HomeMy WebLinkAbout15335 (8) �� CITY OF DIAMOND BAR ,� �
DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES
21660 E.Copley Drive Suite 190� � �
(909)860-3195 Faa(909)861-3117 PRE$S
�^'� BUII.DING PERMIT APPLICATiON ` FIRMLY
o AD RESSZS�S7-1 � 2(�j'� Z l��{'L�I N �PUCATION PERMR 15. P/C
DATE � -� NUMBER �� 4
� APN LOT TRACT ISSUE �� TYPE OCC
DA7E CONST. GROUP
p OWNER "�ArL LC-�D ./k.
� ADDRESS � ZONING SETBACKS
0
W CITY 21P TEL REAR Rw ❑
APPUCANT TEL SIDE/SIDE STAEET RW O
CONTAACTO I QO L�FI SIDE p
q� ADDRESS ' ._
� CITYS�\r55►�r� ��'�o ZIP �(�_ TE �Q PflOPOSED U5E - - _
� ARCWENG/
DESIGNER N0.DWEL "N0. .. NO.
ADDRESS UNITS � _STORIES ��� BEDROOMS
�N CITY ZIP TEL _ - _ -
OESCRIPTION S�.Ff. FACTOR PSF ADJ.AREANAIUATION
q� OYINER-BUILDER DECLAFiATiON SFR/ADD�REM
O
p 1 MEAEBY AiFlfW UNDER GEN�UY Of PERRIRY iMAi l AA1 E7lEA1PT FROAIIHE COHTHACiORS LF Gdf2o9�GIpOfl . .
W CENSEUWWN71{EFOLL�M/wCiNEA50NISEG7a71.6BU5WE55ANOPROFE5510N5COD@ANYqTYOq � (�
y COINlit1M71CHqE0U1qESAPEAMITiOCONSTRUGT,ALTERWPiiOVEDEMOLIS1iOfiREPAIpANY5Ti41G W
Z iUNE YRqR TO R9 65UANLE ILLSO REOUWES iHE AGRICMti FOFi St1Gf PEPIMT TO FLLE A SICNEU PitIND6Ck
� STATEMENT i1fAT HE Ofl SNE IS UCENSEU WiiSUANT TO 7ME iROV1510N i OF TfE CONiRACTOHS l4 �
� CF114E LAW((]IAPiEN 0 1COYYENCPIO N7TN SECiqN 7o0010F DIVLSIDN]OF TME BUSINESS AND PRb POOIISpd
FESSi0113 OOOE)OR iHAT ME OR SHE IS E%ENPT TNEiIEFROw/w0 iME BA51S FOq 7HE KIEGED E%EAIP-
Tqt1ANYVqLAT10NOFSECT10N7Wf.lBYFHYAPPLICANTfORAVERAU75LB1ECT5iMEADVLICJWTTO Z Rg�Rpp�
� ACML7ENALT'OGNOT40fiEl}4NFIYEMINWRED00LLAfiSlfSao).�:
� Ol/SOWNEROFiMEPpOYENTY.Of1YYELPLOYEESYAiHMiAGES/SiHEIR50LEODYPEHSAT10N. Q C��f� �
WILL DO TlIE Y10fY(AND TNf STiM1C7UqE 151qT WTEIOED Op OiFERED FOR SALE(SEG 70u.BU54 J
NE55 AND VROFESSIOHS CODE TIIE CONTRACT00.S UCEl�SE lAW DOES NOTAPGLY 70 AN OWNER OF �
� PADPEATYYA108URDSORMGROYESiHEHEON.ANDYAfODOESbUC11YIOfL(HIMSELFORMERSELF011
___"__'_'.""(_ _71Y10UGH10.400.MEROMMEIIDLOYEFS.DROYIDE�TMATSIK]IWGROVEYENiSARENOTN/TENOEAdi C�
�1 OFTEREDFORSALEIF�lqWEVERTHEBM.DWOpiM1PHO�EUENi1950lDWtTNWONEYEWOFCOMRE-- ' -._._..-. -._____.
.____ _._... _
Z �TUN.7HE OYMERBtAIDER WILL HAVE illE BIJRDEN OF PHOYINO TIIAT NE Ofi SHE WD HOT BU4D qi _._._.._ _
� MPROYEFORTNEPUiVO^uEDF&YEl
w OIASOwNEROFiMEPROPEHTV,AYEXCU151VF1YCONTMGTNOVATMLICEN5E0/riliRACTORS
. (= TO WNSiRUGT T/1E PiqJECT(5EG 7DIl BUSWESS M10 PROFE5510N3 COOE THE COHTRACTOR4 LL V81U2ti0f1 . ADJ.AREA
LL.1 CEttSEUWD0E8NOTAiPLYTOANONMEHOFAVHOVERTYWMOBUlD50HIUVROVE9MEREOq.A�O
Z MMOCOHtMGTSFOASUpIPNWECTSWITF1A00ffTRAGTOHIS)LICEHSEDPURSVM7fTOTMECOHTMG pUANTITY DESCpIPT10N FEE �
� 700.5 LJCENSE LAW.�
O I AY E%E11D7 UNDER SEG &t P.G FOq TWS PEASOl1 U
3 � -
DATE OYMER
Z W
� UCENSED CONTRACTORS DECLARATION w
� INEREBYAFFIRNUI�ERCFNALiYOFDE0.IUFVTHAiIMILICENSEDUNDERDRONSqNSOFGUPTER V. - -
� � �(GOAwENGIN(i N7TH SEC710N IaoO)Oi DM510N]OF TME BUSINE55 ANO PROFE5510N5 OOOE.AND Z .
W LICENSE 15 M FLLL FORCE N+O FFfECT.
m
0 LICENSE ClASS�LIG.NO. , ]
�-j arE�-1�1-DO � coHrw� I !�O a
w
� WORKERS'COMPENSATION DECLAFihT10N U , '•,''� `, • . �
� INERWYAFFIP11101DfRPQlALTYOFDEFUUfiYONEOFTNEFOl10WW6DECUPATqNS �
� Z
� ��IINYENAwILLWJNiNNACERT�FICATEOFOONSENTTObFiFINSUREFORMARKERS' S
WMPEN511TqN.A9PfiONDFDBYSECi10N31o00FiHEUBOHCC�E,FONTHEiERWRNANCE U
Q `/OF 711E WORK FOR NNIGI TM15 GERAUT IS ISSUED. � �
LI MAVEAND WILLYAWTAW WOPoCERS'WMiEN5AT10N WSUHANLE.AS HEIX11flFD BY SEG7IDN +///111
O �7u0 OF TME UBOR COGE FOA 7ME PERW�ANCE OF TNE WORK f-0R Vh11CH THIS PERMIT IS 1�/
is.wEo.�nrwowc�s•coMr�+s�vpn�ruuav+cscu�wExu+ovaicrNuuacau� CONSTRUCTION v�
� STA"� f'u ND PLAN REVIEW
� rPauc �R��L21_ z�I b– O rJS�— E�cra�C
� (ifasSECibN!(IDWTBEOOh�RF7Eo0FhEF'FJwrTSF0a0Nfl�OalMs(i�ro)ORl6S? PLUM8ING
Z 1 CEHTIFY iMAT N iME YERFOiiMANCf OF TME�FiK FOR NIMICN 7H15 iEPIAIT IS�SSUE0,1 MECHANICP.�
(J 511ALLMOTEMPIOYANYVER50NN/JJYWNNER50ASTOBECOAIESUBIECTTOTNE tt�
y wowcEas couv6nsnran uws a cu�cowuti u+o�caEE n+�r��srnun eeco� INSPECTION FEE -� ' :! g ��
S SUBJECTTOTNENqf110Efl5CO�.�DEN5AT10NDROVISqNSOiSECilON77oo0FiNElABON -
caoE�srwiryFoa�nnnn+couv�rwm/r�rn/q��rnov�sior+s. ISSUANCE
pOATE: ��I�'W AaPLIGM: V��1� SMIP - [
� WMNiN6:FALURETOSEd1REN'ORI(ERS'CW.�oENSATIDNCOVERAGE15UNUwFUL./JIDSHKIBE FJdERGYP/C T A
S1191ECiANEYPLOYERiOCAIYPIALPENKTIES/�l10GIYIlFWE5UPi00NENlRWREOTHWSAND Ep1ERGYPERMIT tm�cr 11r^T1T A� �/�� r:'iR
r pOLLAN51i1W.000�,N/�DW710HTO7HECOSTOfCpAPEN5A7qN.0�AlAGESASPHOYI�EDfORW C�� 1'3'1..+*'��
¢ SECTION77aOFTHEUBORCODE.W7ERE5LANDATTOfWErSiEES RETENTIONFEE: B � .
nw., CONSTRUCTION LEND�NG AGENCY PRE-ALT FEE
O
� IMEREB'/AGG1RMlN�DENGENKTYOFPE�iN/R`lTHATTMEREISACONSTiIUCTIONIfNOWOAGENCY
0- iORTME PEAFORMANCE OF iME WORI(FOH HRIKHTHIS PE WAIT R ISSUEU(5EF i�7.pY.G} .
�
� IENDEQ'S W1ME
� IENDEF[SA�DRE55 .
� ICERiKYTHATIIUVEREADT/ISADRIGTIONANDST�iE7NATiHEA80YEWFOR1AATqNISCORREGT. TOTAL FEES - ' .
p_ 1 AGREF TO C01dGLY MATH IILGTY AND COUNTY OFiDw�wCES ANO STALE UWS REUtwt7 TO BUILDWG .
CANSTqUCT10N,ANO MEREBY/itfTF10RIZE REPRESENiATIVES OF 7ri5 WU�(1T i0 ENTERUPON iME ,
� /�BOVEi1ENT10NE0 PRODERtt FOR WSPECTION PVRP06E5. COMMENTS � . .
9 L�F� ��a<v� �Fiax�. .(�C
aPEfW1TiEENAM iNM) �
N C-/ -7-/�
� SNiNATURE P TTEE DATE .
� RECPT.NO. PND BY VAUDATION
WHITE—Depertment Copy,YELLOW—Finance Copy,PINK-�Assasaa Copy,GOLDENRO�FIIe Copy,GREEN—ApplicanCa Copy
� ____ . ,
, ,
; . ,. _
� _. . . _ . . ,_ _ ;
`F::: .
.. _ -- — - .. - - - — - - - - - - - -- ---
,
_ ..
' �1' • . ,. . , ,
�� � ���� � � ,.
:z�'
�:� _ -
, _ ,
gk' -
�;
�,I - -
� ';
P
. �� ? o �
� ," ~ � < � S ,��' � "�
QQ.�. �, .. � ��.p � m ¢ � � . � Z � �,.'. -
m � ' o c> > nzm ¢ w zz � co � ¢ z " a ''. -
�ca000wmc� o — ¢ z acn �i � � ¢
� � F- vio o u. m m z , oF- - � a n, e
L] U r ��I� F z o - Q � z t�i a z �;
Z.W qO � O O D U o o z a c7 � ¢ w z ¢ � o C7 a � z H o rn ��� :
` �.,-� d tJi � ¢ d m Z p Q Z �7 � � w ? W F= Z d O �- W } � r,�. �.
' 1O�' � �_�'�CL W � CL J J � O m CC = = W IL lL F- Q W U � N w 2 llJ V, _
. G (� LL W W W W 2 m Q � U �7 N J _I J (b U J 0 � _1 � J U- � _.. '���. . .. .. _"'_ '-_ _.- '." ' "' _' " _ ' _
`,. � z ^I � 0 W Z � - O O O LL�0 Q Q W Q � lil ' .� .... . .., .
,
a Q .!� 2 Z 2 ¢ Q � � Z ¢ W O Z O O O tL W z � O LL LL S o W _�?�,P: ' ' _
� �ju. � a � � u. � m � am ¢ LLaan. Oo �
!i U '
� a i:fi; - _ --�
h Z `0 7, r - i �_
U — �j(f' _� '
� - - �: � � J
; - , � - � _ ,
f,/i � : � � _ _ .� _ ` � _
- � � a : � � � �,�.�
��` i z - � �� �� ,ii
�- � _ .
. �
:
,
: ,
,
.
-- � ; . o �, , , . ;
;� Q � ` r � � z - - i ; ` w �
- . ' '��:/ w Z Z �', U, Q U � y ZO � �, NW �. i
J fL Z
��,� �' ° � w � � � W � � � � mog � a Y � � � L � m � z� � ?,t�?
� � � r, wa � Wa � � = � z Z �, W � � � . , z Q,
��Tt� °- � wwZ > w _1J � � Z ¢ z ¢ w � , W _ F-h �
"I�y`{�Y ac� o ¢ Omzt� Oiwa � m ,-�_, ' r- �, F" ow JJ -. n. ",
y,.j�jEQ � o� Z � 0. ¢ cnzc� xxxwc� Z � accc� a � c� zw a . U ',
,+� m !/J U = CO p- LLl ll� � LL C3 C:J U �S J J _ W � � Q J J I _.1 1 � . ' F—C� � ��� .,�j.
.
_
C7LL1 � � QO� CCOOOOOZX -� J � � n. W U1
' �. �� �_ w � _c�r, �� � u. ¢ a tx � �n w � � o c"'» c"'n m_� �. uZ-. � i�i0 _ '_ m n ._._�._:::.�:..r___ �i