Loading...
HomeMy WebLinkAbout10420 � �E�PIRED - CITY OF DIAMOND BAR COMMUNITY DE'VELOPMENf DEPARTMENT 0 C T 0 3 2QD0 .,.;.� 21660 E.Copley Ddve Suite 190 PRESS (909)860-3195 I=ax(909)861-3117 °""" BUILDING PERMTT APPLICATION FIRMLY y JOBSITE a� , y i, . ¢ ADDRESS c7��Z^`"1 Y�l CA I�� �,���Q,�' APPLICATION` fr7 �; PERMIT J P/C `' p DATE_._ «�� NUMBER � # � APN LQT TRACT �SSUE TYPE OCC p OWNER - - G�.1 DATE CONST. GROUP t�;v1 i�s p ADDRESS ZONING SETBACKS z CITY ZIP TEL. Q4`O FRONT RW ❑ � APPLICANT --.�,'�V'l+`l:� TEL. � -- � REAR ❑ � SIDElSIDE STREET R1�Y ❑ aa CONTRACT R S��E C ADDR S5 � CITY� 1' ZIP � TEL.� ^-I PROPOSED USE o ARCH/ENG/ z DESIGNER w NO.DWEL NO. NO. a ADDRESS � CITY ZIP TEL. UNITS STpRIES BEDROOMS cn cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � OWNER-BI:ILDER DECLARATION SFR/ADDlREM O p I HEREBY AFFI(iM UNDER PENALTV OF PERJURV i}IAT I AM E%EMPT FROM THE CONTRACTORS LI� G818J8/C8lpOR W CENSEUWFORTHEFOLLOWINGREASON(SECJ03t5BUSMES$ANDPROFESSIONSCODE:ANYCITYOR (n C� COUNTYWHICHREWIRESAPERMITTOCANSTRUCT,ALTER.IMPROVE,DEMOLISH.OAREPAIRANYSTRUG W P&fiOlDeCk Z 7URE,PRIOR TO ITS ISSUANCE,ALSO REOUIRES THE APPLICANT FOR SUCM PERM�T TO FILE A SIONED W STATEMENT THAT HE OR SHE�S LICENSED PURSUPNT Tb YHE PROVISIdNS OF�THE C6NTRACTOPS�U- W � CENSE LAW(CHAPTER D�COMMENCIN6 WITH SECTION 7000)OF OIVISION 3 OF THE 9l��SI1JE�6S A1Vp�P110 �- PooVSpa 0 FESSIONSCODE)OpTHATHEORSHEISEXEMPT7HEREfROMAN�THEBASI5-FORTHEALLEOFAEXEMP• (� - V TION.ANYVIOLATIONOFSECTION7o�7.58YANVAPPUCANYPORAPERMITSU&IECTSTHEA7PUCANTYO Z Rg-RooP ACIVILPENALTVOPNOTMORETHANFIVEHUNORE00'OILARS(5500).j:-- ' ""-' - -'"' � '- � ❑I.ASOWNEROFTHEPROPERiV,ORMYEMPLOYEESWIiHWAOESASTHEIR50�ECOAIPENSATION, � Co1flR78fC181 WILL DO THE WORN,�ND THE STRUCTURE IS NOT INTENDED OR OFFERE�FOR SALE(SEC.70d4,BU51� J N NESS AND PROFESSIONS CODE:7HE CANTRACTORS LICENSE LAW DOES NOT APPLY TO AN pWNER OF PROPER7YWHO�BWIDSORIMPROVESTHEREON,AhUWHO00ESSUCHWORKHIMSELFORHERSELFOR � � 7HROUGHHISORHEHOWNEMPLOVEES,PROVIDmTHATSUCHIMPROVEMEMSARENOTINI'EHOEDOq LL7 � OPFEREDFORSALE.IF,HOWEVERtHEBUILDINGORIMPROVEMENTiS50lDWITiINONEYEAa6P'COMPLE� Z 710N,THE OWNER-BU�LDER WILI HAVE THE BUfiDEN OF PNOYING THAT�HE OR SHE OID�NO7'BUIID OR � IMPROVEFORTHEPURPOSEOFSALE). � � w ❑I,ASOWNEROF7HEPROPERfV,AMIXCLU51VELVCONTRACTINGWITHLICENSEDCONTRACTORS � 70 cONSTRUC7 THE PROJECT(SEC.704a,BUSWESS ANO PAOFESSIONS CODE:THE CONTRACTppS Lb ValUatiOn ADJ.AREA W CENSELAWDOESN4TAPPLVTOANOWNEROFAPROPERTYWHOBUILDSORIMPqOVESTHEREON,ANO � WHOCON7RACTSFORSUCHPROJECTSWI7HACONTqACtOR(S)LICENSEDPURSUANTTOTHECONTRAC� QUANTITY DESCR�PTION FEE TORS LICENSE LAW.). O ❑I AM EXEMPT UNDER SEC. 8.a P.C.FOR THIS REASON d � U LL' DATE OWNEH F O U � UCENSED CONTRACTORS DECLAFiATION ,w � I HEREBV AFFIRM UNDER PEWLLTY OF PERJURV THAT I AM UCENSEO UNOER PROVISIONS OF CHAPTER � 'Ey. � B(COMMENCING WITH SECTION�000)OF DNISION 3 OF THE BUSINESS ANO PROFESSIONS CO�E,AND Z �! XL� MY UCENSE IS IN FULL FOflCE AND EFFECT. m LL! o '�. � �5 L���,'��" � � UCENS�C SS LI0.NO. � � f��q U DATE 4r CONTRACTOR- d W � WORKERS'COMPENSATION DECLARATION � � 1 HEREBY AFFIRlA UNOER PENALTV OF PERJURY ONE OF THE FOLLOWING OECLARATIONS: V � Z Z _I HAYE AND WILL MAINTAIN A CERTIFICATE OF CANSENTTO SELF-INSURE FON WORKERS'� 4 Q ///COMPENSATION,AS PROVIDED BY SECTION 37000F THE LABOR CODE,FOR THE PERFORMANCE C� Q �OF THE WORK FOR WHICH 7HIS PERMIT IS ISSUEo. � QW _I HAVE AND WILL MAIMAIN WORKERS'COMPENSATION INSURANCE,AS REWIRED BY SECTION 370a OF THE LABOR CODE,FOR THE PERFORMANCE Of THE WORK FOF WHICH THIS PERMITIS J ISSUED.MY WO��M NSATIOy lySURANCE CARFyER ANO POLICY NUAIBER ARE: CONSTRUCTION -� CARRIER �a ai�N�_t.%� PIAN REVIEW ¢ POIICY NUMBER v' �/ ELEC Cr--� ______ ��� � (�HISSEC710NNE�NOTBEOJMR.Ei�E�OFTFiEPEWMISFL�RONEMX�DIiED0IX1M5($t00�OFtLESS). LUMBING ...^� (f Y ���,�f W .e""_'- � �CENTIFV THAT IN THE PERFORMANCE OF THE WORK FOR WHICH TNIS PEFMIT IS ISSUEO,I MECHANICAL C'3 SHAL�NOT EMPLOV ANV PERSON IN ANY MANNER SO AS TO BECOME SUBJECTTO TH[ Uj WOflKERS'COMPENSATIONLAWSOFCALIFORNIA,ANDAORE iHATIFISHOULDBECOME INSPECTIONFEE SU&IECTTOTHEWOflKERS'COMPENSATIONP VISIN50 'ECTION3IOOOFTHEIABOfl - OCO�E I S OHTMWITMCOMPLY WITHTHO �.PR I51 ISSUANCE e�"'l� �� {�eb"'a'3� p DATE: qPPLICANT: SMIP W J WARNING FAILURE TO SECURE WORKERS'COMPENSATION CAVERFOE IS UNLAWFUL,ANO SHALL BE ENERGY P/C � SU&IECTANEMP�OYERTOCRIMMALPENALTIESANDCIVILFINESUPTOONEHUNDFEDTHOUSAND ENERGYPERMIT DOLLARS IS100.000),IN AODITION TOTHE COST OF COMPENSATION,DAMAOES AS PROVIDE�FOR IN J SECTION 3708 OF THE LA90R CODE,INTEREST,ANDATTORNEV'S FEES. OC RETENTION FEE: QCONSTRUCTION LENDING AGENCY PRE-ALT FEE: � IHEREBVAFFIRMUN�ERPENALTYOFPERJURYTHATTHEREISACANSTHUCTIONLENDINGAGENCY FOR THE PERFORMANCE OFTHE WORK FOR WHICH THIS PERMIT IS tSSUEO(SEC.3097,CIV.C.�. Z W � LENDER'S NAME - . ' 1— IENDER'SAODRE55 ¢ 1 CEFiiFV THAT I HAVE READ THIS APPLICATION AND STATE THATTHE ABOVE INFIXiMATION IS CORRECT. TOTAL�EES ! . .� W 1 AGREE TO COMPLV WITH ALL CI7Y ANO COUNN ORDINANCES ANp STATE UWS REIATINO TO BUIl61NG � �/' � CONSTRUCTION,ANO MEflEBYAUTHORIZE REPRESENTATNE3 OFTHIS COUNTV TO ENTER UPON THE � � ABOVEMEMIONED PROPERTY FOR INSPECTKKJ PURPOSES. ' Z COMMENTS o �,��,-�.14 �-. J � - m PE TT NAM Pft�NT) �`" � F".` ' ,.I:',f,a � Q : N � ��� �� � SIGNA REO PERMITTE DATE '�'��� � ' RECPT.NO n, r�' 4- pAlp BY �.,.GA����RTION WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GpLDENROD—F(le Copy,GREEN—AppllcanPs Copy' ' :.,...,v K �._,,.��; >�.. ,.:..t�,.. 9 s,�:..3`,-.: x.� �.;;T��� ,N�a'?�� ' . r..: �p,�; ^s,;:�. z . r.s?., >� -.,��: . . . _ .,'�.: . . .. , .:..i. „s�� ; . � �t",�'?`;5k f�,'�Y�r7�9r 3t�,�0Y h3��a 1 o-'.f.�.?s M d�er���,a' d 'g?�-`� 4 �,bzam�;'�^.� �;e�•.ri. 7r '�'d� � �'�"s'""'' . �.��!�..�, . . 4� ���.,�n�M �" 1a,ds:'] . , ,,.. _,. . , ..�.� �� :.� y �� � � ( � '� .. s Y g..:;�. "�v. � �, `�, '�, � '�' °�a , .,r � � �'�-�����►�BA�'!l'��1[� I�AR '��4 .�.,"�<.` �wza�. .,.�r' . ..::, . ..,. �r..:,'. '�i . �..;. ,�a.e :;r,i.��'.. �r�; .., , : ; � ,... ..i.�. fi`4������'�� ���;�,�� , ..; ;<, .,�. �,�.,.<;,�' s � e � � _ o .� e � � � ._-_ SET BAGK , .. _. . t. ._� . __ FLOOR.�OI�T _ _ . F7'GS/FORMS/STEE� _. � �^�:. : -____ _ . FHA REC�NATS � , : , . .,. _ _..,. . ELE�'i'R!C G�tOUND , ; l3RIDER FLOOR dUCT . , ,�„,, _ GROt�Nt�FL[�NIBING ' _ ; . i UNDER F�LUOFt G�l�ibl`)IT _ � t' _ - _ SL.6#8 GRADE ` �, FIREPLAGE F�3U`iVD`ATION `_� , _. � _ .:.. _ . F9�tEPLACE BOt�D�EAM.. � P{,: . ; , ; T�141P POV'VEFt : v, .: i►��l'ER�EFtViGE ,;.,_... _ �! MID HT. BONQ B�AM _ .. �.- . .' ; . .. . .. -- ------- -- — -------- -+--- �-= ------ �tt�C�F S�iEATFii1VG . ; ; 8 F`T. 6C}�I��Ed�tt� , ,, . , � �R�iV�iM1lGfilE�vl"9LIATION `' � ;.,�INA�.BQNDBEAM __ __ _ ,=` y i — , ' ...; , � ,,-. . F�OO�GC)9lER _ � PRE-GRADING , , { - -�: ryaFF,•. a . - ... ._ .. . _ ._ .: .:__... ..... . ..�, '-- f�i0�1G�i Fi��4TQ'N'G _ , ; , , , ..:_ �ENGHiNG �OU€�ti ��ECTf�fG � -_ ... _ i. '=_ RQUGhI GRADINt.� ._:_.._ __^-- .. `. _.. ., t��UGt-i PLUNiBIRiG�� _ _ � �11VfSH GRAT)ING" _: ., . — . ., ..;., � ,,; � ��-i�iM1IEF�JB"UBTEST PC3dL:E"LEGTR„ , . . � .,. � .�-.- � _ .. � �C �. EX'1'.LATHiSED91�G ! ._. ___�',,__ __ ' POQ�F�NC7tVG ` ; _ ,,. -____. �,NA�L If�Sl1LA1`ION � _ .__ . _ , POQi�FI�4AL : : _ , .. , , -- __._ _ ��ILPIVG iN>ULRTIC?N. f-- _ OFF SiTE 1PlIF'S. , , � � - [}�3YVlfALL N�€I_ING 4 C7E�iCr^aTiC)�!S --------�--a____:.�.�� _�_----------_ - ---_--�.�_� _� _ , SEENER � �. _.. : . FIfVAL�(�G;. . _ �- S�P�€�TANK I _ , _.. - -, i_t.APdDSCAF'E/I@�RfG ,.. ; ______ __ `_�-- -- --.�� ____----- ., S��P f?ETlL.L_ l . _ . , 'M::'. , °.;' .:.' ON'SiTE!N1PS. . . . C�AS A1R TE6T . � FIR(A�Z�iJtNG t -- �I�VAL CONS1': FlRE DEPT: �'IPVAL ; ----- — � . .._ '-Flf�lF�t 4-i�ATING _ __... >.. _ : HEr1LTH DEPT. FlNRL;. ! ,:.,.. - _.�� ���. _ �INA�PLllhl181NG . , - --_ ENER ��S PAID .--- _-- --___��____ � e _ :' .� _� --�------ _: -_ ...�'.---�--w :: - Fi�tAL EI.ECTRIC � bEV. 'GY _ __ .. . . _ -. _ .__ _ _ - _._ _. .. _ + �, i . � ,...,:;. _ --- _ __ —_ ----,- .. .� ,�_ _.. _._ ... .,. .... e � � � . , , . : � 4� , ----- _ ; ,,,.:�, �.. ,,. C'a{�l�II6VdE��"� . ;., .: ,:, „_ ..:. ;:;, , ...,.�, . , ..,a..�. , _ .. .._.. . . _ _._. _ _..__._ . .:,. - --. - �,,. .. _: ___. . _.__.... _.._. ._. , .:.. . �. .:,: r�J � .. s � . . ._ � � ; . , , , � ,,... „ ,. G _ _ . .:: .. , .: . _ ,,R >_ . , .,, ;.. ;.: : ; ; _____ . ._ ____.. _._.. — nu ' _..�' ._�._ ...._ _ �;�.�. .s "� -,. �_.. ' � �. � -_._..t_�- _ __—._���_ '`--�.� _�_ __--.__.._ _".'.�. Sr, ... �.`, � ^.:'.}. °y'^ .;. ',.. �,...,. 4. .. ': . : . . ' '. '. . . .._„ ._ .. . .. . ,�... ,. .. , .,. ._.,,... .,� { . .. . ..,,_. . . . . .... __ . . . . .. . _. . ' :: ....... u �...�il ..Aci'. ^ . : hxl• , " ;�=c��.. ._�-.,, . �,.,.. . � . �, e ........ ..._ ___. .✓��:,;:g ,.._w.... �. • ., ., ._. ..____._.._... . �. , .. �, ... . ' S..y � , i .. , �����. r a1 �.� �..a.,... . .._. .:.. ' '.: ' S�g�y7 pe yqp{�/ .,: " .. .. '..:.�.,: F . ':^-� �� ' P"!IV ITi1V�l����.. . .. . _ . .... ..____. . T I ...._ :.. . ..... .... :'. . � a7�Gf..f'I/U �71LG ...._..... ., _...,_.___..... ............ . ._ . ...... ,. �...''' .. , .� .. .,� . . '.._` . '. �. . ..:.:��.. �'�� � .�...:. .. . , , -.�_.��. . �;:.. .:', � _..._.. ...._.._..... . .._.. ........ .. . .. . . . . _ _ - ... . . ..��r, �. :.r:":. .-..,.,, a -:.,:. .� � . � .�,I „ , . . _ . . . _. . . . . .. .,..:�, �..�...., ,; t... .. .. , , .. ..i ;4�;.1,a '' _..: �;,.. ri �..';�i�s �"a.:, r,,i',- ,a3-,r qu .� n::;:�i . .. . .. . ., .,., .... , ,_:�, . . , .... .. . . .. . . �.1.. .. .... .. ._. . ...i:�� `" .n..:"' . ..,.. . . , . , - , - � ` . .... � ... . . . -. r _. ,. . . i .� . . . i. ,. .. .. .. . . .. .. . ...... ........ . ...0 .... . ,, ... .,. ' . . �...,...�..����m. ��m,.�.w,.,�