Loading...
HomeMy WebLinkAbout16728 _- --- - --�------ � "� f �'° , _ �, CITY OF DIAMOND BAR °'�" DEPARTMENT OF C0IVIMIJTTITI'&DEVELOPMENT SERVICES w , 21660 E.Coptey Ihive Suite 190 (909)860-3195 Fa�c(9Q9)861-3117 p'F;E$$ v�'...., BUII.DING PERMiT APPLICATION ` FIRMLY I o ADDR,ESS ���� ��7�7��"���;�'"�'JI`L�' DATE CATION --�TYPEB R �� #/COCC ISSUE ��y �y( ' � APN LGT TRAGT DATE `"LJ (a`! ' CONST. GROUP p OWNER . �° L� o ADDRESS_��,�'r�--��-�:��c' ZONING SETBACKS � CIIY i �IP TEL. FRONT RW ❑ g APPLICANT TEL. .,e REAR f� � SIDFJSInE STREET RW � , � CONTRACTOR �N Y6 SIDE (❑' ADDRESS , r�^}. �a�,..--- I o CITY Z TEL. PROPOSED USE � � � ARC t — � - � z DESIGNER �,ty NO.DWEL. NO. NO. a ADDRESS UNITS STORIES � CITY ZIP TEL. ��EDROOMS cn ' crs DESCRIPTION SQ.Ft FACTOR PSF ADJ.AREr'VN/ALUATION �� ' OWNEii-BUILDER DECLARA710N SFR/ADD/REM � �- � ��� - O p� . 1 NEREBY AFFIRM UN�ER PEN/eL7Y OF PERJURY THAT 1 AM E7(EMPT FflOM THE CONTRACTDRS LI� G8f8ge/CefP014 - � ���� � W' .CENSELAWFOR7HEFOU.OWINGREASOh(SEC.7031.SBUSINESSANDPROFESSIONSCODE:ANYpTVOR � '6�. ��COLIN7YWHIGHREWIRESAPERMITTOCON57RUGT,ALTER,IMPROVE,DEMOLISH,OflflEPAIRANYSTRUG L� Pgtio/DBCk ' ' ' z� 'TURE,PRIOP 70ITS ISS�ANCE,'��OL.SO�qEOl11RES THE APPIiCANT FOR SUCH PERMIT TO FILE A SIGNE� � � 'W. '�STATEMENT THA7 HE tlR SHE ISI LICENSED PUflSUANi 7D THE PROYISIONS OF THE CANiRACTOAS LI• W I ,�` '��CENSE LAW(CHAPTER 9(COMMENCINa WITH SECTION 7WoJ OF DIVISION 30F THE BU51NES5 RND PRO- � PvaVSpB � �� �� � � � �.fESSIONSCODE�ORTHATHEOF�SHEISEXEMRT7HEflEFROAAANOTHE6ASISFORTHEALLEGEDEXEMR �,TIOPI.ANYYKK.ATpNOFSEGT10�d703/ti5BYANYAPPLICANTFORAPEFMITSUBJECTSTIIEAPFIICANTTO Z Re-Roo! �� 'ACBVILPENALTYOFNOTMORETHANF�VEHUNDREDDOLLARS(S5a0j.): , �., � ❑I,A90YMEROF7HEPROPER7Y,'ORMYEMPLOYEESWITHWAGESASTHEIRSOLECAMPENSATION, COR1rtIBtClel -� �.. . � � �N7LL 00 THE WORK.AN�7HE SYRL'CTURE IS IdOT INTEN�EO OR OFFEAEO FOR SALF(SEC.7a44,&J54 � �; ',,NE65 AND PpOFESSIONS CODE:'hIE CDNTflACTORS LICENSE LAN'DOES NOY A➢PLY TO AN OWNEfl OF � �, � � '';P�PEHCYNRiOBUIIASORIM°ROVES�,THEREOM,ANDWH060ESSUCHWORKMMSELFORHERSELFOR Q" ',THRIXi(3H4iISORHER04VN6MPLOYEES,VROVIDEDTHRTSUCHINPROVEM'c4TSARENOTINTENtlED6R m ' � �',,,'��FFER�FOR SALE lF,HOWEVEFO,YHE BUILDING OR IMPFQVEMENTtS bOID WITHIN ONEYEAROECOMPLE � �'��TION,THE OWNEF-BUILDEH WILL HAVE THE eUR�EN OF 9ROVING THAT HE OR SHE Pil�NOT BUIID OR ��,��iMPROVEWRTHEPURPOSEflFBAL.Ej, - W� � pI,A50N/NEROFTHEPR9PERTV,h.NE%CLl1SNELYCONTRAC7INGlNITHUCENSmCONiRACTORS �, g�, �TO COIVSTRUCT THE PRD.IECT{SEC.7od4,BUSINESS A�4D PR6FESSiONS CODE:THE COhTRACTORS LF V8IU8PIOf1 ApJ.AREA ', ���; �'CEN9E LRW DOE3 N07APPLYTOjAN OYVNER OFA PPOPERTY WHo dUuLDS OR IMP90VE9 THEREON,AND ��WHOCONTRACTSFORSUCHPROJEC35WiTHACONTRACTOHiS)LICEfdSEDPURSUANTT07HECONTRA6 QUAN71'TY DESCRBPTVON FEE Y 'TOPS LICENSE LAW.). Q ❑IAMEHEMpTUNDERS6C'. B.Bp.C.FORTHIS'�EASON Q � ��; � V � � onre ' owraeR � I Z, w ; �� � LICEIe6ED�CONTRAC70RS DEC4.ARATION W . � � , � �', I '.1 HEREOVAFFIRM UNOE71 PEPJALT\'OF PER3URY THAT 1 AM LICENSED UNDEft PROVISIONS OF CHAPTER � �,V. 8(COMMENCIN(iWRHSECTfUtdY,000)LIFOIVISIDN30FTHEBUSINESSANDPROFESSIONSCODE,ANO Z I ?!S �.MY UCENSE IS IN FULL FORCE AND EFFECT. m � � o 'LICENSE OLAS ' �� LIC.NO. -.�__ � .j I.�I V 'OATE CON7RACTOR� 0- .'.�i �, � WQRK€RS'COMPENSATION DECLARATION � . . . � IHEflE9YAFFIRVAUNDERPENAL4YOFpEFJURVONEOFTHc'COLLAWING�ECLdRATIONS: Z � � �_IHAVEANDWILLMAliJTA1NAC@RTIFICA7EOFCANSEN7705ELF-MSUREFORWOpKERS' _ . CGRPENSATION,ASPROVIDED�YSEC710N3TOOOFTHELABORCODE,FORTHEPERFORMANCE `U OFTHE WOFiK FOR WHICH THiS�PSRMIT IS 15SUED. � W �,I HAVE AND 1NiLLMAINTAIN WOF�KERS'COMP'eNSATION�NSURAF'CE,AS REWIRED BV SECTION Q 37WOFTNELA60RCOD£.fOH'��,THEPSqWRtAANCEOFTHEYe'OEKFORWHICY.THISPERMITIS �, !S£UE�.MV WORKERS'COMPEMSATfON i 6URANCE CARRIEfl AND POLICY NUM9ERARE: CONSTF7UCTION > cnaR�E� '�'"'��'i`�r—�Ju�'� PLAN REVIEW �� Z rol�cvrauueen ELECTFIIC <C • p (IHB55ECI7�iNE�`pTB�QR�If�!I.ETEDOF7HEPE I3FaRONEiiIJPDREDWI.IPAS(SIa610flLE551. PLUMBING ___ �'�, Z ICERTIFYTF7ATINTFsEP�AFORddP.NCEOFTMEWd7FKFORWHICHTHISPERMITI5155L'E�,I MECHAMICAL � � YlORKE STCOAIPEN A?Y�NL4WSOFCALIFORNEA,RNDIGR ETHRTEFIUSHOULDBECOME INSPECTIONF E �_ � � � St�,1ECTT6THEWORKERS'CqMPENSATIONPROVISIONSOFSECTIQN3looOFTHELA90R � ' ```�����\ � CO ;�HALLFORTHWITHCOMPLYWITHTNOSEAPOVISIONS. ISSUANCE � �—q � P �� L U'J 4 �� p ORTE: � � APPLICANT: - ° SMIP � �3 LL1 ", J WARNIN6:F ILUflE TO SE E YYORKEpS'COMPENSA?ION ERAGE IS UNLA4VFUL,ANO SHALL BE ENERGY P/C 6 I� ,�__ `—y:� SU&IECTA EMPLUYER i0 CRIMINAL PENALTIES ANo CIVIL FINES UP TO DNE HUR�PED THOUSAND ENERGY PERM��`,T= E . 'DOLLARS(StOo,Doo),It-0 ADDITION TO YHE COSTOFCOMRENSATION,DAMAGES AS PROVIDED FOq IN �. �SECTICN37oeOFTHEL4BORCODE,iNT;EflEST,AN�ATTORNEY'SFEES. RETENTIONFE . � � � CflNSTAUCTfON LEN�iNG RGENCY PRE-ALT FEE: O � iHEREeYAFFIRMUNOEftPENALTi'DFPERJURYTHA7THEREISACONSTRUCT'�.ONLENDMGAGENCY - FOF TNE PEFFOfiAAANC6 OFTHE�NOFK'�W H WHICH THIS P6RMIT IS ISSUED(SEC.309],CIV.G). . Z W. I � LEN�ER'S NAME ' � . F-- � .tENDEfl'SADDRE55_ , ���, _ / . w. I CER7IFV THAT I HAVE READ7HIS'�APPGCATION AND STATE THAI'THE AHOVE INFOqMA710N IS CORRECL TQT%L FE�S '�f�°'NA�� � � IAGREETOCOMPLYWITNALLCIMAND��COUNTYORDINANCESANDSTATELAW3RELAi1NGTO8UtLDING V � CANSTRUCTION.ANDHEREBYAUTHORI�EREPRESEN7ATIVESaFTHISCOUNTYTOENTERUPONiHE ;s� � ABOYE-MENilONEO PpOFERTY FOR INSbECTION pURPOSES. �� ��p � /°� � ,_ .,���u �',���. Q �� ��. ., COMMENTS ' �� �r . � m � PERMITTEENRME PRINT . f/S � {j� SIGNAT OFP R [RE I � I �ATE � � _ � � RECPT.NO, PAID BY � VALIDATION � � ~ '�4VHITE—De arlmBntC � - . p opy,YELLOW—Finarsce Gopy,PWK—Assessor Copy,GOtDENRO�--Fife Copy,GREEN—Applicant's opy . . za�, ;�^.�7Qe. � ���a��a,�� .�.:���:a";: . '''ua5 A " t? � *�� �.a"��""4 �kr �n'�� # . .g'mrr,�«�'a,r " � �- �" �.���,.."'". � �'�@ :�`;"....6 �*'r .� c� �k:v x.,,�'"�,a t�';�.� . �•" . "�� ��` x'�'�_ .@c.�xi �'-�Y'+�'���?��".�"T�..��""'�'�a , ��^��"�'�:�.�,�."e�,.:�a,��'�,.�^Y"5,s�' � a". �'rer.�"'�, cs `w�°%t�.�'""'."'`':�,� ,� �e� �. "`'�r� .� �����; `���,'�� t � ��``��s� �a������� ,. ��,,� �:��a�`��„���n��,���'��g ����'d��s���"��� � � �,��'`�� o- ^���� �. , ,� :�`�„��';�.r,���° �_a " e.�'" .�.a:�:�.�:.�,`���'�":��.:'�� u��:�'��^�a�"�'�.�J��::���'w,��� ��.,,��,_n�:.���'�s,:?��;�,�.s,�`.r�`���..�,r�"�,.�... ��,��.��.����� � 5�E '�,���°i ' � � � � ��� ��� � �� � �( � I � � � �.....�.�� . 1... .._ A......�..�....... . � . .. ... .....,,. ..... .._.. t...�.�_ � �7 a�r4��=i'S�'"t�.-� � � ; � } �'-�4�" €,� -i'-., � � � � � __ _, .�_. �___.__ _.._._ � _____ �_ _ _ _.._... ___ • ��..��r d i���,. ..��`�.��.R��'^� . � � ( . `.r S ��4i J'+�'� ..�_ k�,_;�`7#„�". ':- i .. ,.... .. ; �.;--,_"'____. ...,-...... .._._..._....,.....,-__......,.�.......�.....,�._.......�._.,__._.,._...M__"__..._.. � ,�_ � ._ �W �r.. v..._'--.._ �.W_...� .w.,.�.--- �..___ . � , .-. ; ' . . . , _�__ �.,a'�.�""34,�..4!"`g �..a.,.��.73"ix,_"a . � .g r _ .� .'_ . .. , � , ' .A�� i'�: �4 � ..�. �� `i �' . � � � � _......_ ................ .v..�......,....... ._. ...._, � .._....,... ._...�_.._._.».._�........ ..'_..v'"'___.__._.__..._._ . , -.____.....__.._..,.._..._, ...__." ' �.p �,y.-g ¢�. --; .....__. w.JM.�r64=�..i'?,!'d'.k..� ` 1.._.._ ' "C` '1 ,.��.: . .'. ! ..J!�� I . ���"�� �"t�ti'��-....�.,,�� �4�.....,...�._.�,.,_.....-.,.�...ri; _.�..._... �_....._._�. .��...»._v_...�:. .b m_,.;.....��........,.,.�...�..-. —�:.`..����_...��._I..._...,.....,.m_ _. . ... . .. .. ...., 3 F� €`���.� _ _ t`�.rs � �_ r C . � ��aa �"��"s-r� �,� � ��� � �_a"i..� � � � �Y�':��n � :.� i.,� 3 i'� �,i� � z"�� w y i,. ' ^�;,.... "�e"'r'4 S; �'''taid. ,__�._.�..�. ....... ._ . � ,�_,._._._._.. _.�� ' !9� i r �"~�'s����""�,'v �� �!_�t"� �9�? " �' ,..m__...., �__ ',:`� r�`'?'°� �''•s 2�"____.____ ..�.�. _ _....� � � _ ..._.._ _ � __._ ...____ � -�. +�� �:�`�' '] °�'���k_� �a f (g ta _ __ �U.��r� �, _�ny� _.______ ..�_. ____.._ _. _._.. _ _ : , _ �' ���I�8..,« � �f � ° , . .� �.�.;,�ka �"°r�i � I �. - .a,_.. �...._.�- � . �.�_�._. . . � �m...f .��,�.o.. r�._...M.._..�.....��......,.,q......__....._........�................>..n.,...,..... ..y.,..��� ....... ._. .�....�...__ ._ ..._.___.. _.__._.._._..�,.,............_......._.»,.�._�.�,__......� l � ����� �t�.. �� ' ! �� �., �� ��� � ' �_ _ __ _ _ �._____ _ �__�...___ .._,_,� � __ _._ _ _ __ ._�____ _�., , _ ._ __... .___.___m._.,.___.___.ew � i�M� =.�i-' :: 't'�A��6�a� ` 9 { ` +�� �-;�'� ��"�'_� i ._ � � _.�_ .�.____;._W_____.�_.___�__...__._ ...�. _...�_..____ �.__ __. .w___. _._.__ � -i-- _�. . _ �i�"�si�r a..,'{;��,.`.�s �,.�•�i . � � :�'�a.�v L i�':��;.���".��.u._ ,... . ..._._�..�M_._._..�._._...._..,.„__..' "`" . . , _ ,,� . __..,�...�..,.._ ��,._.._..W......,.�_�_ .__.� . „a �,� %J�: ..$�a ; '�!`i�� .__-_.!�.....__�..p�._��...___.....�._.�_�_.._._ � i `'s�� �;x ;� �:� _ _ _ a .:�,__ _..y, �f'� �..�._, ____ ____� � m._._ _�__...___.___..�_ __ . .� � a"��i.,r�q =.;..,.�.�.....�.«.._..�-....� �' ��4_�.� :� ���"�` ; � . . , € pfi p �b'€''S ��� L�$ 1 � .e_..... .._..._..._._...,,..._.�.......�..L...__. ......_.............__ --... ,_ � ,...............__.�._...,....._..... _.._ _. ."'"...__ a13.E�u.'�`µ �'`':d.a ,S!.�:: �n� 1 :....,_.._..,,... .' � 5 °..�-r�' '� - i;"t �� � f � _�__... �i. � ...___W. .___ -�-� �._. ___Y ....... __ __ ___,. ;��.tr�'�;t�`'��$..��k �,��3�v ' ` � ���,r"-� �. �.�,�� __,? ..� ___��___ __._.__._.__W__a.__._,_._...._ ��,_..�,.�_.,� .�_ _.. ._� _.�..__. �._.__ , � __.�_.. .�.__�_.,_..�____ ���'��� i ��� � f � ..AgW� , ---5.—�.t.._'_._.___. ._......:-.._,__..___..._..._'_.._.___.___....._...__�.�.._.___ . ... . _____._. _w_.._...�.__._...iw._...a..._._..._...__._....__.w._.. . � 1..i �t�:i�lSE'S j_�..��: ,t�... ��s.4� nl �"it.;i, . . � ,... '-�.. ,�... .. .......m..... ...,.""' ...-""--!-'3 .. _.. . . _ . �. ...................m.r.._ , _... .. .. �...,...... .. m S °.� k�r��: ��.,�.. l i - �� s; . � � d � 'at�a ,�--� 3 .: ... .....-.e.� _,..,,_.....�...._. . .>....�._.:._.�.._....�:.�......_.w.�-� ....? _... _:. ..�.....�__.._..._...�, ,�..,_.,._._..�w_,.....,...�.�. _ ��3���.s.».�"�,�..._....�. _�,�....., �`] e... �___�_�'"' j �''' ' .+`': ����� i::_ € .W . . �. S5 �;jZ f� -�.-� li�.^�+�_-. ..�.,_....._, .......14:-'"'�a'�,__.Yc!,.--.-.-..__�.__.__..........s {� � r .,y @ ; . . . ._,_ .,.__._.._._.. .._.. . ._ .�� � ...,. ._._..,,,. .;_._...,. . ,.._,_._. � _.�.��..mm._.. .__.�..__.._....._r,mm i �;rz� � �s t' � � �_ � .r �'" ._._..._ _.._ ,____._m --._._.,_.. .___._....---.__..__._� .__..__.,_ �.___..__...___ ,_ � 'i �.�;� �� � ?I,..K s,� .,... E....� _ . _ �. ,.�.� ..�:'s s u �.. : . _ . .. _. ...,_..-i .. ., ... __._. . . . ._..�_„ ._ ..� _. ._ .. _ .._. �., .�._........_�..__..L... .. ._.__.. . : "........ .. ....:_ _„ � a6[ ' v��:�.s J�S�i$`+�t.tl !, � -s 1 <' �. �. ' . : a.........._�,.._�._...._.__�....._..,.r......_..._._...;____._..._,__��..__.............._...___.____._..... �.n.�...........�.___......___`__........m.. ...._.m.....,....-._.v.........,_.. �_..,....:...,...___.,._..._.._ ,.__.-_......._�,.__r...._..........., ' � � t � r � � .. ,._........� .�.,...._._._.... '._.___�__........_�,. '., . .....,_._. , ._._ -r#�a+�+.t�'r ��t�a�",� "� •�€4d �, w k . ........ . .. . .. . . .. . , �..u� . . . . . �.m.�_...,....___._.�._._...._____,__�............._.__._�__._._._�_�.,_ _._ .�m�����;�' �t�" �'a�._��*� ��a�"�.���,o-',.���xz�._ - , '., 8 : d"°.;�*� �s�i1�'a r-:��; ,. :. ', . .. ,�. y„e�,.�ts sa j�:;, m� e.»s a'2.�-f3 �C?� '(�.�.� ._ _ _..__w_.. ._,�_._........._.._ _.__._ .:...._.,___ ��, ,m�_�,._..M�._.._�_M......„.�... ._.____.__��.. _._�_..__,_,___._,.___.. " z .`�.__,�,,.._.__..��_m..,.,v._...�„ i � 1 ��..a__� � e,,..,..m._.,_._..m._._.�w�._.�_.___.M..�.____.a.._.,._,_._,...�_......�.,____...__ . _.___.n__..___.� , .__�__.._..__.___ __ __._._.,.._.,.,�.__,._w,._.__..._____._,_....__._. � .___._..___.__..________._._ _---..__.,____ ._,.___._,._.__.,.___._�__.._ ____._.._ ._.__._�...._ ' � —__� ___.�______m_W_._�____,___.________�_—..�. � � ; 3___0e__.._, _ ._Ww.___. .._ti_,.�._._..__.�.._..._�.M_._._, _x.._..�; � g..�..:.._�..w....._..�,..,.._..�__,.,...._.............»..,...,.._.._._..__..._.....,.....__...a.�..,_...______...,.�.._..__.__a�...�_._..._...___._......_.�...._„_......_:....�._..__m..._._._.__....._...,.__............,..._u....__.,_..._,_.....__.._._._�...,_......_.....____ _.n.._.._....._: d z_,.,..____,_..._.�...._�.....,.,,�...............__......__�..A.._....�...,�_...,.,..�.....w.........o._...._.._......_.._........_,..._._.__.._____,.........�.�..._.'. _..:,.,.,___....:.__._......... ._.._.._....,.._.-.._.�......_...___........._...�.,..._._._......,.....,.._.._.__._.._._.._._...W.. � � . . . ... . � .� . k , - �' �, - 3. yL.__�"`__�____...�.,...._._..,......_.-�,._.,..___�_.._.m.._s....._._......,,......�.......___....._>._...,...__..«................:....,.:.:.._.�...,__.. __..,.....__.........�._.:......_...,_�...e.._.__,_......,.,..�......_.._.�_.,�.___..__. �', . _._..._...._ _...._._...._.— __,__-_ .y � .. i � ......._.._....,...._..._.........�,:_._..�...,.-...._.�_...........�.,...............,....._.......,.._..._�. ,._................�...._m.-.,....�_..__..,...r..... ' ��,.....�_.....................................�...,._._a..,.....�..^...__.,,......,........,....� .....,._.....,..,.........__................_............,._,_.....� ..,...� _ p f � _w....«....�...- . � - ..........�...__......................................e..........�_......_......_�.._.__....�_. ........_....... _ m ......_.�,.,........�..._.m._.��.,....,_._�.�.___.:.._........,.,.._.............._.._ .«...��_.�.._. ....._....�...... � . .......w.....m..._._. ......_�...,_.._ j g�� � � � , � �4..���4r° t'� ���I m. . . ...'' . i � ��� '�"'��'`..i �„`�.�` _._--�-___—_ - -.____,____ ..,._.�__....w.___._.,___�� ._..._...._�._._�:...,____.____._..,... ,_,._,_._...._..____.__,....___.�.._._.. ..�._ _...._ y .w..,«r k� . . "M ' '. .. .'X y:. �"� m'��a���" --�s� ..... . _....... .b...... . _.. . ..._ _.w . __.._.... . . ...._ .._..... . . ...._. __._,_ ��,�.�'�,s ��.^i��`�N4 . � ����g��*�zq��� £ � ` u����'�"���,� .....�..,._..e.........,�___......._.........»._..�,.....v..m._...M_..«......�_......,...._..:.:......g,.._w.,.�..,...,,...�....,..._.__.......�.....>,_._,__.....,.,....____.�..._�......... ._,...e.,,...... ..._._....._.,_� x! � :: 'r,e�' '�C�^":%���.����{ ... . . . . _ .. _[' � ,_.�.� " �4 `� tt�� i,,. .._......,..>.._...�..:�_.M..._._._.,..._..__»-,:_.�_.._,._,_....._...,...._.„.,,._..__......�.,..:._._._._........._..,...�......_,..»�..._�........._._...._..,._._.._.__.__....._.,.._...._....�,...,..,._........,...�._._t -;�.'�; '���u"'��k.�.� � _............... .a.�.e..._:._.___.,._......_'._...___�..._ _.___..____....;..�,_ ..._.____.___....,.....___.,...._ ......,�..,...___... .___�....._ ._,.__-_ _.____ .____......... �. � ' � . ^ .� ,� � �#� �� ...,..,....._._.u.,.....�._.:..,..�..........«__-.........:......;.,,......._.»__.m.........-..._...................._.__.,_..._....n.........,_............,._.._..............._.._,_...,..__.,.......,...... ...�...______._.�.............._.._.._....,....,.,_. __,__Y��. � � ���� , � � '�t ��«�� d � � ���� �� L"..������..,�� . . . € '. . .,9.�.: .,�'`�',.� ,�,�t�k # � �y ,. ..._..__._.._ _..__.._....,. .._......_.._._._..__'_._._ _ ...___._ .._....._ �.......... ._....._,__._..._..__...._�..__.'_ . �.. . ._._. .. ... .., .__t �...._ . . ' . ... . . . ,_