HomeMy WebLinkAbout10-1280 _��_ CITY OF DIAMOND BAR
� DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES
'' �,w 21825 Copley Drive,Diamond Bar,CA 91765
(909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS
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� SEC710N 37oe OF THE LABOR CODE,INTEREST,AND ATTORNEV'S FEES. EN ON F . .Z���O
OCONSTRUCTION LENDING AGENCY PRE-ALT FEE:
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� LENDER'S NAME
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� TOTAL FEES 7 J� �
� 1 CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CARRECT.
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�-- `-' CITY OF DIAMOND BAR
�"--��`— DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES
I
�- 21825 Copley Drive,Diamond Bar,CA 91765
(909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS
""�'+ BUILDING PERMIT APPLICATION FIRRALY
} JOBSITE � APPLICATION PERMIT �/e�
o ADDRESS_I�U'� �\��`�'i;h C�FCJ� DATE NUMBER /,,.G �� �/C
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w TURE,PPIOR TO ITS ISSUANCE.ALSO REOUIRES THE APPLICANT FOR SUCH PERMI7 TO FILE A SIGNED w Patio/Deck
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� CENSE UW(CHAPTER B(CAMMENCING WITH SECTION 7D00)OF DIVISION 3 OF THE BUSINE55 AND Pq0- POOUSPB
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Z �HAVE AND WILL MAMTAIN A CERTIFICATE OF CONSENT TO SELF�INSURE FOR WORKEHS' ¢
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¢ CAMPENSA710N,AS PROVIDED BY SEC710N 370o OF THE LABOR CODE.FOR 7HE PERFORMANCE U
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Ow _I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REOUIRED BY SEC710N
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� SECTION 3708 OF THE LABOR CODE.INTEREST,AND ATfORNEY'S FEES. EN ON F . ,�C�J G�
OCONSTRUCTION LENDING AGENCY PRE-ALT FEE:
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� LENDER'S NAME � �
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I , I DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES ,��
21825 Copley Drive,Diamond Bar,CA 91765
�(909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRE$$
'�^'� BUILDING PERMIT APPLICATION FORMLY
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STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CON7RAC70R5 LI-
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Q OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. �
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Q 3700 OF THE LABOR CODE.FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS
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WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OH OFFERED FOR SALE��SEC.70�l;BUSI- J
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� ' IHAVEANDWILLMAINTAINACERTIFICATEOFCONSEN770SELF-INSUREFORWORKERS' _
� COMPENSA710N,AS PROVIDED BY SECTION 370o OF THE LABOR CODE,FOR THE PERFORMANCE �U �
Q OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. �
w _I HAVE AND WILI MAINTAIN WORKERS'CAMPENSA710N INSURANCE,AS REDUIRED BV SECTION
Q 3700 OF THE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS
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j CARRIER PLAN REVIEW �
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Z ELECTRIC •
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Z I CER7IFV THAT IN THE PERFORMANCE OF THE N'ORK FOR WHICH 7HI5 PERMIT IS ISSUEO,I MECHANICAL �.rCC�!('. ''x"
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� WORKERS'COMPENSATION LAWS Of CALIFORNIA,AND AGREE THAT IF I SHOULD BECOME INSPECTION FEE
� SU&IECTTOTHEWOqKERS'COMPENSATIONPROVISIONSOFSECTION37000FTHELABOR �.. � -�'`��'R;� �:�i � t��,.••��
� CADE,I SHALL FORTHWITH COMPLV WIhI7HO5E PROVISIONS. c�,_ISSUANCE.^^�" 1' ' �
p DATE: APPLICANT: SMIP � �
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� SUBJECTAN EMPLOVER 70 CRIMINAL PENAI.7IES AN�CIVIL FINES UP TOONE HUNDRED THOUSAND ENERGY PERMIT., �
r DOLLARS(5100,000),IN ADDITION TO THE COST OF COMPENSA710N,DAMAGES AS PROVIDED FOR IN , �
J� SECTION 3708 OF THE LABOR CODE.INTEREST,AND ATTORNEV'S FEES. ��"'� .�
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FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3097,CIV.CJ, .
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� LENDER'S NAME
F- LENDER'SADDRESS J �
w I CER7IFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CARRECL TOTAL F E ES r F.� �,~•
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Z ABOVE-MENTIONED 7ROPERTV FOR INSPECTION PURPOSES. COMMENTS �
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MR. & MRS. BRUCE V�/ANG
1705 SOUTH KIOWA CREST P✓
DIAMOND BAR, CA 91765
RES PHONE: (909) 860-8021
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August 9, 201 1 ; �/
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To: City of Diamond Bar
Department of Community & Development Svcs �j
21825 Copley Drive G� ��'— � � � �
Diamond Bar, CA 91765 '
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C�� �
RE: ReQuest for Extension - Bereavement ;
,
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To Whom It May Concern: � _ '
�
On 12/10/10, permit # 10-1280 was drawn for a sewer repair at our residence. This permit
became part of an arbitration hearing with the Contractors State License Board, reference CSLB
Case Number: AS2010-645, AS2010-644 between Bruce Wang and Malcolm's Plumbing & Rooter
Service, Inc. I
Part of the arbitration judgement was that the permit had to be satisfied by Monday, however, due I�,
to the passing of a family member, my husband, Mr. Wang, personally had to travel to Taiwan on
Saturday August 6, 201 1 and his return will be between 8/14/1 1 and 8/16/1 1 .
Please accept this letter as a request for an extension to satisfy the permit with State Contractors
License Board and the City of Diamond Bar. o �
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Respectfully, � o�
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Mrs. ruce ' ng � ��
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, i Co�t��ck�r��tate E.i��n�e E3oa�d Ar�it�atic,n i������m
C��B 1Ga�e T�O�uenl�es: A�2p1�-64�, A520:L�i=��4
grur.e 1Nang Jahn Eari Malcclm an� B�lizd� Ma9oGtrn
Y.oS�. Kiovva Cr�st br. Matralm's Plurnbin�&Rooter Se ' ��.--
�iamond Bar,CA?1765 dba Ps1r. Rooter Piuenb's,n�
l.icense �: f75�23 131.67 CarneyAve,
Baldwin t+a�-k, CA 9Z7Q6
• Licen$e #: 767a4,'
I f�THE,4BC:VE PARTIES A��,.�EST�N THE MA.T1�R Of=CSLB CASE N��,b45.AS20��44
T�e Under�igned �rbitr�tor, in �ccardance w�th Caiifomia Business and Pra�`essians Co�S��
§it7�S, has €nve�t�gated and c.os�sidered at1 Cltie materi�I facts and evail�ble;nformat�on
- N�rain�ng to,tnis ca�F,"�i�c�i�as oeci�ed upon a �nai dnd tiinding Arbicr�ti�n A}"vard as -
des�ribed �v�low.
��__�_�____� t���IS�IOtal � -------� �2�l��� �i
A�jl usted second eontract balanc� �ue to Respanden��or sewe:� ���'
laterai finin�.� _ ----- I � �,o�7�.Q0 i
�ess payment rnade by f:ampQaina��t or� first contract for � �
�xpior�tory excavation at cleanout. _______,_�� (_ �,���.�o) .___f
` Less c.ast to comRle.te �ancret��vork �ursuant to fir�'t;�Qntract, t 2��.;�C;�!,
[---- --- J . Tf3TA,E.: $ 3,�7�e€�0 ;
� :ornpl�inat�t sh�I! p�y fhe Respondent Malcol►»'s �lumbirt�c°�Roa}�r
Service, 1nG. �he���m of$3,�a7,fE0.
� 4tl�+�r: U�an r���9�a#af the �r+aney d�� fra�n Cmra�plai�aa�t#c�
Respondent, F�e�pcars�i��t is ardered ta r�rr����z�h9ec#�2�n9�`�
, i..i�n �el�€1 ��a�R�st the subjec#pr�p�rey, wFt�Q�e fa�art�en
cale�c�a� �ays.
•� O���r: �or�ptaar�a�� as���red tv f�r�aGze +�i#.y tsuQ9d€ng ���r�a'e�
fo�'Sul�ject a�a�rk v,►�thin �ou�e�n G;�ie�e�as�aoys.
7'.-f�S.��BiTR?.T*�Y3 AifGfi�'D St6AI:��E 4Ai.ID,4t�i: 6INbIidG UFJI�!ALL Pl;�TiES COIOCEkFi:f?.
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Z �HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF-INSURE FOR WORKERS' ¢
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Q COMPENSATION,AS PROVIDED BY SECTION 3700 OF THE LABOR CODE,FOR THE PERFORMANCE U
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Uj WORKERS'COAIPENSATION LAWS OF CALIFORN10.AND AGREE THAT IF I SHOULD BECAME INSPECTION FEE
SU9JECT TO THE WORKERS'CAMPENSATION PROVISIONS OF SECTION 370o OF THE LABOR �7 �/ �
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DOLLARS(L10o.o00),IN AODITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR iN
� SECTION 0708 OF THE�ABOR CODE.INTERES7,AND A770RNEP5 FEES. EN ON F . ���}�
OCONSTRUCTION LENDING AGENCY PRE-ALT FEE:
� I HEREBY AFFIRM UNDER PENALTY OF PERIURY THAT TH`cRE IS A CONSTRUCTION LENDING AGENCY
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� I AGREE TO COMPLY W1TH AlL CfTY AND COUNTY ORDINANCES AND S7ATE Uw5 REU7ING 70 BUILDING .
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~ WHITE—Department CoDY,YELLOW--Finance Copy,PINK—Assessor Copy,GOLDEN OD—File Copy,GREEN—ApplicanYs Copy