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HomeMy WebLinkAbout16017 (37) . :: ` �� CITY OF DIAMOND BAR `� �_ DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21660 E.Coplcy Drivc Suitc 190 (909)860-3195 Faz(909)861-3117 . PRES$ '„" BUILDIIVG PERMIT APPLICATION FIRMLY o DDFlESS���J� �7A'�I%�/1tiJ C%V'��A,/QYi �D DATE CATION ,_I ��- �I N�BER V I �� � APN LOT TFtACT �SSUE TYPE OCC p OWNE��I�A DATE CONST. GROUP LLp ADDRESS� PACLiIi L1�� .Sr.� / J.7 ZONING SEfBACKS u' CIN��� v ZIP�Z�T TEL. FRONT RW ❑ � APPLICANT TEL. R�A � � _ SIDE/SIDESTREEf RW ❑ CONTAACTORG ' f 4- . / SIDE p ADDR S r � CITY ZIP�� TEL���/' P�OPOSED USE � ARCH/ENG/ DESIGNER NO.DWEL. NO. NO. � ADDRESS UNITS STORIES BEDRODMS � CITY ZIP TEL. � �n DESCRIPTION SQ.FT. FACTOR PSF ADJ.AFiEANALUATION Q OWNER-BUIIDER DECLARATION SFFi/AD�/REM O p 1 HEREBY AFFtlW UNDER PENALT'OF OERRIRV Tui I uA ExEuoT fpOu THE COMRACiORS LL GaregolCarport W CENSEUWFOR1HEfOLLOWWORE/SON(SEC70.t1.68USDlGSSANDVROFESSIONSCODEANYC1iYOR (n �� COVMYWl9p/RE0Uf7E5APER4RTOCONSTi{UCT,A�T(RIMPRpVE.pEA1plI5M,ORRE7AIRANYSTRUG patio/Deck �Z NRE.PRqR TO RS ISSUANCE,NSO REWWIE9 T1E AGPLIVNi FOR SUd7 VERMIT TO FILE�SiGNED w � STATEMENT 7MAT ME OR SNE IS IICEN5E0 VURSUANT TO TH[PROVISIpNS OF TN[QOIITMCTOHS L4 � � CENSE UW(U/APTEX Y(CpAMENpNO WI7H SECTqN 7000)OF DMSqN]OF THC BUSINE55�NO PRO POOVSp2 FESSqH5CO0�ORTlUTHEORSHEISEXEMPTTNEREFRDYANDTNEBASISFORTHEALIEGCDE%EMP- (,� TqN.l1N'/VIOLATIONOFbECTI0N7071.69YANYAiPIICANTiOi1J1VERAl175Ufl1ECT57NEAPPIICANTTO Z �gR001 � AtlY1liEN,LLTYOFIqTMOR[TWWFNEMINDREDDOLLARS�l50C�.�� � O��150'M�EROFTHEPROPERTY,ORMYEIdPLOYEESWIT7WACL5A5THEIflSOLECOMPENSATqN, COTfT1BfC10I - MALL DO iH[WOi1K.AND TME STRUC7UNE IS NOT INTEWED OH OF�ERED FOR S�IE(5EG 70u,BU56 � N NE59 AND iROFESSqN.4 COOE:IME CONTMCTORS IICENSE UW OOES NOT APPL1 TO AN OwNEH OF � PiqGEHiY Wlq BU0.D5 OR NAVROVE57MEREON,M1D YY1q OOCS SUCM NqqK MIuSELF OR HERSELF IXi Q TNROl10MNI50qNCNWMEYPIOYEES,PROVIOEDiHA75Up1Y7ROVEM[NTSMCNOTIMEN�EDOR m �•�� OFFERCDiORSALEIF,NO4YCVEiL1HEBULDWQORMVHOVEAICMI550lDWITM40NEYEAHOFCOMOLE- Z T10N.THE OWNER$UILDER WILL FI�VE TME BURDEN OF PROYNO THAT NE OR SNC DID NOT BUi:D IXi � YVROVE FOR TNE PURPOSE OF SALEF �V Olti^.OM'NCROFTHEVHDVEHTl:M1IXCLUSMLYCOMMCENOWfT}fL10ENSEDCOHfMCTORS �c ro ca+sTaucr n�vnwccr�sec�o..,eus�r+ess u:o vno�ss�a+s caoe rMe oorrrrucrons u. 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ISSUANCE ��� ` `� (l� •U � ir1 p DATE: � AP __ SMIP W ENERGYP/C TYOFlliAM � WAiW:NO:iAILUR[T 5[CUHEWOiLCERS'COMPENSATIONCOVEMGEISUNIAWFULAND51U1LBE Ti � SV0.1ECilWEMPLOVERTOCAI�IINALFENALTIESANDGNLfWESUPTOONENUNDf1E0TF1IX15AN0 EN[RGYPERMIT ��.IA.L.DIN ,ANDSAFETY OOl1ARS(f 100.0o0J,N ADDITION TO THE COST OF CpdPE45A7qN,DAMACES AS PROVIDE�FOR IN ¢ SECTION770EOFiHEIAeORCOOE,HTEREST,ANDATTOANEYSFEES. FlETENTIONFEE: OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: � IHEPfBVAFFIRMUTAEHPENALiVOFPEiLNRYTHATTNEREISAGONSTRUCTIONLENDINCACENCY ' � FOft iM[PERFORMANCE OF THE WORK FOR NMIp1 THIS PEN1A171S ISSUEO(SEC 709],CtV.C.). . LLJ � lE'IDERS WwF S � LENDER'SADDRE55 w 1 CEHTIFY THAT 1 HAVE READ TAS APPlIGT10N AND ST�7ETIUT THEABOVE NFOfwATqN IS CDRRECT. TOTAL FEES ��� �J � IAGREETOCAY.DLYN7TMALLCf1YANDCOUNTYORD'JUNCESANDSTATEUWSFEUTNOTOBUrtDINO � OONSTRUCTION,IWOHER[BYAUTMORIZEREVHFSENTATIVESOFiHISGOVNT/TOEHTEHUPONTME � Z A80VE�MENTIONE�PROPERTYFORWSPECTIONVURPOSES. 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