HomeMy WebLinkAbout15658 (22) CITY OF DIAMOND BAR �
` -- � DEPARTMENT OF COMMiJNITY&DEVELOPMENT SERVICES
�� 21660 E.Copley Drive Suite 190
� (909)860-3195 Fax(909)861-3117 PRE$S
�'^^'. BUII.DING PERMTT APPLICATION FI LY
y JOBSITE � / `� ���A'� / ��� APPLICATION �� /�/� PERMIT PIC
o ADDRESS 7 'T f DATE IZ W NUMBER_i��O�$ �
� APN L T TRACT ISSUE }y !, 7YPE OCC
��� 2 DATE �'V 6 v CONST. GROUP
°C OWNER
O
o ADDRESS ZONING SETBACKS
W CITY ZIP TEL "S FRONT RW O
� APPLICANT �L REAR p
� SiDE/SIDE STREET RW ❑
CONTAACTOR O SIDE ❑
ADDRES M/.vi ✓- _
� C(TY ZIP 1Z�'L/ TEL /J PROPOSED USE '��S ��L't'%'- '1� �
� � -
ARCWENG/ � � � �
� DESIGNER NO.DWEL NO. I NO.+i C�c�
= CrDnDrRESS ZiP �L UNITS STORIES BEDROOMS
N
rn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
p� OWNER-BUIIDER DECLAAATON SFR/ADD/REM
O
8 1 HEt1�'//iFFlNJ llAEl1 PENALT'OF PEM1URY TUT IlJA E%EitM FRW TfrE COMMCTORS LF Garage/Caryort
C£lfSEUWFOq7MEfOLLOMT10Rf/tSp/(SEC70J1.68USMESSANOVROFESSIONSWOE:M7'(qTYOR (n
� COl)lIYYNdtlIPEOUIRESAOFfAQTiOCONSTTiUC[ALTFRMPRpV�pEuqJg�ORREPAIRANYSTRUG W PatlolDeck
IURE PRIOA TO fT9 ISSUANCE,KSO REq11AE5 iNE ACPLICAHT FON SUp17ER1A1T TO iRE A StONEO
� SThTEWENT TNAT HE OR SME IS 110EN5 W PUR3VANT TO TNE ifiOVI510N3 OF TME CONTMCTORS LF LL
� CENSE lAW�61APTER f(CDMMENCMO WI7H SECTION 7mo)OF DMSION 7 O�THE BUSMESS A1A PR6 PooVSpe .
fESS10NSCODE�ORTMATHEORSMEISFXE�PTTHEREFROMMlDiHEBA515FORTHEALLEGEDEXEMR (�
TIDN.ANYV�OIAT�ONOFSECT10N1071.6B7IV/YAPPIICAHTFORIIVERMiTSVBJECTSiHEMR1CANTiO Z Rg.Rpp�
r A dY�PENILT/OF NOT MORE 7NAN FIVE MINDRED DOLIMS(t50o).k . .
O ❑tIISOVMEROFiHEPROPERTV,OqMYEMPLOYEE5N17HWA0E5ASTHEIq;ALECOMPENSATtON, COrtIm8�C18) � .
� 1NLL 00 TME WORIC AND THE STRUCTURE�3 NOi IMENDED OH OFFERED fOR SILLE(SEG 70u.BUSF �
� IESS AW VRDFESSIONS OOOE TME COHTMCTORS LILENSE UW DOES HOTA7RY TO AN ONMER OG �
7i10PER1Y 1Nq8lMD5 di MPROVES TIEREON,MlD WHO OOES SUC11 Wi71iKHIM5FIF OR NERSELF OR
C!� 1HROUOM Ffi9 CN MEti GwN EL�PLCVEEA PiqViDED iWQ SUpI MIVROVEUENT3 AHE NOT MENDEO OR m
� .OFF�OIEDFOHSALEIFFIOWEVER7NEBlADIN�ORMPHWEL1ENf6SOLDWRMNONEYFAROFC9MPLE•
Z MIN,THE OWNfF�1.DER NHJ.IUVE iNE BURDEN OF PROVMNl TUT HE OR SNE OID NOT BUrtD dl
= MPfiOVE FOR THE PURPOSE OF 9iiLE}
� ❑IASOWpEROFTNEVIqPE1R7,IlMEXQUSNEIYCOH7R�CTMUWRNIIC�NSEDCOHTMCTOR! �
TOOONSTRUCT71rE 7RnIECT(SEG 704.BUSiNESS ANO PROFESSIONS CU�E TNE CONTMCiOR4 LL Valuatbn � AOJ.AREA
CENSE UW DOE9 NOTAPRY TO AN OYM�ER OFA PAOPEANN4q BURDS OR MPROVE9 THEREON,Mt0
� w+aeoertw�crsFonsucnvno.�crswmuca+rrucror�s���Nsen�unswwrrorr+ewivrruc pUANTiTY DESCRiPTION FEE
� tauucv+seuw�.
� O I Mi E%EMPT UNDEN SEG B.6 V.G FORTHIS REASON � �� -
3 � ...
LL' oar¢ owr+eq U
� LICENSED CONTFiACTORS OECLAAhT10N w
� IHERCBYfJT67YUNDENVENALTYOFVE0.RIRYTMITIALLICENSEDUNDERDROVI5iON50FCHAPTER �
s �(COlOAENtfl�WfRi SECTION 7000)OF OMSlON]Of iHE BUSME55 M!D PROFESSIU l4 COOE,IWD Z
X Ary UCENSE 13�1 FULL fORCE fN0 EFFECT.
a ��E�,SS C-35 �.�. �i�fri � � �
� �� ./e—�L Qa eorrtrueron �� � a .
w
� WORKEii5 COMPENSATION DECLARATION �
N1 HEREBY AFFlRM UNDER VENAITY OF VERRIHN ONE OF iHE FOILOWINO OEQAMTIONS: Z
� _INhVEM10WYlMAMTAINACER'TiFlCATEOFCONSQfTTOSELFiNSUREFOHWDFKERS' _
OOYPENS4TION,A7 OROVIOED BY SEC7tON J7a0 OF THE LABON COOE,FOR TNE VERi'ORIA/�NCE W
Oi 1FIE YVORK FON MAIIUI iH19 PERMIT 19 ISSUED. �
�
_I IUWE A4D WRl AUMFN WONCEHT COi.�PENSATION�NSUMNCE.AS REOU�H W BV SECTqN
G ITDOOFTMEU180AC�OE�iTMEVEAfORY/�NCEOFiHEwORKPoRMMip1T1nSVERMfTl9 �.I� ��
= I$SUm,WNpANER5001APEN�4L��a+INrSU�+,NJCEGARIENINDPOIICVNU/ABERME CONSTRUCTION "Y
j cuwm `s�d'V �v�� PLP.NREVlEW
� POLICYIUYBER �2 ELECTRIC - -
o �n+ss[eroN�rroreeootianmcFnevwareana+e�uaavmu�cs+or,a�� PLUMB�NG
z icEmarnurNnrtven�r��an+EwancFor�wMai�soErwnn�ssueo.i MECHANiCAL AA YY`11
(�} SfULL NOi EMPLOY/VJV PERSON N M!V/AANNER SOl15 TO BECOME SUBJECT TO THE -�7SR�T
- - � -(n WONKERSCOA�FFNSATIO/dU�'�SOFCALIFORMA,ANOAGREETXA7615HOULOBECddE----- -- -" -INSPECTIONFEE-
_ __.-_-_-_ _- __..__________ . _'-_'
__ ___ _ __ _ __ .__._ . ____ __._.___'- __ .-___
S StIB1ECT TO h1E NOi1KER5 COMDEN4ArI0N C KJNS OF SECTION]70D OF 7ME UBOR .�,�
cop£is�utlFp�n+w�TMc�r�yvnTM . ISSUANCE
o ' (]�1' ':�I�):
pA7E; Z.�c7 �pp���� L SMIP
� W,fiiNlNfLiAILURETO5EC11REwdiKER5COAIGENSATIONCOVEMGE�SUt1A sHuiee ENERGYP/C
St1B1ECTINEMPIOYEqTOCRIMM/�LPENALT1E5Mi0CNRFINESUPTDONEMIM7 -DTqUSMlD ENERGYPERMITCj
� DOU.MSIi10o.00C).NIDDITI0NTO7HECOSTOFCOMVEN5�l10N,ONAA0E5A5 OViDEDFORIN �I . .
J SECTION�7wOFTHEUBORCWE.NTEAE5LMI�IRTORNEY'SFEES � J ��
pC REfENT10N FEE:
a CONSTRUCTION LENDING AGENCY PRE-AlT FEE:
O
� 1 HEREBVAiF1R4 UNOER PENJLLTY OF PERNRY TMl1T THEFE IS A CONSTRUCTION LENDMO AGENCY
FOq 7NE OERiORMANCE OF 7ME M/ORK fOR WHICH THIS VERMIT IS ISSUED(SEG JOY7,CN.C.} .
�
� LENDER'S W�ME
� LENDER'SADDRE37
W ICERTIF7iHATIIUVEREADT1f•9MPUCn7��NANOSTATETHATiTfEABOVEM�FMW�T10N13CORRECf. TOTAL FEES � � �O.
�y ItaFEETO00E1PLYN7THPILC�TYMlDCOUNIYORDINI�NCESANDSTATELANSREUTR�(3iOBUlDINO
� CONSTFIUCTpN,AlAHERFBYAUfIqRIZENEPRESENf�TNESOi1HIgC0UNTYTOElREqUPONiHE
/�BOVE-MEM EDiROFER7YFORINSPECTIONPURPO5E5.
9 �" ,' � �N COMMENTS
� � ` � «
O° rew�meewwetrwrrt�
t�n �/L�Cl�
(n SI(iNAiUREOFPE��TTt DATE
� RECPT.NO. PAID BY VAUOATION
WH�TE-0epeRment Copy,YELLOW--Finenos Copy,PINK—AsxssorCopy,GOIDENR00—File Copy,GREEN—Applicantb Copy
�:.:.- , l� m-�i , ` I - _ -- .,__ _O._ �-�o n 2 i � v � � � z � � g � � o � � U � � � c � T W r,.
�� � � y s,
� � r r O � ` -I �.. r � (n i � 'a m 2 O G7 - cn O D O, n � n Sl�
`{ � . " �rrt cm � zmr- y zc acrnm <'Zr" � � o � � i ��
-�A _�,; cZ � ' ,, z m -n+ z ,-�i � � � � nc � ow � � � �n'z � � � m � � �' ��;
. . � ' � (�T. � �, ' ..� . Z � G� . � � � z � co D Z � .� = C� � O V�
� � � " . ; f�it� ' . . � � ��' L7 � � � cmn z c) � r�G�i m z z m . ���
�;
m z -+ � -Di . � � � � �
' � a
� ieiG:_.__•--� � ... �- ' .
� i-El
�
� � :� _ ��
� � � i _ iii�,
� � �
\ .,3. L'. �i .
i
C.
C '�
I
I
_ — - i
� —
% -
�
f�l �
_ �I �
a��;�I N -C
- �`+ m o
_ 1 n -�
� � iYi fTl � 2 TI T O � T O O � � '9 T A UJ � ?I W ?� 'rl T C C T T .I ;' � 0 .
. ��� 2 fn Rl 7J Z 2 R7 T O O O z O m � Z O � D O O D � . ' O D
__' . ' _ ' ' _ _ _ _ . . ..ni 7] T � � � m Or � n � O O O = � � D O Z m n n 'n T O O '7��� z :
. . _ __. .. .. . .., m � � _ n n r r O . .
,'�;. 'n fn 2 fii N fn D -i T7 -n m S = 37 � p � r 37 3) I'n � .� O
/� _a m v0 z � m mrG� z
�ay m -� zs � � o nz c� ozoo � �N fn Z
� - � �.�[i:9� � '� -n Z � rt�7 Z v r n '1 O D Z ��W Z W �i O O (�i) .�-i �1'1'M . n..�
� ., �� D -i z � rn � tn � z D Z 0 G� m m � O O � � 'C. �; o-�
L � � - �e•w � -t7 y � . f]' (� � 2 D 7 W Z C � O a�I �I.�D
. '. �� Z r � 'S7 . �.S ➢ O p O C �_. '�.'� �.,Q�.�.
' �' r ' S D -Di p 'n'� �' ^'".f . ..
-. . � O C ,
1 z � j
i i '
— j — ' I_�4
„ �
`�:�
: ,`��
I
_ ,�i ,�
.
,
,
, I �
,
� ���
- -- ....__ ._ _ -�: :
_ `