HomeMy WebLinkAbout11681 CITY OF DIAMOND BAR -' �
-- " DEPARTMENT OF COMMUMTY&DEVELO E S
21660 E.Copley Qrive Suite 190 �
(909)8603195 Fax(909)861-3117 PRE$$
'��'�'_ BUQ.DIIVG PERMIT APPLICATION � FIRMLY
o �DRESS 7�� S. �a2E�i4T OATECATION S Q �� NUMB R I �"' �I ff/C i
13riv,o D�e:.
� issuE TYPE OCC
APN LOT TRAC DATE CONST. GROUP
°C OWNER
O "
" ADDRESS 5. ro �i} � ' /L. ZONING SETHACKS
8 cmrA�ar�o.,n �,R-.�-ziP ' -rE�. G z. FRorrr . _ EXP_IF�� ' �
� APPLICANT TEL REAR p
� SIDE/SID E STREET_jj f�n�R1+�l�p_.❑
CONTRACTOR o i � SIOE - ""� v J LuUU p
ADDR�SS Z
� CITY�C�4I�' �/��n�2[�'1tP92�.� T��S�S'7�I Z`� PROPOSED USE -
� ARCWENG/ • ,
� DESIGNER NO.DWEL.. NO. NO.
ADDRESS
�m, Z�P �� UNITS - - STORIES BEDROOMS
�
v� DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
� OWNER-BVILDER DECLARATION___._ ' '
� - _.., _ SFRlADD1REM .
O
i�nmr�u+nEn oFwun oa v¢aum nuT�ua txeuvr es�rne cormucrons u Gara
8 CENSEUWFOR7/1EF0.LOWMOHFASON(SEG70]t.SBU5P1E54ANDPFqFESS10N4CODEANYCITYOH _ (n ��g�rt - -- -
�S� OOIINfYWF110/AEOl11RE4AVERYRTOCDN91AUCf,ALTE0.YViqVEDEAqL15M.ORREOAIRANYSTRVC- `. W Pdi�0/DBCk
11/R6 PRIOl1 TO R!ISSUANCF,A150 REONRES TNE A7PLICANT PoR SUCH PERMR TO fllE A SICNED w
STATFMEMT 711AT ME OR SME 19 LICENSED PURSUANT TO 1ME PROVISIONS OF iHE CONTMCTORS U� . lL
. _. � LENSE UW(OIAREq�(OD/IMENCl10 WfTN SECTqN 700M OFOMSION�OF THE BUSMESS IND iR0. POOIISps , .
FESSIONS OOD�Oq TIUT NE OR SHE IS EXEMPiiHEREfROM/�NO TF1E BA51$FON THE AILEOEO EXEMF
T10N.NlYVIOLAiIONOFSECT10N7W1.6BYANVMPIICIflfFOR11VERAn75UB1ECiSTHEMPLIClu1770 Z RSHOOf
F, �rnn�vfl+unaaorr.aaen+�m�rurmacnoaw+snsoo�r. -
� O1�30MMEROFiHEPROPEHTY.OqA1YEMROYEE9W17HWAQE3ASTHEIRSOI£COMPENSATION. Q CpmTBfCi01 �
WRl DO iHE WOiK IWO TNE STi0./GTURE IS HOT INTENOED Oq OFFEREO FIXISALE(SEG 7M(BUSM . J
. � NESS ANO GRDFESSION9 CODE TNE CONTMCTD0.9 LICENSE UW DOE9 NOT A7PlY TO AN OWNEq OF ? ,
PtqPEHTY N4q BULDS Oq 11APfiOVES1HEREON,AND WHO DOES SUW wORK M�ISELFdi HERSEIF OR
� TFUIOUGH M9 ON HEfl OMM tLROYEES,PROVIDED T/IAT SUCII MPROYEMEHTS ME NOT R7TEN�ED Oq m
� .OFFEAmfORSN.EIF.IqWEVERiMEMlDe100RMPROVEMEHTb50lDMrtTMNONEYEAROFCOM0.E.
Z 'TIOM.TIIE OV/NERBUILDER MA.L MAVE iME BUPDEN OF VROVMlO iH�T NE OR SME DID NOT BUILD OR .
� � MPROVEPoRTMEPUNP05EOF9AlEy : . -� . . . . .
O l��MtFN OF7HE ifpPERf`/,MI IX0.USIVA7 COMMCTTN3 WITH LICETISm COH�MCT00.4
iD WNSTAUCT THE VR0.IECT(SEC.Mu,BUSINESS.WD VROFESSIONS CODE 71vE CONTRACTORS LL VLIul1W�1 ADJ.AREA
CENSE UW OOE�NOTAPPIY TOAN ONNER OFA ORDPERTY vAq BU0.D5 OH IAtViqVES THERE01(NA
� w+acavrn�crsronsua�vra.�crswmucarna�craus���Nsmrunsu+wrrornewrrrrua �UAMITY - OESCRiPT10N - FEE
� fOR9Uct7�sEUw} ..._ . . . . ..
01 M1 IXEMPT UNDQi 5EG� B.t i.G FOq 7H15 REASON Q
U
� � � OY —�,
DATE OWNEq • V
�4 � W . . ... . . ... . . . ... .
LICENSEDCONTTtACTORSDECWUTION W /�� S
, CC IMEREBYAFFM1tiJUNDERpEN�1TYOFVEtWM7HATIMILICEN5E0UNDERPRONS10N40FGF1AfTER . �
p, ��C04MFNClq 1YITH SECTqN 7000)OF DMSION!OF iHE BUSINE59 ANp PpOFES5qN9 CCDE,M1D Z .
u, Y1'LI4�NSE IS N fUl FOqCE Ni0 EFFECL m �
o ��E S P �.�. !0 73O 3/ � �
� o�� " D� cormv�croR�p—��Cm.� nJ- C� �c0 '�,
. � WORKERS'CAMPENSATION DECLARATION �'30'� ¢ __
N1 HEREBY�WI UNDER PENALTY OF PERIURY ONE OF TIE FOLLOWINO DECUM710N5: � Z ��, �OQ
/
� V I�uYE AND wM1l MAR1iluN►CERTIFIGTE Oi WNSENT TO SELF-INSURE FOR YVofvcERS S _
CWCENSAT/7N.ASVFOVIpFDBY5ECT10NTfo00FTMEUBORCODEi'ORtHEiERiaR1AWCE �U
OF TNE WORK PoR N'Mipl TMS iEtaRT IS ISSVED. �
0
._� _INAVEANDWM1LMAIHTMIWdIXERSWMFFNSRTIONMAl11ANCE.�SREGUREDBYSECTqN _. - . .
Q �700 OF THE UBOR CODE PoN iHE FERPDiA1MlCE OF THE WOIiR FOR MMICFI THIS FERMIT IS
� asum.wwowcEnscouo�ws�rar+wsuawceuna� iwopaicrru�+eEnu�e CONSTAUCTtON l
� c�a�Eq �6 h • • PLAN REVIEW
_ � POIICYIAJA�BER lA/Ci/�h S/ �.�I ELECTRIC
d
' Q- (nas�r�wreEm.+��IDOFnfp�n.trswntt+E��oamootluasM�i��ss1 PLUMBING
. Z I CERTIFV TUT N iHE iERfORW1WCE OF iHE WORK FOR Wl1tU1 T153 FERMiT 14155UED.1 MECHANICAL . . .. . .
! _(� 51t/�Ll NOT EMPLOY NJY FERSON N IwY AiANNER SO AS TO BECOME SUBJECT TO 7HE . �.. �
��- (n � �� MORRER4COMPENSATIDNUh'SO�GLLiFpfWII�IWpAOPEEiMAT6�$/qULpBECOiAE--� � -�� � '�NSPECTIONFEE�-��---�-"'�
- � - Su91ECTTOTXEXONfER4'COMPENSATlONPRDVISIONSOFSE ]700 . .. - _ -
isr+ui.ronnnxni r�r rr�ansqros ISSU/wCE �
O
p 0A � �j��\ /,� /Xi SMIP . .. •
� WAAMNRfA aEiosEaraEwawc[nscouo�sand��q,ioEisuut�wctx.ru+osN�ttee ENERGYPIC
- � SUBJECTAN ua�oven ro crweu�rcr�uriEs�am rwEs ur m or+e rnx+�nEo n+wsum..._ - ENERGY PERAAIT- - - . .
OOlJM3 ry100,000�N/�DDITION TO THE COST OF COMPENS�TION,ONAACES AS 7ROVIDED fOR M
' J SECTION 9)0�OF iNE UBOH COOE,NfEREST,MID ATTORNEY'!fEE9. �
RETENTION FEE: � U
O CONSTRUCTION LENOINO AGENCY PRE•AlT FEE '
. � IHERE9YAFFlRAIUJDERVENII7YOFPEMIHYTFIATTHEREISACONSTRUCTqNIEN�ad(711OENCY � . . .
FOR 7HE PER�OFUTANCE OF TXE WORK iOR WHIU/THIS DERMIT IS ISSUED(SEG]007,pV.CJ. .
�
� LErAEH'S fuME - - '-. - -. •
� � LENDEH'S/DORE33
� ICERTIfYT7ATIHAVEREIDTH14MM1CAT10N/NO5T11tE7HATTIEABOVER7FORMl1T10NIS00RRECT. TOTAL FEES �
W IAGREETOCOMPLVWI7NIJ1C1fVANOCAUNTYORDpUNCES/WD57�TEUWSREUTNOTOBULDINO - �
� Cd15TN/CT10N.ANDHERE8VM/TFIDRIZEREPRESEMATNESOFTHISCdIMTYMENfERUPONTHE
� � �BOVE#IEMIONED PROPEHTY FOR INSFECTqN VURYOSES. COMMENTS -
9 �� '
� �
m vE m�n�
a
�
y PEMYiTEE DA
� _ _ _ RECPT.NO. PPJD BY VALIDATION
• - VYFIITE—Depnrtment Copy,YE N/—Fhence Copy,PINK—Aesessa Coq,GOLDENROD--Fib Copy,GREEN—AppficenYs Copy - - - . -
` � ' (�� � 'rtTT � tncncnoc) � mvi7o7� 3�.7� -n7� � � vi � m � tn �''.
mm ' ° ' ' � , � ! zzz 'zammm9mn � x000.o � oam �' Amc� �.
�y �T7'0 . I �' D D D D � m � � � r O C C C�O D O � � m O n � W,,- -
,�--{ ��. �_ � � ', r� r- r, f' n '0 -._.I ffl � Z r r, `L f,) L7 L7 T �.?1 Ri "O �
� ;'U O I ;._ J� ��, -o m x C� �7 � C7 3l D � z ➢� m 2 S 2 n z cn � tl L� z � �7 a �
'� - j I r-, r � �o o O c� r,.
c O -� � m vmx0 +nx � p
'+ 1-i '� � � l: .. � I�;fil ', C� � �.Z m r- z ', Z Z C � � r r m G �. fil � � D 'D n � � ��
�D � c m D r G�
i _,m v> _ c D m m m �;cu .
r
.. � c � -i � -i < m cn
z �,� W Dz -1 � . � ac � c» nZ c �
% ���� .C!)T. . . . z GS - r. '-'� o -i m � Z � --_i = Cl 70 ,. � O !n
� N U7 ' ' i�, G� � I Z � O z m z � � ,�"r- Z m I m C -a o
.m N I .C � L�i � Z � A� � (7 L7 � Z m _
� ,m . .. :� . Z - -i p _ �G9 � � : 's*�..-w�
i� 'a , A�� C Z _ �a] `' ""`rx� .
_ , � , , , , � � ,_
��� � � /j � ' . . , ;
� O,. [ I� �. „ i
' �. � ., . -, . `' (,� [..� i I I ,41 0
_ �-,
;' i.;T � i I i �
j`i �
. � '� " / - �' _ ���'•
I •/. - ' '
./' I I .� 'i � �.` i i' '%, : - _ .
� � � �
, �'�. . . _ � � •.�
� � 0 N �
_ � O
- - ' - ' Rl O S 'n ?1 O '�1 O O '� � � T 7] W � ?i O� � T T C C T1 �l �
- -- -- - -- - ._ . ',,_ i 1 , � m z � m - -
. . �� m < � m D � z y o � o 0 0 � �c z m n � � m m o o a O � D'
- - -- -- -- -- 70 T � � r � N r n Cn r r r = � C') � r � 2 -p 'D m m �7 O Z: �
� ' `+�� - -. ;'a � m = � pmDZ -Dimzm � G� � Z � OZmD � �n �nDA ' � �
; .f ' �n � � z � -� c> o � � � c"'iD � � v_ Z Om � � a � o . -..m ,Z
i /' ;.- .:_ t °. a -�.{ �' z c�i, L-" - uZi -n , z -i v D i z � � Z w Tfg o c�i, ,'y'-i .n 0
; . Zc� . �, �n DZ � � � �.� oo.� s� ;O.
i ;;; �� � " � � �' � � � � c� � I D ;"mpZ �'o `�J �
!,. ,�'� .�� - Z G7 . � •' D O C , • �,,v,fD .
� / :� ' � �:m �"o -�i %, �
. �' �, � _ ./� � r� . :. i:•� a � ., .
� � Z d .� �
,; i �` �. `Z - � =.
/- - ��a
J/' 'i�jl � �� � ! � 7� . _.
I � �
��� � r - (•- �� I �`, � i
�� � � . � - � � r.�!_ _ u .:� r
�, � r,
.l , ! / ; �� �
! ' . . " d �, 'i!' . � .
, �'f� �' 1 - _ �' L� - ! . < I � � .
%� � 1 . _ . - / _ - � , �.
4� � ✓ I 1- �
, /' i '_ L _ I _ j .
•
" `�` _' '.... ._" __ —_ _...._____ ._'_ _.. __._. . . . .� .. _ . ___. ... ._ ..� , .. . . ..... _ . �
. - „ . . ... .i ,... . .i ,. . . . _ _ ' _ ' " _ _ ' _'
., � -.. . ....
� - � '� � i�: . . . . ' . -