Loading...
HomeMy WebLinkAbout10357 ,����� _ .�, . ..,,�;.._... � :..,..�.<�,,::�,_;.. . ,.,:::� - _ ___ � ,..,.��....:.;�,�., _,--.;.� - �• CTfY OF DIAMOND BAR � COMMUNITY DEVELO�MENT D$PAf2TIV1ETVT � 2166o E.Copley Drive Suite 190 PRESS r,.�,.,, (909)860-3195 Fax(9p9)861-3117 BUILDING,PERMIT'APPLICATION FIRMLY _ .:__ .. ,. �., .: .., o� JOBSITE ��� },J,�R� �I = APPLICATiON �����?.�'A PEFiMiT����''�� P/C ADDRESS � � DATE `�' r NUMBER # � ISSUE ,,� �+p TYPE OCC APN 4 T TRACT DATE [+����� ` CONST. GROUP p OWNER �1 -, _, p ADD SS � ` r U '' ZONING SETBACKS gCITY�i� �' ZIP i�� TEL. " 1� Ea FRONT RW ❑ APPLICANT .t(17�✓1��L���. TEL � � -S S D F J S I D E S T R E E T R W ❑ mCONTRAC R ,Ci� , Li"1 . SIDE ..._T_._ _._..._ C7 � ADDRE S ';"� PROPOSED USE �'�''�"�°� f�+`�� 7�'�� � CITY +'� , T 71P TEL.jt)�'2�1�(l S Zl ,„, .c� Y'' P�+ �'A�S.�s�' A ARCHlENG! � iz DESIGNER NO.DWEL. NO. NO. Q. ADDRESS a CITY ZIP TEL. UNITS STORIES BEDROOMS � DESCRIPTION SQ.Fi: FACTOR P5F ADJ.AREANALUATION � OWNER•BL'ILDER DECLARATION �� SFR/AODlREM O (] I HEREBY AFF�RM UNDER PENALTV OF PEpJURV THAT I AM EXEMPT FHOM THE CONTRACTOAS LI- Gef89B/CSf(7D1t W CENSEUWFORTHEFOLLOW�NGflEASON(SEC.7o31.58U51NE55ANDPROFE5510N5COpE:ANYCiTYOR �(n C.� COUNTYWHICF1flEWIRESAPERMITTOCONSTRUCT,ALTER,IMPR6VE,DEMOL)SH,ORqEPA�RANVSTRUC- W PBfiO/DBCk � 7URE,PRIOR 7o IT&ISSUANCQ N.SO FlEWIRES THE APPIICANT FOR SUCN PERM�T TO FlLE A SIONED w STATEMENT 7HAT HE OR SHE IS UCENSE�PUpSt1ANT TO THE PROYISIONS OF THE CONTRACTORS U� W � CENSE LAW(CHAPTER 9(COMMENCINQ WITFI SECTION 7000�OF DIVISION�OF THE BUSWESSAND PRO- �'�' POOUSpd: FESSIONSCODE�ORTNATHEORSHEISEKEMPTTHEREFROMAN�THEBASISFORtHEALLE0E0EREMV• (J TION.ANVVIOUTbNOFSECTION7031.5BYANVAVPUCANTFORAPERMITSl1&IECTSTHEAP7UCANTT'O Z qe-Raof A CIVIL VENALiV OF NOT MORE 7HAN FNE HUNDRED DOL(Aa5(35oD).1: ' � � � ❑I,ASOWNEROfTHEPROGERTY,ONMVEMPIOYEESWI7HWA0ESASYHEli1SOLECOMPENSATION, L7 Commerciat Z WILL DP THE WORK AND TNE STRUC7URE IS NOt MTENDED OR OFFERED FOR SAE(SEC.70�a,BUSI- J � NE55 AND PHOFESSIONS CODE:THE COMRAC70R5 IICENSE lAW�OES NOT AVPLY TO AN OWNEfl OF = PFiOPERTY WHO BUIlD30R IMPROVES THEREON,ANO WHO DOES SUCH NlORK HIMSELF OR HERSELF Oq CL iHROUGHHISORHEROWNEMPLOVEES,PROVIDE�7HA75UCH�KIPROVEMENTSAR6NOTINTENDE00R � Lt�.l OFFEREO FORSALE.IF.HOWEVER,THE BUILOING OR IMPROVEMENT t5 SOID WITHIN ONE YEAR OFCOMPLE- yTION.THE OWNER-BUILDER WILL MAVE THE BURDEN OF PROVING THAT HE OR SNE DIO NOT ffiNLD Oq = IMPROVEFORTNEPURPOSEOFSAL�. W ❑I,ASOWNEROFTHEPROPERTY,AME%CLUSIVEL�CANTRACTINGV✓ITNLICENSEDCONTRACTORS - W CEN�SENLAWOpESHlbTAPPLYTOSAN�OWNEROFAPROPEflTVWHO58UILDSO�IMPAOYE�TFIERETd.RANO' V81Uet1011 Ap.I.AREA � WHOCONTRACTSFORSUCHPROJECTSWITHACON7RACTOR(S)LICENSEDVURSUAN7TOTHECONTRAC- QUANTITY DESCRIPTION FEE � � TORS LICENSE LAW.�. ❑I AM EXEMP7 UNDER SEC. 8.3 P.C.FOR 7HIS REASON Q � U LL � OATE OWNER V . . . . . �s[ LICENSED CONTRACTORS DECLARATION W Cl_ I HEREBYAFFIHM UNDER PENALTYOF PERJURY THAT IAM LICENSED UNDEP PROVIS�ONS OF CHqpTEN � � 9(COMMENCINOWITHSEC710N7000)OfUIVI510M30F7HEBUSINE55ANDPROFES51ON5CADE.AND Z MV UCENSE IS IN FULL FORCEAND EFFECT. � UCENSE CLqSS �n�� 1 _, I.IC.NO. �^`"��ry�� �� ��,�� ,r� �j U DATE t � � CONTRACTOR`���,��''i LL W ..... .... .. . . J � WORKERS'COMPENSATION DECLARATION � ;� � � e � I NEREBV AFFiRM UNDER PENALTY OF PEi1JUqY ONE OFTHE FOLIAWING DECLARATIONS: Z :��';� � },: � _IMAVEANDWILLNAMTAINACERTIFICATEOFCONSENTTOSELFINSUREFORWORKERS' _ GOMPENSA71pN.A5PHOVDEDBYSECTIONa7oaOFTHEIABORCODE,FOR7HEPERFORMANCE U ¢ OF THE WORK FOR WHICH THIS PERMIT IS IS9UE0. � 0 w ^IHAVEANDWILLMAINTAINWORKERS'COMPENSATIONINSURANCE,ASHEaUIREDBYSECTION �I Q 370o OF THE LABOR CODE,fOR TH&PERFORMANCE OF THE WORN FOR WHICH THIS VERMIT IS ` / ��..:r• LSSUED.MY WORKE{iS' MPENSATION INSURANCE CARHIERANO POLICv NUMBERARE: CONSTRUCTIO � ¢ �.Lz� ^f',n kG����'� r�n w � CAHRiEFi 2 POLICY NUMBER �y�,�y�� n„�,'.���_,,���^- ��„ ELECTRIC ¢ 0 (IHB6EC110NNE�NOTBEWMI'LETWOFTHEPEfN1ff6FORdJEHUWilED00L1ARS�610D)ORI.�&) PLUMBING Z I CER7IFV THAT IN THE PERFORMANCE OF THE WpRK FOR WHidl THIS PERAIIT IS ISSUED,� MECHANICAL C!7 SHALL NOT EMPLOY ANY PEFSON IN ANY MANNER SO AS TO BEfX7ME SU&IECT TO7HE � WORKEFS'COMPENSATIONLAWSOFCALIFOflNIA,AN�AGREE7HATIFI3HOULDBECOME INSPECTIONFEE � SU&IECTTOTHEWORKER6'COMPENSATONPROVISIONSOFSECT10N3700pFTHELABOR ......� = CO�E,ISHA FORTHWITHCOMPLVWITHT SEPqOVIS�QN� / ISSUANC 1 p DATE:�� APPLIGANT: ����.�„r.�,1�_—_ �IP P •e�� � GY P!C WARNIN(i:FAILURE TO SEWRE WORKERS'GOMPENSATION COVERAOE IS UNLAWFUL,AND SHALL6E � SUBJECTANEMP�OYERTOCPIMINALPENA7IESANDCIVILFlNESUVTOONEHUNDRffDTHDUSAN� ENERGYPERMIT OOLLANS(510�,Ooo),IN AflOIT10N TO THE COST OK COMPENSATION.DAMAGES AS PROVI�Eb fOR IN � SECTION 8708 OF7HE LABOR GODE,INTEREST,ANO ATTORNEYS FEES. qETENTION FEE: OCONSTftUCTION LENDING AGENCY PRE-ALT FEE: � I HEREBYAFFIRM UN�EA PENALTYOF PERJURY THATTHERE IS A CONSTRUCTION LEND�N�AGENCY FOR THE PERPoPMANCE OFTHE WORK FOR WMICN TNIS PERMR IS ISSUEO(SEL.30B7,CIY.G.�. W `e'°r � LENUER'S NMIE a..,.�:;-:� 1— LENDEiYS.C�DRE55 '� �� k `51 � TOTAL FEES ��s '`J' ° ""�" � I CER7IFY THAT I HAVE READ THIS APPLICATION AND STATE THATTHEABpVE INFOpMATION�S CARRECT. � IAGREETOCOMPLYWITIiALLC1TYi{NOCWNT{'ORbINANCE$ANOSTATEUWSRELATNGT0�8UILOMG " �. �-- CONSiRUCTION,AND HEREBV AUTHORRE qEPFlESEN7ATIVES OF hIIS COUNN TO ENfER UPON THE �` z .400VE-MENTIONED PROPERTY FOfi INSPECTION OURPOSES. COMMENT . ��� I � �� r I� ^' n 'J � ��� ��,��t2 a � ? �� : � PERMI E IPRINT) � � � . y, � i .. : "� �t;.:; v � .. . . . . , . . . .. . . � � .��,::. . .,'s ,�ii '�� SIGNATUREOF MITTEE DA � � . . ..... ,,. _ .. , ,. . . . � • •::+ ._.; RECPT.NO. � PAID BY 'r VACID/K170N��-�... ... �' - .. ,., � . ,..:_:..,..., . _, ., . � WHITE—DepaAment Copy,YELLOW—Finance Copy,PINK—Assassa Copy,GOLDENROD--File Copy,GREEN—Applicanl's Copy �` `�i'� � . hdi O9'■ , iel�P'l.➢tlB,' J@ V�_,y�3s'9Y[. :, .. r�, 4 J �!' : r ..e..i . , ..-•� . ������.:����� ���.���,r.�� �{< . �`.� �,, ,�.;;��� ,.,. . ,.:+�w.:�:"� - � . , .,=.a...;.:'_;�t ,_;�'. _: ... ..;_, _��,:. .. ..,�c-a.::. -, :- .,..:.,.�,.o..,.,.�.,..e . • � 0 � s. . . m- ��� .�. � �::., , , .�: ... . .. .�.... . _ ,�,�_ � . B � , v s: ,: _ ._ _ . ,., a�3"�ACtE,::, . __ �':,, v.__ .,. _ _ �LG)C)R Jt�l�7 -' _.__-- --_._-. _� ,, __._--� �.____ ., _ ��aA �1"GB/F�FIMSJS7EEL __ . . .�`�_ , ' FH�v�EQI�TS - ...... „ � .., .._. _ � ,.,.. �, ELEC'fR9C GFiOU�lD ; :;U�FLtJCJF?DUCT _ � � . � .. .._ 1. � uRC3�3ND PLU�lBtIVG ` ___. _ _ . '. ��'��Fd-��Ot?R't�fJniDL'1!T ' � ; � - -� ' __ � , ,-_ ' . SE_/5B Gi�AD� ��� _.,. _ � � .,, ir� ,. FBFi�F�LA��E�i.7f��PrTi�N �._ _ . . �'---- __._ ---•,.-- . --__�____�_�_�_____._._. _._._ _ - .= �TE9UiP PO�lEFd ----- _ =- ._ __ _ . .... -: �'� :. . , �I�i�C'LP�GE B�M14C�BEAtd3 . .. _ � ;.; � , _�:. _ ,c': _.���� � � �7U,A7ER SERVICE �' _._,_;-�� j,� � � MI[3 F4T.j�C�N�? ���fv�` _ ` {- '� - ��,. ., . ._, — �--� � � __ _ _ :-, ;,�. ��i�s�s�EA-����� - _ �� ��i' , s�r �c�rv���a�� __ �� _�1 ___. . —.._ _,_�_.____�� F�Ai1Al�dU/ilEh9TILiJ�1'9C)Fil Ft�IAL SC3�1C9�3EAiv! --_ - �" � __..__ _. ...__,_.,_� - tr FiCDO�C�9fEF3. __ .._ _: . _: _ _ Ph�E-�RAl�1�IG ___ _._..i. ' =---r----� . _ _..... __._.___ `d) r,-.: F�09�s"".yH a$EATI4VC-a ' '`_: ,'. a .;;:� ._.:-. 6�t�dt::§11IV�a. - .'--�--- _.. _. . _..._. ..._._..- - _ � ____.___._ ��.�, :. ' �67l�Gl-4�L�GT�I� ��. �. .:_ : ROU�H G�aADii�G - _ � _ � ______. _ � � EiC�t��Fi��.UIVl�3tNG � � . i-1�91SN'�R,4UiNG . ; IV , , , _ -- -n----�--,--�--=---�-- ,��. -�-----�---r---- SHOW�F�rTUB TEST � __ _"��f� _:___._ ,�__,.,_ . P4�(7L E�E�T�?!C , ,� 3�, < . ., ;f� � : :_ � �_..____ _ �, . ,� _�,__ .. �1C"f:LATNI�iCfih9�.; �-. _ .. . j F'OOL��N�I�kG . ' 4 r ,- .,. VUALL IP�StJLAT9OiV __ , - � PQ�OE�FIt�FiL� � �`� � � },Y; _.. �� --__. _____..�.� � .� ,�� ��il�li�iG lNS�JLATi(3iV ___... ._ _ _ --S'_t���.5`!Tc lh�P$: � A , :;. „ �, �,::� , •.;:` �R`14�6�LL 9VAI�9NG ' D�l�I^�1T(tJNS ' � ' ' °;' — - , ,: � » ��bV�6�._. _ . _. _ � FE�&dOL E�G � _ � �. `� �_. �W-- ��,���.._._._..�.�. � ' � ' '' ___ � SEPTI�TANK . : LAhl�3SC,�F��iI9�P�iG � � '�'�' , . � .. . 1 . .. . � `_-^^-- —1-----_.._. ._._.,.�__..._._... �_._._._ SEE�F'lTJL L. ' _". , GC�SlT� 1��6��. i , "` __.. __ _�_ _._ _,___ �_ GA5 AIFi TESI";... � �ll�{kl.�t3�lW��_�_�_�, �, � ...__ -_ -�� � _ -� - _._ -__� �'if��� CC7NST. _ ._._._ �o � l� ��, � �1���EPT:�'E�3�,L _ . � _.._ f� ; , _,� ___ ____ , , FI6�Al_NEAT'lBVC .�� ��NE�LT�4 C��P7. �lNAt .� �� � = � .� __, �___�__� �I�IAL ELECTRlC � 13�V. �EES!?��f� ,. ,� a , ` „- �: __.._____.. --�___-_. ---�-----�-��.-� � ., _ ,. �;� "" '._J�__ �...,.�.� �FC�l�L 4�LUiviBilVC �..„, ---�.. �-�N���Y . ,�--w-�}.. ; �; � � __. . _ -- � - »� rd,,, ;x s � ' ' _ --.; � � .. _ :�A-� .a. �. _. __._.. ._�____.,� _ t i __. _. _.. q � � .,—..— __ � �»� , . . . 'w__'n' ��. . . . 3 I{. _ _ . � ae, . _ ' ' .. .�'� ' .. ��;: R, '�Y�?'f � , �� , . . � . . _..,...� ,.,, , ,e .. _,. . i �,�} { �,. ,,, '�.... ,.. .,......_.._. ,._ .... _. ..._ . . . . y, _.._.._. _ .._ .._. . ,n 0.�p k' � ...)__._' . , . .- ; �'��'YOy'��1`14��_—�___�._.:._.� . . . . ...�.�:, ... �i[" i C '.•:" lab.�'r':.Ju . ' "' .::''r�t 3':v:,:b'�:-+ .� _it�:�.; , ... ...... ..... I__,'_��_�::.._..e........_.v.,� .._� .>,_.....__.�..._.r...,,� � . . ___.�._ E..r:•'-"_.�.F ' . ��_..... ,...._._.....-.._....._.�..... .._,......_.._.,,....v............. ............. .. ...._._.,_..... �._....._...�-.....,...... . . '.: a� � ::'-t:i R( '-.:�:: �.':41 .,. . "�! „ ..____ :!'- u��. 'S' b th ' �w� _ .� —..........................�. ' . , ' .,. .... .. ...... ..:..._.. ..,....,. ..._ .._..... .._ ...._..... .... . . ...... . " ,�. , j _ � � '. ' '�G�frthli'= ",:7 . - � �� ...a '.:: e: ... . �'� � . . ^ .. .. �._._.....,..�"""" _ �.c ... � _,.. """"""" _� . . ._, ...._. .._.., .......,_ ._.. .. .. ..... ...-.....^.t^�^...,,. » i � .. -".._..�y �, `,.,,,t^-�..« ....:. �'. _r., _ .. _ P f ..._ ,.. . ._..... __.._. __.... _. .... .... .... s Y^"'� ._.._ ,�,.. . ,.. . .. .. .:: .. �.�.___.�.__....._. �__.....,.�.,'_' _...._..._ _ �...._. ..,`__ _-__ ._. ._�., _.�_ � ' �._ ,� A. I �� .. . .._.. . ._._.. .. ... ... . .. . ... .. .. .._ .;,: . .. . ..: . , „ .1....,-;.....� :.,�,. ,-� ,.. ;.. _ -«.__. ti.r �,<.., 3- ..: ....._._ ..'J.. .-.,,.....,..--•- — '..�.._. .._.:_ ..i.._.r .F L ,.... _.sLi...J .1.�.. a.. .;,.' . xi.��, _l.<..�.... �. :�t{i� �Lr �9F� �....._.._.._ _..,...... . ._ ......._... . . .. . . . ' ' _....._.... ... ..... .. . _.__ �z . c � --. i.N, � . ...i , �< :, . , � .��_... .�:;.. . v.� .. ': . ::. �.���_. �._... . .�-� �''�......._ ' �_._ _. . ...._ . _ . .. .... .. ... . ..-._... _.... .� '��t, �.., ,, . . .. ' , _� i,4 Y "`t'tY1. . . � ..; . .. ., ..�..�._..�........._.�.,..._.....�.�._,_..�...�._ __�.� �.".�.,.�_�_--��.—__....._�.... ._ ._ �. ._ __ _ �.�...." ._. ' , � J � ............ . . _. ................. ... __.. .._ _..,.__.... ... . .. rJ - y, .�. . : � .:._.. .. _. ... ..... ,., _.s, .._3 �...: . „ gar--�--^----- . ._.. .__--.. ..._... . . .�.� ... _..- -�--.i:'_..�.z...-.._�.__�.�.._ -,.-.-.- ,.,...� - .. .. � : . . ""C i �.::� ---�-._._._'_....._ . __a �' , . :-C ��� t t A�15e��r ' i- ..._._._.. . . . ............ ___..._ .... ... .._......._. ...__ _. ..� . v.�_._ r . ',�' . �,.. 'dC>: ✓,. ,.6Xe �--'� . --- ..,. . . -�. .«_. . . , . ._ .... ��FTTl�T�t�K SlZE_ . � .,,. - _. _.. 5����6�1"�`11.7..5.�.��_..___ ._ _ _ _ _ ��� ry - - - ____� _._____�. _� � .� _ - - __ _. ...., ___.,__ .._. __ ,;. � „ , -- � �II � i�� i..I�I „: ' . i ,� 4: �r; � , " ' __.—___._._ .____ ..� _ , 4 r, . . ...�_-�...._. .�_.._ . �._.._�__.._ .._...� . . . ........ .____._.__........ '_.e. .� ..�.�...��...--�-..�.._..__..._.. . �i, ._ .. ._.__._.. ........._""____... ... ....... ._ .._ . ',...,.^� Y.t.�::f 'c i ...: - ', k . ._... . i.,�...1!iv,�Pft4.. ':.;,.. �.Ai:u c ..�.�.:.. -..'...-,.'.� _..... Yj,,.. . ! _. _..___"_;:__...._.�_. ..�.- _ ,._,_-rn--• .�. .ni. -�r�-�.a.;r,.�H ;� . - � '., �, .,. .. . . � +..,, . , .. .... i� r�;' � .. ,' ' -, . ,..,_, ,. ,.;,�,�, � �::_ .,_.: � .�:: ._a.c_.:�� � ..t-�--•�---�-ti � ��--�_.,_ ._....:..� _,.._---.�._ ___..._---- '..�_..._ _.:_.�.._._.�_..._�.. _.I � ''°"....�.-"��_""_'.�.�'�"_ ' . _.,__ ,. LL, t .,I_+1 11 '-; „ _�`_� 4 ' _. � ' ._, ._ � F_ � _���.�,..----- -- --- � : _ . _ - � �� � �� �:�+`r/�o�v��- �as6o' ��P�`^� ?I/�b.6 �n�/�'�,�'� ' �'%•�N,�� ~'� �. ;T_.__ ----. - ---------- -__-- , t � � ' ' 1� �ae�/ �O D s�il�' S�'''� '7r/e:`�r.,d- �ov`1`��� , _ � �� , � ,:3:�...�.._ , ._.7,.:��.,..��.. � . : .,. _ , � � i �� ma.�._�.._�..�...�...__.�m�..o�.,._.�...�..�.�.��, ,.�...�9._.�.,,�.� �..�..�.:�w.��.�.,�W......ma