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HomeMy WebLinkAbout13638 . � � EXPIRED � CITY OF DIAMOND BAR' . DEPARTMENT OF COMMUNTfY&DEVELOPMENT SERVICES MAR 2 D 2002 .. � 216bQ E.Copley Drivc Suite 190 • . (909)860-3195 Pax(909)861-3117 , . pRE$$ • � ~`A^',� , ' BiJILDING PERMIT APPLICATION . FIRMLY JOBSITE APPLICATION • PERMIT P/C o ADDRESS f)7.5�-� C�REE�S�O� S�i' DATE � 'I�'�� NUMBER Y � �� � APN LOT TRACT �SSUE - ,, ' TYPE OCC DATE CONST. GROUP p OWNEFi �$,�T�� �f�'1M.\R�'2 A D D P E S �.C l�-r,y G C��1Z►J S�{�'�"c S�� ZONING SETBACKS � CITY Q R 21P TEL. � U 0 FRONT RW O APPUCANT r- ��, REAR ❑ �'�-*`P^�t— �— SIOE/SIDE STREET RW O � CONTRACTOR SIDE ❑ � ADDflESS PROPOSED USE � CfTY ZIP TEL : ARCWENG/ DESiGNER N�.DWEL NO. NO. � CITY �SS 21P 7EL UNITS STORIES BEDROOMS � �n DESC I ION S�.Ff. FACTOR PSF ADJ.AREANALUATION � OWNER-BUIWERDECLARATION SFq/ EM 8 1 MEREBY AFFtliI UNDER PEWLLTY OF PE0.A1{1Y 7NAT I MI E%EMPT FROM THE CONfRACTOR9 L4 G8f8p9/CB�pOf1 � � � CENSEUWiOR1HEFOLLOWMqREASON(SE47W1.6BUSWESSANDVfWFE5S10N5CODE:ANYCITYOR (n COINfttNMICNRE0UINESAVERMR7000N5TqUCT,ALTERMPROVE.DEY0U5H.ORREVAIRANY9TRl1G `W patio/Dedc IURE.MiON TO 1T9 p3UMICE AL50 REOUIRE3IHE APVLICMlf FOR SUCJ1 VERMIT TO FIIE A SIONED � 6TATEMENT THAT HE OR SNE IS 110EN3E0 RJFiSUNR TO 1HE iROV�S10H4 OF T1f QOMAACTOil3 L4 , CENSE UW(QIMTER Y(COMA/ENCNO MnTM EECT�ON 1000)OF DMSIDN]OF TNE BUSINESS ANO PRO� � POOUSPB FESSIONS CODE)ql iHATHE dt 6HE IS EXEIAPT 7MEREFROMAND7HE BA513 fOlt 7HE ALLE6ED E%EMP� ipN.ANYV1OlAT1ONOFSECfION70]1.6B1/11NVA7RICJWTFOR/1PERAi178L161ECTSiMEMPLICMlTTO Z Re-Fioof �,_, AC7VILPENALTYOFHOTAIORETIANFIVEHUNDREDDOLURSpSDo).Y• O L�4.J�90NMEROFTHEPpOPER1Y.OqWfMpLO`/EESVATIIWA(iE5115T11EIH50LECOMPEN3�T10N, ❑ COmrtl6fCl21 � Z WILL�DO 1NE YNfIK ANO THE STRUCTURE I5 NOT INTENDED Oil OFFERED FOR 511LE ISEG 7oN,BUSf J � NE59 AND OROFf44qN3 CODE T11E PONfMCT00.9 IICFNSE Uw DOES NO7 ACPLV TO AN OMINER OF = FNOPEHfYN?IOBULDSORMPROVESTMEREON.IWDW/qDOES5UG1 WORXMIMSELFORMERSEtFOR TYqUGH INS OR HEN OMM EV PLOYEES,P110VIDED iHAT SUpi UJPfqVEA1ENTS ARE NOT MEIDED OR m OLFEREO FORSALE 6 l7dNEVER 7HE BUIDNOONMPRDVEAlENT13 SOLD VAiHN ONE'/EAROFCOYPIE �'TqN,THE OMMERBUM1DER VALL HAVE 7HE WRDEN Of Pf10VNO TUT HE OR 6HE OID NOT BULD Ofi 4P{qYEFOqiNEiURPOSEOFBALEI. ' � 0 L ti4 O'MIEROF iME PiIOVEHTY,AY EXCLU9NELYCOMMCTWO Yrtil1 LICENSED COHfMGf00.S TO CONSTRUCT iHf iNWECT ISEC 70M.BU11NE54 N1D PROFESSIDNS CO�E THE CONiRACTOR3 LL YeIUeUOt1 � ADJ.AREA CENSE NW DOES NOTMPL�N JW ONmER OFA YROPERTY YY11D BUR09 OR W PFqVES iHENEON.AND � N1qCONTMCT8FOR5UCFiPROJECTSWR1fACONTMCTOFi�S)LICENSEDPURSUANTTO7HECONTMG QUANTITY DE�CRIPTION x ioasucErueuw.F FEE . � O I AA1 IXEUPT UNDER BEC. B.t G.C.FOR THIS REASON <( � � .� � - i 1 U � t u' 0/7E � ' OwNER � � J UCENSED CONTRACTORS bECLARATION � INEREHYAFFYWUNDERPENAIttOfGEitA1RY7HATIAMLICEN5EDl1�1DERVHOVI510NSOFCHAP � �(COW�ENC4qVrtTN8ECTIDN7ooa)OFDMS�ON�OFTNEBUSINESSAIIDPROFESSiONSCOOE,AND z MY LICENSE IS N iUI.L FOFiCEMI�EFFECT. m � UCENSEqJISS IIC.NO. j V DATE CONTRACTOft a. lL � WORKEFiS'COMPENSATION�ECIARATION a NIHEREBVAFFiRMUTAERPENALTVOFPEAAJA`/ONEOFTHEFOIlOWINGDECUMTI0N3: Z � ,IFUVEMAWILLWJNTAINACERTIFIGTEOFCONSENTT08ELFaNSUREFOFIWORKERS' � COMPENSNTION,ASPRONDEDBYSECTIONY7ooOFT11ELABOfiCOpE,FOqTHE7ERF0(1MANCE w OF THE VlORK FORMMIC/I THIS VERMR IS ISSUED. � � �_I YUVE AND WILL MAIMAN WOPo(ER9'CdAPENSATqN MSURANCE,AS REWIRED BY SECTION � Jia00CT1EL�BOitCOOE,FORTHEPERiORA1ANCEOFTHfWORKFORMMICHTH15PERMRIS � 154UW.WWpRKERS'OOIAPEHSATqNINSURANCECMPIERANDP0.1CYM11A8ERARE: CONSTRUCTION ��� +� CARRIER P EVIEW � POLICYNUMBEH CTRIC � � (n�ssEcnce+r�IDraTBeoa.at�DOFnfv�.nswaor+Erata�uoou��s�co�oatFss� PL - Z ICERTIFYTUTHTHEVERFOiiYANCEOFTI/EWORKFONWN�CHTMSPEiWR615511ED,1 MECHANICAL 811KL NOT EMPIAY ANY PERSp/N ANY MANNEH SO h5 TO BECOME SU&IECT TD THE y WORKERS'C011PENSATIONLAWSOFCALIFOPNIA.ANDAQREE7M�TIFISFIOULD9ECOAIE �[�ISRE FEE S SUBJEGTTOMEMGRxER3'COMVEN5ATI0NP110V1510N90FSECTIDN77poOFhIEIABOR �� COOE,I 8lIALL FOfihM1T1 COMPIY MA7M iF10SE PRON510NS. tSSUANCE � WTE: APRICAM: SMI '� WARMNO:F/�LURETOSECIIREWORKEi44'COMPENSATIONfAVERA0EI5UNU�MM.ANOSMALLBE ENERGYP � � SUBJECfIWEMPLOYERTOt111MIWLLPENALTIESANDCMLFNIESUPTOONE/1UNDREDTYqUSANO ERGYPERMIT pOLLAFiS({IaO,Ooo),W ADDITION TO THE COST OF COMPENSATION,ONM�ES AS GRONDED FOR IN � BECf10N]70eOFiHELABONCWE,NTEHEST.ANDATiORNEYSFEES. NFEE: oCONSTFIUCTION LENDIN6 AGENCY pRE•ALT FEE � IHEAEBYAFflRAlUNOERGENALTYOFPERJUPYTHATTHEqEISACONSTRUCTId1lENDW0A0ENCY ' FOR TFIE VERFOFMNICE OF iHE WORK FOq NM�pI7M�S VENAIT IS 155UE0(SEG i0a7,CN.G� � � LElIDE1CSNAME ' . � LENDER'S1IDORE55 W I GERTIFY THAT I HAVE PEAD THIS MOLICATpN M1D STATE TNT iNE/1BOVE NiOPMATqN IS CORRECT. TOTAL S ���� �3 p, I A6REE TO COMPLY WRH ALL CRY AND COUNT`I ORDWANCES�NO ST1UF Uw5 NEUTNO TO BUILDINO � CONSTRUCTWN,ANDHEREBYAUTMOR2ERE7RESEMAtIVESOFTwSCOUNTYTOEHTERUPONTIE �.. ^�I��— �� `�,�0-� ABOVEJAEMIONEO PpOPERTY FOR INSPEMION VUR706E5. / �� COMMENTS � `M. Q�'1— m RMI ENMA NT) ' . Q � S-l0� ✓�, R. In� 1 ! � i � a�c ov n i E o�TE . RECPT.NO. PAI�BY � i� '� VALIDATION WH�TE—Da Copy,YELLOW—Finenca Copy,P�NK—Aaaessor Copy,�OLDENFiOD--File Copy,GREEN—Applicant's Copy � �������=� CITY OF DIA11AOfVD BAR ., , ,�.��:;...�.:� 500� 0 S fl11.P3 `:=--'1`%'- � , .if�SPEC�Ti ION RECt7t3D ��:-:,;•.�: °�#,;.. _.'. .. � . . '�. 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WALNUT VALLEY UNIFIED SCHOOL DISTRICT � 880 SOUTH LEMON AVENUE WALNIJT CA 91789 CERTIFICATE OF COMPLIANCE . - With Fee Provisions of �, - i��.�;<<'�r���i�• � •.+-. .Lr i Government Code Section 65996 `� :':�' . " :?'� `-";• _ ;.,r_ �. DEVELOPER/OWNER o lt {Z�2 -�, a��� � .� � ;� ADDRESS ac�?S�\ R-'E�a��O� �R. Signature of Applicant CITI'/ZIP W(���n,'T- . L-P t.�'F. , �(�'7�,� The person signing represents that he/ is auchorized TELEPHONE °�O�c �4 y—��\C�`�. to sign on behalf of.the owner/developer and that the informadon provided is true and accurate to the best of hismer lrnowledge. NEW LOT ADDRESS USE OF BUILDING TOTAL SQ. FT. ResidentiallCommercial/Industrial Ciry HOME IMPROVEMENT OR REMODELIN�C PROJECT ADDRESS� / DF��P'�'IO �1 �� TOTA S . i�� � �(�' lJ�-Fi� . Diamond Bar Walnut (Bedroom, F ' Rm., Kitchen,etc.) Signature of Superintendent o[Bulldings � � � � ll� Date Y� � TO BE COMPLETED BY SCHOOL DISTRICT � FEE SCHEDULE: The development fees levied by the Walnut Valley Unified TOTAL FEES DUE� . School District under provision of Government Code§65995 $ ra��'0 are: (EFF. 8/17/98) Residential Development $1.93/sq. ft. Receipt�/ Commercial/Industrial $0.311sq. ft. Date_ Fees are assessed on TOTAL square footage "living space" of ALL new or remodeling constructi p ojects OVER 500 sq. feet (eliminating gazage or uncovered patio). � This is to certify that all fees due to the Walnut Valley Unified School Disuict under provision of Government Code Section 65995 have been received and a building pemut may be issued. This is to certify that the above described development has been determined to be EXEMPT from the development fees of Goverument Code Secdon 65995 and a building permit may be issued. Exempdon Justification: PROJECT IS S00 OR LESS SQUARE FEET OTHER . U�Q.t�l�l..o� ��' ��Cu-(Ja� /C.V Vemon Medeiros Assistant Superintendent Fiscal and Facilities Management 1/87 Rev. 2/88;6/88; 8/89; 1/90; 8/90; 10/90; 8/92;6/93; 11/93;8/94; 6/96; 1/97; 8/98 PLEASE SEE NOTICE OF 90-DAY PERIOD FOR PROTEST OF FEES ON REVERSE SIDE NOT[CE OF 90-DAY PERTOD FOR PROTEST OF FEES Section 66020 of the Government Code enacted as Assembly Bill 3091,set forth as Chapter 549, Statutes of the State of Califoinia, �1996 effective January 1, 1997, requires that this school .•-• . -district provide a written notice to the project applicant,at the time of payment of school fees, mitigation payments or other exactions. This notice is to advise you that�any protest in'regard to such amounts or the validity thereof in accordance with Section 66020 of the 'Government Code and'other'applicable law, commences with such payment or performance of any other requirement as described in Section 66020 of the Government Code. Additionally, this notice advises that the protest thereof must occur within 90 calendar days thereafter. . • . , , . , . ,, , , . , . , . . ; , , . . � . �