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HomeMy WebLinkAbout13521 (29) . ... , , , �� CITY OF DIAMOND BAR � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES / 21660 E.Copley Drive Suitc 190 � � � � (909)66a3195 Fax(909)861-3117 � PRESS ''^'� BUQ.DING PERMIT APPLICATION . ' FIRMLY � JOBSITE ��/� �r'�mo�� CoKr7 r APPLICATION PERMIT � P/C o ADDRESS DATE NUMBER r' � p � y .p0 ISSUE ' (' (� TYPE OCC APN OT TRACT DATE �("��`"I� � OWNER 1G1 C CONST. GROUP o ADDRESS G r ZONING SETBACKS �W CITY e ZIP +TEL. /S� —/ / - FRONT RW ❑ APPLICANT TE� SIDE/SIDE STREET RW ❑ � CONTRACTOR bt1 , c• SIDE ❑ ADDRESS � CfTY ZIP 2 2- TEL :b Q PROPOSED USE � ARCHlENG! � DESIGNER NO.OWEL. NO. Np, = CD�DYRESS Z�P TEL - UNITS STORIES BEDROOMS � � DESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION O OYYNER•BUILDER DECLARATION SFRIADDlREM 8 I MEREBY AFFlFM U1i�ER VENAITI'OF YERAJiIY TN�T 1 AM E%E47T FROM iHE CONTMCTORS LI• G2reg0/C81pOR • � - � CENSEUWFOqTHEiOLLOWN�REASON�SEG7071.68U5PlESSANDPROFESSION:OOOE:ANYdTYOR (n COlMYN411CHRE0UWESAPERYRTOCON5TiK1CT,ILTEi�MPROVE,DE1/OL15H.ORqECuqANYSTRUC• W patic/Deck TL1RE.PRqN TO R9 ISSUANCE ALSO REOUIRES THE AVPLICANT FOR SUG1 PERMIi 70 FILE A SIGNED W � STA7FMEM T1UR HE pi 511E IS I1C£NSED PURSUMT TO THE PROVISIONS OF TNE CONTMCTORS lb � � CEHSE UW(CIUPTER 0(COMYENCNO VAT/SECTION 7000)OF DIVISqN i OF TXE BUSINE55 AND PRO• POOVSpB � FE3310NSCOOE10RiHA7ME0115ME19DIEMPTTNEREFRpAAN0711EBA515FOli7HElLL1EG[OEXEMV• C7 T10N.ANYVIOI/lT10NOFbECT10N7W1.6BYAN'IAPPLICMlTFDHAYENAITSUB.IECTSTHEAPPLICANiTO Z qe.p�} �„_, ACIVILFENALT/OFNOT►qRET11ANFNEHUNDREDDOl1AR5(f500).1: � � OLASON?1EROF1HEPilOPEflTY,OfiIAYEMPIAYEESWITNWAGESASNEIRSOtECOIIVEN5AT10N, COrtllTl0ftl31 . . - M11LL 00 T/1E WOF+K,AND iNE STRUCTURE IS NOT IMENDEO OR OFGERED FOR SALE(SEC.7aa1,BJ56 � N NESS IIID VROFESSIONS CODE:iNE CONTRACTOHS L�CFNSE lAW DOES WJi APPLV TO AN OYRIER OF ? , PROPEFifY M?i0 BUILOS OR MPR01IE5 iHEREON,AN�VIMO DOES SUCH Y/ORK NI45[lF OR MERSELF OR LL TWi0U0NHSORMEROVMEAIP�0YEE5,YROVIDEDTMnT5UG1 WVROVEMENTSAHENO7ttlTENDEDOR m ,;:i' � OfFEAEDP01i5ALEF.lIOWEYEF�iHEBULDIN�ORIIAPflOVEMEMI55pDWIiMNONEYEAAOFCOMPIE• Z 'TION.THE O'MIEP�6ULDER N1LL HAVE TNE BURDCN OF PROVPIO iHAT HE OR SHE DW NOT BVIID OR . = IMPRDVE FOftT11E PURP�E OF SALEI. , w OIASDYMEROFTHED1i0PENTV,ALE7fCLU5NELYCOMRACTeJOWrIHUCENSEDCOHfRACTORS �L TO MNSTRUCT THE iRO.IECT(SEC 7oa1,BUSINE55 AND VROFESSiONS CO;;E:iME CONiMCTOAS LI- Valuation A0.1.AREA �J CFNSEUWDOESNOTMPLYTOANOYMEROFAPflOPEflTYYAiOBUILD50RW.PfY�VCS7MEflE0N,IND � MMOCONTMCTSFORSUQ/PR41ECT9WIMACONiMCfOH($�LICENSEDPURSUANTTOiH[CONTMG pUANTITY �ESCRIATIOV FEE , � iOHS LICENSE UW.). _ . . O IAM IXEYPT UIOCR SEC. B.t G.G FOR THIS REASON u' DATE OWN[R � ', LICENSED CONTRACTORS DECLARATION � � 4 w `.. 2 1 NEREBYAFFIRi1 UNDER PENALTY OF PERRIM THAT I AM�ICENSED IMD[N PROVISqNS OF CNAGTEq .,��/���� � • � �(COMYENCNOM7MSECTICH7o001�DM5lON�OFTNEBU5INE55ANDDROFE55KK�5CODE,IWD Z ✓^'�"""1/ 1 �`,�• � �',,� '• I • �D �� W UCENSE IS N ML FORCEAND EFFECL m ��... UCENSE C1ASS p UQ NO, d�d�,����d�"''"I� �'" � t� DATE �� u=i�CONTMCTOR__�;_L��IL1� d Sl � - . ��''_ � WORKERS'COMPENSATION D[CLARATIC`7 Q � IMEREBYAFFIRMUNDERVENALTYOFiE1WM0.NEOFTHEFOILOWINGDECIAMT10NS: N � �I1UK/JJDVALLMAINTALYACEHi1FlCATEOFCONSENTTOBFLF-WSUiiEFOlINVRKERS' . � CpAPENSAT10N,115 PROV7DE0 BV 9ECT10N�70o OF TNE IAEWi CODE FOR ME 7ERFORMANCE OF 1ME WORK FOR WHIp17/115 V ERAaT IS ISSUED. � 0 �IHAVEANDWILLLUIHiAwWORKERS'COUPENSATIONMSURANCE,ASREOI'IREDBVS[CTqN ,�� ,�� i7oaOFTHELA00ACO0EiORiHEPERFORIAANCEOFTHEWOH1cFORN'HipfTHIS0ERM1T15 � ISSUm.Af/wOiu/�,�p S'�°�"PENSATqNWSJRNiC LARRIERANOPCIIGYMJM6ERME: , CONSTRUCTION > CMNEN ' V D I a Bil /—� 4 PLAN REVIEW � ���BEA Nl� • � � _ o E , �'���' "� �� ��9 -� , , ,-� � (IHSSECM�NNEmNOTBECOMtETIDOFhEPERMibiORONEHIR�[XIEDDCl1AtY'i1=�00)p1LE7S? PL BING CLT�r`•-.•�• , •r•�� W � '-.i..._.�_. «_.-' Z I CER:IFV TIUI'.W THE PERFORYANCE OF THE WORK FOR WHICH THIS iERA1R IS ISSUED,I M HANICAL ,�,;� '�_=�� - �•/ (7 SHALLNOTEYPLOYANYCENSONNAHVA,uNNERSOASTOBECpAE5uB1ECT707HE •�• •+•�-� .�.-• +�• y WOR1(ENS'CO4PENSATqNU�W50FC11�FORNIJ�MIDACREFTUTIFISMOULDOECOME INSPECTIONFEE S SUOJECTTOIHEWORKEflS'COYPCNSATIONPROVISIONSOFSECTqN�70oOGTHFUBOR COOE,IBWLLLFOR7MMTHCOMPLYYAMTFqSEP(R�OVISIONS. IS CE 7 ����� � w DATE:1S 11-��1 APPLICANT:�1 GII A� A. 1�'1 E I le�� . T� . � WARNING:FAILUFETOSEWREWOfIKERS'COMPENSATIONCOVEMGEISUNUN'FU4AND51U1LLBE ENERGYP/C �y SUBJECTMIQIPLOYERTOCRIMINALPENALTESIWDpVILFwESUPTOONEMUNDREDiM0U5AN� ENERGYPERMIT ¢ OOlLM4(i t00,00a),QI ADDITION TO THE CAST OF COMPENSATION,DIW AOES Il5 YflOVIDEO FOR IN SECfqN770lOFTHEUOORCOOE,IHTEREST,JWDAT70iWEV'SFEES RETENTIONFEE: OCONSTFiUCTION LENDINGAGENCY PRE•ALT FEE: � IHEREBVAFFIRMUNDENPENILLTYOFPE0.IUHYTHATTNEREISACONSTRUCTIONlENOINOAGENCY FOR THE iER W RMANCE OF TME WORK FOR NlHIG1 TNIS iERMiT IS ISSUED(SEQ 70W,CIV.C.�. �� � r� I 7"I \ � IENDER'SNAME , C LENDER'SADORE55 � ICERTIFYTUiIHAVEPEADTHISAVPLIGATIONANDSTATETHATT1EA00VENFORMATqNISCDRREtT. TOTAL FEES � IAGREETOCOY7LYVVIIHALLCfTVAN�COUNTYOf101NANCESAN'JSTATEUwSRELATINOTOBUILDIH� � COHSTRUCTIOt{ANDHEREBYAUTNORQEREVRESENTATNESOFTHISCOUNTYTOENTERUPONTNE ' - Z MOVE-MEMqNEDPROPERiYFORINSPECTIONPURPOSES. 0 COMMENTS � `L .�i �1 � . m VE—`RMf�NAME(F � � �, ��_�I_^� Q �n /i �.� rl N ��,c�. `f �� L N SIG uREOFPEHAIITTEE OATE �-- � RECPT N0. PAIDBY VAVDAnON WHITE—Department Copy,YELLOW—Fnenoe Copy,PINK—Asaessor Copy,GOLDENROD—File Copy,GHEEN—ApplicanPs Capy ... ,. . . . ,., .. _ , _ . .. . � ' :1 . � .. . ... . ..3.. .I .. r .. ..-�.' . .. t..- ! . . ' . . . ' ' � . ' ' ' � . . . . . .. .� .. � ��� � r ' . CITY OF DIAMOI�D,BAR , „ ��•�, ,,:._.i.,,-; ; �.-.. �1(rlSRECTION•RECOF�D ��:� � �. �. .., � -. •': 1� '`...\ , . ... .. : ���.i�F-i���'r:�^��)���r�.�r� 1,!_����r.r'J :��►��1►'�~�._.��.�""+e ►� f ��;�'���; . 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BENCHING : . ., _, � �.: .ROUGf-f ELECTRIC.---'--- ,_ ._ " -'_.. :,_ . • ROUGH GRADING _ - - - ------ ._ .. ... _ � .. , ,ROUGF;PLUh1BING '- - ------ - � - -- '� FINISH GRADING ; . SHO`�V�AJTUB TEST �--- - -- - - � -' � ' POOL�ELECTRlC • • � ---- �XT.LAiH!SIDING _.....--.- --.. ...- --. .. .._ . .._ ..._ .... _ POOL FENCING ' � iV'l�1L!1NSULATION - =--- __ - -. � POOL FINAL . � i , �iCEILiP�G ti•:JULATION -._. . ... .__. .. . .. ; .._.._ . . . OFF SITE IMPS. . • .' ' - I -: DRYVJ�ILL NAfL1NG -; " - - ' � ' - - -" � DEDICATlONS ' � .•� . _.._.._. ' ���1�4�ER � �'��J,�%�- FINALENG. i;St1'TICTANK ; LAPJDSCAPE/IRRIG. , , . �.SF.cp nii/L.l.. .. ...._....... ON SITE Iti1PS. . ; � rG�.S F,i=i EST ; FRJAL:ZONING � ' .. � .::; -----�-----: __. . __._. _Fir.:?,i..�.:or�ST._--------- - - - - . . . - - ._ .' _ . . FIRE DEPT. FINAL . . , i : ; _ F;r:�__:�EATING. _. .. HEALTH DEPT. FINAL --. . _._._......... � ',: ' -- __.. �`: ;.:r•:_'tIECTRIL'......... ... . . .-- - -...- - - DEV. FEES PAID - - - --- ...... _ � : ?, .._ __ p - -- . , �- •��._PLU�ABINa•- >��/- � . ENERGY ; '.. : � �.�—�-—.- ,. ..-- ' '_ - ._, -- - .. .._ _ _. _ .: • . . � , . .. , , i -- _ _..._- --. _.... --- - -...... �, , ILf:1�P.:;��*-,ti�L+C, � , � �. '__' .._ � ..'A..92�'.J..�Y` �.�...^1.'7:6.'.t�..._ ::f r::...:_ - 1.- . . .'_ '_'"......___'._.._ . ._ . . . __ .. .... .. . . . . . ' {. . . . . . . �- . . .. . .�_ �• �� ' � ` �. ' � � _ �..1�. ' , ' . .. .. .. . . . . . .... . :.�. . ' . . . ' � ;;,.,-:��MENTS --. ._ �...._. _ .. ---- _. .. . .. ... _ •.V�.�14 . ... . . . ' . . . . . � . � � . . . , t . . . , _ , . . , , �. ._.... .__ '.. . _... ".._._.. ._._ . _ .. . ._ . . . . . { ; ' j .. ... . .. ... ...'. _... . ... . . . .. __. ' . ' i , . .. . . ' I i . � � '' " : . ... .. . _. . ._.. ..... - .. -. '., • � � ..� . . � � . . . I .. . . � � ... . - ' i I . , . .' _"I � . .._ ____ _.. . . . . .. . _ . _ .. - ' . . - ' /.._""'�,_. '� ' � � . . � _.i '..:. . . . I � .. .� . . I � . 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