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HomeMy WebLinkAbout14396 (19) � _ . __ ----�- -- ------- ---.... _ . CITY OF DIAMOND BAR � . �� -- DEPARTMENT OF COMMLINITY&DEVELOPMENT SERVICES �� . 21660 E.Copley Drive Suiu 190 � (909)86U-3195 Fax(909)861-3117 PR E$S . ��TM'�, BUILDING PERMIT APPLICATION � FIRMLY JOBSI'� � APPLICATION PERMR/ P/C o ADDRE3S'� ewel COUTt DATE 1 1-1,rj�9� = • • NUMBEF{ 8 ' ' � ISSUE " ' � 'TYPE'�-•. : - OCC APN LOT 31 TRACT 5222$ DATE ��• CONST. GROUP p OWNER Standard Pacific ' � , , ADDRESS 7 ZONING SEBACKS � •.' � CITY COSt8 flS8 ZIP TEL. FRONT_ •'r � . . _ . � RW ❑ APPLICANT TEL. REAR ❑ � SIDE/SIDE STREET - RW ❑ CONTRACTOR oo um ing SIDE � - O ADDR S Grest Ay� .: um ns . an, � C� �1 . Z�P yLS�TEL�II���- PROPOSEO USE � ARCH/ENG/ ... � ...._ _.. DESIGNER NO.DWEL. , NO. NO. ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. � DESCRIPTION SQ�FT. FACTOR PSF ADJ.AREANALUATION N � ONMER•BUILDER DECLARATION SFR/ADD/REM •'�' O p I MEREBY AFFlIM UW ER iE1UlTY Oi PERIURY TNAT 1 AM E%EMVT iROY iHE COHTMCTORS L4 Garape/Carport �� � LL CENSEUWFOi17NEiOLIOWNOREASON(SEG7m1.60U5PlESSANOVROFESSIONSCOO[ANYCENOR (� ' ZOOUNIYYIHICl/REODUIESAVER7ARTOCONSTit1CT.ALTER�PROYE.DCA10115H2ORREPAIRANV5TRUG� W P811dDBCk TURE.PWdi TO ITS 159UANCE FL..O il[OU�HES THE APPLICAr7T FOR SUCH PERMIT TO FILE A SIGNED � �L 6TATEMEHT THAT HE OR 9HE IS 110EN5ED PURSUM7T TO TME PMVISIONS OF iME CONTMCTORS l4 LL . --i ,•� CENSE UW(�➢hR Y(COMNENCNO WI7M SECIqN 70001�DIYISqN�OF iHE BUSINE53IND iR0• POO�SPO �[• iES5pN5 COOE)OR TIIAT HE OR SHE IS EXEMPT iMEREFR0IA M10 i/1E 8+�515 FOR 7ME ILLLEGED E%EMP• ilON.IIM�NOLATqNOFSECT10N70.7t.68YANVAPPIICANTFOR�PEWAT6U8JECT5THEMPLIGNTTO Z R8•R001 � `�r '� �F A CML iENALTY OF NOT IAORE T}IAN FNE NUNORED DOUAAS(t5[Ol): - � OlASdPINEROFTHEPROVERMORMVEMVLOVEESYNTHWAC[SASTHEIq50lECdA7EN54T70N, � �mmarcial - YKL DO THE W WiK,AND TNE STRUCTURE IS NOT WTENDED OR OFFERED GOR SFLE(SEC.7ou,BU51� J MESSM/D iRDFE55qN5 COOE:THE WffTMCTOi1S UCENSE UW OOES NOTMPLY TO/N OWNER OF -- �. �' - �� PROPERTYWFq8U1LD50RIMPROVESTNEREOH,MIDWNO00E55UG1wORKHIMSELFORHERSELFOR � . .•� TMROUOM/Y90HMEROVMEI.IROYEES,PROY�EDTIATSUp14PROVEMENTSARENOTMENDEDOR m _ OfFENEDWR511Eff.110WEVERiHEBULDW00R�AVR01rElACNTI550lDWRHINONETEAHOFCOYRE� � � �.J��'•1: .J` I 'l!":. Z �TI�N.7HE OWNE14Bl1RDER WILL FUVE THE BURDEN Of PROVNO h1AT ME OR SNE�I�NOT BUIID OR = W VROVE FOR T11E PURPOSE OF SAlE1 � W 04�SOwNEROFTMEPROPERT`/.AME%CURNELYCOMMCTNOWITHLILENSEDCON7RACT00.4 (= TO tDNSTRUCT THE P110JECT(SEG 7oN,BUSINESS IwD GNOFESSIONS COCE THE CONTHNCTORS LI- �Va1u8110f1 ADJ.AREA ll! CFHSEUWDOESNOTMPLYTOIWOYmEROFAFROVERttYA7OBUlD50AIMPROVE9MEREON.AND � W1pCONTRAGT5FOH5UCHPRO.lECTSWfiHACOHTRACfOR(5)UCENSEDWRSU/lRTOTMECONTMG QUAN7ITY DESCRIPTION FEE � TORSLICENSEUW.} O 1/A1 IXEA1Pf UNJER SEC. B.l D.C.FORiHIS REASON Q LL o"—c 19 Fixtures 207.10 D�TE ON'NEH V � W 1 Dishwasher - - 10.90 6 LICENSEDCONTRACTORSDECLARATION w 6 'Gas �Outlets 13:7� 2 IHERFBYAFFIi61UNDERVEN�L7YOFVE0.RIRVTUT1AMlICENSEDUNDERPROVISbN50FCHAPTER V. 1�• � Water Hea�ter��' 1�• � s �(OOA�YENCHOWIi115ECfiW17o0o)OFDMSION�OFMEBUSINESSANDPROFESSiONSCODC,/�ND Z W UGENSE i5 N FUI,L FOfiCE M10 EFFECT. . . � '' o u��,�a,,u C36 ��.,,o. 260324 J ^ y� ave�-15-99 c«naacroR Hood Plu�� = WORKERS'COMPENSATION DECUIRATION �31' a N "IHEREBYAFiIRAIUNDERPENALTYOFVERMiY0NE0FTHEf-0LLOWINGDEGUpATIONS., U � , � Z _ Q � •�_^{1UVEINDVALL�MANTANACERTIFIGTEPFCONSEMTOSELFaNSUREiOAWOiU(ERS ��•. 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PLUMBING �-�(F�n Z ICEN7IFYTIATNriIEVERFOMIANCEOfh1EWORKFORWHICHTHISVERMITI5155UED,1 MECHANICAL � () 511ALLNOTEMPLOYMIYFERSONNANYIAANNER501LSTOBECOMESUB1ECiTOTHE vj MqqKERS'COMPENSA7qNUv50FWJFORN1IANDACRfETNATIFISMOULDBECOME INSPECTIONFEE SUBJECTTOTHEWORKERS'COMPENSA710NPROVISIONSOFSECTqN770oOFTHEtABOR ISSUANCE �t75•n� ��� S CaOE.l511ALLFONiHVA7HGCMPLYW17117/qSEPROVISIONS. � � SMIP � W pATE: APPLICANT: ' � WIUWINQFARUHENSEWREWONCEH9'COMPENSATIONCOVEMGEISUNUWFl1L.ANDSFiNLBE ENERGYP/C SUBJECTIWEMROYERTOCRIAI:NALPEwLL71E5ANDCMlFWE5UP700NEYNINOREDTHOUS�wD ENERGYPERMIT �� � DOlLAflS(i I00.000).W IDOITION 70 THE COST OF COMPENSIITqN.DA/AAGES AS PNOVIDED iOR IN � SECT10N�7oeOFTHEU�BOliCOOE.INTEREST.ANDATTOFWEYSFEES. RETENTIONFEE: FDIAMONDBf1R ,�� CONSTRUCTIONLENDINGAGENCY PRE•ALTFEE: � IHEREBYAFFIRMUNOERPEHALTYOFPERAIHYT}UTTHEREISl1CONS7RUCTIONLENDiMil1GENCY UILDIN�ANDSAFF.'I'ti' �Z FORTHEiERFORIAANGEOFTNEWORKFOHMrtiiCHTH15VERMITI5155UED�5EC.70D7.Crv.C.). , W � � LEHDERSNAME C LENDER'9I�DORE33 W ICERTIF/i1UiIMAVEREADT115A7PUGTIONIWDSTATETUTTIEABOVEINFORMATqNISWRHECL TOTAL FEES � , � 111�RFETOCOMPLVVATHALLCT'ANDCOUMVORDINANCESANOSTATEUWSHEUTNOTCIBULDIN6 CONSTi41CiqN.AND HEREBY AUf1qRRE RFPRESENTATNES OF TNIS COIMTY TO EMER UOON 7HE 7 � AOOVE•MEMqNECiROGEflTYFORIHSPECT10NVl1RPO5E5. COMMENTS 'P��• ��O 0 � �m PERMIiTEE NAME �'�'' � c'"'/�-�c �r'��`'`� 11— S— Uj S�GNATUREOFPERMITTFE DATE ' � RECPT.NO. _PAID BY VALIDATION � f� WHITE—Dopartmant Copy.YELLOW—Fina Copy.PINK—Aesessa Copy,GOLDENROD--File Copy,GREEN—Applirant'a Capy � �Dfl `A(1n,� Il .r..--- ,.f1 ... _�L 11 _ - -�� �A��._. 11 1� ;. .. - . . . .. . , :.. . - � . . .., .: • . .. . ,. � . ,. 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