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HomeMy WebLinkAbout12-2069�--- - --- - ---- -- �,� _ CTTY OF DIAMOND BAR � - � DEPARTMENT OF CONIII4UNITY&DEVELOPMENT SERVICES 21810 Copley Drive,Diamond Bar,CA 91765 (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)539-7027 PRESS �����'� BUll.D G PERNIIT APPLICATION FIRMLY � JOBSITE *� APPLICATION i C Q PERMITrry �jy� P/C o ADDRESS � �� �`� u e'� DATE � �� NUMBERL�`""r � # o ISSUE � �, p NpE v� OCC `r APN LOT TRACT DATE 1. �Z CONST. �1 GROUP p OWNER � ADDRESS ZONING SEfBACKS o � � Z C�TM � o T � FRONT RW ❑ REAR O I Z APPUCANT TEL. SIDE/SIDE STREET RW ❑ � CONTRACTOR �� � SIDE ❑ � ADDFESS '� — PROPOSED USE � CITY � ZIP " TEL. w ARCWENG/ � z DESIGNER NO.DWEL. NO. NO. � ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL � DESCRiPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � � OWNER-BUILDER DECLARATION gF'R/ADO/REM O p 1 HEAEEIV AFFlRM UNOER PENALTY OF VERNRY TMAT I MI IXEMPT FAOM T1iE CONTRACTORS Ll- Ge(2 J0IC8fPOfi W CENSEUWFOR7HEFOLLOWINOREASON(SEC.7mt.60u5WE55IW07ROFE55101�5cOOEANYGTYOP (n CJ CpUIY{YWMtp1AEWiRESAPEWARTOCONSTRUCT.ALTER�9ROVE.QEMOUSi4.OHREPAtRAN'lSTRUG W PatiolDac)c �Z rvq�pRqR TO RS ISSUANCE.ALSO NECN�RES 7HE APP�ICAM FOR SUCH PERMIT TO FlLE A SIGNED w S7A7EMENT TWR HE OR SHE IS LJCENSEO PUi15UANT TO TIE PROVt510N5 OF THE CONTN�ciOR9 L4 � LENSE LAW(GYIAPTER Y(COMMENCII�IO WR11 SEGTION 7oDo)OF OMSION�OF 7}1E BU31NE55 MI�PR6 � PooVSpa O fE55aN5CO0E�ORTHA7HEORSNE�gD(FJ�IPTTMEREFROMANDTHEBA315FORTHEALLE6EDEXEAIP• (� U 7qN.ANYVIdaTIp10F5ECT10N7Wt.59YANYMPIJCANTFORAPERMITSU&lEGTSTHEA7PlIG�NTTO Z R9-ROOf � ACML PEN�LTY OF NOT MOPE THAN FlVE NUNORED DOLLARS(f5ao).Y. Q O1�50M�NEROFTMEPROPEFfV.ORNYENVLOVEESVM'iHWAGE5A5THE1H50LECOMPEH5ATKIN, � �mmercial Z VALL DO THE WORK��E STRiKTURE IS NOT IHTENDED OR OFFFAED FOR SALE�SEC.7Ms,BUSi- _7 . NESS AN�PROFESSIONS OOOE:THE CONTFiAGTORS UCENSE UW DOES NOT AV7LY 70 AN OWNER OF . � PROPEHTVY.?�OBULL0.40RIMPiiOVES7HEREON,ANDWMO00ES5Up1�NOf1KHUA5ELFORHERSQFOR m � TFI{qUONNI50RHEROWNEMPtOYEES,VROVIDED7HAT5UCHWPROVEMENTSMEHOTINTENOEDOR W OFFEqmFORSALEIF,HON�EVERn1EBVILDW60HWPpOVEMENTI550LDWfTHINONEVEAqOFCOM�LE- � TON,THE O�✓NER-BUILDEP VALL HAVE TY1E OUROEN OF VROVPld THAT HE OR SHE D!0 NOT BV0.D 00. Z 11.IPROVE FOR THE PUR➢OSE OF SALE� � ❑L�.40WNEROFTHEPROPERTY,Al/IXClUSNEIYCOH�RACTWOWRIIIICENSFDCONTRACfOflS � w To CANSTRUC7 THE PR0.1EC7(SEC.7ot�,OUSINE55 AND FROFESS10N5 C6DE TNE CONTMCTOfls L4 V21UatIOn AD.I.AREA W CENSEUWDOESNOTMVLYTOANON?IEROFAPROPERTYWMOBULLDSORIMPROVESTHEAEON.AND • � WNOCOHiAACiSFOR5UCH7FlOJECT9WfTHACOMMCTOR(S)LICENSED7URSUANTTOTHECONTiUG Q�J{U.fT�7Y DESCRIPTION FEE � Y TORS UCENSE Uw.� � �I Ah1 IXEMPT 11NOFA 5E4 B.1 V.C.FOR TIIS REASON � � U Q � DATE M�Ep ~ U � UCENSED CONTRACTOAS DEClARA710N �j 2 1 HEREBY AFFIRM UNDER PENALT'OF PERWRY T1UT I NA LICENSED UNOFA 7ROVISIONS OF CMAPTER � � Y�OOMMENC��M3 VAT17 SECiION 7000)OF OMSION]OF THE BUSlNESS AND PROFESSIONS CQDE,IND Z i� IAY IICENSE IS M FULL FORCE AND EFFECT. � . \ � G m 1JLJ � UCENSE SS � IIC.NO. I � 1. j U D�7E � cONiRACTOR `-3'r0 W � WORKERS'COMPENSATION DECLARATION Q � � U � 1 NEAEBV AFFIRiJ IAJDER PEN/�LTY OF VERNM ONE OF 7HE FOLLOW Wa DECUAATIONS: Z O __�MAyE Mlp YAl14AINTAW A CERTIFICATE OF GONSFN[TO SELF�NSURE FOR Mf�RKEPS 2 � CpA1pENgp71pN,AS PROVIOED BY SECTION 3700 OF T1E UBOR COD�FOR THE PERFORMANCE W OF THE WORK FOR WH�01 THIS PERM7T IS ISSUED. � � w _I HAVE ANU WILL MAIMAW WORI(ERS'COMPENSATIOIJ INSURANCE,AS FlEOUIPED BV SECTION O 1700 Of THE LA80R CODE.Fo0.THE PERFOf3MANCE OF THE WOPo(FOR WhCO�THIS PEAMtT is 155UEp.My WOqKEAS'COUYEN5AT10N INSURANCE UARIER AND POLICY NUMBER ARE: CONSTRUCTION j �Ep PUUJ REVIEW � voucrr+wneER ELECTRIC 0 (fMgSECfpNNE�NOTgEdp�,qFTEDpFhEpFFR�f6FOqpPIEFlyaii�pqAIR51f1mtaHlFss1 PLUMBING � - - W 1 CERTIFY THAT W TNE 7ERFOHMANCE OK TNE WOHI(FOR WHIU/THIS PEHAIfT IS IS.i"UED,1 .MECHAN�CAL Z CJ SFWINOTEH7lOY/V11'PEfiSONWINYNINNERSOASTOBECAMESUBJECYTOTHE � WORNERS'COAIPENSATIONUN50F iFORNIA,ANDAOREETHATIFI BECAME �NSPECT70NFEE S SUBJECTTO THE WONCERS COA1� SA PflOVIS10N3 OF SEC710N OF TRE LA80R i wsrn+wm�couv wrn+ Evs�owswi+s. ISSUANCE O SMIP ATE ���APPLI . � ENERGY P/C WARNINQ FAIWP6 TO SECUHE WOiiKERS COMPENSATION CO RAGE IS UIJIAVIFUL,AND uHILL 0E ��—y 5Ug.1ECT AN FI.IPIOVER TO CRiMIN�L VENhtTIES ANCI QVIL FW UP TOONE HUN�RED TNIXISAND ENERGY PERMIT pp�LARg(f100.000��N AODIiION TO THE COST Of COMPENSATION,OAMAGES AS PROVIDED FOR M � SECTI�N97oeOF7HELA90RCO0EWTEHEST,ANOATTORNEV'SFEES. � RETENTIONFEE: - a CONSTRUCTION IENDING AGENCY PRE•AlT FEE CL 1 HEqEBY AFFlRM UNDER PENALIY OF PERRlRY THAT THERE IS ACANSTPUCTKIN LEIJ��NO AIiENCY d FOR T1E PFAFOiiMANCB OF TNE WORK FOR WNICH TNIS PEFMR IS�SSUE�(SEC]OW.GV.G�. . � � LENOERS NMAE . F� LENDERSAOORESs � � I LEqlIFY THAT I HAVE iiEAD 7TI18 APVl1CM10N N�D STATE 7)UTh1EABOVE PlFORAIATIDN IS CDRRECT. TOTAL FE ES . � ' �J• w 1 AGREE TO COMFIY`MTH 1J.L ClTV Mu3 COUNTY Oi1D�NANCE3/�ND STATE UWS REUNiG TO BUSDIN6 . � TRUCTION,AND HEREBY AUTHOWZE REPqESENTATiVES OF 71tl5 CL%1NTY TO EN7ER UPON TH • . ZE-MIXf1DNED PROFERTY FOR I PECTION 7VRPOSES. 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LP,NDSCAPEiiRRIG. _ __ SEEP PIT/L.L. ON SITE IMPS. - GAS AIRTEST FINAL ZONING - FINAL CONST. FIRE DEPT.FIh�lA.L FINAL HEATIt�JG HEALTH DEPT.FINAL FINf\L ELECTRIC DEV.FEES PAID FINAL PLUMBING E�JERGY FINAL PLANIUG � -- ' __'�__�. ___ _'_'_-__ , 9 _'_.__.__.`__ ' . .,� FINAL ENGINEERING ' `� � _.___ —_.____--- ---------------_I- -�---------- ---- C�MMENTS _._-._�� ���'L�1?-�.-�`� --- - - � SEPTICTANKSIZE , __ _ SEEP PIT/U SIZE