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HomeMy WebLinkAbout10648 _ �� v�� - . _ /� `_ � - ' �� CITY OFDIAMOND BAR ° � � COMMUNTTY DEVELOPMENT DEPARTMENT 21660 E Copley Drive Suite!90 (909)86Q3195 Paz(909)861-3117 � PRESS BUILDING PERMITAPPLICATION FIRMLY � JOBSfTE / /_ o ADDRESS��� NDI�J� _�JI�J✓TGtS �_�� DATE'CATION NUMB R OG �� ISSUE TYPE OCC p OWNER �OT ACT �/� DATE _CONST. GROUP � ADDRESS U l2 ZONINC, SETBACKS - , � CfTY a D •ZIP,�L�gy TEL. FRONT qyy � APPLfCANT TEL. RE'°`R qW O � SIDE/SIDE STREE CONTRACTOR SIDE � � ADDRESS � CITY � ,�/[q . ZIP TEL. _ L�? PROPOSEDUSE 6'�I���i � o ARCWENG/ / /�"7iha. _ i � DESIGNER NO.DWEL NO. / NO. a ADDRESS N CITY Z►P TEL UNITS STORIES BEDROOMS � � DESCRIPTION SO.FL FACTOR PSF ADJ.AREANALUATION p� OWNER-BI:ILDER DECLAAATION p SFFi/ADD�REM Q 1 HEREBY AFFI1Ut LhOER PENALTY OF PERAIRY TILl71AAf EXEMPT FAOY THE COHiA,tC70R5�i. 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B.�P.C,FOR THIS RE1140N � � p �� � U LL' DI1TE � OWNER ' � � . � � (S 1 Q / F UCENSEO CONTRACTORS DECUViATION W . � IHEREBYAFFWYUNO(RVENALTYOFPE0.NRYTNATIMIIICENSEDUNDERGpOVISqNSOFGMAPTER � a, �(COMMENCWOWIiH3FCTIONfOoo)OFDMSIDNDOFTHEBUSINESSANOPROiESSqNSCO0E,M0 Z y' `K 4Y IICENSE IS N F111L iORCE/ND EFFECT. /_ m � LICENSE CUSS G S �p,Np, G�G� ' � V DATE CON7AACTDR /�' W � WORKERS'COMPENSATION DECLAAATION ��� � � � IHEREBYIIfFIRAIUHpERiENAllYOiVERA1MONEOF7MEFOLlOWW6DECUMTqNS: ( U � � 0 �_IHAKANDWILLMAINTAINACEqTIFlCATEOFCONSENTTOSELF•RISUREFOqMAqKE � COYPFNSA7pN,A9 P7bV1pED BY EECTION 77ooOF TNE LABOA COOf,FOR THE PFqFOAMANCE �U � —_ OF THE WOFIN FOR YV/IIRI TMIS pERMIT 6155UED. � 0 _IHAVEMqNnLL4UMAM ERS' PENSATIONINSUqANCEASREWIHEDBYSECTpN , � 770oOFTHELABORCOOE.F iHE RFORM OFTHEWDRNfORNMICHiMIg0ERA11TIS ISSUEO.MYMpiKERS � NINSUR�EC,tqRIERANDPOIICYNUMBERAFE: CONSTAUCTION .... ._._� _ CAHlUEH • � PLAN R[VIEY! �,L G � va�cvHur�e[a • � ELECTRIC �/�('��] --- Q (nssccnor�ruEnNoreeooMR.etmaFnEr�7swrianEt�ra+[Doaw�R��l ' PLUMBINC3 �—]' •� w .Z ICEHtIFYi1UiNTFiEPERFOiU/ANCEOfiHENqqICfOqWt1iG17HSPERYITiSI55VEU.1 MECNANICAI C7 SHALLNOTENPLOVANY7ERSONNANVYANNERSOASTOBE ESUBJECTTOTHE (p M'ORKERS'COYPENSATIONUWSOFGLLIFOiiNI�NlO REET IFISHOULflBECOAIE INSPECTIONFEE ' � � � `- SUBJEGTTOTNEYpitKER3'COMPENSATIONGROY151 SOf6 TqNA009GTHELABON r.� Oco�o �isrw/�.�-Fo/rin�win�canv�rwm�nas q isaH ISSUANCE p DA7E:,�,�(1�[A7PLICMR: ^ SMIP � ^, ENERGY P/C � WAAHINaFA�URETOSECUREYlORKERS'CAMP SATqNCOVE EISUHUWFK,AIASI/ALLBE � SUA)ECTµEYPLOVEqTOCRIY1NAtiENALTIE ANOCIVIIFINE PTOp1ENU1DR[D71qUSAND ENERGYPERMIT OOl1AR5(f too,0o0).N AffOR10N 70 TNE C0570F COMPENSA710N,�MIAOESAS FROYIOEO FON IN � SECTiM177oeOFTMELABORO00E,NTEREST,ANOATTOiWEV'9FEE5. +� � � � � RETENTION FEE: pCONSTRUCTION LENOING AGENCY PRE•ALT FEE: 4 1 MEREBV AFi1iW WOER DEN�LiYOC OFAIUAY THAi THEHE IS A Cd157AUCT�ON LFNDWO AGENCY � Z fOR i1/E Pf RFORUANCE OF TNE WORK fOR WHIOI THIS iERMiT IS ISSVED(SEC.7007,pV.G�. 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' _I � �� � , . „ �. � � 1 SEEP PIT/U SIZE � 1 . , , --- --- --- -- -- ------ -- --.. . . i I � Y ` ,. '. ' . . . ,`.., . . , '; j - . �, :. j — _ - -- ---- -- . - - . --- - - - _._ _.. , ; . . 3 . ��� , - - ---. __.._ _.__ . . _ _. _ -. , a � _ i ( - , _ . . __ _ _ . _._ . � , .,-- - � , -- -- -- — - � �,-�_�_� _��,��..;T t ,. _ __ -- --- - .; - I ,,��w� ,�� ; ,� , ,,. ,� - � , � � ,: � , ._ _. __; . _ . ��, „ '�, .. . .. ......_.......... .._ ....--•— --. .. _.._...----.._........... .._.._.. ...... _ ..----- � \`a) �(`'c � I I • �\`..��y•, .��.� �1;,\ ` � I I _., _ . . . _ .._ . _. . . _. . . --. ... . --- - - -. .. , .. � _ . , j 1 C\�- •� —��; ��� �`� ��� � �•�� j ; ,. . . . . . . _ _ . : �• - , . : _... __. . . - -- • -- ,� - ' �, , , , � ; � � .. , .. � ,., . , _. ._ _ . .__ ;. .� . .._"._._.. '�'_"___ '. "_""'ti _� . __ ' .. _. .. ...._..:_ .''" "_ _' 4 "" ".._. . ' _"_ '_ " '.,..,.... _.. _.._.."__' "" "_"' �..r.. -..:.d , � \