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HomeMy WebLinkAbout10784 �. - - CITY OF DIAMOND BAR COMMUNTTY DEVELOPMENT DEPARTMENT r � ;..c . st�o E.copi�y n�v� . PRESS (909)860-3195Fax( a6�-s�i� • FIRMLY ���' BUILDINGPERMITA AT[ON � ,�pggl� . � � . S . ' APPLICATION J, PERMR �'1 !C q .�� o ADDRESS ��' � DATE LL NUMBE �� M � � ISSUE TYPE OCC APN LOT TRACT DATE CONST. GROUP � OWNER _r�t+��: P�li1SSJ�•� G}(c1R.GK "" ADDRESS � � R� 'r ZONING SETBACKS w CIN � , � ZIP " � TEL �" REAR Rw p . � APPLICANT ,_.������.��.�,� TEL �• ^ • SIDEJSIDE STAEET RW ❑' � CONTRACTOR �Af,�P+,t C��N S?f'r�• SIDE ❑ gADDRESS /� ��( ,�/'o� �'��:�..Q PROPOSED USE V � r �`f �� C�7 y,�n�.r„�f.e__�__r«•e't_ Z I P�l,t T E L^.C��_�].^_i t� ✓ . r w ARCHlENG/ � . .+ � DESIGNER �E�'' ''v+`J NO.DWEL. . ' O. .� � ADDRESS 'i�`�?4� f'� 'I}+ti" � UNffS "" STORIES BE�ROOMS `� � CITY � ZIP�ey�TEL. y 9t�A l /.Z G N DESCRIPTION SO.FT. • FACTOR PSF ADJ.AREANALUATION � OWNER•BL'ILDER DECLARATION SFR/ADDiAEM S �� O p 1 HEREBY AFFiRM UNDEH PENALTY OF PE0.AJNV 711AT I IW E%EYvi FROM THE CONTRACTOi15 L4 GefH�!/CafpOft . W CENSEUWfOqTHEFOLLOWWOPEA+�N(SEG70.11.6BUSNESSMiDPROFE5510NSCODEANYCITYDR (n C� .WUNTYWwR1RE0U1RE5A7ERMiTTOCONSTRUGT,ALTER�P�E.DEMOIISH.ORRERURM7YSTRUG W P811Q�DBCk �� 7URE,PRqR TOITS IS5UNiCE�WD AEWIRES T1E APPL1CAtlT FO(i Sudf PERMIT TO F0.E A S�GNED W ETATEMENT THAi HE OR SHE IS UCENSED FURSUANT TO TME VROVISIONS OF iME COHiMCTONS LF � CENSE U�M ICNAPTEH 9(COYYENLN01N�7M SECTqN 700010F DINSpN 70F iHE BUSNIE55 A1O GHO- V" P��Pe fE55qN5 COOE)OR i1/AT HE OR Si1E IS EXE�PT iMEREFilOY AN�THE BA515 FOfi THE ALLEGCD E%EMP• TIDN.M7YVIOlAT10NOFSECT10N70f1.6BVMIVAPPLICJJITFORAiERYITSUaJECT57NEAVPlICJ1NTT0 Z ps.Root � A CiVIL VENALTY OF NOT MORE T1W7 FNE HUNDRED DOIl/fiS(l5�1.): � Ot���EROFiMEPROGENtt.ORMYEMPLOYEESWITNWACESASiHEIR..OIECOMPEH5AT10N, Q C�m���� . WILLDO THE WORK.M1D TXE STRUCTURE IS NOi INTENDED OR OFiEREO FOR BALE�SEC.7ou,BU51• J N NESS AIID VROFESSIONS COOE:TME CONTNALTORS LICENSE LAw DOES NOT APPLY TO AN OWNEN OF � _ . VHOPERTYYA10BUlD50RIYVROVE5IHEHEON.AN0VR10D0E55UCHM/�7PKHIMSELFORNERSEIFOR Q THHOUONHISORMEROYMEMPLOYEES.DROVIDEDTMATSUGIIMPROVEMEMS�FENOTNITENDEDOfi. . m � � . QOFFEREDiORSALEIF,HOM/EVERTMEBULDwOORMAPROVEMEMISSOLDNnTMNONEYEAROFCOYPIE• ' � Z TION,7ME OwNEiiBULLDER 1MLL MAVE THE BUMEN OF PROVM70 T1UT ME OR SHE D�D NOT BURD OR = MVROVE FOR THE PUR705E OF SAIE). O L��ER OF THE PROPER7Y,/UA E%GLUSNELV LONTRAGTiNa WR11 LICENSED COHTMCTORS A Q TO CDNSTRUCT ME iR0.1ECT�SEG 70N.BUSINESSAI�YROFESSIONS CODE:711E COHiMCTON9 U• 91W l'IOf1 ll�O ADJ.AREA W CENSEUWDOESNOTAVPLYTOANOWNEROFAPNOPERTYNRIOBUIIDSOHMPiqVESiNEREON.AND f Y�qCONTMCTSFOFSUd�ORdIECT3WITH11C01RMCTOHI5�l10ENSEDPURSUANTTOTHE00N7MG pUANTITY OESCRIFTION FEE � � TWiSLICENSEUW.). 0 O 1 AM EXEMPT UfDER SEG B.L P.C.FOR TH�S REIIAN U V" DATE ONMER � � . . � . . . . Z W �¢ LICENSED CONTRACTORS DECUIRATION W [L IHEREBYAFFIRMUNDERPENKTYOfPE0.1UNYTMATIAMUCENSEDUNO[RPROVISqN50FCHAPTER Vr � f(COINAENCINO YATM SECTION 700D)OF OMSi011]Of TNE BUSINE39 AND VROfESSi0N4 COOE.AMD Z �� W IICENSE 5 MI NLL FORCE ANO EFFECT. m � � � UCENSE CUSS �UC.N0._,� J � DATE ��CONTRACTOR �• W �- --�� - WO KERS'COMP[NSATION DECLARATION 2 I i N J ,I c� N IFIEREBYAFFIRYUNOERiEN�ITYOFVEMIF7'/ONEOFTNEFOlLON7NO0EG1AMTqNS: \� a . � _IMAYEMOWILLMAINTAINACERTIFIGTEOFCONSENTiOSElFaNSUR[FOfiYlOfMCERS' S � COAIPENSA710N,A5 VRDNOED BY SECTON]70o OF TNE LABOR LODE.FORTHE PERPDR�WICE W OF TME WORK FOR NMICN TM�S VERYiT IS ISSUEO. � .�. -. . , � w _I HAVE/ND VYILL MAWTAIN WOi1KER5 WMPENSATION M5UR1wCE,A5 REOU�RED BY BECTqN � � Q 770o OF TME LABOR OOOE FOR THE DERFORIIANCE OF THE WOfiN WR WNN]ITHIS iERMiT15 ` ' ' � � • • �• � ISSUED.MVVMORKERS CdAPENSATpN INSUIWlCE UM�ER N1D POIICY NUYBER AAE: ` CONSTRUCTION � � � _ CAARiER PLAN PEVIEW . . , .. .. � va�cYNu�eEn ELECTAIC o (fwssEcnor+��wreEmr.a�nocnEaEw+rtsroaorEM+ar+Enoau�risR�mlaA� PLUMBING Z I CERTIFYTHAT N TME PEpFOPoAANCE OF THE MNHK FOR wMId1 MI5 VEHYiT 6I55UED,1 1AECHANICAL ` (ry S/ULL NOT EMPLOY ANY GERSON�N ANY AUHNCR SO hS TO BECO�E SUBJECT TO TN[ . y WORKE0.5'CpAPEN5AT10NLAW50FCAL�FORNIA��+�ETNATIFISMOULDBECOME iNSPECTIONFEE S SUBJECTTOTHfWORICERS'C04PENSATIONVROViS10N50F5ECT10N 7000FTNEUBON �SSUANCE coo�.is�uucor+nn�n�ca�v�rwm+naosE io�+s. � O SMIP •.p DATE: � PPLICANT: � ENERGY P/C � WARMH6:FALURET SE EYIORKf0.S'COMv 5 10NCOVE E15 WM. 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