HomeMy WebLinkAbout10117 CITY OF DIAMOND BAR
�, � ' COMMUNITY DEVELOPMENT DEPARTMENT
,,.0 21660 E Coplcy Dme Suite 190 PRESS
(909)8643195 Fax(909)861-3117
""". BUILDINGPERMITAPPLICATION FIRMLY
�N JOBSITE /' �I APPLICATION � r � NUMB R1 L(—"L M/�C `
ADDRESS�� I� L7'!� ��cS�-�' �,�� DATE
$ ISSUE ,�TYPE � OCC '`��
APN��O TRACT DATE ` ' ',CONST ' GROUP
p OWNER I� � ,
p ADDRESS ZONING SETBACKS �•i',
� CITY/,�f�/)�JYL� ZIP���TEL FRONT ^`; -,. � �.\._._V RW �
APPLICANT El. REAR ❑
� SIDFJSIDE STREET' RW ❑
CONTRACTOR SIOE ❑
� ADDRESS �tl,"-,�L �=E�.T. ,�f •h
� CITY_[��f ZIPq�� .,�, TEL�r�r�� PROPOSED USE
oARCWENG/ ♦-�- � "T�� `' �
� DESIGNER �,��}'l1�I(� NO.DWEL NO N0. ,.
ADDRESS UNITS STORIES BEDROOMS
� CITY ZIP TEL
�
cn DESCRIPTION SQ.Ff. FACTOR PSF ADJ.ARE/WALUATION
� OWNER-BI;ILDER DECLARATION
0 SFplADOlREAA � �
p 1 HEREBY AGFWIA IWDER GEtUliV OF PEiWNY TMAT 1 A11 f%EMVT LRON TME CONTHACTOpS LL Ganpett'.arpat " ' '�� - \�
W CENSEUWFO(1THEFOIIOWINOREA50N�SEG70.1f.5BU5M1ESSMIDPROfE5310N3CO0E:ANYGttOq (n . . .
CJ COUHTYVhYCNREONRESAVER1UT7000NSTRUCLKTERYPROYEDFV0U5M.ORREWWANYbTip1G w P,���
Z lUHf,VRiOR TO ITS ISSUANCE,A150 REOUWf4 TME APGLICM7Y FON SUCN VEfLdT TO FILE A bKJlEO
LL� S7ATEMENT TFNT HE OR SHE IS UCENSED GURSUMlT TO THE GROVISIONS OL iHE CONTRACTOfiS 1� W
� � CFNSE LAW(OIAYTER�(COYYEl/CPKi MIIiX SECTqN 700010F DIVI510N]DF i/1E BU5WE55 AND VfiQ LL POO{l$pi . . .
FESSIONS CODE)ON TMAT NE OqSHE t5 EkEMVTTHEREfH0�,1 AND ME BAS�.S FOq ME ALLEGFD E%EY0.
TqN.ANYVqLATqNDFSECTqN70.1t.6BYANYMVLICANiFOAAVEHM1iSUBJECiSTHEAPPLICAHTTO � Z R6�R001
AGVLLVENALTYOFNOiNOHETIIANFIVEMAIDRE000L1AN51i5001.k .
0 OI�OwNEROFTHEGROPERTI.OqY�E4VLOVEESWITMWAGE5A5TNEIRSOLELOMPENSATqN, � O r,pmmgtCi3l �
�Z MnLI DO iHE WOAK ANU iHE STiWCTURE IS NOT IMEN�ED OR OFFERED fOA&tLE(SE0.7ou.BU54 J
, � NESS ANO PROfE55�ON5 GLOE TNE CONiMGTORS LIGENSE LAW DOES NO7 AP7l�TO AN OWNER OF � �' . �
VROVEA7Y Wlq BURDS ON W DROVES TNEREON.AND MAq DOES 6UC11 VYOqK NIYSELF Oq HE0.5ElF Ofi
Q iNqOlX1NW50RHEHONR1EUPlOYEES,PROYIDEDTNAT5lK11WPROVEMENTSARENOTWTENDEDOq m
w OFFEREDFOqSALEIF,HOWEVERiMEBU0.DWGOFiwVROVE�dEM1550lDWIT19NONEYFAHOFCOMPIE- .
. ..___._.. p . _. ...
Z TION.iME OWNE0.Bl11lDEF WILL NAVE iHE BURDEN OG VROVWO T11AT NE Ofi SME DD NDT BULL�ON
� MIPROVEFOHTMEWRPOSEOFSALE} �
w O4�SOwNEROFiNEPROPEHI'Y.IwE%CLUSNEIYLONiRACTNOMniHLILE715EDGp(fHAGTOHS
(L TO CONSTRUCT illE GRQIECT(SEG 70ar.BUSINE55 AND VROFESSIONS COOE THE COHTRACTORS LL V11U3UOn ADJ.AAEA
t11 CENSEUWDOESNOTAP�LYTOANONMEROFADROYERTYW1qBUlDSOAYiROYE4TMEREOKMID .
F_ wHoconrw�ctssonwa�ariaeasMnrn�cant�on�s�uc�nsmvuruunnTron+ecoKraw OUANTITY UESCRIPTION FEE
.I TOli4 UCFNSE IAW.� .
� O I/�u E%EYPT IX+DEN SEG 6�7.G FOq T�uS RFA�ON � D�C�
� U �
� F . !
DAiE ONNEN V �
�¢ UCENSED CONTRACTORS DECLAFUT�ON W •
K IHEREBYAFFIRYUNOERPENALTYOFOE0.R/HYTUTIAYLICENSEOIM�DERPpDVIS10N50FCHAPTEp V, '
p. �(COA/uENGw6W1MSECT10N70ao�OFOMSIDNfOFTMEBU51NE55ANDPROFESSqNSCODE,ANO 2
YY LICENSE IS H FULL FORGE MD EFFEGT. m
O CS'.3 J�' �
�� �.�. �
� a+� cor�tw�cTor� �0 a
w
� WORKEAS'GOMPENSATION DECLAFiAT10N �
� U
N IHERFBYAFFWYUNDERVENALTYOFVERRIRYONEOFTHEFOLLOWW(iDE0.I3i�ilONS: Z r �J
� _]!IWWENWWLLLMAa1TAMAGENTIFICATEOFCONSENTTOSELfd115UFiEFORqDR�(ERS � �
COMPEHSATqN,A5 PROVIDED BY SECi10N 770o OF TNE LABOIi LODE,fOR THE PFRfORMANCE U
� OF T/1E WOFIK iOR WMiCN TWS PERwT IS ISSUFD. �
O
Q �rave um wui wwr,uN woaucAs•oo+.wcruAT�wsuwwc¢.�s aeouwen er sscrar�
]7oa OF TXE LABOA CODE FOfi TME PEHFOfiMMIGE OF TME WORK fOR WMIQ1 TMIS PERWT IS -
J ISSUE0.W/NORKER$' OYP,E�NSAT/gr+WSUMNCEW1piE POLICYNUMBEHANE: CONSTRUCTION
a caawEw L�/ � v,� � �}'� PLAN REVIEW
o raucr tiuuesn �S•�=0� ELECTRIC� .
0 (n+ss[cna+rEmrioTeEawt�necn�vFaetswaaraewnn�ntatusR+ao�oa�ssl PLUMBING� a I /
Z I CERi1FY TWR N TME iERFOR4�NCE OF TME NORN FOR NMICN T111S PERW T LS LSSUEA,1 MECHANICAL N
(7 SFWINOTEMPLOYINYPERaONINANYAWrNERSOASTOBECOYESUB.IECTTOTME
(q WOWCER5L0►IVENSAiqNLAW50FCAlIFORN1A11NOAGREETIIATIF151qULOBE E INSPECTIONFEE
S SUBIECTTO EV.I'XiNERS'COUVENSAi�ONVijOVi5nN5 SEGTION 7000F H.
� Fpi�TM��y�TM ISSUANCE '
O � .�
p DAtE: ' I�PPLMaWi. � :�L�I SMIP _ p._�
� WARN �LAIIURETOSEWREMORKFR5C01APEN5ATqNCOVEHAGEISUNUWNL,M105W1LBE E�'1ERGYPlC
� � SUBJECTANEMPLOYERTOCRIUNKCENAITIESANOCMLFY.E4UPTOONElIIRdDHEATF10U5AND ENERGYPERMIT
OOlU0.S If f o4000�,IN AODRION i0 iHE COST OF C011PFNSATqN.DAYAGES AS PHOYWFD FON W
J SECTCN�7aOFTHEtABOFiC00ENTEREST,ANDATTORNEYBFEES � -
Q
d CONSTRUCTION LENDING AGENCY •ALT FEE
� IHFRFBYAfGUYAUN0ER7ENAtTYOFiERA1RYT11A1iMEHflSA00N57RUCTiONIFNDWfiAGENCY �
� fOR iNE VERiOiW/JrCE OF iHE WON(fOR NM�CH TM PERW T IS 4SSUFA(SEC.�aGT.Cril.C.�.
� IEHDER'SNAYE � �� / /
` � LENDElt3 ADOtiE55 �
�� � 1 CERT�FY TMAT I HAVE READ lia4APDLICaTiOl1 AND STATE TIIAT TNE ABOYE INFORMATqN IS WHHECT. TOTAL F , S . , � ,
� 1 AGlIEE TO COMPLY VATH ALL UTY ANC GOUNTV ORDUUNCCS AND STA7E UN5 RELATMO TO BUILDINO
� OOHSiRUGT INDHEREBVAUi/qNZEF1EGiiESENTATIYE5OF1w5COUNTTTOfNTERUPONiME
ieove++ Eo �nvEarr vECiqrr �5. �� / COMMENTS
� �/ %`f
�
m PERMt E �� . .
� , --- 4 . . . .
� OFPERWI7EE - OATE-
� RECPT.N0. PAID BY VAUDATION
NMITE-DapaAmenl Copy,YELLOW--Finante Copy,PINK-,Assessot Copy,GOLOENROD-File COpy,GREEN-l�Qpl�anCs Copy
Y
t n I I ' I
1I 1F I � ' _I 1
� .L-i n i C 1 A i _� � U. '- �. _ " �' � �11'.- _ _,- -_ _ __ . I . � _ _I- . . ' �
` T Y I_. _l _ ' '
� �.1 , t ,, �� , � ; ; ; V`y � - �- � ;= , ;-I ; i f ,,j�,
i ",, V�, i i r � � �I , ,� �: I I !. ) i J ! ,,' i
; � � �� I i � �: I � � '�;\
� i� ��� � ��.� j �i I � _ - �' I I � l ' � ,��,� �
k r , , I 1 . , , ,, r: � �, � ; �. I
� �r� �� .'� ��i��'1 i �� I,� � ,, I. � .I � 1�_ i . � I , I � ,
� ; �{ ���i��,��� ���� i� � i �' � - �,� i � 'i �' � � � r' � � i
'� � : `* i � � ' ��'�; I; � : � 1 � � i' ���� �a: j
` ,� '`��rIJ t^,� i�! ' :j ��` � I I ' � - � �� ' }'�" � �� !
r J
ac' 1 i� _ ' � :I 1IM I I - : . � �;.' ��� ri �:
> ,� i i� � �
� �rl � ^.J J�} "N�' I � �{ .I:�� I, I �_ _ I � 1� '� /I�l � j,� I � �(\' ',
�` �� � ' � � _ F � � ; �� ��;�, Z I,
,` ; ' '�.�1� ' (j �' � � -�.+� I ' .I r�'� �,�1 °I . � : � :� �^ �,
� -� �, � �,;�� � � ��,� � ' i i �� -� "�� j _ � .� }. ,�� �: ;�;: � ✓ n�
� + j � , ! i i � r. ; � ; . ' J � ,,
i, � O .c. ,la.I
.,�. H�4 C �i .�� . - i , ') e � •� .�; ' ' �
a�� �' � K: q ��' -�; � � ��i �� ��� - � �� ' I, '� ' f-
� � �� , z � � �. ;
;: a �- � '�.a,� o .�; . -�.. � 4 , � � ''� � �_ '� _ �. ,;. , !
,= C�_'�y ',-��.� 1'1;� � �,�!m aQ W ' z z � t� � `t'LL � ��, I � : I .. � �i ' I I
`>" 0 .(, i�y;vi ��� g pY� ;z m 0 ? ' � � � � � S�Z w c z LL d a' � � ' � % � {�� t;
� LS1 ` ,,_7 p ` a��u �,I''�" Ga:� zo 'c'� ¢ ¢ w Q —�oc� �-' � zF= +=� cn� 1. � j .; � ,
� �;� � LL � r� m��0 c� ¢ Z L � w � u. �.J Q Q � �_D r=- iwi. � ��.� -- . .�� /� —-��,� I I �., _ _� t
�..� lt� -. C7 z w ¢ a � ��I
w
t � -�' C crw'� '���a''. = m J-c� v_� s — � cnr J� �I � - - � _-� -- - -
..� _�D,� o e. w I w ol_ t W�_Z � -�o o O � n Z. c_�> �} �� --I --� -_i�- --- -- -- -
�' Q�Q - ; �= Z_Zic�s �iZ�¢�w O�� O D O u: w Z Q r Z tz w�w ZI M �-- --J,
Q' --LLlLL � �I li I.` �.L CC .L74. m 2 LL d a a G O.li.:J � LL li.�5.��'{iI - _ _ j _ _- �
j. LL`�,� �I�—}-- � � �- -- � I� I. .(' »I � `�
s p.,a •: i i ' - - j; i' J�i I ' ; ' ~ � I �
P �� (� li�I I -r _ � j ; � � ! j.�,«f'� � i 7� 'i � ., �
�. � � ��i�I ,''� � i i � ''` �-�~ -�' - �-- I �� c 1 i�
5 I �'i
U .
�
I i�
- - i .
- C I
- I� I
;.,
I�;I p 1 : 1 �. i • '� � �' � ( i � .��� i < ` .� ��' �
_ _ I�'I I J�i Q\ ��; �.� i ' ;�� ' {,-., ,� . :r
w I
f
..i i I � . I i �.' . !� . l:�
\ ,I
/ � I� � E_
� i.
�
. � - 1 •�: . I ,
f � . .��I, I� iI �� � —__ — —� ' .� I I ��� i� II ��i,� �• r ',
I k � i i I i I .I �(��! I .� , i S t ' J� ,
'ti�' � .I� � . �I � � I V� I i I � II , �il . - i �.
" �� �'i �� � I� � � ��� � � � i s % � ' i 1 ��
�i'\{�1. , ' ,' i 4�:j I � � �I, ' ! � � "I; �-.
� I � OI" I' I -- i � ' '1 � II� I I i I . } Y�!
' � J � ��yr . � �, -_-•'. .-- . 2 'i I � � , i W; � , �'�I
= �,J I� FW- � �] � .W.C7 J ' � U I Z W � Z O Z �.I � ` i �, 1�� ' ,'`. I � .I , N W ,. '.
, �� Z � g ' ., � '. _{_� U Z .'� . . . �. , i , �N '�' .
; I�''' , Cn CC � lyj � � FZ- W ¢ 1- U � m 0 ~'� Q I Y � �" F_ Z � m ,� j � �' � ' i I, Y ln �#,. . . � ��,
,� � � a o W ¢ ¢ w ¢ W � � �'g � z !z � N � U z . 'Z I� r,7L •1 � Z�' � ��
f �.T"��X ¢ V a � w 2 (.�7 O s w a ai Z � �`t �_F-W,-. z W w ��� � j W I , .� i :� ,, I FQ-F=. . '', . .
Z: � ¢ O �n � � - � � U �, u -� � � ,,, /7 .�" ,
f1�Y._Q � ¢ zc7a ¢ cnZU222w ? Z ¢ ¢ Ua.� U = wc}�F '� � , , 1= - Ud
�..h C7 W O m g � O Q O � � � O � J W F- a Q J _l J J !� I �, . ..I.. I� I"',a �, , � '.,.
lJ � r� SW�< os0000x ¢ W � WWWazz `zz�� �!o. f` , �4-�� �i, l� �_ ww
;� `�" - cn � u, c� cnr-�3cr � ¢ ¢ ¢ av� w3 c� orn �nwc� ll. 11 � �+...' C3 � i I1"� �� -
, . .. , , " , � ' v�cn .�--�----'
�
c " �' '