HomeMy WebLinkAbout15327 � CITY OF DIAMOND BAR
DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES
21660 E.Copley Drive Suiu 190
(909)860-3195 Faz(909)861-3117 PRESS
�^^'� BUII.DIIVG PERMTi'APPLICATION FIRMLY
� J08SITE � APPUCATIO PERMR P/C
o ADDRESS2�I 7`I� ZI 17�2� 2��7'3 I�.IQL�� DATE NUMBER� It
g ISSUE / TYPE OCC
APN LOT TflACT DATE � CONST. GROUP
p OWNEfl T�LL�( `.�f1�� 1�.�.i�.
ADDRESS ZONING SEfBACKS
� CITY ZIP TEL REAR Rw p
APPLICANT TEL. SIDEISIDE STREET RW ❑
a� CON7AACTOR �]J FI� BQCi� �00 FI N6, �IJG, SIDE O
g ADDRESS 2'�3q? K Ya-�C eo rt F -
PROPOSED USE '
� CITY�IY�,I�tJ ylE�O ZIPQ2�e91 TEL�u�)4j�-'jyLl� _ J
ARCFUENG/ � - �
� DESIGNER N0.DWEL � N . N0.
AODRESS UNITS STORIES BEDROOMS
� CITY ZIP TEL
N
h DESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION
p� OWNER-BUILDER OECLARATION SFR/ADDlHEM
O
p 1 HEREBY AiFlRY WOEH VENAL7Y OF VE0.LRY THAT I AY E%EIIPT FROu 7HE[YWTRACTORS ll. Garage/CarpoR
LLl LENSEUWFORiNEFOLLAYlwOREA50NI5EG70.71.68U5WE55ANDPROFESS10N5CO0EM7YqTYOR (A
COUHTYWHNS/REWWE9AVERAIRTOCONSiRUCT.ALTER�dPNOVE.DEYOL�51iORHEPAlNWrYSTik1G W PatiolDeck
TUqE.Yf1OX TO RS ISSUANCE ALSO REOUIRES THE APPLIGAMi FOfi Sl1GH PERMIT TO FILE A SIGNED W
6TATEMFNi MAT HE OH SME IS UCFNSED VUiY.UulT TO iHE PROYISIONS OF TME CONiMCTORS LF
� [{NSE LA1M�6UV7ER�(CQ411ENCW0 WIT/bECiION 70a01����3 OF TNE&151NF55 ANO VRO� � Pool/Spa -
FESSIONS COOE)OH TMAi HE OH 511E IS ExEMPT TMEREfROAI A1�h1E 8A519 GORTME N.LEGED ExEMP•
TqN.AtfYYqlA710NOFSECT10N701fABYN1'/A7DLICANTFORADERM�iSUBJECTbTHEMCLICAHiiO Z RB-R001
� AGVILPENKiVO�NOTMORETXANFIVEINNDREDDOlLAASltsool.): ,
� O�ASON/NEROFTHEDiqVERTY.OqWEMPIOVEESWITNWAGE5A5THEIR,.OLEW4PEN5ATqN, O �((�8(Ci21 '
WILL pO THE WOqK.M�D 7ME STRUC7URE IS NDT WTE�UED OR OFiEREO FOR SALE(SEG 7ou,eu54 J
N NE55 AND iR0iE5510N5 COOE 7HE CONiMCTOFS LIGENSE lAW DOES NOT APPtY 70 MI OWNER OF j
OqODERTY Nhq&llDS OR 4GROVES TMEREOK AND 1Nq DOES SUCH WOHN MIE15F,1,F Oq HERSELF OR
CL TWIIXIONWSORMENO'MIfiWLDYEES.VRDVIDEDT}IAtSIIGNIM7ROYElAENTSARENOTHTENDEDOH m
� .OFTQiEDfORSALEi.l�ovhYE0.THEBUIDwGORWPROVEUENT1660LDWI731WONEVEMOiCOMRE- .
z 'ilpN.TiE ONTIER$ULLDER N'tL1IUYE 7ME BURDEN Of VROVNNi iMAT F1E OR SHE DW NOi BUILD Oq
= MPRDVE FOF iNE R7FiO5E OF SLLF�
� ❑LASOWNEROFiMEDROPEHTY.AMEXCUSNELYLONTMCTNOWITHLICENSEDCOHiRACTOHS
TO WNSiRt1GT 7ME YR0.IECT ISEG 7aa.BUSWE55 MID VROFESSiONS CODE iME GONTRAGTORS l4 Valuation AQIAREA
CEWE UW DOES NOTMPLY TO AN ONNER OFAPRODERtY YAq BURDS OR Y/PRpYE3 THEREOf4 ANO
� vnaoorrrrucracoAsua+ar+o.iEcrsNnnuca+rw�craa�s���rueoauasuurrron+emwrrue pUANTIN DESCRIP.TION . r� + FEE
� ion5 ucEt+se uw.4 .
O IAM El(EMPT UOEA bEG &4 P.G FOR iW5 HEASOti Q
U
W ¢
OATE OWNER U . .
� �- � UCENSED CONTRACTORS OECLARATION W
J
� W
IHEftEBY�fiWAiUNOERVENALttOFPE�iriIR'/TIUTINAl1CFN5EDUNDERPROVI5lON50FC1uPTFR V.
s �(Cp.WfNCN6Wi7H5ECT10NT000)OFOMSION70FTNE&15WESSAlY)VROFESSIONSCOOE.AW z
��L WUGENSEISNFIJLLFORCE/WD(E]FFECT. m
� IIGENSE—CyUSS C� �—I LIC.NO. w j
�j DATE l� ���C.� CONiMCTOFI � a �
W
� WOflKERS'COMPENSATION DECLAFil1T10N �
� INERFBYAFFW11lRmEiiPElL1LTYOFiEiLUHYONEOFiMEfOLIOWWGDECIARATqNS: U
� Z
� �IHAVEAI�MnLLYAW7AWAGERTIFlCATEOFGONSFNiTOSELHNSUREfORWOFKERS' 2
COnvENSAiION.ASPRD`ADEDBYSEC710N97ooOFTHEUBOIiCODEFOqiHEPERWM4WCE U
� OF THE WOiK FOH Nhf1G/iMIS PERAUT IS ISSUm. �
0
1 HAyE ANp W�LL Wp(TAW WOFlKERS'CqAPEN5AT10N N15UMNCE.Af fiEWIHED BY SEGTION �
Qi1o0 OF TME LABOit CO6E FOH THE GERFORMANCE OF TNE WON(iOR WMICH THIS PEM11T IS �
� �,S�Ep,yyYp{yl(Eq5'Qp11PEKSAiqNWSUAANCECARR/ERAhDPOLICYNUAIBERARe: CONSTRUCTION
� GwuEp STA'TE �I��L� y�/ __ PLANREYIEW
� PqJCYMkaBEN (� �7�LL-1,�<r� ELECTRIC 1�L
� (nassEcf�oNNFmNo76Eoo.ALE7mCfilEPEiidT6wROr$ItK7t[n0otu3iSR�m)ORlFssl PLUMBING � �a'�. ��
�
Z 1 CERiIFY 7HAT W ME PERFORAIANCE OF TME MAHK FOR WN�CM THIS DEiwIT IS ISSUFD,1 MECHANICAL
(} SNALLNOTEM7LOYFNYVERSONCl/NYMANNERSOASTOBEGOMESU&IEGTTOTME
N NOiLCERS'COMPENSA?IDNUwSOFCALIFORN�AN+DAGNEETHATIFISNpADBECOME INSPECTIONFEE
S SUBJECi TO ME WORI(ERS'COMDEHSATION DPOVI510NS OF SFG7qN 77000F 7ME LABOH �SSUPNCE
coo�.i coRTHvnrncowv�rvnrMna vqovisia+s.
0 /�y� SMIP
0 pA7E; � W APR�C+WL .
� WARwn(iFALUIiETObEp1REWOfiKEilS'COAIPENSATqNCOYEFUGEISUNUWFUL,ANOSF1AlLBE ENERGYP/C
� SUB.IECTANEMPLOYERTOCNMWALPENK7�ESNJQCMLGWESUGi00NEHUNDpEDTNWSIND ENERGYPEAMIT
OOLLAHS(l1o0.Om1.W�TION T07HE COSTOF COAIVENSATION,DAANCES AS PROVIDED FOR W
¢ SECTION770lOFTTtELA60RCODE�NTEREST,ANDATTOHNEY5FEE5. RETENTIONFEE:
pW.. CONSTRUCTION LENDING AGENCY PRE-ALT FEE
� IMEREBYAFiIRMUNDERiENALTYOFVERAJRYiHATTNERE4SA00NSiRUCiIONLENDwGACENCY
n- FOq TME PERFORMANCE DF TXE WORK iOR WHN71 TMLS PEflAUT IS ISSUED(SEG]DY7.GK GG
�
� LENDEFCS tiAME
�S IENDERSAODHE55
W I CER11F'!iYNi I HAVE READ TMIS MPLICA7pN AND STATE TH�T THE ABOVE WFpRMATpN IS COMEGT. TOTAL FE ES . I-
d IAGREETOCOMPLYN7THALLGiYINDCOUNTYORDWANCESANOSTA7EUW$REUiW670BUlDW6 __
CONSiRUCTION,At�HENEBY AUTIqRIZE REPRESENTATIYES Oi TIUS COUNiV TO ENffR UPON T/1E
Z �eovE.uEHrar,EovaovEmrFoauuaEcrnnwarosEs. COMMENTS
g �'�L►Fi= i�2a�n► �c�or��l�, .rtic.
� DFAM�j]EEIUAIE(7R1Ni) 7 I / —O`�
� /
ySIGNANFiE FPEFWIT�EE �TE
� RECPT.NO. PAID BY VALIDATON
YJF11TE—{)epartment Copy,YELLOW—Finance Copy,PINK—Assessor Copy. OLDENROD—Fiie Copy,GFEEN—Appiicant's Copy
�
: . , I
. , . ,. _
.- ; . _ , � �
i ��-- -; - - - - - - - . �.
, �i I
1: �-a, I
��
�i pt
�I � _ _,
Nii I
Utl _ —� � �
:�I
i
�m
i
F -
- +I Z
`' � �;. � � � Q .
i �. =�''I , U � ¢ m � � � .
Q p �� � ozoa � � c� � a - '
p] i m ¢ w ? z � Z o
p �`� ¢ Q o o � w m c� o � ¢ z a �n � �; � z � r b :
❑ iF-"cn0 ou. m m z a � r �- a � ?k :
(?. 1 cn f- Z p z o c7 -' z w a
Z U,I �T;�o � o o � � a 6 � w z ¢ � o c� a � z � W m ��.�
O � .if� L tL m Z p Q Z (7 J w Z W � -� Q — � 0. � �L
� � CC � J J f: m m CL = 2 = W lL LL. 1_- C W � � N � 2 W � =:_j '
� , o ¢ wwaa = � c7vuN � JJcnq � o � � "- ¢ 1e;
aO p ¢ ooW Wo awz � 000tio � '� 4W �� L,
,� = z z ¢ ¢ riz � woz000LLwz -' zctw` w -- ?��, ;
� '�,I��� � > > � � � m � a m [C LL a a d O O u. � O u. � _ � ui �-M .
h —
o �� � -
n. ,:� � _
>- -
�
U ? ''�'� �. ;" _ � ---
�
i• ; � _ _ I /
_ _ � I _
�� , � - - - -
� I, r,�,•
�
- ��' Z c�, ��k �---�-.�
+� ; O ��^ �
+ �E� w z Z C7 � ' U z w C7 Z O � ' �� N W J
' � o CO � _ � � � m � z � 5 � � c? `-' z cn _= mnr.
. I�i (n � � CL z CC F- U t m � � y ' Y J � F -- F- [L1 �� � � . . �
� Y(A i
_ . �;, ` U J W W > h- w W Q � � ' Z s' . �fl�
�- � > Q a W J J � � �7 `- � Z J W � F- U T2 ' G ' Q= . �
. � . ��mt�CY,) � U � �L 0 (n 2 � � S LLl d Q � � — J H F_ ~ � W J J w . ~'- ,
''�1�m � � � � n. w LL ��u. c=7 c=7 (=.7 W `tJ Z C7 � ¢ U d � U 2 w a � U d .. .
W Q .� J J s _ - f--a. �
'- . .'.f` (7 W � Q � H O a O � � � O ' J J � 7 a W Ul `L 4 4 . -,
- �� �� J Q J W 4 O Q O O O O �: � ¢ W CC W W W 4 7 �'- • ' � ' Q � �W ,
- � �fn � W C'S fn H 'S LC tL Q CL CL CC (1J lll i U � fn CI] (/1 (7 lL lL L f 1�.. � � i�: (� Cn Cn � � � � 1
_ _�__� - - - �..�_�..__--.-�--_