Loading...
HomeMy WebLinkAbout12121 (14) --- ,.... __ _ _ - - __.. ,..,. __ ��.. _._ ;,, ,.. . _ ... ... _ _ ,�.:.- , ... _ ___-- .-_ _� � CITY OF DIAMOND BAR „ � COMMUNITY DECrE�01'i1iI�N'i'DEPARTMENT 21660 E.Cop]ey Dnve Suite T90 ,_% -M.w . .. , PRES� (909)860-3195 Pax(909j 8b1-3117 �'vK" BLJILDING PERMIT APPLICATION FIRMLY � JOBSITE �Q `�G��� APPLICATION -`.- ' PERMIT ( � P7C -- �� o ADDRESS'"" ,:. -��: DATE I ' NUMBER��/ # ISSUE (� j�TYPE OCC `^ APN--�� L�7 TRACT DATE �"�I�" I✓ CONST. GROUP � OWNER ,Jl�+„��C'�„' �.1 o �� FRONT „ " RW ❑ o AD�RESS G'E. I...��L-. ZONING SETBACKS Z CITY �1 �►� ���PEP.yY./�?� I REAR d i--- zAPPLICANT�.�l��� ;_ TEL. � SIDE/SIDE STREE�' RW ❑ ¢ CONTRAGTOR ` C C� �"' _i�_` SIDE ❑ � ADDRESS� ,��p''f e-- PR�POSED USE � �1'H. ��� ^ � CITY" ZtP [/Y� TEL �SS'S=1C3�� I w ARCH/ENG `'r}��I � �--- �?r+�^�yw, C.^ t�c>d �����? S � DESIGNER ► V �/VD� NO.DWEL. " NO. NO. a AbpRESS � � UNITS STORIES BEPROOMS � CI'TY d �� M ZIP �&L. � pESCRIPTION SQ.FT. FqCTOR PSF ADJ.AREANALUATION cn � pWNER-BI;ILDER DECIARATION SFq/A�D/REM � O p I HEREBY AFFIRM UN�ER PENALTY OF PSRJURY THAT I AM E%EMPT FROM 1NE CONTRACYOpS U- � GaragelCarport L7.J .. CENSELIWFOFiHEFOLLOWINGREA50N(SEC.7031.SBUSINESSANDPROFESS76NSCOOE:ANVCITVaFi C.> COUNTYWHICHREQUIRESAPERA11TTOCONSTRUCT,ALTER.IMPROVE.DEMOL15H2ORREPAIPANY�5T�+UC- W PatiolDeck � TURE,PR�OR TO I78 ISSUANCE,k�50 REQUIRES THE APPLICAN7 FOR SUCIi PCRMIT TO FILE A SIGN[0 w � STATEMENT THq7�iE OR SHE IS IICENSED PURSVANT'O THE PROVISIONS OF THE CdNTRAC70pS LI� � CENSELAW�CHAP7ER9(COMMENCINGlM197H�5EcilON'lOOo)OFtlIVISION90FTHEBUS'MESS'AN�`?R0� �'i' PtlDVS�7E1 o , FE£SIONSCOOE)ORTHATHEORSHEISEXEMPTTHEFEFROMANDTHE6ASISFORTHEALlEGEOEXEMP- (�J v 7101V.ANVVIOLATIONOFSECilON7o31.5BVANVAPPlJCAMFOfl�1PERM'TSUBJECYS?HEAPPUC.fN�`TO � Re-Foof � ACIVILPE4ALTYOFNOTMORETHANFIVEHUNDREDDOCLARS�$5oa).): ��� - 0 OI,ASOWNEfloFTHEPRoPERTY,OflMYEMPLOVEESWITHWAGE5R5THEIR50LECOMPENSAYION, � Commercial Z WILL 00 7HE WORK,AND TH'c STRUCTURE IS NOT INTENDED OR OFFEFED FOR SA�E(SEC.�044,gUS�, J NESS AND PROFESSIONS CODE:iHE CONTRACTORS LICENSE lqW DOES AOT APPLV TO AN ON/NE4j OF ♦% � PFOPERTYWHOBUILOSORIMPROVESTHEREON,ANDWHOOOESSUCFIWOR12HIMSELFOR'HFb�S-lFpq m � � T�IROUGHHISORHEflOWNEMPLOYEES,?ftOVIOEDTHATS�CH�IMPROVEMENiSARENOTIN�EN�EpOR , W OFFEREDFORSALE.If,HOWEVER,7HE6UILDINGORIMPROVEMENTI550LDWITHINONEVEAROFCbMPLE� � TION,THE OWNER�BUILOER WILL HAVE THE BUR�EN OF PROVING-HAT HE OR SHE DID NDi BtSILD OR � IMPROVEFORTHEPURPOSEOFSALE), � = OI,ASOWNEapFTHEPROPERTY,AMEXCLl1SIVELYCONTRACTINGWITHLICENSE�CONTRACTOaS W� TO CONSTFUCT THE PROJECT ISEC.]Oa4,BUSINESS ANC PAOFESSIONS CdOE'THE CON`fRACTORS l.i- CENSFLAWOOESN�TAPPLYTOANOWNEROFAPROPERTI'WHOBUILDSORIMPpOVES�'HEREON,AND V81u8lIOPl _ [ ADJ.APEA � WNOGONTRACTSFORSUCHP4iQ/ECTSWITH-ACONTRACTOR(SjUCENSEDPURSUANTTOiHECONTRAC- �UANTITY DESCRIPTION FEE Y TOfiS LIC[NSE LAW.). � J 6 C:I I AM EXEMPT UN�ER SEC.___._ 8.8 P.C.FOF THIS REASON � 2 _ ._—.....---. ...�._.�- CC �—`' onr� ownER V o LICENSED CON7RACTORS DEQLARATION, , � w ¢ CC IHERffBYAFfIRMUNDERPENAL7YOFPERJUFYTHATIAMLICENS[DUNDERPROVIS�ONSOFCHAPTER- � � 0(COMMENCINGWITHSECTION7oDo�OFDIVISION30FTHEBUSIVESSANDPROFE5510N5CODF.,AND Z X MV I.ICENSE IS W fULL FORCE AIJO EFFECT. � Q LICF:NSE CLASS (�/'-++ C� LIC.NO. I'__��� � -. _.. . ~ DATE �'�/d '—�e� CGNTRACTQA •tr�C '�;`C3N � a — W �i����e�F-y� . . . r�' WORKERS'COMPENSATION DECLARATION . Q � I t1EftEBY FFFIRM UNDER PENALTV OF PERJURY ONE OF THE FOLLOWINd DECLARATIONS: U C!J � _ . Q � ',HAVEANDWILLMAINTAINACERTIFlCArEOFCONSENTTOSELF-INSU41EfORWORKEPS'� - � COMPE�SAT�ON,AS?qOVI�E�6Y SEC'ION 370o OF THc LABOR COOE,FORTHE PERFORINANCE U , Q OFTHE WORK FORVJHICH THIS PEFAAIT IS ISSt1ED. . . � � `�/I_NAVEAN�WILLMAINTAINWORKERS'COMPENSATIONINSURAIJCE,ASREQUIRED�BYSEC'7IpN� Q 37000F THE LABOR CODE,FOR THE PERFORMANCE OF TF1E WORK FOP WHICH THIS PERMIT IS� . �1 � ISSUED.MYMlORKE,R.S,g'.C�O�MjP�ENSAi101r�j'SURANCE AFtRI[R ANb POLICV IJUMBCRAPE:� GONSTRUCTION j CARRiER /19T'�., °����`�-�-��� PLAN REVIEW ,� t _ ��Q„' '�"�' ��� Z70LICYNUM6ER��_./ �-__ . ELECTRIC ¢ .;THISSECf10NNEmNOTBEO�MPLEfEDOFTHEP=RMRISFOPdVEHUhDREDDJIJ.ARS(E100)ORLESS} PRUMBING � � I CER?IFY THAT W THE PERFORMANCE OFTHE WORK FOR WHICHTHIS PERlAIT IS ISSU[�,I � ����. MECHANICAL z LJ'' SFIALLNOTE4IPLOVANYPERSONINANVMANNERSOAST08ECOME$UBJECTTOTHE '� � WORKERS'COMPENSATIONLAWSOFCALIFORNI NDAGFE A7 ISHOl11.OBECOME '� INSPECTIONFEE F- SUBJECT TO THE WORKEPS'COMPENSATION O ISIDNS S CTI 37oa OF THE LABOR ��') � CODE.ISHALLFORTHWITHCOMPLYWITHT S '�� ISSUANCE 4 „3V[/ � p DATE�� APPLICAN � SMIP ,r.l� a u, /r-�r- J WAR�JING:FAILURETOSECUREWORKERS'CnMPENSATIONCOVERAGEISUNLAWFUL,ANDSHALLBE���� Eh1ERGYP/C J ! � SUBJECTAN EMPLOYERTO CRIMINAL PENALTIES AN�CIVIL FINES UP 700NE HU���REDTHIXISAND . ENERGY PERMIT OOLL4RS(5100,000),IN hDDIT10N TO THE COSTOF COMPENSATION,DAMAGES AS P{iOVIDED FOR IN /� � SECTION 3708 OF iHE L.160R CODE.INTEREST,AND ATiORNEY'S FEES. RETENTION FEE: I �P(/'P � d CONSTRUCTION LENDING AGENCY PRE-ALT FEE: � IHEPEBYAFFIi1MUNDERPENALTVOFPERJUflYTHATTNEREISACANSTRUCTIONLENDINGAGENCY d- f-ORTHEPERfORlAANCEOFTHEWORKFORWHICHTNISPERMITISISSUED�SEC.3097,CIVC.). -----�-'��—� . Z W � LEN�Efl'S NAME _�_--_ F- I.ENDER'SADDRE55 � .-. � j ��- W ICERTIFYTHATIHAVEREADTHISAPPUCATIONANOS7ATETHATTHEAF3OVEINFORMATIONISCORRECT. T07AL FEES� . i ��� ' �� d I AGPEE TO COMPLY WITH ALL CIiV AND CAUNT`�ORDINANC'eS AND S7ATE UWS PELATMG Tp RUII b161G � .� � � CONSTRUCTION,ANOHEftEBYAU7HORIZEREPRES�NrATIVE50FTHI5COUN7Y70ENTERVPONTFIE � , ABOVE-MENiIONE�PROPERTYFOR INSPECTION PURPOSES. � � � -�� - COMMENTS___ . � . �� .� � .. . .. QPERMITfEE NAM P _ . . ,�,,yy��� Y � , . . U� `� �g[� �.: i ���.. . .. . t..: (q SIG � eovPERM . . , � °'TE RECPT.NO._ . �� �PAIDBV��` VALIDATION � _ .. . , . .... . . ~ WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy.GREEN—Applican't's Copy � �� �� - � �� � � � � � ��� �� �� . . : . � � a � � `� � � ' , � :� : � A w � � ., � � � . . � �r�'��.�� ! a �'�����;�����_ � � � �.^..._.___�.�_ _ . _ _________ , �_�_._ _ @ �"(��.�°,%�=����la,�'sl`,�`4'?'��1.��._� �'9�9,�"i r�`-�E�14aT� i , I.��� i . ....-.� � ���:.,��!�°'�,�����_____'i_._ __ � _~_ .�__ ���{,�����°`,��42��i:�:i_, �m; ���_ c� __ �_.___. � �p�- ,J,� , , - ^-� ��p� �q Q"�( ' ���x;,(�` !� �vl ,..e't��`���€��{�.e��i��$,'.'L.s����E�� ' � � �A :.' ,. ".. -� ,..M r, ..� g A.���t1 E�f=�.J�N?. �@*d:.� ��� � � i L � . _ __.�.._._.w.. � .... ._.... � ��.��t������ i � � �` �3��;;`�'�...�t.��: FL�B�h3��a i�?� �� . : _., ��—j �__�__—.___._,.�.V *_; _.� �___.__. �..._._ 3 �i E��ta������43 __ ._��� . i I [ =�;��L�t �£3t��'C}���t�� � ' ___-----_ s a�`dr� F'Y��.:���d��C;� m F � x ../ '- :�.��; '�����:�'.���E.�.�E��9... ...,����`�--� �. .. .. � � �"�;, , , � � �C.�C?(����,��1 ; , � a ��?t���� �:T;�tfl�� a_.��'.;.��'` ..__. ___�__ ° � - ._. -----' ;��ts�:� �:af4�%$?'�€..��TaC��I ?`��c ��l�t�=__�����v___�----�-` ,,� �.—� ��,?�3�°�C��"�� i � � �R ����1(�`�:,' ` � ,.� , � , t�:...,; ,_ � � �`� _ _ ; r..4_:_�_._� �. , . . �.. __..___._. � ��:'?�I� h�c�,�i';�I� � - �,, I }R ����C,N;�t�;, �____.,�._�_ , ____,_._� ��� �r€ �'�.�(�T.��,i�.�_ _._�'.rn'=��`�L7,t',7'tl-��E�'r1�"ilN� � r 3 �€���s�l�i��,t�t��1�:� ' `�_���� t=is'�i��9 Ca�r��ad�IC� ' i � ia-�:,�r` g C'8' � _� � � t"'9 +'° 4 ��m � '�i, � � ;�,'3"C,�3�� _µ�/f 7�j� ay'� �.,,_FL�v1��t,C � 9 ��-°�a`T.�.�:�~t Si��i�i —��.4 ( ��.� �;�`���r=�1i�t�i��"`:c -- --- i t �.• �, 1'r,l��.� � ;_ i , �`��.i��`�.}� 1�,:s��` ��,�___ ��a�'��.F�t��3L _� � � `..`__--_—_ ---� �' .� � � �__� : �..���..�+; €4��.�.�.�:3�s�'� � . .•��``/' .{ # ;�F��:a v 1���. ' ; ,___._ __ .P._ _ _._..__. _ —_._ �_______ �._,_,.�._____ � � ��'�`JJ�!��°�;4�s��Ev,,� __ _yu��°; � ���i D�T4�?�S s �� � __-__a_� _.___. _ ........ __....� � ��4�Vi�� � : ; ,�-�- ` "_�..�... '. i �l�tt�:L�.��. i � e.�LF's�� �?�^":�dS1 ��_ @ � 7 � ?c.,e�.€VL�+3�✓P:T"GIk!"4Ci[i:. � .•••.�.._.....v. ...._�. ✓ }-.�3..« �°.3.�.....��ym...�w�...e.....�...---.—,�^—.._^,-- '—"it---...-�n_�.�^v. t � ..�..__..�._.___...� � .. 4:�L.�7"�1 3�.1,e. I � ; � ( �`L' '18'� € ��� i . ��� -«_�-e.....-...��....F-_........o..e...;�.re ._ �.. „_._....� ._.....�..�.�. —.�._.__. ��..� __._... �;�"h`�a3�`�"��"E Z " �`�'� � � 1' f �l��i��'C'��,��� ( _ _ mw.- _...._`_�� ¢ ��t�E�_;p��v��'. 7 ._-i.�..-�._ �'�fi� ���'�. �3"°�6��. 3 ... am, � __._____v �F��S�� r%��I�*§�'a � �t-i�'t�`t'#-{ �E�T. ��P�r1C�. � �_w � __ _ __ �3��' �-�.���"?=:�� 1 � � ` � �-�"� � :����t�1C� � �; �� ti �._._. __��._._.__________r__._. _, ___.__�__�C_,___ j �i��a��P�;.l.v��a;°�,C'� � E =�v���Y , . � 9 ..��2�`��_lL- ��=�-— ' `'` � _____� � _�/aL���—..._�°e��__�,�.� il_.'!�_� � � � � _ ------�---� � �..,., w... .. - ,,= -�—.. , ' ,.. , , ...._= _ - , �, � ; _ : ����'�����`� , '� � �� _ a � -��' �'"��_ _/��-�.--,�� - � � � �� � � ��� � � � � � ��.�. ;, s ,� -------------, �Z�° l� l�� �m >�tc��� � c7�?e�i-� � . � , _ � ,,,, , � � � i � d� ��.�,�_""-- ,; ,, ' -,-------------+ z...._ � � �;i, �I r,:�. - : __ +� � � r '' f� a.,c: "��7f✓,�i� �L c,�-�r.�!!� � °'�_________ �.,,u�� is� �i ' '„�i� . __ � . _ �,,.�� � e��� s� � � , � .._ � . _.�.. _.�. � �.�_ `� -------_—_� ; � ,����. � ., .� xi� _ . � � � �� _______�� � �w sr� ��� �. �;:�a.� ' � P �---__.____ �__� ___.--_�_ '' ' ' � ` _,.�-� � �� ,.. ; ;_ �� �.;. _ _�_ k �� _ , _�_� , : � ; ;: ;; ; , .. � �������"��� �1�� _____�_� s, ... _ . ._, , " 1 , � � ���� �i s.!�,��l�� �_ � _ - , , : , __._ �_.�__.�_____�...�.._.� _.W < < < �; � ' ���,I���;. ��� _ _.�... : �� -� � _. - , , ; . _ , : � �.�i��.� 1 ,y, ....� 1 . _ i�� �, , ��� � __._ _. € $. <.:, ,. � , � � j ?i. ;: ��.. . ..3� f1 �"":'"`k ' I ....._—.... i��.._..._��9____`'� � , � � � - , , ..�-,-.--�.w.`- �..,. . �, , ; , ; _ _ _ , ~ , � ;. ,, . _�.,.. � __.�_ � � � „�—.-�-�.>-.-�_� _ ---- , ... . . . , � . ,. � . , �, - ; . � , : �� �� . , � � � �. �` �,?'%:� � _ _ , � �� a . • -: . } . '. . ' ..�.. �.e ryi � I ... _... .,.�•� . �L'.$��7t__`��"���I!� �.��. , , . � , _ _...,�.. , ; �.�..y..�,.��.»�.a .�..��. �W�"� �..�____._._._._...�_.,.,_.__....�_..._ _.�__........,_,_e_ �.._______ _____ _---- ------.-_.......�...,K.,�,.__r_a..�.�.,..._,.m...a�....�.�._..._.,__.._v>....�,.,....,.�,�M.,.�,a..«_�....