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�� CITY OF DIAMOND BAR � DEPARTMENT OF COMMUMTY&DEVELOPMENT SERVICES ,�� .> 21660 E.Copley Drive Suite 190 (909)86Q3195 Fax(909)861-3117 PRE$S ����'� BUQ.DING PERMIT APPLICATION FIRMLY � JOBSfTE ZOQ C�O� ��� �� APPLICATIO PERMIT I�)� P q -0� o ADDRESS � � � DATE NUMBER 71 g ISSUE TYPE•. �,' OCC APN LOT �2 TRACT DATE CONST. GROUP p OWNER � ADDRESS V T ZONING SETBACKS ' �u' C�'n( ,C L4 ZIP TEL - REART -� RW p APPUCANT ��� TEL SIDE/SIDE STREET RW p � CONTRACTOR �G ��'UN`�-�L-- SIDE p � ADDRESS PROPOSED USE /veLl.� • 5� " P� � �7 CITY ZIP TEL Pu ARCFUENG/�S�%��� , . , � DESIGNER NO.DWEL NO. NO. ADO S UNITS STORIES BEDR�OMS � CITY 21P TEL. y DESCRIPTION SO.Ff. FACTOR PSF ADJ.AREANALUATION � OWNEF-BUILDER�ECLARATION SFR/A�D/REM O .C� O I HEREBV AFFlRIA UNOER PfNALiY OF PEFWM TF1Ai IAM f%EidvT FROY iHE CONTMCTOiLS L4 G8rdp9/C��pMt � u� � CENSEUWFORTMEFOLIOWV!(1NFw50N(SEG70.11.6BUS�NESSANOFROFESSIONSCODLANYGITYOR (n OOUI�RYWHCJ/REd11NESACFIWRTOCDN57AUCf,JLLTE0.�DROVE,0EWU5M.ORREPAIRANVSTRI/G (L �� �'7 7URf.PNiOR TO ITS R9UAHCE.ALSO REOUWES 7HE AVPLIGWT FOR SUCH PERMIT TO FILE A SiGNED W �r � ST�TEMEHT TMA7 NE OR SHE 6 LICENSED PURSUANT TO iNE PNOY41ONS OF iHE CONTRACTORS LF � • .. � CEHfiE UW(C1IMTER Y(COMMENdH�WITH SECf10N 7000)OF DMS�ON]OF TNE BUSiNESS ANO Vi10- PaoUSpa FESS�DNS CODE)OR 7HAT ME OR SME IS E%EMPT TMEREF(i0Y AN�iY1E BASIS FOR TME iVlE�ED E%EMP- TIDN-ANYNOlATK7NOFSECT10N7m1.6BYANVAPPIICFNTFORAGERM1iSU61ECTSTHEMPIICANTTO Z Re•Roof �,,,� ACMLVEWLL7YO�NOTMORE7WwiNEHUNDRECDOLtAHS(f5oo).k - . � O1�50Wt1EHOFTMEiROPERTT,ORMYEM7LOYEESWI7MWAOLSASTNEIRSOLECOMf�ENSATqN, � (�,pmmBrCidl . � YALL DU 7ME WORK AND iHE 6TRUCTURE�NOT IHTENDEO OR OFGERED FOR SALE(SEG 7a�,BUSI• J N NES$AND iqOFE39qNS COOE:THE COHTMCTOR9 UCENSE UW DOES HOT AFPLY TO AN OYVNER OF ? • ' , ifiOVER7YV//iOBU0.D50HMVfiOVESiHEREON.MlDWIi000ESSUdIWONNHIMSELFOFIHERSELFOq m � TMROUGHW90RMEROWNEMPLOYEES,PROVIDEDTHATSUU/WPqOVEMENTSAFIENOTNTENDEDOR OFFEAEOFORSKEIF,NOWEYER1M�bUlDN60RMPROVEMENTI3" �WIiMNONEYEAf10FLOMPIE• � •TON.THE ONMEHAUILDER WILL H1VE 1HE BURDEN OF CROWNO TNAT M[OR SHE d0lqi BII�LD OR MPpOVEFOR7HEPUAPO5EOF8ALEL �y,� OLASOWNEROF7}1EiROPERTI:IUAEXCLU5IVELYCONTMGTWON'17MLICENSEDCONTRACTOR3 � TO CONSTTIUCT THE 7R0.lECT(SEC 7aI,BUSIHESS AND VROFESSIONS COCE:iHE CONTRACTOHS U• V01113SIOf1 ADJ.AREA � CEN6EUwDOE9NOTAPPLYTOIWONMEROFAPHOPER7YIMHOBU1lDSORMPqOVE9TXEREON.AND Mh1DCONTMCi9FORSUOIVRQ1ECf5N17HA00HiMCTOP(5)LICENSm%JR;UMITMTMECONTRAG p(JANTITY DESCRIPTION FEE � � TORSUCENSELAW.� O IAA1 EJ(EYPTUJDEN SEC. B.l D.C.FOR THIS f1EASON Q U � � DA7E OWNER V � W UCENSED CONTRACTORS DECLARATION W � IHEREBVAFFIRMUNDERGf/U1T`lOFVERIUMTHAi�MILICFHSEDUNDERGROVISqNSOfCHAPTEq Vr s �(COMMENCw61MTH SECTqN 7000)Of DMSqN]OF THE BUSINESS 1�ND PFOFESSiONS COOE,FND Z X MY LICENSE IS N ML FORCE AND EFFECT. ���� � 0 110EMS� S � IIC.NO. J �j DATE CONTMCTOR _ _ a W � WORKERS'COMPENSATION DECLARATION 4 N I HEREBYAFFaiM UNDER PENALTY OF GERIUHY ONE OF TXE FOLLOWING DECUMTIONS U ' N Q � �IINVEANOMl:L1MANT�INACER'T�FICATEOFOONSENTTOSElFdNSUREFORKOqKERS' S � CqJPEHSATqN,115VilOVIDEOBV5ECT10H]7000FiHELIBO�C00E.FORTHEVER�OR6IANCE W OF TIE WOHK FOR VMIGI TNIS PEiW�T CI ISSUEO. � O _NAYEANOWiLNAMTNNWORKER500MPEN5A7GNIN5URANCE,ASREW�REDBYSECTiON Q ]7ooOFfHELABORCOOEFORTMEFERFOMIMKEOFTHEWORKFORWH�CHTNISDEIWITIS g8��Sa . � _ ISSUED.EfYWOfi ERS'CO/APEHSATIONWSUMNCECAARIENAND70UCYWMBEflAAE CONSTRUCTION ' ] CAMIER ��L�� PLAN REVIEW I 1 � � ���Ep .� L � e�cr�ic i• �Ero � �ssEcirx+r�rtneem.�t¢iiuoFnfrEw.�rswaaaEMra�ooatu�6�mlontFssl PLUMBING 1 S�D►�O�D� � Z ICERT7FYTINTPlTiEPERFOfWANCEOFTHEWORKFOHW11K711M15PERMRI5155UED.1 MECHANICAL �,SG��OL, `�. 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' � � � DRYVdAL.L NAILING �- - 8�o QR � t�'+r.. �� DEDICATIONS � � 5E�'JER FINF,L ENG. SEPTIC TANK LANDSCAPE/IRRIG. � ' • ; , SE[P PIT/LL . ' • •- ON SITE IMPS. � ' : CAS AIR TEST FINAL ZONING . FIN�,L C��JST._. `�,�j_� � FIRE DEPT. FINAL • �f'iN.S!HEATING _ __._ HEALTH DEPT. FINAL - - - - 'Fl�JAL EI_ECTRIC - - - ' DEV. FEES PAID ' 1_ —- --.._...� . �i"1AL PLUt"BIPda - � � -- ENERGY I � _ ; � 5�_ _ ��� I 1 � �-�..�:�-..,-._ �jfc.'„x.5;:i�'c�tr. � ., , . , �; � . _ .. ._"'" _.. . ... . .. ..i.\!e. _ . _ . . '__"_'___ _ ._. � . , , _ ''—� � • t ! . ' � . . .. . . ..._ . . . . �`:^'.,nl'�Y i: . . . . CO��;tMENTS ... _ ... . -. - -----.�_ �_L`_ �:_._'�' �� ��- __ 1'.._ �_�-- . . �:�,:' y�-'r..I" j � ' � "�� •.�� '-�i . ;�,�_� , �.; �:r '1 - •.�, f � - . . ��' -�� �. .` ,. , _ r' .._ � - -- - . .... :1i �. � �" j . . . � � :'�1�.:� � ' . � . . � � � � �� � � . --��T�-:S . f . � .' i _i �.. ' � � i . 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