Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
11150
_ _ — _. __. .._.�,_�;,� ,..___„--_---�- ____ _ .,,.,..,�._��.,._,._.�...___ _ ._.. _.. , , , -`�...�.. ......,� ---�`----� CLTY OF DIAMOND BAR � � CDMMUNiTY DEVELOPMENT DEPARTMBNT .;,w . 21660 E.Copley Drive Suite 190 PRE$S (909)860-3195 Fax(909)861-3117 ` �'y"' BUILDING PERMIT APPLICATION FIRMLY - �. , ; ,z.�.«,r•: ,�`� � JOBSITE e " — APPLICATION , � NUMB R� #/C o ADDRESS�'-/�+�✓ �- � ,. .. . � - ���11�"3 DATE__— OCC W �" TYPE , APN LOT ISSUE � COMST._ GROUP O OWNER k,a TR�� DATE , p ADDRESS�LL( �e�7,y� y� - ZONING SETB,ACKS oC(TY�,� •/d'd� �^i 3 Tel es!� FRONT RW -]j --- o APPLICANT � .,� Z�P TE� REAR z "�-- rE�.d " " SIpEJ51DE STREET RW � ¢ �^ � m CONTRACTOF� �t,+ �' � � or� i,,,.w„ SIDE — � ADDRES �"C> * • > '�.` � r' Oa�- �, ,�, ��, �,.___..- � C��' � ZIP 6�C 7'�°L.��-e���� PROPOSED USE_ oARCH/ENG/ �z �ESIGNER NO.DWEL. NO. NO. a ADDRESS � UNITS STORIES BEDROOMS � CITY �� ZIP��� TEL�"`I, cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION � SFR/ADD/REM � p I HEflEBY AFFIRM UNDER PENALT'OF PEF.:URY THAT I AM E%EMPT FFOM THE CQNTRACTORS-U- G8/898/G2�OfI W CENSELAWFORTHEfOLLOWMGREA50N(SEC.7o31.5BU51NE55ANOPROFESSIONSCADE:AN`/CITVOR (n C.) GOUNTYWHiCNREQUTAESAPERMITTOCONSTRUCT,AI�"ER,IMPROVE,�EA�OLISH,ORREPAIRANYSTaUc W Pytio/DeCk W TURE,PRIOR TO I?S ISSUANCE,ALSO REOUfRES THE APPUCANT FOR Sl1CH PERMIT TO FILE A SIGNEO STATEMENT THAY HE OR SHE IS LICENSED PURSUANT TO THE Pf70VISIONS OF iHE CONTRACTORS LI� � CENSE LAW(CHAPTER o(COMMF_NCWG WITFI SECTION 7000)OF DIVISION 30FTHE BUSINESS AN�PA0- � POOUS�73 FESSIONS CODE)Oli THAT HE OR SHE IS EXEMPT�HEREFROM ANO TNE BASIS FOR'HE ALLEGE6�EXEMP� � TION.ANVVIOLATIONOFSECTION7o3I.58YANYAPPIiCANTFORAPERMITSUBJECTSTHEAPPLICANTTO � Re-ROOf � A CIVIL PENALTY OF NOT MORE THAN FIVE FiUNDRED DOLLARS($500)�): � � � ��"`- '����"�-� Q ❑I,ASOWNEROFTHEPROPERTY,ORMVEMPLOYEESWITHWAGESASTHEIfl50LECAMPENSATION, Q COflll'f10fC18I z WILL DO THE WORK,AND THE STRUCTURE IS�'OT IN7ENDE�OR OFFEflE�FOR SAlE(SEC.7044,BU51� J . NESS AND PROFESSICNS COCE:THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER CF � PROPERNVlHOBUIL�SORIMPROVESTHEflEON,ANOWHODOESSUCRWORKFIIAASELFORHEpSELfOR = C[ THFOUGHHISORHEROWNElAPLOVEES,PPOV'DE07HATSUCHIMPR'OVEIEENTSARFNOii1JTENDEDOR m QOFFERE�FORSALE.IF,HOWEVERTHEBUIL�INGORIMPROVEMENTISSOLOWITHINONEVEAROFCOMPLE� Z TION,THE OWNER-BUILDER WILL HAVE THE BVFDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR � iMPflOVEFORTHEPURPOSEOFSALE). � G I,AS OWNER OF THE PROPERTY,AM cX0.L1SIVELY GONTRACTMG W ITH LICENSE�CONTRACTORS � TO CONSTRUCT THE PROJECT(SEC.7049,BUSIN=SS AVD PFOFESSIONS COpE:THE CONTRACTORS ll� V81U8Y1Of1 ADJ.AREA W CENSELAWOOESNOTAPPLYTOANOWNEFIOPAPROPERTYWHOBUILDSORIMPFOVES7HEREON,ANO � WHOCON7PACTSFORSUCHPROJECTSWITHACONiRACTOR(S)LICENSED>URSUANTTOTHE'CON7RAP QUANTITY DESCRIPTION FEE � TORS UCENSE�AW.7- O ❑I AM EXEMPT UNDER 5[C. B.&P.C.FOR THIS REASON U � — � �'�' DA'E OWNER F"' Z W o UCENSED CONTRACTORS DECLARATION . . , i j -. ¢ - CC I HEREBY AFFI�M VN�ER PENALTV OF PERJURY 7HAT I AM IICENSED UNDER PPOVISIONS OF CHAPTER � '^'� � 9(COMMENqNG WITH SECTION 7000j OF DIViSION 3 0F THE BU5INESS ANp PROFESSiONS CODE,AND z � � � ry C X MY UCENSE IS M FULL FOFCE AND EFFECT. , � . �,�, 'r=p,�1�a, �'�., y,"'.� LtJ � j��,�'` • .. � � LICENSE GLASS �✓9�y' `�� LIC.ND.�� �/1 � � U DATE I—�-�°-7y°'C GONTRACTOR��.+�`'1�.:��_e.._Ir� n- W ..� . ..:. . _ �)Il� . � WOFKERS'COMPENSATION DECLARATION� ' �� { Q � V U � I HEREBYAFfIRM UNDER PENALTV OF PERIUPV ONE OFTHE FOLLOWING OECLARATIONS: � Z Q 0 I HAVE AND W ILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF-INSUP,E FOR WORKERS' _ COMPENSATION.ASPROVI�EDBYSEC?ION37a00FTHELABORCODE,FOR7HEPERFORMANCE C.) ¢ OF��F�R WHICH THIS PERMIT IS ISSUED. � 0 w _ AVEAND WILL MAIM"AIN WORKERS'GOMPENSATION INSURANCE,AS RE�UIqED BY SECTION Q 37o00FTHEL4BORCODE,FORTHEPEFFORMANCEOP7HE'NORKFORWNICMTHISPERMITIS � ISSUED.MV WORKERS'COMPENSAT�ON INSURANCE CAR,/R�IER AND POLICYNUMBERARE: CONSTRUCTION j cnaaiER_�,✓-`-,��y� �t� �I_.A 9 PLAN REVIEW Z PoucvuuMsta / °�f�3 �'/��7�� .-� ELECTRIC ¢ �"___.__,` ` 0 (1NISSECiIONNEEDHOTBEO�MPLEfEDOFTHEPERMf(LSFGRONEHUNDREDOOI.LARS(100)ORLESS). ,,,PLUMBIN } G/ Z I CERTIFYTHAT INTHE PERFORMA�CE OFTHE WORK FOR WHICH THiS PERMIT IS�SSUE�,I MECHANICAL (.:} SHAIL NOT EMPLOY ANV PERSON IN ANV MANNEfl SO AS TO BECOME SU6JECT TO TI IE � WORNERS'COMPENSATIONLAWSOFCALIFORNIh,ANDAGREETryATIFISHOULDBECOME INSPECTIONFEE � SUBJECT TO THE WORKERS'COMPENSA710N PROVISIONS OF SECTION 3700 OF THE lABOR ''`q � "'"""'� � CO�E,I SHALL FORTHWITH COMPLY WITH'fH0 PROVISIONS. �SSUAN E � �` p DATE: �.^a- .•�. C APPLICANL -^"- '.SMIP JENEFGY P/C ^ � 1' WARNING:FAILURE 70 SECUFE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL,ANDSHALL BE � � SUBJECTANEMPIOYEPTOCRIMiNALPENALTIESAN�CIVILFINESUPTOONEHl1NDREDTHOUSAND ENERGYPEFMIT DOLlARS($too,o�).IN ADD'�TION 70 THE COSTO=COMPENSATION,DAMAGES AS PFOVIDE�FOR IN .r_I SECTION37oBOFTHEL460RCO�E,INTEREST,ANDATTOPNE`('SFEF.S. RETENTIONFEE: � � . CONSTRUCTION LENDING AGENCY PqE-AlT FEE� O � I HEREBYAFFIRM UNDER PENALTV OF PERJURV THAT THERE IS ACANST�UCTION LENDING AGENCV n- FORTHE P[RFORMANCE OFTHE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.309],CIV.C.�. , Z � W y S� LENDEF1'S NAME # . F= LENDER'SADDRESS _ /ry �,✓- . � ICERTIFYTHATIHAVEREADTHISAPPLICATIONANDSTATETHATTHEA60VEINFORMATIONI$COFlR[CT. TOTAL FEGS ��'��/' �. � (.,�.1 � IAGFEETOCOMPLYWITi1AlLCl11'ANDCOUNTYORDINANGESANDSTATEL4WSFiELATWGTOBUILDIIJG �'� � + -' � CONSTRUC�ION,ANDHERE6VAUTHORIZEflEPRESENTATIVESOFTHISCOUNTYTOENTEftUPONT-1E - � Z ABOVE-MENTIONED PROPERTY FOR INSPECTIGN PURPOSES. COMMENTS � � - � �� � �,✓��A-/�d�[ "� ���2 — m PERMITTE�ME(PRINT� � ¢ "�,� q c�- , � � SIG ATU OF PERMI�EE �~ DATE Y �� � � y �� = f RECPL Np. - PAID 8Y - aV�LIDATI � ~ WHITE-Department Copy,YEILOW-Finance Copy,PINk:Assessor Copy,GOLDENROD-File Copy,GREEN-ApplicanPs Cop� '� � � "'��" �.i� �� . ., : . , , ,- , . : ... .. . . ,> , . , . <:. ��,�;,,. � � , , . ,. ,. . . . . .. _.._. . 4� .. M1, p�' ..�.a k��..,. ,"�tM1 �1��w.A'� �ir t -a.f'.:� ..j^' .. .. ��i P . � . . .... 9 R .... . . .. ... .. � o � ..._ . . ...'.....� .. ..r.._.._... . :I. '..r.:. �.,� �. � � 6 � . . .. . , � :4 u^ �.. � � � � � � ID �� :� � � � � � � � � � � i . ... . .v:�. .. .� . . ,. .;«a . :- .. .v�.:a�.w. .+C ..v .a . .. .„�,�3'� zr+�' . �. . : urozs . . � ..::. .:,,c w E l�i���',� . � __ :". FE..+��3.,;�;�T" -� . _____ �__ _._.__ _. �__ __.__ __. __. _._._ ____ �....--- € F.�"�`°"IE=�,��i�'�l�s"�"�°�. i !-A Fi��?�,1�"c �,.�"�,'"���d�����,__ _ -___-____-- __ :J�B���' ����:';=d C?�::,� � �~�i ..______ � _�� _..__. _._ �._.�� . . _ _ �. _ �...._.-Y-- . � +�."3�.�'.i_�?i � �.��41P'�i!���.."i , ., .___.�..,.�.... ,i.��'���g �';�}�..�.(�"✓�.l�\1L��`� I. _ . ..... . � — �...._...__.....,,�_. '_.._. . ._...__ �. _� .. _..�� g�a•.✓��Q����.+�-A:�� �"___..,_.r _ _ �__._._._._._� � , � � . 1 � -d d s.» � _ ...........�_...,.._._.__...._._. —_.._� ..�.._._......._........._ __ _.� � �,���"��f� f �' �' '�{�i_� _o'�����:>C�? _ � ����� �t'sx�}a�� J� ' � F'C`r���a_ � __,_____wM_ ��»� w.�.- 1 `'°` �!. 7 �-s a P ��--'"'_ (g �$$ .�$ �'.#d 1'" �__.�-.—...-a-- _W.. ._______�._._ ....�(q.� ��T� . �'`�'� at���l��'�s_ _�d. € Y 7��SS^'. .7 1�T?�[tI��� � i,. . . �{ :3�� d ��1'�i-8 G�`4.J^'� � ' 7 _.._i�.�. �„„-{' . ..,.__.�.� g �:9 a,,q'p3p __ � .:.?A F� d"S 3 '� I � e"E::`d�}.".�P.�m'3 i!J �l.�..1tl�k'i � � �€��� 3���� ��a��_����c��, � --__..___---- —�--------�--- - �_______Y_______.__ �_ �_�. sF?��3F�C3����d � �. a ;�-%r= �:=��E�����"' , . ��_.�_:,_._____�_. _.�.. j ;y;�°+ ¢_ ,__pS��q ____. _ .�_p �¢��{p,� ¢ A""i„,�ti.."R`�i #'�""�7XY�aP�9 �� . .. —":. ". ' �. �l 7�aJE 7lig:a�.`» .... . .. ,... . � ... �j p- j �-^� _ �. - „� �ro ._-p..�._F.�.g_ ^� ,�.,....e.. } E 'w. ��i..!" �£ [.�.':�J. �'ea:✓ ( . . ; , C1'y�.�F...?."'!6A6�."ALO��"=.a F§ p�� 7,_._».�-.}g .<._. t ...._,_._..,..... .�..ew... q� t��....�.... pk^�3}�qi^. ..�. _ ._._._. t 3"�"i�LX`.;�� 6 i V��i.]S�`f� 1 t � � ��!4Iw'I 3•��d"tr..SE1S14a � ...,."" _ y. .� . .y� . __m_._ # �g � � „r. . � ......_. . f . .. . . . 7 ' � .� . .. —._ ........_...�.....,...._,_. q ���..✓;sl�t,.��i�.,ICa 'v.,�_,, � . . I. F'�'�.`� ,�..�..�� �{e.� � . ____..�.�.,..__._. _....._.�.._.. ._.....� ._._...�_ . _--- __..__...._..._ �.�...... . . . . _. , . �-�, �;�-;f�'�'lt��� ! 1 ���}€.�"�ivt�l�lC�_._.___�___ � _w._ � �_ _._. ._._n,�� .�a._ _._. �.�¢d�E �..1"�a��.1?�,�i�i�i� I _.._ _.___ ___ I �iaC:'� �'9R!9�,L � � ______.._ � ,____� ��___ _s��� � � �? ��i E f�JPS. . ,__�_. ___�__ �^�'� �fia3 3�`.-�`L� t��;�� 3 � �° -r E i —_ __ �---� _._._ ._.�� .. -- _ _.�._..�__ _ _ �_. C3�"���� �.�c�is ��� _._.! _._ � ��"C �I�T��te,r; _.. �m__--____ _ ._..�_�.�._ _.�.e. _____._. _.�_.._ ��a�l�r� j ; ��;'�.�' ��� ; __ ��r.°-�'!+d������ i ._ _P-_ _.__.._. ���`�3`7�t����/ie�Fi[�. _._ _�___._ . � �_ _ _._._�__ � _.__ ___.�W_ _.___ 3 �",�r��a`f.r'L �. ' a ^S�a�iT� ��mc:� �__ � __:..��.... - ; � a �t��°��,I��'"�`�' � ; � ,. � _._,_..�..�.� ����d{�� �'C��4�Ca _.. .._.._ ___�_ _ .__ _--_ _ _ �-��,���.�"��auT` � � + ��-st=?�� -r�. �`��G� { -�-�—__ ��_.�� _..� ,�_..._...�_ ..____ _..�.n..._.m. ��RP::�1�. F��1-$l':�'S� �� i i R^l-`€�+;��.�i� �`,t�=`�"—�- �0�9,R6 � g _,.�____.�_��_____ __.—__. — ---__. ___.___. _ _�. � �a�'�,�.flv�Y.�i..:��d� I �_.._� �.._�__... : i 1 ��lf ��� �"%v�.i � .. . I _ �...,�..._ ._ �_; .�_........_ ...�...�.a-... —____ ._,_._d ���`-,`�$����.�§�+��t�� �µ ' �, N� � ����°:2r . . .. . I . - � � ,._„�.„w,._.__..;_ . _ _ __..._....:.._______ .,_.�.. . _.......�..�......_._... >._. ��.�. '. _°m...e.w_ '�'.--�"___.�,.w...._._. ...w._ , , .� .... „� � .. , y. € I:--'- ---�----'� �....».,.....__ . �-. . :� „ � . ; �_____ ._�_�_ ��_ � �,� =::w. ., „ -___—_ ______..__._ ___..w__M___._� - ,.. , , � ,: l ��,��1�������� _._� �....�. _. ....�� __. ��. ��.w�� __._.__.---------. � --� � ; _.____._� � _._� _ � � —___ . . , �_..._.� ___ _ , . ,.. �-: ` � __e--- .__.._..._..._..�..__.�______ . ; .. �� _ , , . . :..� . � ' � . .__. w..__ .__ .._____�:.�. � ��, ' ` __ _ ,.� ��,��_.�. .�� �_ �.��__m.�e ; , , _. _._.._ � � � 1;r����.��,�? m - . � 4�� �-. ._ . � , _. : _ .. . .. . � . � . ,. . . ,. g . .. � . . .. �„ . ...- . .. . .. �. , k ���'���������`s�� ._.....__�___._ __._d_. .�_. . _. � ���m=�I�C��'>��:� .__. ._—_____ _._. _______. ___ � .� � �„,; .�..._._,__.._.�k�_...______. . ____._� ; ,�u, � __. �.�_..____—,_.._ _....� � � � .�---_—»-_ --n ��_.__".�.£ � _ _____� __"""""_�."`""""" _� � a _ � _