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HomeMy WebLinkAbout10174 A �� � - - CTfY OF DIAMOND BAR � ' � COMMUNITY DEVELOPhfENT DEPARTMENT :,.e 21660 E.Copley Drive Suite 190 � PRESS (909)8643195 Fax(909)861-3117 " ' " '""', BUILDINGPERMITAPPLICATION FIRMLY � J08SRE /�p�—� ,��+�f` ���� '. APPLICATION � PERMR C • o ADDRESS 09�7J V GO DATE NUMBEfl N ISSUE TYPE aCC � APN LOT TRACT�,�aSc��_ DATE CONST. GROUP p OWNER Ly/�1, , , o ADDRESSpd {�-+/ �J� ' ' ZONING SETBACKS � CITY ���rJ��l ZIP'��� TEL.S3�,C'S�i�.i2 REAR RW p APPUCANT TEL. SIDE/SIDE STREET RW ❑ o� CONTRACTOR SIDE ADDRESS ppOPOSED USE I�-���'`'e— � yy�K� CITY ZIP TEL. o ARCH/ENG/ _ � DESiGNER ' NO.DWEL. NO. • • � NO.� .• n. ADDRESS �UNITS STORIES BEDROOMS � CITY ZIP TEL. � DESCRIPTION SQ.Fl: FACTOR PSF ADJ.AREANALUATION Q OWNER-BCILDER DECLARAT�ON SFWADWREM O p I NfREBV AFF71u UHDER VfNALN OF VERJURV THA71 MI EXE�PT iROY 7HE CONTRACT01lS LL GefBpBK.B1pOR � W GENSELAWFORTMEFOLLON7NGREASONf5EC.70.11.68U5iNESSINOCROFESS10NSO00E:ANYCrtYOR . (n U COUMYWHIGIREOUIRfSAVERMiT70WN5TRUCT,IITE0.�vROVE,OEAbLISH.ORREPURANY3TRUG W P8l'10lDBtk � � � TURE.PA�OH TO RS ISSUANGE.AL50 REOUIfiES 7HE APPLICANT fON SUCH/ERu17 i0 FiLE A SIGNED W � .STAiEAIENT THAT HE OH SNE IS UCENSED PURSUANT TO iHE GRDVISIpJS OF THE CONiMMOR3 L4 � CENSELAW�QUPTERY(COMMENCN6N7TMSEGTqN700010FDIVISqN]OFTMEBUS�NESSANDiRP � FcaUSPa .� - - FESSqNS OODE)OR 7TUT HE OR SME IS EXEMPT iHEREFROM AND TME&lSIS�OR 7NE 1LLLEGED EXEMP� TION.ANVVIOLIITIONOFSECTION7071.SBVANVMPLICANTFORAVEfWIiSUOJECTSiMEMPLICANTTO Z RB•ROOI A CML PENALTY OF NpT MpqE 7li.W FNE HUNORED OOLURS(fSOD).1: 0 OI.ASOWNEROFTNEPROVER7Y.OflMYEA1MOYEE5N77HWAGE5A5THEIR50LELOYPENSATqN, _ Q .. . , � Z WILL DO THE WORK�ND TME STRUCTURE IS NOT IMENDED OR OFFERED FOR SALE(SEC.701�,BU51- J COrtlmefCl01 NE55 AND VROFESSIONS O�DE:THE CONTRACTORS LICENSE UW DDES NOTAPPLr TO AN OWNER OF N OROPERTYWNOBULDSORIMViqYESTNEREON.�NDN710DOESSUCMWORKHiMSELFORH[RSELFOii = ' - [L -7NROUGH MIS OR HEA OWN EY7�OYEES,VROVbED MATSUC//W 7ROVEYENTS AAE NOT IVTENOEOOR m � OFFEREDiORSl1LE.IF.FIOWEVERTMEBUIDINaORnAPROVFA/ENiIS" JNnMWONEYEAROFCp1PLE• ' Z TqN,THE OWNEA�BULAER NnLL NAVE TME BURDEN OF PNONNU T1uT ME OR 311E OiD NOi BUiLD OH � = MPROVE FOR THE iURPoSE OF SALE). � /� O L�OWNEA OF T11E GFOPERTI:AA1 E%ttUSNELY CONTMCTINO NnTN LICENSEO LONTRACT01i9 ¢ TO CONSTNUCT THE VROJEC�ISEC.1oa�,BUSINE55 An0 PROFESSIONS COOE:THE CWrtMCTORS U• V311181ian ADJ.AREA W CENSEUWOOESNOTAPPLYTOANOWNEHOf�GROPER7VWNO8UILDSORMPROVE4TNEREON.AN� � W1pCONTMCT5FOR5UCl1Pqp.lECTSWItHACONTRAf.'tOR(5)LICENSEDPUFISUMfTTOTMEGONTMG QUANTITY ESCRIPTION FEE � MRSUCENSEUW.�. . , . . .. . . O O IAM D(EMPT UNDER SEC. B.1 P.G FOR THIS REASCN ' a LL OA7E �' OMMER � v � � ... � LICENSEDCONTRACTOR ECUI ION W `- � IMEREBYAiFIRNUNOERPEW�LTYOfPEiWRYTNAT1AYlICEN5E0UNDFRVHONSqN30FCNMTEH Vr � d �(COMMENCINOWI7115ECTION70oo)OFOIVISiON70iTNEBU51NE55ANDVROFES5qN5CODE,AND Z � r.n'L�CENSE IS P!ML FORGE AND EFFEGL : m •. � LICENSE CU55 LIC.NO. �,,.1 � V DATE � CONTMCTOP � a W . . . � WORKERS'COMPENSATION DECLARATION 4 N IHEREBYAFFIRYUNOERVENALTYOFPEiWFfYONEOFTI7EFOLlO'MN��EWMTIONS: U � ¢ , � �IHAVEIWUYNLLIAA�NTAINACER7IFICATEOGCONSENTTOSELFdNSURGiOR1NDPoCERS' S C04vEN5ATqN,ASVROVIDEDBYSECT10N37aoOFTMEIABIXiCODE,FOHTHEPERFOq4ANCE `U Q O�7HE WIXiK FOR WHlp/iM13 PFRMIT 19 i33UED. � � �IHAVEANDVIILLIJAINTAW WORKERS'COYPENSATIDNC15I1RANCE,ASREOUIREDBYSECf10N �� ���III / O4 �7000FTMEUBORCOOE.FORTNEGERFORMANGEOFTMEN'ORKfONWM�CMTMi9PENYrtIS � ��y� �L� 65UED.MYNORKERS'COYPENSATIONINSUiVWCECARRIERANDPq.ICYM1A16ERME: CONSTRUCTION j �•� "�1�� _ /�1 S J . j URfLER PLAN PEVIEW _ . 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