Loading...
HomeMy WebLinkAbout11189 _.� �� � CITY OF DIAMOND BAR �`�) �_�� COMMUNITY DEVELOPMENT DEPARTMENT d -„.;w . 21660 E.Copley Drive Suite 190 ,,;,y�,,,, (909)860-3195 Fax(909)861-3117 �''�Y PRESS BUILDINGPERMITAPPLICATION`. FIRMLY ¢�� JOBSITE ��L/ "r'?/�2� _N ' APPL�CATION �"Z, � NUMBER #/C � ADDRESS � �� h1 : DATE r°'. APN LOT TRACT " ISSUE TYPE OCC �- �_-� ; DATE CONST. GROUP p,' OWNER G�Y�It�� o; ADDR�SS ��• ___ ZONING SETBACKS Z; CITY r^�i rl�roho�y�C1�'l ZIP TEL. �i �° I �+ FRONT --- RW ❑ . �; APPLICANT TEL. REAR _ ❑ z: SIDE/SIDE STREET RW LJ Q- CONTRACTO �� �C.v w7� SIDE ❑ ADDRESS � r� t � CITY (.�u��ti°�+� IP._a�r�TEL. �� y � - PROPOSED USE �� ��',H^ �-^��0�� �Lei w' ARCH/ENG/ � - Lum ' zi DESIGNER "`�`�"' w NO.DWEL. j O. sJ NO. �; ADDRESS ,, UNITS t STORIES J"� BEDROOMS � CITY ZIP TEL. • v�. _ ;_ � DESCRIPTION SQ.Ff. FACTOR PSF ADJ.AREANALUATION 'p� OWNER-BCILDER DECLARATION SFRlADD/REM '�' i �p-. 1 HEflEBY AFFlRM UNDEH PENqLTY OF PERJURY THAT 1 AM EXEMPT FROM THE CONTRACTOHS LI- 'Gdfd98/C9fpOfl ' 1L- CENSELAWFORTHEFOLLOWMGREASQ4(SEC.7031.5BUSINESSANDPROFESSIONSCODE:ANYCITYOR �^-(n U� COUNTYWHICHREQUIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE,DEMOUSH,ORREPAIRANYSTRUC- z� TUPE.PRIOR TO ITS ISSUANCE,RL50 REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED �W PatiO/Deck .��. S7ATEMENT THAT HE OR SHE IS LICFNSFD FURSUANT TO THE PROVISIONS OF THE CONTfiACTOpS LI- -�� ;O-� CENSE lAW(CHAPTER 9�COMMENCINa WITH SECTION 1000)OF DIVISION 30F THE BUSINESS ANO PRO- POOI/Sp2 s, FESSIONSCODE)ORTHATHEORSHEISEXEMPTTHEREFHOMAN�iHE6ASI5FORTHEALLEGEDEXEMP- �(�J V� TION.ANVVIOLATIONOFSFCTION7031.5HyqNYAPPLICAMFORAPEflM1TSU8JECTSTHEAPPLICANTTO ,_Z Re-Roof �� A CIVIL PENALTY OF NOT MORETHAN FlVE HUNDREO�OLLARS(ESoo).): _p. ❑I,ASOWNEROFTHEPROPEfiTY,ORMYEMPLOYEESWITHWAGE5A5THEIRSOLECOMPENSATION, �� Commercial Z' WILL DO THE WORK,AN�THE STFt1CTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7044,BU51� --J � NESS AND PROFESSIONS CADE:THE CONTMCTO�iS LICENSE LAW DOES NOTAPPLY70 AN OWNER OF . � PROPEPTY WHO BUILDS OR IMPFOVESiHEREON.AND WHO DOES SUCH WORK HIMSE�F Ofl HEflSELF OR �W_�, THROUGHHISORHEROWNEMPLOYEES,PROVIDEDTHATSUCHIMPROVEMENTSARENOTINTENDEDOR ' m Q� OFFEflEDF-0RSALEIFHOWEVERTHEBUILDINGORIMPROVEMENTISSOIDWITHINONEYEAROFCOMGLE• _ .��, TION,THE OWNEfl-BUILOER WILL HAVE THE BUflDEN OF PROYMG THAT HE Oq SHE DID NOT BUIIA OR - �� IMPROVE FOR THE PURPOSE OF SALE). W._ ❑I,ASOWNEROFTHEPROPERTY,AMEXCLUSIVELYCONTRACTINGWITHLICENSEDCONTflACTORS ^ay ��- TO CONSTRUCT THE PftOJECT(SEC.7044,BUSINESS AND PROFESSIONS CODE:THE CONTRACTOqS LI- V81llAllO'1 [� ADJ.AREA - W CENSELAWOOE5NOTAPPLYTOANOWNEROFAPROPERTYWH09UILOSORIMPROVESTHEREON,ANO �-: WHOCANTRACTSFORSUCHPRQIECTSWITNACONTRACTOR(S)LICENSEDPURSUANTTOTHECONTpAC- QUANTITY DESCRIPTION FEE -- -�; TORS LICENSE LAW.). : -� - '� ❑I N.1 EXEMPT UNDER SEC. 0.8 P.C.FOR THIS REASINJ _�_ Q � V � ¢ � OATE OWNEfl ' F- � � W � LICENSED CONTRACTORS DECLARATION �. W � ¢ � i HEflEBY AFFIRM UNDEF PENALTY OF PERJUFY THAT IAM LICENSE�UNDER PROVISIONS�F CHAPTER , � -- ' d . 9(COMMENCINGWITHSECTION7o00)OFDIVISION30FTHEBUSWESSANDPROFESSIDN5CODE,AND Z X �MV LICENSE IS IN FULL FORCEAND EFFECT, . . � �LICENSE GLASS�a��� LIC.NO. ��� � � W �ATE ���"��� !(�_ CONTRACT -�s,��� � d � ` �� WORKEFS'COMPENSATION DECLARATION ��y�Q� � U � -1 HEFEBY AFFIRM UN�ER PENALTV OF PERJUf1Y ONEOFTHE FOLLOWING DECLARATIONS: � J Z � _I HAVE AND WILL MAINTAIN A CEFTIFICATE OF CANSENTTO SELFIN&URE fOR WORK[flS' a _ a COMPENSATION,ASPPOVIDEDdYSEC(ION37000FTHElAeORCODE,FORTHEPERWRMANCE U Q OFTHE WORK FOR WHICH THIS PERMIT IS ISSUED. � �..W_, _IHAVEANDWIILMAINTAINWORKEPS'CAMPENSATIONINSURANCE,ASRE�UIREDBYSECTION Q 37000FTHE LABOq CODE,FOflTHE PERFORMANCE OF THE WOFH FOFi WHICH THIS PEflMiT IS . - '� (r1- Q ISSUED.MV WO �RS'COMPE�NSATIDN INSUR�RRIER A��ICY NUMBER ARE: CONSTRUCTION ( �� /' ? CARRIEfl e� � '°'C PLAN REVIEW 0 POUCYNUMBER �� Z EIECTRiC Q � (IHISSECTIONNEmNOTBECOMPLEfEDOFTHEPEfiMf(ISFORONEHUtJDf7ED�Di.If�RS(Sim)ORLE ). PLUMBING Z I CEflTIFY THAT M THE PERFOHMANCE OF IHE WORK fOR WHICH THIS PEFMIT IS ISSUED.1 MECHANICAL C� SHA�LN07EMPLOYANYPERSONINANVMANNERSOASTOBECOlAESU&IECTTOTHE � , � �/j WORKERS'COMPENSATION LAWS OF CALIFORNIA,ANDAGREETHAT IF I SHOUL�BECOME INSPECTION FEE �-� � �' � SU&/ECT TO THE WORKERS'COMP N VHOVI$IONS OF SECTION 37000F THE LABOF � • ' � OE,1 SHALLFO�HWITH LV WITH E PR VISIONS. ISSUANCE p�7 p OATE: ~�� `�i p pLICANT: "� SMIP ___ ! �� �� ENERGY P/C :.p� . �� `.'fi �y&���g�+ � WARNMG FAILURE TO SECURE WORKEFiS'COMPENSATION COVERAGE IS SHhLL BE - �y �SUBJECT.ANEMPLOYEFTOCRIMINALPENALTIESANOCIVILFWESUPTOONEHUNDflEDTHOUSAND ENERGYPEFMIT DOLLARS(E100.000),IN ADDITION TO THE COSTOF COMPENSATION,DAMAGES AS PROYI�ED FOR IN � SECTION 37080F THE LA90R CADE.INTEREST,ANO ATTOFNEV'S FEES. � ' RETENTION FEE: OCONSTRUCTION IENDING AGENCY PRE-ALT FEE: � - � I HEHEBY AFFIRM UN�Efl PENALiY OF PERJUR7 THATTHEflE IS ACONSTRUCTION LENDING AGENCY �- FOA THE PERfOfiMANCE OFTHE WORK FOfi WHICH THIS PERMIT IS ISSUED(SEC.3097,CIV.C.J. W- � ___.__._.___ . LENDER'S NAME F— LENDER'SA�ORESS � TOTALFEES � � � I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAiTHEABOVE INFORMATION IS COFiPECi. W IAGREETOCOMPLVWITHALLCITYANDCDUNTYOR�INANCESANOSTA7ELAWSRELATING70BUILDING d � CONSTRUCTION,ANDHEREBYAUTHORIZEREPRESENTAiIVESOFTHISCOUNTYTOENTERUPONTHE � Z ABOVE-MENTIONED PflOPERN FOR INSPECTION PUflPOSES. . — \ _ ( COMMENTS _______._...__. � 6 '4-�Rl yw �.-.t.! �� � m PERMITTEE NAME fPRINT) '�g� � . . � � (-�� 1 � / �, �(� __. Uj E DATE �-/�'/y�� = RGCPT.NO. �"v L PAID BY VALIDATI N� v ~ WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,6REEN—AppiicanPs Copy � �j�.l� � � � � � i I ��� ' ��I���� t � ' � � � ��� { � �� � � � � � � � ! � iI � E_ � i ' � � �" � � i �_ � � � 1 � f �� ' � � � � { I � ,� P � ( ( ' �I � � ! � � � � i � � � � � R � f � i � 4 i �, i ,. € i � , , l , � � , � , � , , ; I, � t � � � i I ' � � � ( I ' � E � � ' � � � � ( ( �. ( t � � � f � f � j I �� j � � 1 I f � � � � i � ' � � i � ' i � � � � � (p � ! � � ; � � ( � � �� ( �� � � � � � � ( � � � � ; � � �_ � i �i ( --l-- —�--;--j—�f�—�-1—. ;--�-- — � i � ' I �� � � ��� ' ; � � 1 � i � } ; ! � „ { ! � ' � I i i �� 3 � � � i � � I � � '. � , � � � 3 � �� � � � � � � � � � t i � � � i � I � � j i � � � � � ` ' a j ; 1 � { � � � ; � � � ,� { , � � ��" �� � �� �� j� � i � ,--�—�--�--=--� �� , � i { ; —�--, � � � � � � , � � � ' � � � � ' s � - � � `�1���' ; � � � i � ( � � � � � ; I 3 � � � ;� � � �� 3 � � � � 3 � � ��H � ! E ! � � � � � � � � � � ��� m � a� 1 � , ; � €�, ��1 � � f � ; , � i � � i� � � o������ � i� ������1 j . � �I � �;���� tl i, � i ( � { � � � _ � cr cc �,I� �cu �a c� G � c� �� �cc t � . ; � €- .n���c��c�. cc��� � � � � �, � c. � �- �-•yI �� fi � � � { � ` 1 � � �- �. ��c� � r<����— � � ' � I � � . � � �? ��O+u� kul C� � � � Iun. � � a. ,� y � s � I � � � �'���'�.. Li� � ���€'� ����cc�� � �t��`��c��2��1��a�. � 0�4 , �' I i � ` ; � i � � � � u c i���.�.� � �. �;��������� w a. u.;�,r¢'i.�i.El� r y.� s .'�u ta� � �� ; � � � � I 4 � -,j¢' t, rv n, tL . ��C3-U t t? --�� �� c��i.J ....E' �_d 7-- u- . .� � . I - � �9 - � �„ 7 ;�3 � I, 1 G� ,� t �; E C?�' � .�,�u. �,, � u� � sa � o :��c, d � � � �c � u,�� a i � � � i � � µt� j '� � .� s � r- es- ; �z r� � � � �^ � ���i �i � � � �=,.0 zf.� z� � f I � u u. -� -��u. �. �:� cGa � ,x ;�..a `� t �' � � �j� �. �.t, c��E� 3 j � �a � 9� - � � a- �s—� ti b�- � � i � � � � I � I � � - i�� � �— �; �� f�� �i I � { � ' � C f ; � � � � ; ; � f ► ' i � i � � ; _�- �� �m � � � ; 3 , � � � � � �j j � ( ��. � � � , ; � � �� �� , � , 5 E � ; ,t I9 j � ; -� �+ j i ! ; j { i I � � b � I I � � � 7 � � .. ` € ( 1 � q 4: ( 1 � � � � � 3 �� � i �- � 1 � � ' � � � � � � � � , , � � � s �� � I i .�� � � �� ; 4 � ��� '� � � I � i � � � � � ' j � , "� � �' � �E � , � ; i E � ; �� � 1 ! a � � i � � # : -��-' ' ; "� ' -�- �-_�-_� �--�-r � ' � ( � i ! � � � I � ; � � '� �! � ' '��� � + � 1 4� I { , � � f I � � _ . � ; � � ^� I � � � � � � ( � � i -�_ � ; � i f � j 3 � .� �� . ; � ;� -,;a � � •, ,, : � ������'�� � � ' I i � �:=� ' ( � �� � � � � C��7 ! I .,' ���,._ �� � � � �� � � � ,� � ��� �� � .F � ► ; ��{�� � � ?a, � , ,������ ��� ; ; ¢ � � ; � � ; � � ; ���� � � � �1,a �:���� �� ,����� � ��� �� � � � ��r�� a � ; ; � �� v� e�� ��i� 7 �Er-�mt� r- .�.�� �c���t� � � <'� � t � � ����z � �i�, .; u.}� �ly ,,� � ��ui �I� �`�� � `� �-�� � �`�i�i���� � `� � � ' � ��� � c ( > w � ��� � � �- 1� „,;� ;� 7 �-�'� �� -�_ � �_ 1 ;;_,�. � t Cyl�l � .�I�`� v? ���('� �"�e� � � �, i F-�°�'3 ����J�a: � � . � � � �� � �, 1 c„ � c -:� �.� r�i ,� 1 �� � t �, �. � �� � v� ,��'� � , . � c� c� -�� � �� , c� u' C�7 -.+� �y �. tu.a.i� ��c'3 '[��. �E� � : � ('r= �„ i ' ( �� � �" c i�.�����-'��j-' 1 � . � I i � � F- C.I LJ C."� �a.�=�'i��� �{c'"':�' �� f:.a7 I M^ ' i � I -.r .� , . .51.7� �_t t�: �.t L ..,, �.} P6". ,... G" ,�+ C� �. i:�"''�-C; CC�W.lll ilt�.`�i 3��� +�' . . �g � � U.i:.L! -u � w c� u��r.� �[;��s�x�� e��c%= w � c.?s�:v�=cFa <n�..��:,.C��. �:w.,w:,� C� , i � � ecrr�a . � � _._,_.� � i € ��.�.�.. ,��.._���. �..�� _ ,.�._.�;,..�.1�_� G t _