HomeMy WebLinkAbout13888 (17) CITY OF DIAMOND BAR
- DEPARTMENT OF COMMUNTTY&DEVELOPMENT SERVICES
21660&Copley Drive 5crite 190
(909)860-3195 Faz(909)8 1-3117 PR�S$
����� BUII.D G ERM A PLICATION � FIRMLY
� JOBSITE /`— APP A PERMfT I? P/C
o ADDRESS �� �r� � ` DA � � NUMBEa/ � n
$ ISSUE TYPE OCC
APN LOT TRACT DATE CONST. GROUP
� OWNER
u' ADDR S— r(�� Q'�/ ONING SETBACKS
� CITY - � ' ZI TEL FRONT RW ❑
T— REAA ❑
� APPLICANT �TEL SIDE/SIDE STAEEf RW �
CONTRACTO O / �I SIDE ❑
ADDR S pR P USF� /' � 7� �t•' O / {�
� C ZIP 7�TEL e
o ARCHlENG/ �j� •
� DESIGNER N0.D EL NO. NO.
CnDRESS ZIP T�� UNRS STORIES Z BEDROOMS
� DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
v�
� � OVYNER-BUILDEA DECLARATION SFR/ADDIREM
O
� i r�nEer�mwr u�Ea vewan oF venurn nur i ru+exeuvr rno�a n+e cavrrucrons u Garege/Carport
CENSEUwFORiMEWl10WMORFASOFI5EG7W1.5BU9P/E55M10PROFE55qNSCdJEANYpTYOR (n
� OOUNTYMM1Md1RE0UIRES�PER6�RTDCONSTRUCf,AITER���F.DEMOU9l�ftEPAIRINY57tiVC- W P81�01D0dC
TVR�pRqR TO 1T9 p9UANCE,K50 HEOUIRES THE MPL�CANT FOR SUp/7EMMT TO FlLE A S�GNED w
� STATE1�ENfTUR HE OH SHE 19 LICENSED NFSUMfT TO 7HE VROVISIONS OF THE CONiMCTOR4 LL .
� GENSEUW(C1uPTEqi(COIJMENCMOWITIISECT70N7000�OFDMSqN10FTHEBV51NE53MlDPR6 V" P��OB
FESSqNS COO�OR TTIAT ME ON SME IS IXE►1GT 7HEREFROM ANO T7E B�S�S FOR THEALLEOED E7(EMP-
TtON.ANYVI0LAT70NOFSECTION)oJ1.6BVANYMPLICANTFOR�PERMIT6UB.lECTSTHEAPV�ICM7fT0 Z ReRoof tJ
� AGVIL PENALTY OF NOT AIORE T7uN FIVE 1+JNDRFD DOlLAR4(t5o�).}.
� 04u�'MEHOL7NEPqOVEHf'I.diMYEMPLOYEESWITMWAGE5A4TNEIR50lEWMPENSA710N. � �mmerctal ��
N1LL 00 TME WOfiC MID 1HE STRUCTURE�5 NOT IHrENOED OR OFFERED FOR S�IE(SEG 1oN.BU54 J
NESS IND VMFESSpN9 COOE TNE�CTORS UCENSE UW DOES 1qT APPLY i0 AN OWNER OF
� PROPEiT'1N10BVlD4011A1PqOVEB1MEFlfdLANDV.f10DOES5Uq1WOFlKHIMSELFORNERSELFOR �
� THRQ10HiE90RNEROMMELPLOYEE9,GROVIDEOT�uT5lA1I1JPROVEMENT51JiENOTMEp�EOOR CO
OFFFRm FOR SAE IF,/qwEVE0.TtE BUlDIN00R MPROVEMENT 19 SOID WITNMONE YEAAOFCO4RE
Z �TtON.1HE ONT1EHslIrtDER N"LL F1AVE TME BIMDEN OF VROV WO THAT ME OR SNE�ID NOT 9URD O!i
� MPAOVE FOR T11E PURPOSE Of SN.F}
❑1,AS ONNEROf THE pHOpERTY,AY E7(CLUSNEIYCONTRACTMI9N/N LICENSEO CONTftACiOfI!
to ooruraucr t�vr�Ecr�sec tou.e�sir�ss u+o orartssroHs 000E:rr�co�+rnrcrorn u• Valuatian ADJ.AREA
cEnse t�w�s nor�sr�r ro�n awen oF�rnovEnn wxo euxns oA a�opoves rr+Er,Eon,�vo
� wraca+rructsronsuavnarEcrswirH��aoacsl��+sEcour+s��wt*utHecarrruo QUANTITY D _CRtAT10N F'EE
� TORSUCENSEUWI. . ,.J .. , .
❑IM1E7mAVTUNDERSEG &tV.C.FORTH�SREASON Q
U
5
�=' DAiE ONNER V
F LICENSED CONTRACTORS DECLARATION . . . . � .
� IHEF�E81'AFFIIWUNDERPENAINOFPERIUMT/U71AlALKEN3CJUN0ERPfiOVI510M50FCHAPTER � . .
� �IODu/tENGMOWR}15ECTIONMODI0FDM5qNaOFTFBU5e�E55AND�FE CO^�,AND Z
lL W UCENSE IS N GUIl F�!f'�jFy�E�. / 1 m
f �'1 !/� L'i �
� LICEN�� ��IIC.NO }� a -� �
J DATE ,!�
UJ ///���
� ��WORKERSCAMP ONDE TION �
� 1 EB��UNOERPFNALTYOFiE RYONEOFTHEWILOWIN00ECUM710N5: U A r �
� Zd
� IHAVE�NON'M1.IAUMiANACERT�FiCATEOFCONSENTTOSEiF�IN4UREFONYICINCERS' S 7AN'lU� �� V
�i OOYVEN9AT10N.A3PROV�0ED9YSECTIONJ7ooOFTHELAB�FCWE��NTMEPERFORAIANCE V 11�
� oF n+e waa ron wi+ic++nas veaMrt rs iswEo. � N� .PtiV ) t' `"
IN1tVEMAWRLI/AINTAM iM(ERSCU�PENSATdlINSURANCE.ISREUnNED8Y5FCT10N
Q �p pF THEUBO OR iHE PER WRM6NCE 0i THE WORK FOH�YM!^-t�TM VERMR IS �
O �j1Ep,yy � R�����NS�TJJy�R1EHAN0 PQIC�,Il7����: CONSTRUCTION � ��• ��
� NWNCER � N f `•.J�C PLANREV�EW
� 0\� vaic+'ruva�rt � ELECTRIC '
� (f1;55ECf�t�hEE�ptpTgEN1,RE7F)ppP7fEpEnAfSiOqp�EHltd+EDpcy1AR41f�ao�oqt65� PLUMBING
Z I CERTIFYiMAT MT17E PERFd1MANCE CF FOA MMK,NTMS GE�T t91S5Uf0,1 MECHANICAL -
(� 51W1NOTflA?lOYN/YVER40NNMlV SOA4TOBECMIESUBIECTTOTME -
uj VqPo(ERS'Cd�VfN5�ii0nUw5oFC�LLi /JN�aREET1uTIFl pULDBE00ME� INSPECTiONFEE
S SIR.IECTTO7ME NERSCOMiENS�TI� 1 SqN90F3ECTq 76ovrne ISSUANC£ �Q
��y+µy PLY q5 PROVIS�ON4.
� p� . �L` �aR SMIP t. J D-
�
w ENERGY P/C
WAFNiNRFFILURETOSECURE SCW.�FENSA710NC�OVERAOEISUNUwR1l.IJ705NALLBE
� st�ci�wEup�pyEqiocnn,�M flLLLTIESMACNRiMESUPTOONENUNDNE[171Kn15MD ENERGYPERMIT
DOIL\RS(f 100.000).RI/DDRION T TME COST Oi COMPENSATqN.DAI.�AGES AS PROVIDED FOR M/
JOC SECT�oN]�oeoi7HElAeONCODEINTEREST.NlDI1TfORNEY'SFEEA � R�(�fTIONFEE:
a CONSTRUCTION LENDIN�AGENCY pRE�ALT FEE:
a IMEREHYAFFlRMUNOERPENILTYOFCE0.RJRViHATiHERE�SACONSTFiVCTK7NLFNDRJ0A0ENCY .
n- FORTHEOERFORMANCE�F1NEwORKWFMMI�NIM�SVEiwIT�SISSUED(SEC]ovr,c�V.G). - - -
�
,� IENDERY WVAE � - �
S
M' LENOEHS MDFlE59 .
� ��EqT�ry TUt�WNE pFJD}HI9 FVPLIC11TqN AND SUTEnu7 il+ ►BOVE MFONMA7qN IS COARECT. TOTAL FEES � -�;. . ��Q� � -
� IAOFEETOCd�oIYWITHAlla7YANU MNJLES STATE NELATRK1108UILDINO . , _ .
CONSTifl1CTION.MA XER£BY�UT1�0 EREPRE EMATIVES TH��S 7V TO EMEfl UPOrI TME „ ,
� EDPiqGENTYFU91N5PECT RPOSEA COMMENTS �
o � �. � �
� -
m ENAME(P �
4 � '..
�
N i E _,� U�7E � � �
RECPT.NO. PND BY VAUDATION
K7iITE—OepartmMt COQy,YELLOW--F'e+AnCe CDpy,PiNK—Assessot Copy,GOIDENROD—Fil9 Copy,GflEEN—ApplitanYs Copy
./
. . _ .. ._.. ... . . >.
..•._�il'^7 T T fi) fn (!1 (n O C7 � �T! N 27 7J 7J 7] p�]7 � m (!1 � � � �
� tn_cn ('� �� � -, r m m m A m a = o 0 0 0 o n � A m � �
m� Q � m -a � r � occcono -� � o .-'j r
. ��,:, .� „� � , 3 � 'r- r= r�- � D -�o c> A r Z r rn m x x x �7 � ��9 v G) z A "^ n ,�„,j � �.
'i-.1 .����� �n � � ' C m m � � � D ' r' � C = � 'ra � m O +C� m m� q � n 7O,_,J � � � :i
� ��� C D' � � � -�-1 z � � r T. � 3) C � p � I C7 -D_I 7J mZ= < � m C 7J � �;� . �.i
. il �t, Z .-1 : 77 ' r= '� CA "i -1 - (� � O [n � � �, �
't� � cnx fn � n � z �r � zmz � � ..� zm mcm l� � i�
�. 9 N V1 , n' � _� z 'n tn (J C7 , y � . z Z m .
;, m N � . O -i _-I` . � p r "'.i
..� fTl ; z .O- _ i�'.
:I Z a
�.�..,..._.... 1 I �I `�.
ll[.�, � , l:p �,
'u!�
_ I, ��
, � .r
. i i. �
/ � ' �c,�a � n -
'.� L � ;�
: _ � .+� //� •
V� ..� r
/ ?
; m o
! — n � J:
� � ��i _i � r:
� .� Rl p 2 T T O T O O 'T� � � T 3] W � '?t W 7 �'I T C C T � � -:;
„�i z m m � Z z � z m ,� O O o Z O m � z � z� Z z = � ,
-�� fn G D m y �y •- D O 'n O O O � C z m D ,�-�, � �m rrl�� � D � �;I z D ;.
�I . . - - .�,� � � � � r- ,� � r n cn r r r = G) = G) '_,m ,-=-I �. S� 9 9 m � y�! �
� � m 2 rtl N fn n m D -1 -n T m 2 � al�O T T p r- t�,� � Q
>� { mp -o � nz '� mzzm � � czio �zppnc� r r �A •L.,k� . fi. Z ,
�. � - ����.^ D � T Z � � � Z � � Z -ni o o � W� m Z m T o o ai rN-1 +�' n��
� 7� � O O � 7� ��'�'" ' O
i a� p „ a � ' � �' � c� � z y � mzc � o �� � D :.
_ . a . � D r � � � �`� \�'m�o a CCi @ � � �7 ;
' -� � r � z � 1 .j �� _ �
/� � ' �4'I y � .� �
-� . .� r. e�.
II . � ��1
I / _ _ �� r� , � i'
' � ri
I �:
�y ,
� - ! �4�
� � � ' � _ �.� o ��
. ,
- I, I : - �