Loading...
HomeMy WebLinkAbout10078 (5) CITY OF DIAMOND BAR � COMMUNITY DEVELOPMENT DEPARTMENT � _,,,,w . 21660 E.Copley Drive Suite 190 PRESS (909)86Q3195 Fax(909)8613117 �'„�'f BUILBING PERMTT APPLiCATION FIRMLY � JOBSITE �� f,, �� y APPLICATION PERMIT P/C ' o ADDRESS �r`� �' DATE NUMBER '�� # � ISSUE TYPE OCC APN—y�y LOT. TRACT DATE CONST._ GROUP p OWNER fi'1�� �'��' — o ADDR SS � j�' �`� ZONING SETBACKS ^ g CITY�` • ZIP • TEI�'�� �'�' ' �* FRONT RW " APPLICANT TEL. REAR _ ❑ SIDE/SIDE STREET RW C � CONTRACTOR �' °L /� �."+c � � F'� - t�"�• SIDE C � ADDR��SS " ` � PROPOSED USE � c�Tv�J�� • ;ZIP� TEL` C•, � ,.' i� w ARCH/ENG! ' z DESIGNER NO.DWEL. NO. NO. a ADDRESS — UNITS STOfiIES BEDROOMS = CITY ZIP TEL. __ � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � � OWNER•BI:ILDER DECLARATION SFRlADD/RERA O � 1 HEREBV AFFIRM UNDER PENNLTY OF PERJURV THAT 1 AM EXEMPT FROM THE CANTRACTORS LI� � Garaga/Carport W CENSEUWFORTHEFOLLOWINGREASON(SEC.7o31.59USINESSANDPROFE5510N5CODE:ANVCI7VOR U CWNTYWHIpiREOUiRESAPERMI7TOCONSTRUC7,ALTER,IMPROYE,DEMOLISH,IXiREMIRANYSTRUG w patio/Deck Z TURE.PRIOR TO ITS ISSUANCE.ALSO REOUIRES THE APPLILANT FOR SUCH PERMIT TO FILE�SIGNED W S7A7EMENT THA7 HE OR SHE IS UCENSED PUH5UAN7 70 7HE FRDVISIONS OF THE CONTRACTORS ll- � � CEhSE UW fCHAPTER B(CAMMENCING WI7H SECTION 7000)OF DIVISION 3 0f 7FiE 6U5INE5S AND PRo- U' �aoVSpd OFESSIONSCODE)ORTHATHEORSHEISIXEWPTTHEREFROMANDTHEBASISFORTHEALLEGEDEXEMP- U TION.ANY VIOLATION OF SECTION 7031.5 BVANY APPLICANT FOR A PERMIT SUBJECT5 THE APPLICANi TO Z Re-Roof � A CIVIL PENAlTV OF NOT MORE THAN FNE HUNDRED DOIU �S5W).): ' � ❑I,ASOWNEROFTHEPflOPERTY,OHMYEMPLOVE ITHWAGESASTHEIRSOLECOMPENSATION, � COmm8fC181 Z WILL DO THE WORK,AND THE STRUCTURE IS NOT I DED OR OFFERED FOR S0.LE(SEC�Oa1,BUSI- J NE55 ANO PROFESSIONS CODE:TME CONTRACT LICENSE LAW OOES NOT APPLY TO AN OWNER OF � 7ROPERTYWHOBUILOSORIMPROVEShIER ANDWHODOESSUCHWORKHIMSELFORIiERSELFOR � � THROUGH HISON HER OWN EMPIOYEES NDED THAT SUCH IIAPROVEMENTS ARE NOT INTENDEOOR m WQ oFFEREDFORSALE-IF,HOWEVERYM IL�INGOfiIMPROVEMENTISSOtDWITHINONEYEAROFCOMPLE- Z TION,7HE OWNER-BUIL�ER WIL E TNE 9UROEN OF PROVING THAT HE OR SXE DID NOT BUILD OR � IMPqOVE FORTHE PURPOSE &ALE). � :.'I,ASOWNEROFT ROPEHN,AME%CLUSiVEL�CONTRACTINGWITHLICENSEOCANTRACTORS Q TO CONSTRUCT THE 7 JECT(SEC.7ala,BUSINES3 PND PROFESSIONS CODE:THE CONTMCTORS LI� VelU81iIX1 ___ ADJ.AREA W CENSELAWDOES APPIVTOANONRJEROFA7ROPERTYWHCBUILD50RIMPHOVE5Tf1EHEON.AND F WNOCONTRACj ORSUCNFROJECTSWITHACANTRACTOR(5)iICENSEUPUPSUANTTOTHECONTRRG QUANTITY DESCRIPTION FEE TORS LICENSE LKW.). .�//�� � / ¢ ']I AM E%EMPT UNDER SEC.__ 2.8 P G FOR THIS REASON � L"3J�'L� ..rjc �� C-'' � _ — �e�.�'"L:. .: f , 1� - ► � DATE OWNER_ _____— ./''�4," .-- Z �. s � LICENSED CONTRACTORS DECLARATION � � ••�•� • • ¢ � 1 HEREBV AFFIRM UNDER PENALTY OF PERJURV THAT I AA1�ICENSm UNOER PROVISIONS OF CHAPTER d B(COMMENCING WITH SECTiON 7000)OF DIVISION 3 OF THE 9USINESS AND PROFESSIONS COOE,MID 'X MY LICENSE IS IN FULL FORCE AND EFFECT. � LICENSF,F S ��"* LIC.NO, �.�" ��� _ � /P "'''`� V DATE CONTRA�+�"- W � WORKERS'COMPENSATION DECLARATION �� a �� ,� �, n.����y�4�`� ��! :. �t- _ �•`� „� � � 1 HENEBY AFFIRM UNOEH PENAL7Y OF PERJURY ONE OF THE FOLIOWING DECLARA7ION , U � q � � y�� Z f+: � � �fHAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF�INSURE FOR WOqKERS I � ' � G ' � � COMPENSATION,AS PROVIDED BV SECTION 3'1000F THE UBOR CODE.FOR THE PERFORMANCE W " �, OF THE WORK FOR WHICH THIS PERAIIT IS ISSUED. � w 1 HAVE AND WILL MAINTAIN WORKERS CAMPENSATION INSURANC�AS RE�UIqED BV SECTION Q 3700 OF TME LABO E,FOR THE PERFORM E OF THE WORK F�R WHICH THIS PERNMT IS � ISSUED.MY WORKI�P NSA I�yN INSUH�E CARRIEP AND POLICY NUMBEfl APE: CONSTRUCTION � CARRIER_ Y PLAN REVIEW ZPOLICY NUMBEH� � � " ELECTRIC Q � �a Q (TT1155EG710NNEmNOTBECOAAPLEfEDOFTI-EPERMfi15FOF10NEFYRDfiED �ttaoOFiLE551 4 PLUMBING ��' W � Z I CERTIFV TMAT IN THE PERFORMANCE OF THE WOflK FOR WHICH 7HIS P[RMIT IS ISSUED,I MECHANICAL ` � � (�} SHALLNOTEMPLOYANVPERSONINANVMANNERSOASTOBECOMESUBJECTTOTHE � W00.NERS'COMPENSATIONLAWSOFCALIFORNIA,ANDAGREETHATIFISHOl1LDBECOME INSPECTIONFEE pg j SU&IECT TO THE WORKERS'CO +�OVISIONS OF ECTION 37 THE LABOR , �SSUANCE }y l�S C� 1�l.793� I� GO IS LLFORTMWITMCO PLYWiT D PROVI910N ��5�� w `� O �re . ���i� . . `p DATE:1��— APPLICANT: ' �'��. l.� ^" � •/ '— SMIP J � ENERGY P/C _y WARNING:FFILURE TO SECURE WORKEFiS'COMPENSATION COVERAGE IS UNUIWFUL,AND SHALL BE � SU&IECTANEMPLOVEPTOCRIMINALPENPLTIESANDCIVILFINESUPTOONENUNDRE�THOUSAN� { ENERGYPERMI7 DOLLARS�f�OD,000),IN AODITION i�THE COSTOF COMPENSATION,DAMAGES RS PROVIDED FOR IN J SECTION37080FTHELABORCADE,�NTEREST,ANOATTORNEYSFEES. RETENTIONFEE: Q a CONS7flUCTION LENDING AGENCY PRE-ALT FEE: O CC I HEREBV AFFIRM UNDER PENALTV OF PERIURY TFIAT THEftE IS A GONSTRUCTION LENDING AGENCY � FOR THE PERGORMANCE OF 7HE WORK FOR WHICH 7FN5 PERMIT IS ISSUED(SEC.3oe7,CIV.C.). � -- � Z W � IENDER'SNFME___ _ -- Z F— LENDER'SADDRESS — — , Q ICERTIFVTHA7IHAVEREADTHISAPPLICATIONANDSTATETHATTHEABOVEWFOFIAATIONISCORRECT. TOTAL FELS W IAGREE7000AAPLYWITHALLCITVAN�cOUNTVORDINANCESANDSTATELAWSREI.ATINGTOBUILp�NG � CONSTPUCTION,PND HEREBV AUTHORIZE REPRESENTATIVES OF THIS CDUNTYTO ENTER UPON THE ZABOVE-MENTIONEDPNOPERTV FOR INSPECTION PUR, SES. COMMENTS_ 0 _� tS�9Q�."�� �. �A.�r.'f-9... � � m PEH (P NTl � G� _ _ Q ' � -- - v> „ N SIGNA OF PERMITTEE" DATE _ + RECPT.NO. ��F<�PAID BY �-�_�1�_VALIDATION_ ~ WHI7E—DepaRment Copy,YELLOW—Finance Copy,PINK—AssessorCopy,GOLDENROD—File Copy,GREEf�—Appiican-�ts Copy ! _.. . .,. . ,.. . . ; :,. ,... .�„. , . , : .. ., . ... . ... , ..;. .. . ._. _. :. ... . „-;. .....-.....,..�.,.. . . ...............:.�. ... .ti.:. ... . , , , . 4� ., • ... ..,,,_.. -.. „ .,, ... ... .. .. . .. . .. . . . . *R�9� Y'� 9eF� iW��ifYtll�it62, VPm� . �.�F��' ` },� ; -:':L�': � . . . . .. . " .. . . ��:'::SR.'.1.::...i"Y.=`:...A " l�ai�'��"�'���� �;�'�<`��'�'� ' :... .. :��;:.: . , :� , . � �:� ° � s ' � '� ,� `� � , -� �' _ 'A, ..:• � . � ,. ,�r :��:� _.._... - :ET Fs;;CK . FI_��?F�._!.^...,-� . . .:.._. " - ... ...._ ; •::, , � � ._...--. .--__---- -- �--------- ----- ---+---_-....-- --- ''- - --.. --. {_i.--- _-- 1�c . - - - - -- ---_._ _L. . F 3 C:c�•I�.�RMSiSTEE� � . I F�I-Ei�,�F��",4T=; - - _ ._ .. _. _...... _...,_�.... -- —�- ____.. _.._.....:___.-------�..--- ,: ---------=� -:----------- ' --_-.-.---�=----= : �LE°.�"-i RiC i.�F?�.iUiSID ; � - : ;. .-- U"d�C�i ��i.(��1N L�UCT ._--- - - � ,. -_-__^_.._._� - ---------�-- ---- --�----- ---�— :- -� {-_.-.,-.-,_.-_: - ------__:.__.�._ -.t-...--------°-=----=---------= �-�-=---._�_.....__ ;�Otlt���LU�n[3l�:G � ' � ; � �i�t�E� F'!..!��i�C�'r.�[�oGiflT �------�--•�--------=-----,_.t__.---.._.._...--.�. � _. � ..._-�-----,.._....------�--- �---... . � �--.._._.._...._._... ..----------------�_ _...- ---- _--- --- -._...----------._,.__�._ �I._.,�E3 rFiAf_i.v....---------- � . I �I!7�.ni._�`yC'FF rQi�f��i?A"rlirJ : : ' - 4'_'__.._. ._i...'_"_"'__'_'"_"_,__..._'.___"' '�"'""''_"_..."''" "' '""'_"_'_"'_"' '"_�"""""'.:__�._..:' ' e T�P�� i�C)1��� - --� I i ; f"�E`i='i�rcC;�:�C�3�J[? �EA:?1A " ' r.._...__...... .._..._........:....._.�... _ . � r •--- ---�------ ---------------�-----------;------� - -------,-�---------------...-- ------------- -- -- - ��_...----�- ---__.._ �,�e't�TEtr S�FiV�C�. . . 1'_._. .. j . . • • , �,A�G N"�."Eif3�l,i?�3E,�.!� .. � . _ + • ' . _--------------------- --- • - a=S������e4�i 1�I�des � ' ��------._,._..----- - '._i�' `3(�n'� �f'":`•�'i .. _._.__j-__ . :---- -----._,-.__..... --- _ . . ,. � ------------�._ -- -._.—_._ _ - � ; ----..__...._,.... �=RA�llt+l�rv� I � - _... .__.......--- , ��f��l; - - --.. --:- --- - -.:.-:�._.. .... _-• . -- .,.. .. ._ L.� I�iTi_�A-1JN I � , �i.'�p,;'i; iac,�,.�1� . . ._ .. ...._.I .�,._ ..«, __----_._ .___- -----A--------._:..�y----=--- - - -- _.- :'..-_-__. _ __ --- ---------_.L.—___._-._ � . ._.. . �.______.___...----._..., _. I�C.)4�F CC7i/E� - - _ _ _ ...- , - I _..;,�P.r�ivc ! _.. . . _... ----__...';....._ .._ _....._ _ � F . � � - � `.�lJ:.P��-1 h'r'_'.,vTiil�e:� �f=/t''�' -��-- 4h'Cfil�;-_ - ,-.. - - _-�-------..._i...--- :---.--- --- .. . _ ,� P� ...... ............ . .._....M1_........._...� , • • - _ _...__._.. _.... .._......__.._......__. __. ;"s : �.�' � B: :. ` ......:- � t��....._�.. .. .. �_. _... _.. 1.;, -.. .... _.. . � y;� � ." '�- ,� ' " � Cst .� .....----_.. __..... _.. _ :��:;_�r' �.._� �' C : '� . J�::"ri F1.4�JI�Ca __ ....._.....__...--... ----.. ----------.. _ , _:..t_ . _..... ........... _.._... .. - - - - - - �--- -•. � r. � -- - --- - ---.....- -- - -- -. . ---.-- i t^�(�i:Gr; r';_UMB��"<G ' - � �';^i v�`.. . .. , , . .., . . . ----__._. .---------�-- ----�------- ---._ —--. ._......._._... . ,_:, .. ; ;5�-l:�R���It ':. -- -- ._ �.,.___—_-__-�---._ . '`�E-?C�+f��Ri�iJ�T[:ST yi - ! . ' �CC)i. �I_�rT -...._�_ ,_.:- _-�� F^�i�.... _�.,. _ --- --- ------------..._.. _. I � ...__ ���� ---------•------------....------- --...__.� .... _ .__.__�._:.,:___�_�._..-=- -- ----- - . .. .. -.. .. - - ----�---- - - ; q � __.....-----------._.._.... _._. � • s.:�- .. ._ :__'�--`=--_.•=-.'_.___-k �k`T. .��1;/,��:�1€�I�. � . OU>; r:_,J�;f�1C� . : , . . ,: , , -- r ..:., , . "'...___''__"'�-3-i r p_-___ ..""'_'_'__' .... f l [1.�I.__ , .i : " .i �•i�', : f __"__' .��_" _"___"'_ { � ____'_'.____`_"__'_-' __."_-"'"'""_'_"I�t_-__..._�"..._ "".�...'"_...�_� .....�__,..,�V ____'_"_' . _ 4°dAl.�ihiSl'�1?��i.�IY � I �4{{1i. i=:� � . ' ' � .�""_""""____'___"" __"" "__ . ...'._ ..t . , . � ... .:_._.__.. .. .. .-. ' ' ' ' " ' "_ "...""'"'"...._."""..._' ""_""'""" .._. �;r-�3..i�;G.'�?SI.iLF�i�:'Ji4' � �7- `;�-;=`j ry.-ac� _.. _._ .._..____._._...______._..._--....� i"F`a :. tv: , ' i _ �.-- --- -�---._--------...---`-.-.:-....:.....::.-- : .' -�--�. _._ . . . ... � - --. .....-'-..._..'-- ='-- - -._..'..:.----....� ��H1��'AL��Jki�_�N� n,. f�,�l��I(�!�S �� � � ;" � ° � � � __..._.__..._ _—�I—_---�--- -----.._.__.__.---�-------�---`` ----=-------------- --�------------------._...__.i_ '�.'-:_�_.� SEY�+�F� ; � � F!�l�L.�;�s�. ; I , . , ; ���..��____.__._._.__..__�_-J__�.._ ._____.._____.._.._.._"_'_._.__._'___:.._�..".._'__'.__'�.___...' '- ' _.__ �_"__'__L_.�_.__....�..�__.�___""_._. _.___.-_- ; S�i��lCiAI�K � ..- . � L�ND:�(„�,i�'�`!Rrlu. ; '. , ; ; ' 3 �- --------------�---------- -�---------- --- - --- --- - ---_ �_ - 3 .. , --._ � � _ _•,r.. .. . .. .... .. _ _. - _ --- -� --------r-�--��--------�--_.�._._....-------,'----- '_.,t-_""-I � a�.,������i��.�. i _ . . ; . --.._..._t___l�eV__S�T� i��i;i��C � � � . '— --------- � �iFt�l�f�i 7��: �------'-'---- ----'--.-'- ' - . __. -_--- _ `-- --------- �-'----�'-'----_...._..'----� ' , ; ; r' -1---------; `IP�F..:Z�:7�11?v v .___._._ . . , ,._.�___.._._..___..__.----..__ .�.-.----•--�-- ' __.._.._........ .._.. ._._•--•- - --- , ��hl�:�COI�ST. � . � ' j �=IRF C'Fo T.��;.i�.i�L ---_ -------:-----------.--- --...----.._..-- - ----•-- �; ----------------...--_. ._._� , . � _ _.. �`�;trl9,'�i'EHTlfvC� .• ����� - _ - ---- --�A- ------------- ------------:.,---= --------..--_.__._� / �' C. :�? '�. .:y.... Y !: �_...-------- ----.........----�� - • .._ =_- - -- ---- ----- - � �• hi�,Ai_7.' 1��f'�. ri l� �.�,'` • - -._.... ...._..---�----- - . , : ' � : � t r' i e...., , ±-''f��,�l s�3 z-�f�IL. I ' : � �9: - : . ���. ; s.,-�.:5�'�',IL) ; - -'- -�--------- ----•--....-- , : . .�_._� �1. : _... , .. .,.,.,. ._.. . i �__.......---�----...:........----.....---.. �---- --.. .._� _. . . ._:::: .,�: � .. ....__��.----:.:•--.. . ..___.....----�----- --.:.�_.._.__..�,,,;.".,_::,�._.__ ---...--- .,._ .... : � �lN:4L�'Ll��.��IPJ� � � �=Fvt 1?C�`1 � � . ::. "... . ---- i-- .: ----. _ �---- ----. _...- _ ------•-�--._.-:.,.---------...:._..; p'-_�._:___�-_—____ . I'____. ____________'__.__"___._"'_'._' _1'.': • ' _.j i ; R. � � �. .. . . : _ .. ... � . ... - . . { �'.��_..�._.____�.....��____�.�...�� _�"__"__-__'._._... ._.. .. _'"�_J__' . I �� _"___ _____'__"_'_' "_"_` I r ' a .. r .. �_�'�'�__. _ . � . ,p �p Vi � ..._. " '_"'�_____"_�_"_S � � � tl%��bAVI I ' . . .. _..��.��_�..`.__��.'-'_.. ___.__'.__.__.____ . y . .. ___ .._..___•-____ - ___ _ '_."..____.�_._.'..__ __ . .. .�. .. .. . .. . . , ..'__ 1, . '� . .. ` ... .�., . . � . .� I � . ' ' . . . i � ..J .. .. . v. .. :'r�:t �1a "�.. � ! .'. � , ' , .. . ' . . ' .. . ....... _.. ..• . � ��.� ._ � � � ��}�?������ ---......-----,: ---,-� . .---- --------,------ .--, .. . -------._..�. ____.- ----------�-----._._� ..-- - ---- .. :' ..._..-----.__ .,. . ' . � � . . . , _ . . .,. , . - .... , , d ,, - !_...__------ -..__._�..---. _____:_......_.. .., , .. . . _ .._..-----. _... ... - - - -- �_... _.... . . _.. . ----- �'---------...---------- ------- --_..._ , Y---•-- -----_ --- -- --- -- �._.__..- .....`._. -----, ----- --- - -- ------ ---- .. __. . : ---- - ---- --- - -- --= �'. ,. � ..._,.....__.....__._... . ----. ._ .,---..�__- --- -- -- --�-------------__. � ��_..'_"_'_-...'__..___._....__......_. �..T'_"_'_'_ "'__"'_'_'._..�._."_-'__.. _'".... ._.... � ` "" " . . . Y'y s: .... .._ i .- . � - • S � ... � : '�' Ti' " x+. xc.-+ N' _ . : . {. , � ��'_ _'�___'_ . . , .: : _.. . . . _. ...�.��__ ___'__�_-_.�.4�_"`_...__"_"""____'.� �... � .�. r.._.�� _. .:� ' .. Z ,'Y_�. '__'�'.__'.� . . . • . ,..i _.._..�. "__-_�'__ 6 � . . _ .. ...,. . ':i .. ' l`_ _ _ i � ------,- ---,- - -, ---------- -- -- ,----.----.-.---,-- ------;-------._.. ---------_____ .----------------...- - ---- .... , .. -' --- - . .. .... - ,..,. . .. •.. �-,. r .,. , .._ . . . . � �.__.__._._,_ .._..._.. - - -- � v'• . ' . . .. , . _ .. .. ... _..---'- '-- -- ---._ .. ...----�-�--�-------�------� ....-- '_.._...--'----........_..._._ . ..__�_. � i � - - - -- - ---- _ , .-, :�;e_. .. ' .. _ , . , . --------------------------------------------- ---- - ---- ' S�P i 3C T:��BK S1Z� --,----- . -.,__.,�.-------. -___.._ : _. .. .__..._ _ . . ., . } aF_�:� �'i�"lU S&�� _..._,.. ... . _. .. .. _ .,._,._ ., . _ : . ...-- - . �,. . = ...,.:....__,........_....__...__ _ � ----.__._.�__---- I � . : � ----- -- -------�---.._......_ ._._.._. ' .._.._...-- — -.._ _._._. ......_... ..- -- -....._... _ . ---._._ .._. - ....... . ...... ���. ;a � - ,. ,. . � -----------------------------..__.....-- - --.._.. --_.._ . . .....__....--�------_ -----= -_- :-----:----__:_-__... -- - _ ,..., ... .. , . ,. .. , ,. . ,.. .:... �.:.r.:,.: :,..,. .. . . . ,. .� ----------------- -- ---� --.._...--.--=------------_:�.--.::=� ...,:,..�,:�:,:, .,:.:,.,...,, � . . .. : --------=-=- �-.'_.::_:. ------_�:_,-_ -- -- �- — _:.. :.: -. ;�. , , ..:: .. ,. ,.,:..., :. . ... � ' _ ..� . , .:7 .._.__ __.._�.__'__`.__ _'__..___._�.,�___�.._,__�A � . . � . .., .... . .. . . .. ..... ... .,,.: .. , . . ..�. .,-�... � i i... : .. .. .. ... . ,. .... .. .... , ..........,..... . . , ...�-.. . �.. .. .,��.. .. � ,.r.:. . �._.�_ _`__w_'...�___.._.."'""'.�'_'_�.._.._:.__.__..�__�._...3.,L �.�.._�_.___-___—"_-__'___-._.___._.__,_._ � ...-J.s,.._-....._.��..._.......�_...._.�...-_-.._�........__........,..._...__.'_"_____^e._.._.r�__..._.......__._,._..____.. �___........._....a...,__.....�___�...___._._.__._._.._�... ,.,..�..,.. _.�........,.. .,. . ...�__...�. _.:i