....__ -.___•__.__."_..>.._..,.,>_..__... ..<_.,........: s�