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HomeMy WebLinkAbout14036 CITY OF DIAMOND BAR � '"- ��`-- DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES � � . 21660 E.Copley Drive Suite 190 (909)860-3145 Fax(909)861-3117 PRESS � '��'� BUII.DING PERMTT APPLICATION FIRMLY � ¢ ADDRiE5S�� � pf"li�l�� � ,J�-� APPLICATION r� r�-7i f�t..'PERMIT 1�,f�j� P/C-L��,. o - DATE b' � G NUMBER � #_ �. g ISSUE TYPE OCC APN LOT TRACT_ DATE CONST. GROUP � p ��WNER � � "�L� p ,A'DDRESS T.� ZONING SEfBACKS g �;CI7Y ZIP �+I TEL. FRONT __. .^ RW f7 `APPLICA TEL. y �,��� REAR ❑ �"-'u� SIDEJSIDE STREET RW f] � CONTRAC70R _ s ' I r-A-1�.. .Sf✓_ _ SIDE � _ p____ Q� C�TM S .j-- Z��q�_ ��. •� • PROPOSEDUSE Str''iZZ%r'�' � L 'V J �� �-.�� �-/ ; w ARCH/ENG/ ; z DE5IGNER ` � ADDflESS NO.DWEL. NO. � NO. ; �: CITY Z�p ��� UNITS_,_ STORIES �_DEDROOMS_ t y ' _ _" cn DESCRIPTtON SQ.FT. FACTOR PSF ADJ.AREANALUATION � � OWNER•BUII,DER DECLARA710N SFRlADD/REM � O' 1 HEPEBY AFFIRM UNOER PENPL?V OF PEFJL'RV'fHAI 1 AM EXEMPT FROM THE CANTFiACTORS LI- G8f&JE/Ca�Ort W CENSELAWFOftTHEFOLLOWINGqEAS(N�I�SEC.70315F7U51NE5SANDPROFE5510N5COUF:ANYCINOR (n ,_ U, COUNTYWHiCHREWIpESAPEflMITTOGONS7flUGT,pL7ERiMPHOVE.DEMOLISH.ORREPAIAAMYSTfiUG tJ,J Pa(10/DBCk ` � T1RE.PRqR TO ITS IS9UANCE,ALSO RE�UI�ES TNE APPLICpNT Fqft SUC41 V[RMI7 TO FILE A SIGNEU W _ (� STATEMEM THAT HF.OR SHE IS LICENSED PUpSUANT 70 hIE PROVISIONS OF THE CONTHACTOf7S Lb �� CFNSE IAW(CHRPTER e(COMMENCIN�WITH SECfION'l0ooj OF DIVI510N 3 OF TH[BUSINESS AhD PftO- � PooUSpa � FESSIONSCODE)ORTHATHEORSHEISEXEIAPTTHEREFROMAN�TH[bA515FORTH[ALLEGCDEXEMP� � � V TpN.IWYVp4AiKTYOFSECT101iT037.5BYqNYAPPLICANTFOAAPENMITSU&ifCiSIHEAPPJCANTTO z He-Roof � ACIVIL PENRLT'OF NOT MORE THAN FIYE HUYDqEU l]OLLARS(5500�): — - � OI,ASONMEROFTHEPFlOPERT',ORMYEMPLOYEESWiTHW4GESASTHEIR5C1LE0.�MPfNSATiOM, C� Commercial ^ _ WILL 001HE WORK,AND THE STRUCNFe IS NOT INTGNOEO Oh OFFEHEO FOR SALE(SEC.70U.�U51- rJ � NESS MIO PROFESSIONS COOE'THE fANTRACTOR5 UCENS[I.AW OU[5 NOT A PlY 70 FN OWNEk OF ? I ! PflOPEATY NhiO tlUILD50R IMPROYES TIEREON,AND WHG DOES SUCH WORK HIMSELF(iR HENSELF Op � THROUONHISORHEROWNEMPLOVEES,PF�VIDEDTHATSUCHIMPROVEMF:NTSARENOTI4TENOE�Op � � QOFFEflEDfORSALE.IF,HOWEVERIHEBUIL0INGORIMPROYEMF.NTISSOLDWITHINOkEVUROFCOMPLE- I Z TfON,TNE OWNER-BUILDER WIt1 HAVF.TXE BUR�fN OF PROVl,YQ fHAT H�Qq SHE DID NOT!?t111D Op S � IMPRDVEFOHTFiEPURPOSEDFSA.E). r w Cll./SONMERUfTHEPROPEfIi:'.AMF,%(',I.UEIYEIYCONTRACTINGWITMlIC�NS[U(:ONirIACTOHS -- ^ - 3 � TO CONSiRUCT THE PROJEC7(9EC.70M,BUSINE53 AND PROFESEIONS WDt.'i4E CO+JTRACI'OAS t 1� V8121di10l1 ' { CENSELIWDOESNOTApPLYTOANOWNEROFAPAOPF.HTYWNOBUILD50HI�UPF?06'EETHEREIXJ.AND ----' " �-�-------Aa�,AREA____„_ _______ � � N'FIOCONTMC75FONSUCHPROJECTSWITNFCOlJTRACTO��S)L:CENSE�PURSUANTYUTfiE(YJNiRAG (��)�NTIiY DESCRIPTION FEE ! Y TORS IJCENSE LAW J. I _ � gy f11AMEXEMP7UkDER3EC.�_._ __.___B.BPC.FOR"iHISF�_PSUN U _� � 7 .—' __ "____ _____ �. . Il DATE_____.___'_OWNER__'_____'__.-_._-_____ U� E Z W : � LICENSED CONTRACTORS D[CL4R.ATfON � W� � , i � I HEREBYAFF(FAi UNOER PEkALTYOF AERJURY TMAT IAM LlCENSFLI VNOER V.lOV15!045 OF CHAPTER --- \ � � d Y(COMMENCINOWITHSECTION7000)OFDiV1510N30F iHEBli51NES5AVOPROFE5510tiSCX:CE,AND �� ____ � c�I i � MY LICENSE IS IN fULi.FCflCEPND F.FFECT. fJ m � t � IICENSEc 5 W�,.__LIG`IO..:�P�L�w�_p�'",_ � j � E �j DATE����___CONTViACTOR((�lL:.�+1���'/.(t,�' ��- --'"—' � W � r � WUFiKERS'CC�MPFNSATICN OECLARATIC:N � ��� / ��� / • �J�. � �'l I HEqEBY AFFIFIA�iND[R PFNAt'fV OF PF.WUR}'OMf OF?HE:OIIOW:M1C 0[CLAriATIONS: , v ' � � _IHAVF.AtvDW4L!iAA@Il"AINAf.ER'tI�ICATfOFCqVSGN77GSEL�-�NSUAFGOkY�OFlkEliS' - � CP7APENSATION,ASPqO'!iL'EDBVSEC710N3�oobFTH[1A.60RC[)DF.Fi:Ri.�E:PiR"O(1biANCE � �W '-- �. ¢. OFTHE\VOFKFORWN�CFITHIS°FRM!TFISSUED. �r_^- ^- -_ • V IHAVE�NUWiLLAlA1frTA1NWOFlKERS'C9MVE.'15AT70NII:S:IRANCE,ASREQLI�RF0t3v5FCTION £� __"_' � 9]OOOF7HELT.HOR[%IDE,FOHTfiFPLAI=nRAI.aVCFDFTHEYJGANFO.4bV}�;GHIIiISFEHMITIS : 153UEO.MYY(ONNERS'IX'.AIfeNSATIONi^ISl1RAPlCECANPIERr•.�'UPOLiCYi:U613CkiMi�� � CONSTRUC710N ._ .,_ _,_....___..._`___ i - /+ �� y.� —_ j CARRIEp C:±'�+����G I.Y�."_. __'_' F'LAN REVIEVJ � .._ __ � ._.._. ..._ ' �- -��----'- ---- � PotICYNUMBEA��1�. ���(J� -- ' ELECTRIC � Q - -' ---' --...__... .----.._...-... ..--- --..._--- „ �11iS5ECT10NNEBJM�TBEOaV'RE'fFDOFh'tPEWAT�fCxtOhE:1;NLYiF.DIXM1}FS(S+co�GiLFSS1 PllIM81NG ' W � __- _. __'..'._._.' _ i _._-'.•_'_.'_ z I CF.HTIFY'fHAT IN THi;PERFOHMANCE OF1'HE W.UHK fOR WHiCH THIS FL"RMIT IS!SSUf.0,1 ME(;HANICiA�. .__,__ ~ '4 "__�} ��_��-.�-�,�_�� _- _, t,3' SHAL{.MO7 CMPL6YnNYPERSQNINANYMANNER50ASTUBECOIA[.S'JHJF�C.?T�iTHE ""'���. � en W�AKERS'COMPENSATION4AWSOFCAU����NIA,P.N�AGHFFTHaTIFISNOUI.DUFt;OME IN:iFEC710NFEE _ ._._ _ __,..__;,-___ S - SUBJFCTTOTHEWORNEFS'(x7MPchS VHOVIS;��SOF ECIIUY37,]OOFTNELAJOfi ) � cope. sH, cHrHwnNcoM Wf :IfnSEPAOVtSION ISSUANCE ----.__-`---_-_-- -.--�_��G�J_ � .:� 0 onre_� .J_1 � aPVL�c0.� . > SMIP -'----_+�i..�;._.. . -- --- --— � - - -- ----- ' � ENERGY P/C � , ! 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