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HomeMy WebLinkAbout14844 (20) , _�� CITY OF DIAMOND BAR � „ ,,.`* DEPART1:�fENT OF COMMUNITY&DEVELOPMENT SERVICES �3 �� 21660 fi.Copley Drive Suite 190 (909)860-3195 Fa�c(909)861-3117 PRESS ����A»°��' BUQ.DING PERMIT APPLICATION FIRMLY � JOBSITE ' �� W �� � APPLICA110N ' PERMIT ' P/C � ADDRESS DATE NUMBER # c� ISSUE TYPE OCC APN LOT TR DATE CONST. GROUP p. OWNER � " ADDRESS ZONING SETBACKS O Z GTY l �I� P !' T L • FRONT RW ❑ g APPLICANT TEp�. � '�+ ' REAR ❑ 'l SIDEISIQE STREET RW ❑ � CONTRACTO SIDE ❑ � ADDRESS - PROPOSED USE � CITY ZIP d� EL:� `� � ARCH/ENG! W DESIGNER NO.DWEL. NO. NO. a. ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEI. N DESCRIPTION SQ.Ff. PACTOR PSF ADJ.AREANALUATION c� p� OWNER-BUILDER DECLARATION SFR/A��/REM O Q. 1 HEREBY AFFlRM UNDEH GENPLTY OP PERNHY 7HAT I M1 EXEMPT FROM THE CONTflACTORS LI- _ � Gerage/Carport '�W- CENSEIAWFOR7HEPOLIOWINORE450N(SEC.7o31.68USINESSANOGROFE5SbN5CO0E:ANVCITYOR C.� CDUNTYMMICHREWIHE9APERMIT7000NSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREPAIflANYSTflUC- �, � paNO/DeCk :W--_ NRE,PHIOR TO RS ISSUANCE,A150 iiEWJIRES THE APPLICAN�FOft SUCH PERMiT TO FILE A SIQNED �. _�; STATEAIENT THAT HE OR SHE IS LICENSEO Pl1R5l1ANT TO THE PROYISIONS OF THE COMflACTOR5 L4 - CENSE UW(CHAPTERe.(COMMENCIN�WITH 6ECTIDN 70D0)OF DIVISION 30F THE BUSINESS AND PR4 -� PODUSPB �� �FESSIONS COD�ORTMAT HE OR SHE IS EXEMPT 7HEREFROAI AND TNE BA515 PoR THE ALLEGED EXEMP- _� TION.ANVVIOLATIONOFSEC710N7097.SBYANVAPPLICANTFORAPEfiMITSU&IECTSTHEAPPLICANTTO ��Z R8-ROOf .��: ACMLPENALTVOFNOTMORETHANFIVEHUNOREODOUApS�S600).): _�-, OI,ASOWNEHOFTHEPFlOPERTY.ORMYEMPLOYEESWITHWAGESASTHEIflSOLECOMPENSATION,: �0 CoRifllBtCidl WILL DO THE WORK,AND THE STRUC7URE IS NOT IMENDED OR OFFEFlED FOR SALE(SEC.7044.BUSI- .J :NESS/WO PpOFE5510NS CODE:THE CONTMCTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF ��' -.PROPERTYVhiOBUILDSORN.{PROVE57HEflEON,ANDNMO�OESSUCHWORKHIMSELfORHEfl3ELFOFi ,-m ��,' `THROUGHHISORHEROWNEMPLOYEES,PROYIDEDTHATSUCHIMPROYEMENTSPHENOTINTENUEDOR - �w- �OFF6iE0WH5pLEIF,HOWEVER,THEBUILDINGOflIMPROVEMENTISSOIDWITHMONEYEAHOFCOMPLE- -��- �`710N,TME OWNEH$l1iLDER 1MLL HAVE THE BURDEN OF PpOVINa THAT HE Op SHE DID NOT BUILD OR -Z�- -IMPROVEFORTHEPUHP0.SEOFSAL�. . ,'W', - ❑I,ASOVMEROFTHEPHOPEifTY.AMFXCIUSNELVCOMRACTINGWITHLICENSEDWNTRACTORS- - --�-:_ 'TO CONSTRUCi iNG PRQIECT(SEC.7044,BUSINESS AND PROFE6SIONS CODE:TN6 CONTHr�CTORS U--� V01U8�i0n ADJ.AREA .CENSELAWOOESNOTMPLYTOPNOWNEROFAPNOPERTYWHOBUIlD50R�MPflOYESTHEREON,AND. �-�;�. :_WHOCONTRACTSFORSUCHPROJECTSWITHACONTRACTOR�S�LICENSEDPURSUANfTOTHEWtiTFAG QUANTITY DESCRIPTION FEE �:TWiS UCENSE LAW.). j-o� ; ❑IAMEXEMPTUNDERSEC. 8.8P.QFOfiTHISREASON ���,, U - -�i.- .. ; � . u-' o�re owriEa ' U w �B LICENSED CONTRACTOHS DECLAiiATION W ,(L� IHEREBYAFFIRMUNOERPENALNOFPERJUflYTI'IATIAMLICENSEDUNDEftPROVI510NSOFCHAPTEA � � /yy)y . f ��.p_? 9(COMMEttCiNOW17HSECT101V7000)OFDIVISION30FTHEBUSINESSANDPROFES510NSCA�E,AND ,_ z ���+e' �� x' MY L.�ENSE IS IN FULL fORCEANO EfFECT. �. m :4LI't .., � . .,,0� LICENSE C LIC.NO. � � ,� � - �.,',W,` UATE� CONTRACTOR d ::r��= WORKERS'COMPENSATION DECLARATION � �i U ���-' IHER�YAFFIRMUNDEPPENALTYOFPE0.IURVONEOFTHEf-0LLOWINGDECLARATIONS: tn, Q -�' IHAVEANDWIILMAINTAINACER'fiFICATEOFCONSENT705ELF-MSUREFORWORKEFS' S ':�; SATION,ASPROVIOEDBYSEC710N37000FTHELAB�RCODE,FORTHEPEFFORMANCE U� - -. -HE WOHK FOR WHICH THIS PERMIT IS ISSUED. . � �i --W� IHAVEANDWILLMAINTAINWOPKERS'COMPENSA710NINSUPANCE.ASREQUIREDBYSECTION ��Q- e7000F7HEU+BORCODE,WRTHEPERFORMANCEOFTHEWONKFOHWHICHTHISPERMITIS `0-. 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