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HomeMy WebLinkAbout14492 (17) � CITY OF DIAMOND BAR U COMMUNITY DEVELOPMENT DEPARTMENT I ,..e 21660E.CopleyDriveSuitc190 PRESS - (909)R6Q3I95 Fax(909)861-J117 ' ""' BUILDING PERMIT APPLTCATION FI R M LY � JOBSITE APPLICATION PERMIT � ,�P/C �,u/ o A�oREss �21886 GOLDEN CANYON CT. DATE � NUMBER "� / $ issuE . ; t TYPE occ APN LOT 5 rRAC7 _ 47850 DATE "'v CONST. GROUP p OWNER Diamond Bar Westa T.T.0 � o ADDRESS 3480 Torrance BZVd. Suite 3�n ZONING SETBACKS • + � �, '� Z CITY T�rranCp ZIP SQ,��, TEL 3.],(1_�(1�9�q9 FRONT ' '• RW ❑ g APPLICANT Richard G�uld TEL GamP REAR �' p � SIDE/SIDESTREEf ,�_ -_ , .`. RW O rr� CONTRACTOR JCC Constrii�ti on - SIDE` . ` + ❑ o ADDRESS 3480 TnrraneP R1Vd,�.S_tE;�DD— pROPOSEDUSE N0W Single Famil3� Room o CiTv_ Torrance ziP 9050'� TEL camP al-�n��a W ARCH/ENG/ R. Gould & Assoc. ` ' `'' �� � �� DESIGNER � ADDRESS same SS owner NO.DWEL �;,r,"NO: .." : NO. � CITY ZIP TEL UNITS 1 STOFilES 2 BEDROOMS�_ i �n _ �n DESCRIPTION SQ.FT. •,FACTOR PSF ADJ.AREANAL AT10N � ONMER-BCILAER DECLARATION SFR/A�D/REM - O I HERFBV LFFiLUA UN�EF OENILLTY OF VEiL1URY TMAT t AA1 E7(E�.IPT FAOM THE CONiRACTOF4 L4 Garege/Carport � W CENSEUWFORTIEFOLLOWINGREASON(SEC.7071.SBUSMESSANDPROFESSqNStODE:ANYpTYOR C� CWNTYNMICNRE�UIRESADfRM1TTOCON5Titt1CT,ALTER�DROVE,pFAIOI.ISH,OqREPAIRANYSTRUC• W patio/Deek ' —�' � - , ' �' �NRE,PRpR TO RS ISSUIINCE.ALSO REWIRES TME APpLICANT FOR SUCH PEAM�t TO FiIE r SIGNED w � ' - � STATE�AENT THAT HE Ofl SHE IS UCENSED PURSUANT M THE PROVISIONS OF iNE COHTRACTONS l4� � , • i .J - � � � CENSE UW(G7AP7Efl i(COMMENCM(i YM7H SECTION 7000)OF DIVISqN 7 OF THE BUSME55 AMJ PRP PooVSPa - FESSqN4 CODE�OR THAi HE OR SHE IS E%EMPT iHEREfROA1 MPJ iHE B►Si5 FOq THE AILEGEO EXEMR � �� V T�pJ.ANYVIOLAiIONOFSECTION70]1.SBYANYAPVIIGWiFOR�7ERMITSUBJECTSTHEAF7LICRHTTO Z qg-Rooi � � ' � �- � A CMl PENALiY OF NOi MORE iHAN FNE MINORED DOLURS(f500).�: � ' � ❑4ASOV�NEFOF711EOROPEH7V,OFMYEAIDLOVEESWITNWAGE5AS7HEiq50lECOMPENS�TION,- ❑ Commercial � ' . 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B.t P.C.FORTHIS qEA50N Q � V LL Q . 1_ DATE ONNER V � �; ' z W li��.t.1� � LiCENSED CONTRACTOFS DECLARATION W � 1 HER�Y IIFFlRM UNOER PENALTY OF VE0.NRY 7HAT I MI LICENSEO UNDER PROVISIONS OF CMAPTER (� p� i(CdAMENCINGWTISEttION70oo)OFOMSiON�OFTMEBU51NE45�1NDPROFE55qNSCO0E,M1D Z w n �1 X AnLiCENSEISNFW.FORCEANDEfFECL m (-� -+ LLJ ^ � LICENSE CLASS R �x.rro. F 719 R 9 � . � � ITY OF u.l,...."" - VDATE wrrtrucroa� .TCC-CnnStr�irAi, - a - .'�'� �., . RUILDI. �u,•,` � WORKERS'COMPENSATION DECLAFiAT10N Q ' � I HEREBV nFFIRN UN�Ei1 PENAL7Y OF PE0.NM ONE OF THE FqlOWMO DECLAMTIONS: Z _ Q � _IN�VEMAWILLMAMTAIN�CEHTiFlCATEOFCONSEMNSElfaNSUREFORN9FKEF5 . 2 � ' COMPEHSAiqN,ASPiWV10EDBV5ECT10N77ooOFTHELAeOfitO�E,1'ORTHEPEqFORtAANCE U OFTHEwORKFOR`M�KHhnSPERM1T15155VED.� �,:�\ ,�, . .. , ,-. � .,r'..s �.. ,-�' _�t : ��_. . i . ',.l �_ _ . ' � _ .�- .�- ` -.: �`.. . � ' , � _ . .. Q ��IMAVEANDMALLMAtMf�INWORKERSCdAPEN3AT10NM5URANCE,A90.EOlnRE0BY5ECTI0N .; , ` ` -,. 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