Loading...
HomeMy WebLinkAbout17288 � CITY OF DIAMOND BAR - �``� -- DEPARTMENT OF COMMtJNTTY&DEVELOPMENT SERVICES � j 21825 E.Copley Drive (909)8G03195 Fa�c(909)861-3117 PRESS `"�»�`w BUILDING PERMIT APPLICATION � � ��� FIRMLY y JOBSITE APPLICATION PERMIT P/C o ADDRESS L DATE l6�- '-�I NUMBER_�� # � ISSUE TYPE OCC APN LOT T ACT DATE CONST. GROUP p OWNER o ADDRE S Y� ZONING SETBACKS Z CITY ZIP TE . -1 FRONT RW ❑ g APPLICANT TE�. REAR ❑ Z SIDE/SIQE STREET RW ❑ ¢ CONTRACTOR SIDE ❑ � ADDRESS � CITY ZIP TEL. PROPOSED USE o ARCH/ENG/ �z DESIGNER NO.DWEL. NO. NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS � cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O I HEREBY AFFIRM UNDEF PENALTV OF PERJURV THAT I AM EXEMPT FROM THE CONTRACTORS LI� GflfBJfl�CBIpOIt �W CENSELAWFORTHEFOLLOWINGREASONlSECJ031.SBUSINESSAND?ROFESSIONSCODE:ANYqTYOR (n V COl1NTYWHICHREDUIRESAPERMITTOCONSTRUCT,ALTEP,IMPROVE,DEMOLISH.ORREPAIRANVSTRUC� Z TURE,PRIOR TO ITS ISSl1ANCE,ALSO RE�UIRES THE APPLICANT FOR SUCH PERMIT70 FILE A SIGNEO W Patio/Deck w STATEMEM THAT HE OR SHE IS LICENSEO 7l1RSUAVT TO THE PROVISIDNS OF THE CONTRACTORS LI� w � CENSE lAW(CHAPTER B(COMMENCING WITH SECTION]aoo)OF DIV�:SION 3 Of THE BUSINESSAND FRO- � P001/SP2 FESSIONSCODE)ORTHATHEORSHEISEXEMPTTHEREFROMANDTHEBASISFORTHEALLEGEDEXEMP� � � TION.ANVVIOLATIONO:SECTION7o31.58YANVAPPLICANTFOFAPERMITSU&IECTSTHEAPPUCAN7T0 Z Re-Root A GNIL PENAITY OF NOT MORE THAN FIVE HUNDRED DOLLAFS(ESoo).): ❑I,AS OWNER OFTHE PROPERT',OR MY EMPLOYEES WITN WAGES AS TNEIR SOLE COMPENSATION, � 0 Commercial Z WILL 00 THE WORK,AND THE STRUCTURE IS NOT INTENOED OR OFFEFE�FOR SALE(SEC.7044,2U51� J � NE55 AND PROFESSIONS CODE:THE CO�TRAC70RS LICENSE lAW DOES NOT APPLY TO AN OWNER OP = PROPER7Y WHO BUIIAS OR IMPROVES THEREON,AND W-10 DOES Sl1CH WORN HIMSELF OR HERSELF OR � THROUGH HIS OF HER OWN EMPLOYEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m QOFFEREDFORSALEIF,HOWEVER,THEBLYLDIVGORIMPROVEMENTISSOLDWITHINONEVEAROFCOMPIE- Z TION,THE OWNER-9UILOER WILL HAVE THE BURDEN OF PPOVING THAT HE OF SHE OID NOT BUILD OR = IMPROVEFORTHEPURPOSEOFSALE�, w ❑I,ASOWNEFOFTHEPROPERTV,AMEXCLU5NELYCONTRACTI�GWITHLICENSE�CONTRACTORS [[ TO CONSTRUCI7HE PROJECT(SEC.7oa1,B'JSINESS AND PROFESSIONS COOE:THE CONTRACTORS�I� V8IU8fI0f1 ADJ.AREA W GENSELAWDOESNOTAPPLYTOANOWNEROFAPROPERTYWHOBUILDSORIMPROVESTHEREON,AND � NM1IOCONTRACTSFORSUCHPROJECTSWITHACONTRACTOR(S)UCENSEDPURSUANTTOTHECONTRFG pUANTITY DESCRIPTION FEE Y TORS UCENSE LAW.). � ❑I AM EXEMPT�NOER SEC. 8.&P.C.FOR THIS REASON Q � U � 2 ,� 'o DATE OWNER U Z W � LICENSED CONTRACTORS DECLARATION w �y 1./A � I HEREBYAFfIRM UNDER PENALTY Of PEFiJURY THAT I AM LICENSED UNDER PftOVI510NS OF CHAPTER � ('j� � 9(COMMENCING WITH SECTION 7000)OF DiVISION 3 0F THE BU5INESSANO PRO=ESSIONS CODE,AND Z � LX MV UCENSE IS IN FULI FOPCE AND EFFECT. m � � LICENSE CLASS LIC.NO. j � J U DATE CONTRACTOR a W � WORKERS'COMPENSATION DECLARATION a � IHEREBYAFFIRMUNDERPENALTYOFGERJURYONEOFTHEFOLLOWINGDECLARATIONS: Z Z _IHAVEANDWILLMAMTAINACERTIFICATEOFCONSENTTOSELF�INSUREFORWORKERS' _ Q CAMPENSATION,ASPROVIDEDBYSECTION37oaOFTHELABORCODE.FORTHEPERFORMANCE w OFTHE WORK FOR WHICH THIS PERMIT IS ISSVED. � � F I HAVE AND WIIL MAIN7AIN WORKERS'COMPENSATION INSURANCE.AS HEQUIRED BY SECTION O 3]00 OF THE LABOR CODE,FOR THE PERFOqMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.MY WORKERS'COMPENSATION'�:NSURANCE CARRIER ANO POLICY NUMBERAPE: CONSTRUCTION J � CARRIER PLAN REVIEW Z POLICY NUMBER — ELECTRIC � Q � (i}iISSECTKKJNE�NOT8E00MPLETEDOFT�iEPERMfTISFORIXJEHUPARED�OI.IAFlS(E100)OFLESS�. PLUMBING Z I CERTIFV THAT IN TNE PERFORMANCE OF THE WORK FOR WHICFI THIS PERMIT IS ISSUE�,I MECHANICAL (� � SHALL NOT EM?LOV ANV PERSON IN ANY MANNER SO AS TO BECOME SUBJECT TO THE � WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AGREE THAT IF I SHOULD BECOME INSPECTION FEE = SUBJECTTOTHEWORKERS'COMPENSALIONPROVISIONSOFSECTION�7000FTNELABOP CODE.I SHAIL FORTHWITH COM?LV WITH THPSE PROVISIONS. ISSUANCE � SMIP p �ATE: APPLICANT: J WARNING:FAILUftE 705ECUFiE WORKEftS'COMPENSATION COVERAGE IS UNIAWFUL,AND SHALLBE ENEFGY P!C __ � 9UBJECTANEMPLOYERTOCRIMINA�PENALTIESANDCIYILFINESUPTOONENUNDREDTHOUSAND ENEfiGYPERMIT OOLLARS(510o,00oj,IN ADDITION TO THE GOST OF COMPE'JSATION,DAMAGES AS PROVIDED FOR IN J SECTION37080FTHELA80RCO�E,INTEREST,ANDATTORNE7'SFEES. RETENTIONFEE: �„ � a CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O � IHEREBYAFFIRMUNDERPENALTYOFPEPJURYTHATTHEREISACONSTRVCTIONLENDINGAGENCV _ FOR THE PERFORMPNCE OFTHE WORK FOR WHICHTHIS PEflM1T IS ISSUED(SEC.3091.CIV.C.�. Z W � LEN�Eft'S NAME F— LENDER'SADD.9ESS � ^1 � I CERTIFV THAT I HAVE READ THIS APPUCATION�ND STA7E THATTHE ABOVE IMFORMATION IS CORRECT. TOTAL FE E � � �� � W I AGREE TO CAMPLY WITH AlL CITY AND COUNTV OFlDINANCLS ANO STATE LAWS RELATING TO BUILDING � CONSTRUCTIIXJ,ANDHEREBVAUTHORI2EREPP,ESENTATIVESOFTHISCOUNTYTOENTERUPONTHE � ABOVE- NTIONE�PROPEATV F INSPECTION PURPOSES. Z COMMENTS 0 I ,'"`-' m PERMITTE NA �PRINT) � � � SIGNAT OF PE MITTEE A E = RECPT.NO. PAID BY VALIDATION_ ~ WHITE—De artment Co YELLOW—Finance Co PINK—AssessorCo GOLDENROD—File Co GREEN—A licant's Co P PY. PY. PY. PY, PP PY 'n..:'.'�� .. � :... . ...��.:.'„^......�..�., a....M�r.:: ...i,njr 1. �. n..:-r.;fi�m„d;. ._.""i .r r.^" .�1-,�u�.�yN.i .... -.di^'.. .�m-.s. . , �,4, q .�.. . ., ... . �...... <r R � r�t �' R m � �„ ...� i . . . ' i . .. �'b. ... . . .. .�, . .,„�S� g, �.m- �� y ���,. � " a . "t....:� TM �' �..,�s s.s.�€.`�.� '�� :.��"�..��u . , ;� a.a'� �m. . �0. �3 §"��.�y �. �.�,.k'�' �..,d� ,� .� �. a ��-s� x �"�m � F �ti���,�_� �°� �`x. ,� �� . A �����"�:�'� ��� �� �`�� .. .. . : . ���s� � � �" �' ���, �s�= ��.� ; '��°e�� c��� �a ��� �;� �p �g,ro � � �t�4 � �� ��.i �� '�y t � �� i � ° � � �$'�` � ;� �:: r,s�4 `"�`a�� �` ��� at�*"� a �,� �..�y���`����°;,,a � �s� E�°��.�"� ._ �����'�..����",�:��:�����` ���.���""`_� .���° ��,��� �R��a������°�.i��.��������a���i��� ���� '. ,_, , �£� � �.� € � � , ' t // .� ._ _ �..:_ _ . _. i _.. ___.. . _._ _.__�__.__� F 9�f r � ,-F f..,� .� 7 � Cm"�� � � 3 ... . . ... ._ _._.� ..._..._....__�._.,.... . ,.._____.__._.�. , i j { . __.m.__...__ ' . . . .. _. .. _ {....._ ' l�� o .�� � € � � T.€ �� „� / . . . .!� � �a � I � 4-_32 �.� - . � - .�... _ ........... R� � � � L .. .. .. . � t . . P 3 € t-,�.,..r�I� . t:> i � f�^� :� ? -:.�1� �� � F t��d :_��y3"�€. .-�- �... . 1 g � _:._. _.�_ . ` . .__ __._l., ._._... ....._.__.-�___.....__. ._...... .____........ __x.,__W_. _._.._. ._._.._... ..:' .._ _._�___ ____M_w.. __.�„!_ ..............._..�..__� _�._.� p ``° .`- ; r z?C t i �.�'� � `,C t�; 'ra��.` � __.._ _ .... . ._._ . ....._� ...� _ � _... .. ..._.._ w_. ..._.... ___.. _. ._ 1 £-t �g � a 3 t��i �"r'r o-� ; € s tt '�" �?t r_ S � o-..� _ _ _ _ _ . . .._ .... ... _ __ _ ....__.............._. .__ _ 1 ���a a-a Cy:��Ezd° (-- : ,� �� "3 '�rti� �i( �.Sk� � I _. _.. .... ... . . .. . .._ " ._ . _... _......__..�. ..�.._..._.. ,. _ . � _.. ._ 4__ � _... �`� P i"t� '� f' '� ' 1 �� � �s ,1�� �z �re4 7 _ , _ ._. . .. __�.. � _ . . __ ._ _ -----_._ fl �i�'� '3��i .,r. �..��s_�� �'S t� .. � .'(��r :ala`cr �..Pijt�, ; _.. _.. 8 e ? 5 g .._ ._ ..._...._ ....,..,,. __,...... .........._..... 3,. . ...._... ...... ..__.._.....,...........,..... ....... ....., ..........._.._....,_.,,....... .. ..._._..._r ...._.�.,..._..._,......_.._ ...... _. �� ..... p^ .._...�. .� € t �' ( F q f�a„_p.<'� i i ... � .".$�3.� �a 5"?L "'.w: .... _ � �,,. k g ......__..�... ..... .. .... .... .,.,., . ............ .. .. ..... .. _._ 9 S 2f -��.-`# 'C I gm4_E . _ ... . I 1 qp-,� �.; . .. .. . ._ � ..._l . :......_..�._._.,�.e . �..._._.... r__.._.._...�.�.......,.._ l. ' . � 7r";C. � a � � rr [ i i; � i • d ' a � _.. _� �_�. � ...� . . _ -... .. _ �. ...__... . _.__........ ...... . ` . . . �..�...... . t . ..__'-, ._.._... ...._._ _� � I E f � � �L. ,. �S"% �' } ��� �y� I � Ci �' 2rs�.?�. �a�[ .. . I 1 8 r _ _ t� . . .. ........ . . _.... ... _. . _ 4._ . . __......_.....�_�_.._...._.. ° °5:� V i'�a' rE���; Y'` �l � ;r>r�s _ � L..:.... . . ....; � ... .'_ .... .... ........�..,._..._.__..........._._..�..._....__......___....._...................._..._ r ...... -� _._..�._.....____._.__....._�._.. ......__....... ..___..�_.___......_.._-----.._...._...� z `s °e�: .� {;r-� ��r� � j j � ���,� �' .a ^ i € � ._ _ .... ...... ...._... _..._....._____..._ ._ � ..... ........ _.._.._........._ _.�_.. .._.�....._ .... .,_ k�#.�.s�. ��°s'�". i t 5 ..:°d� �� .. . . r�`i�t� �'t F.. �§ � : j 4 .� � o--,.. �� .. .. ..._ � ....., .. ...�. ....._..._ .. �. _ i � c�� ��,� � � �r �i s� ��'� ` � � e ,.. � _._�._ _ . _ _ � . . .. ____.�._� S§"3�`s°b s"�..i '� 't€ ks` �... �,! s8 i t+'1°a9C. .. ..._ ......_.......,,.�..-._ � � W '. � __._ r�_� _�_..w__ � ,fiP i 3$€ � � ; p � . __ � �___�_..... _. __ _. _..� ___. _ ..____ ._ i __. . ___m_m_ � `� �t' "? �Y l i � gs r_;� �' ¢� � � r € ': � [_e tC..�,�. r.a ___ _..__._._�_.._._ _._ __s__._� _.._..._....._,___._.__.�_� _ ..._ �_ . _ < € � �- `�r]..S ' )� { �� ��'�, € � ,.. .e �_.__ ._. .____._...._�_.__..e.. .. .. .._.._..... .._�_ ....,...... � .. _ ........ .. _..._...�. __-__'�....._.. � .._._� ._.... __..�.___--�---__ ' -------� � � ,:�'€.�,r"�e�.�,.�, �\�.� �. ( � � r �ea`P .- 9���.`� I _. ._ ....� . ... ,�..,� �...._ .._.....,.�... .w..._�... _ # _...,.�....w. ..... �'��.,i, I �"°5� .. .. ..._. '� .; �... t�< :.. ¥ �tr.��_ ........_ _ . ... .. ....... �.._,� i €� ${, �,S� ."'€ �r ... ._ ....� _ _ _ . .... ...»_ � � .,i �. �� ���g €.._ �_ . ... _ .._._ � _— . _ _._._ g..,.. ______� � .. {( ._�.f �" /.,J� ._..._..._.ff . _...- 1 _.. . � .......�.... . € _.,. _.._ � _ . . . .. __.............._. p � � ..:.�$ a,y. ���i � ° /Ceb�G..., ...�a���.,, r ( �� d r i.�,... t" i a i.. .,._._ 3..� __.� __, .,� .__f /. � _.___ � ... __ __ _. r_ .._ __ __ _ _.._ _.. 1 � � 'i_C f G { �.t��.5 L�g�.., � � � �-.'�.��§ .`�� . �_...� � _ a.....�.._.r__ .. . ... __ —(� —�_—__ i . _.._._.� ..._...__ . _.. ...... _,._ x...... ...._.� i.. � � ` . ......,.- E. . _. .... ..... . ..,,.. a... ,��q, �y. g� ... � .._ .__.. ... f �.....�......�_�.�_._.........,.w �'�` �y� �'..�,$g��� .�`��" � � �.. :d�� € . ��"x.R�4..d?ki,*e�aa.�-"s '�� �: -�"x.§ I j�.... ,.«.............�._...._....�..__..__ _.......P..........___......�... ...................,...._............. ...... ....................._.............,..._.... �. ^" enzaa."s. . ... ...,...,.............-..... ......... _......_. � �'4om:. I�%Y$� � � �� � ¢ .�� . r 3^..% ......._.....,.....�_..__'_...........�......................____......,.........n....__..........,._........_.................._..._.__.. , ..................................�...._......,..............._____......�.....,.............._ ..............e.... .........,.......,,,.,..........�.....-............,..,._........,. ' _.� 6 � g_,.:>.::«..._............_............._..�... ..............,_.._.,......_................ _____ ......«-..,............_.............. ............._ ...,.......,,.�.. .. . � .... .........._._ ..._...................__....__..........,. ...._....�........._......... ___ ............_..........-....................__._._... � . ...- _... . ... . ...._ ._.._ �___........,,. ....._........__.......,..,..,.,_ ._...,.,_.,....._.�_...,,,_,..., .._................_..,, ..............................._....�.._._........ ._ : � ........._.........__........................._...........____._._.. ............_.........m.m....._._�...,,_._.....,,,�....................�_... �. ._.................r _.."....,..�...__. ..,...�..............................._,,,.....,,..-.._.....................«,...,._.._.�......��__......,,. j ... _................._�..�...,.,......_.,,.....,....,,....__..._............................ ......._.��,........_ .,........_.,.__...... __.....,........,,,..._._........�.................._.{€ � { { .:_.......�..-.._-•-_.�_.-.....�.....,_�......_..,._..._.......___............_..__ ___._... .._.........,... .... . E 4 ( € � a.................,.._.._....._...___._._...__..........____..____.. ...........,.___.__...,........ .............,.._..___._. .__....._...,,...._......._ _..._.......�.._...__.__..__ . .......... .. .._._..._......_._...._.�_..._..._..__.....,..__�.�.,,....._......_.__ .. .............. ..._.._.. ._._` d A........._.___..,,,._...._....._.___._.._._..._..._....:.,...�........ ................._ .,,...........__.. . ..._..____m..... ..._...._...___..__..._... ._. ._.......____._..._ ._...._....... ._________.......____.,_.�._..___......._...,.......�..__......_.�_..._ ...._...._....._____�._._,..� B �...,�........_ �..._._. ._....... ..�...... ...._.._ _._ _._� . � . ......... . .__._..__�'"_`______.._._ _...........____..,.,,...,.._,..._�_ _ � ._______'___"_ � � � . . .�_ ..� _.,.._ ....v._....�.�_'__._ .,.. �.,�... ....,»v........�_.. . .......�...._......... ...._�...._....... ._.._...................__..... _._.....«.._...� "+x `-,_:��I ��;�� �i' � ____._.. .____......___ __. .._. ....._ _ __-----._._._.. ....___.._ _ _..........._._�. w�_.._ _. _ _ � �........__ ___...��. _. � �e:� .`@� , ��_, e.�€. ...rt _. ....._ .......�.. ( .,: � � �:, � � � _..___.._ ___✓.__.._ ._,__-_ _-___.__..��...__. , _ _ __. __ _.. . 1 � � � ; � .���� �: _._._. _ __ �� ._ ._.___m.. .. ... _ a,. � � : . ..., ..._.... ... ..._.. . .. _..._._...�_..�_ _..... ..._ : �� .€ �;-% §m,"��_. �� •� . . � .:. __.,w..........__.__.......__._...__. .,,.,,.....m_........._..._.._..�.�....._........ . ....._..._.... __ ._�_ . �'�' r-¢ . ._'__ -............... ........___—_—_.._._....�._.__._'-- _._.__ � 1 4� � . 4a ��� ,� �!- x ? � � '._�._.._................__...,......__........,__ ..........,_..._....__._..._........._._____ .............._....,.,,,............._..._._._..........__._......._.. ....... .,.... ...._....................._..__...._...._..,,,.._.. .. � $ n. `�; . �� �������� �� �. d ' ;t �&�'��� '� ��� ._ m..__.. ........__ .. ._.,.. _ ...... ......__ . ..... . .. _ .. .. ... ... . . ...... ......_.. ... . .. � � „ ':�Yi� d�.:�a ���„ y � � ��������� � ���� _ ._ __ . ..__ __ _____.._. �[ . _ � �, ����:: k . � �,� ��b � � � _ .__.___._._.._�..___ .� _ _ma.._.._. _ ....a.._ _. ._.______�m�_,__......_.... `..�._.., ..___�__��. .�__ ........_._ .�.....e,.,���_�...»�,��� ...m_a__..,.��.�...e�6...��_ _.�,�, ".