Loading...
HomeMy WebLinkAbout14190 � � n_ �,�, _ CI'TY OF DIAMOND BAR � P�' yTj�r DEPARTMENT OP COMMUNITY&DEVELOPMENT SBItVICES /�" �� 21660 E.Copley Ihive Suite 19D f (909)86�-3195 Pax(909)$61-3117 ( PRESS �"A�' U L, E arrLac�rio FIRMLY � .IOBSITE .� n/./� - � PLICATION � � PERMIT f j� PlC a ADDRESS L-�/��`! _ DATE NUMBER e �� �_ � ISSUE � TYPE OCC APN_ LO ACT _ DATE CONST. GROl1P � OWNER O � ADDR�S ��4 Q.+^Q Qf ZONING SETSACKS w FRONT _ RW I�_.,_____ z CITY n ZIP�p TEL�1 g APPLICAN7 �,�,� ��„A:,L C�' ,_.e....er TEL � � REAR I�__._ SIDE/SIDE STREET_____,._ RW_ fl__.,_..__,___ � CONTRACTOR �O ���ll �� � _ SIDE ,_______ L _ � ADDRE S�'�'1?� (e� C�w�ao�_ ✓�C– pROPOSED USE__ � CITY ZIP�. U 7EL�,_ — QARCHIENG/ �� L30 �l7� --- �------ �z DESIGNER NO.DWEL. NO. NO. a ADDRESS - UN�TS_________ STORIES __ E3EDROOMS � � CI7Y ZIP_ TEL. __ u� DESCRIPTION SQ.F7 FACTOR PSF ADJ.AREANALUATION � OWNER-BUILDER�ECLARATION SFR/ADD/REM O I HEREBV AfFIRM UNDER PENALTV OF PERIURY THAT I AM FXEMPT FROM!HE CONTNACTORS LI- G8fflQ0/CBfGOR � W CENSELAIMFORTHEFOIIOWINCREASON(SEC.�n37.5BUSINESSPNDPROFE55VONSC011E;RNYCITYOf{ ,(n '� U CIXINSYWHICHREQUIRESAPfRMITTOCONSTAUCT,ALT'eR,IMVROVE,�EN.OLISH,ONFlEPAIflANVSTqUC- � �L PafIO/OBCK W TURE,PRIOR TO ITS ISSUPNCE,ALSO REOUIRES THE APFLICANT FOR 6UCH PEHMIT TO FILE A SIGNED w _____ STAPEMENT TNAT ME OR SHE IS LIGENSED Pl/F5UAN1 TU 1 ME PROYISIOTJS OF TME CON7RACTORS LI- � CENSELAW�CHAPTER9(COMMENCINGWI7HSECTION7o0a)OFUIVIS!ON30F7NEBUSINF.SSANDPRD- V' PooVSpa FESSWNSCODE)ORTHATHEORSHEISE%EMPTTHEREFROMANDTHEBASISFORTHEALLEGEDE%EMP- � U 710N.pNYVIOLATKKdOFSECTION703t.58YANYAPPI.ILANTFOFlAPENMITSUBJF.CTSTMEAPPLICANT�O Z Re-Roof � ACIVILPENALiYOFNOTMORETHANFIVEHUNDREDDOLLAR5�S5o0).): � ❑I,ASOWNEqOFTHEPROPERN,ORAIYEMPLOVEESWITHWAGESASTHEIRSOLECOMPENSAiION, L� COI11fI1P.�C18I WILL[b THE WORK N�'D THE STqUCTURE IS NOT INTENDED OR OFF[REG FOR SALC(SEC.704M1,RU51� J �. NESS AND PROFESSIONS CODE:THE CANiFiACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF � PROPERTYNMOBUILDSORIMPFOVESiHEREON,ANDWHO00F.5SUCHW09KHIMSELFORHEFSELFOR m f� 7HftOU0HHI50RHEHOWhiEMPLOYEES,PflOVIDEDTHATSUCHIMPHOVEMENTSARENOfIYTENDE�OR � OFFEREOFORSALEIF,HOWEVER,T1iE�UIL�INGOftIMPROVEMENTI550LDWITHIYONEYE4ROFCOMPLE- �__ __ � T�fV,THF.OYlNER$UILC'cR 6VILL}�AVE'Hc BL'RUF_h CF 9ROVI':C T11.4T I{C CC.3fiE CI^�,OT 3JP�OR � IMPROVEFOqTHEPUflPO5EOF5ALE). _L W l]I,ASOWNEROFiHEPROPEflTY,AAfEXCLUSIVELYfANTflACTNGWITHLICEiJSEDCONTRnCTORS � �TO CANS7Rl1Ci THE PROJECT(SEC.7o4d,BUSIN[SS ANO PROFESSIONS CODE:THE CO�TRACTORS LI� � ValU2�lOf1 ,_____. . . ..........____-_ADJ.AREA _____ W CENSEUWUOESNOTAPPLYI'OANONIJEROFAPFIOPERTYWHOBUII.DSOFIMPROVESTNEREON,AND �� WFIOCONTMCTSFORSUGHPRO,lEGTSWITHACONTRACTOR�S)UCEMSEDPURSUANT707HeCON7iiAG QUANTIIY DESCRI TION FE Y TORSLICFNSEUW.). _ O J �- CJIAME%EMPTUNDEfiSEG._ B.&P.C.FORTH!SAEASON • Q YY� �� ----_ —'_'._..__-_ � � — � OATE OWNER _ __-_____ __. __.-_ U Z _' _ W p¢ LICENSEq CONTRACTORS DECLARATION � W I CL IMEflEBVAFFlHAll1N�ERPENALNOFPERIUFYTHAYIAMLICEN5E0UN0ERPROVISIONSOFC1iAPTEfa � �a, 9(OOMMFNCWGWiiHSECTIUN�aoa)OFDIVISIONeOFTHE6U5W'cSSANDPROF55SIONSCODE,AND z __ ')C MYI.ICENSF.IS IN FULL FORCF.AND EFFECT. � GU ^ / ��J .p LICENSE CLASS_ t_ `� LIC.NO.�@_�L!��___ ; j ��j DAYE �_'_ CONTRAC:TOR.--_"""'_"'_'-'_'."' �_ LLJ � WOHKEFiS'COMPFNSATIUN DECLARATIO�J � `^ �- Q � IHEPE9Y AFFIRM UNDER PENALTY OF PF.RJURV ONE OF THE FOl.LOWING OECLARATIONS: U � � r— 'O IHAVEANDkYI:LMAIN7'AINACERTIFIGATEOFC(�NSENTTUSElF-iNSUREFO;iWOF.KERS' Z� � COMPFNSA710N,tS PiiOVIOED BY SEC170N 370o OF iHE LABOFl CCDG,fON THE PERFORMANCF. w� - _-- OFTHE WORK FOR WHICH TNIS PF.RMIT IS ISSUC�. � � __ 'W -`y�/I HAVEAND WIILMAIN(AI4 WORKERS'CAMPFNSATION M . ANCE,AS REOUIFED BV SECTiON Q' `` 37000FTH ORCODE,FORT1iEPFRPoRMANCEOFI E OFKFOAWHICNT415PF.RMIT15 .�. ISSUFD.M O 5'COM FNSATIO RANCE CAR IE nr.o voucv Nuue�n aaE� CONSTRUCTION . .__. .___________.__ _ J _ .._.. _ .j�. cnaniFa .. ----- --- PIAN REVIEW . ----- -�------------- — Z; POLICYNUMBER_ � � D� ELECTRIC a ��i �r� '�: (MISSGC7KWNEEDND70E�LETmOFTNEPFFUNTlSFOR(NJ[HIUY�i[OUOLlP17S(5700)OIILESS} PLUMBING ��fv° { �_-__-____'__"_"__---_ � �W' MECHANICAL z ICERTIFVTHATINTHEPERFORMA�CEOFTHEWORKFOFWIIICHTHISPENMITISISSUf:D,I —.... __.._-__..._____.--_....._._....-_ (J SHALLNOTEMPLOYANYPEFSOYINPNVAIANYERSOA5T00FCANESUl1JEC�TUTH[ (} `(n� WORKERSCOMPENSATIONLAWSOfCAIIFORNIA.ANUAC+REETHATIFiSHO1:LDBECOME INSPECTIONFEE �y+����51 .,___ __.,..__,_ �•� SUBJECT TO THE WORKERS'COMPENSATiON PROVISIONS OF SECTiO^l 3�0o Of TH[LABOH �� B -_—_ � CODE.ISIiALI.FOli7HWITHCOMPLVWITHTiOSEPRUVI510N5 ISSUANCC' ���� 1sJi� � - ---- -��------ %�� SMIP k�'�"��-� d •. DATE:_..___'_ APPLICANT: ____._"_—___'_. vy' 7'� w' --� WARNING�FAILURF70SECUREWOf1KER5'COMPENSATIONCOVERAG[ISUNLAWFUL,AN�SHALLBe ENERGYP/C �7S'r1�'�M��,�yZ�_�_,__, __„ _,_______ ,�LL; �SUBJECTANEMPLOVF.RTOCRIMINALPENAITIESFNDCIVII.FINESUPTOONEHUNDR[DTFIOUSANU S"�a���r WLLAF5�5100,000),INADDITIONTOi71F.CO5TOFCOMPENSATION,0AMA0ESASPHOV10EUFORIN ENERGYPERMIT ___.-__ �, __"'.._......' '-_-__'_____ __'_' -_ -- ___ ,��, SECi1oNa]o80FTHELABORCoOE,INTFRF:ST.ANDATTORNEV'SFEES. RETENTIONFEE: J. "'_'" _-_"""'__"___'_""'__"_ _"'"' ��� CONSTRUCTION LEN�ING AGENCY PRE-ALT FEE: __ O '��- I HEREBVAFFIpM UNOEfl PEN LTY OF PEflJURY THAT 1'l1ERE IS ACONSTflUCTION LENOfNO AGE�CY a-: FOR THE PERFORMPNCE Of HE WORK FOB WFIICH THIS PERMIT IS ISSUED(SEC.3U97.CIV.CJ. -- ��-� -------�-�-- Z, W, ---"-- .., IEN�ER'SNAME - �_� _""_'_—_"-" '�± '_"""' '_"_'_"""_"—___ ___—_'_ ' I-; LEN�EH'SADORESS _.._.._—..__ -- �` TOTAL FEES � W I CEFlTIhYTHAT�HAYE READ THISAPPLICATION AND STATE THAT THEAUOVE INFORMq710N IS CORRECT. �t IAGHEETOCOMPLVWITHALLCINANDCOUNTYORUINANCESAN�STATEIAWSFELATINGIO[iUILDING CONSTRUCTION.AND HERFBV AUTHORIZE HEPRESENTATNFS OF 1111S COUNTY TO ENTER UPON THE ZA60VE-MENTKKJEDPROPERTYFORINSPECTIONPURPOSES. COMMENTS �,0� � ...J, �ou;s__�,,�-- ----- _ --- - �� PEflMITfEEN E NT) ,� p�, - Q,. (/ �/ �•, _.._. , _._. _ ' ��; SIGNATUREdF :RMITT[E � UATE ` . RECPT.NO._ ____ PAID BY � �VALI�ATION_ _ -_.. "'~', WHITE-0epartment Copy,YELLOW-Finance Copy,PINK-Assessor Copy,GOLDENROD-File Copy,GREEN-ApplicanYs Copy _._.... i �� 4 } ..� �. ... , .. ..` i . � '. i i ! y i � x� . � � � j F i- � i 't ; �r , E}r ,s '`� g � t { � � i .! � � -I � -.. �s� � . �� � : . - _�; � ' ' � �� �'�a d rwlrr et,Y ` p �y.� y �� I . � . ` � "� - '. ' � ! ; i -:i .'� r��4a � �3��7�.,e xr �,cn � � , � . � � ? ��, �_i{ � � . �� -� '� , i . . , I . � ' fi n�, ., . � . r i � j;� � � i ..� t � t i'r n,,,., $�,���.� ���.��h+�,� � , � i � ..a I ..'i i I'.� � .:I I I .. : � � �i 5si-. +.. g 1 i � . � ' � � i j � �: j i I �. + i t y�q ,.E� ; � � . i � � . , ( ���� �� ( � � I � � i , . �: �a�� i ; �.,, �. � , , . � � � .. ''�}i a i i � L � i � '�1 � � � `'_ _ _ i f �d'Y.h �F 'F�M/ .x , ..... . , 1 . � . _ � _'�_ ��� ' � � . . . . � ( 'Y " . � � � � � - � I ' ���f,� � r � � ♦ � . . ; ' . I ' : . _ i � y . � � � ( � ( � ; � � ��; � � ; � � � I j � � - : -- - 1 � --; � � � 1 � ' , . � 1 , ; , � y : 1 � I , i ,_ i I ` � � j � i � _: � ' � ' ; ' ; ; ' ' � ' � ' � , � ��,;; � i � � I . . ; ( ; � � I i � i ; ; , �, � I �� ; f I i ! ; � i � �`��� , � ! � � � � � � � � : ; , I ��.' _ � ' i ' , ' ' I I i �I I ' � i i � , . � � I °i *��� �, , , ; , � � ( _ ; ' , i � I � I i ' � ' � V �c 'a , � , . � , I I � £ ..� f ' . ' - �, - ' � � I � i i � : ; � , + _ _ - � t I � � � � i � ; I � " � �� � `i � � -- r. �� x i - , rl r -r�� � �� t 1 � � ' . I � � . 7 ,Y� I ,.:;( i -r � � � ;T ' � i 1 6 C t ( t>m � - y� �- [ I I � � � ,� . [r � � _ � �-� F � �,� s� € ( - , ; . � i . ' ; �fl �Y`' t �t - 1 I [� {I r f � � � :. �f �i � 1 � . +�.� � � _ 7 � � Y'Y �t � � ��,��� }� �� � i � I i I I I � � :. ' Y1 . ' _ _ ' '�V,ly� � �i� I � s.it �'"��,�� '�f k� ( � ' � � i I t , �1 . (4 ' � i`, �- - L � I� , . �.t� t '. . _� s I y g � � � �i9€ � � ' ' � ..S „a i 4 , i .� `�k''� 3` �S` ( - �.�5 i � � i � i�.�t i .�c�" �� �t�^:� S.5 ' i � ` i , � � �; � ' � ( � i,.: 7•', � � � i i j�� I I I i I ! I i � j � ,�. � �- � � � i �. , s :� ( ;� f � � l � � � i � ; �x t� � - � � �, - �t�= s � 1 ! � � ��� � ' � ' j � � � � i ,� — � — — — — - fi � , ' i , �• � ' , ' � ' ' ! £g ,. . f l _I I I � � � � i i � � i i i � � ( ��:� � � '��� � i � I � ; . � ; i � � � �. � � ; � � � - , ; ; , ; ' � i , � ` , i i— , � , , ,- i '_ i ( � ' � ��' , — — _ . — � — — —— �. , . , � , i i , -.� � _� � � , t i._ � � , � , , , , . ; i , ( `_ __ , ' ' _ _. �... , �. , I , ! l � j i , I " , � � I � ( � _ I r E � � ' � � j ' i 'I � � � i i i ' � ; i ' ; {. � . ' I �; � � � � ' � � , � � � � I I � � , ..' �y � i 1 � ' � ' ; � I � I � � � .� I , I �., , � ' ' ' � � I ,,. I I f I �. � : .i . I I I. �� r � � [� � � � ' . j '' � . j , . i d : ' . � i ( t..� ..� _ .. ��,..,..... �,.....f.. �....__{,_.. ...."'._..1.,.�._ �_.._. .. �..... .��,._.,,� �.....___.' � _i (_ .....,. , __. I... .. . .._'..,. .i_..""' I.. .��_ � � .._.U_J "�