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HomeMy WebLinkAbout11293 � CTfY OF DIAMOND BAR • : , COMMUNITY DEVELOPMENT DEPARTMENT � • \ ;,•C 21660 E.Copley Drive Suite 190 (909)860-3195 Fax(909)861-3117 PRE.SS ~''"'� BUILD[NG PERMITAPPLICATION FIRMLY < D RI SS 2v22 OA� K«t/LL ��V� APPLICATION � �� � PERMIT `/'� � � p DATE � NUMBEH� ISSUE � APN LOT T ACT DATE � CONST. GROUP p OWNER � ADDflESS ZONING SETBACKS CITY ZIP TEL • O• D FRONT RW ❑ � APPLIC NT TEL. REAR p SIDE/SIDESTREET RW O � CONTRACTOR SIDE ❑ o ADDRESS CITY ZIP TEL PFOPOSED USE — W ARCH/ENG/ l t� ' a � DESIGNER M � ��`� u'A'' L � ADDRESS NO.OWEL N0. NO. � CITY ZIP TEL UNITS STORIES BEDROOMS c� cn DESCRIPTION S�.FT. FACTOR PSF ADJ.AqEANALUATION p� OWNER-BI:ILDER DECLARATION 0 SF EM 1 NENEBY AFFlRM UNOER VENALTY OF PEfWRY TMAT I MA E%EMPT FHOM TNE CONiMCTORS U• GefBflBJCeIpOR W CENSEUWFORTHEiq10WINORE/150N�5EG70.71.68U5NESSAt�DVROFESS10NSC00E:ANYpTYOR (n C-) COIRITYWFYGIREOURESAVER417TOCONSiRUCT.AITER.MPROVEOEMOLISH,ORHEPNIRANYSTRUC• W P81i0/DBCk � Tl1RE,ORION TO Ii4 lSSUANCE,ALSO REWIRES TME EVDIN'.ANT iOq SUd/VERAIR TO F0.E�SICNED W � STA7EMEN7 THA7 HE OR SNE IS UCENSED PURSUMR TO THE iROV15iON5 OF THE CONTMttORS LI- CFN6EUW(qUVTER�(COMMENCINaWRF15ECTqN7000)OFDMS�WI]OFTHEBU5IHESSANDiR0. u' POOYSpB FESSqNS CODE)OH i/uT HE OR SNE IS E%EMPT THEREFROM AHD THE BASIS FOR THE KLEOED E%EMV• TqH.AN1'VIOU1TqNOfSECTI0N7o71.6BYANYAGPLICANTFOAAiEfWITSUBJECTSTMEl1PVlICMlTTO Z Re-Rool F, ACMLiENALTYOFNOTMORETHANiIVEiM11NDREDDOIURS�i500�.�: O 04�SOM'NEROFTHEPROVERTY,ORMVEYVIOVEESYv�THWAGE5A5TNE�R50LEC04VENSATnN. C,q�merclsl . Z WILL DO iHE MIORK,AND T11E BTRUCTl1RE IS NOT WTENDED OR OFFERED fOR SALE(SEG 7oa1,BUSI- J� � NE54ANOVROFESSIONSCOOE:IHECONTMttORSL10EN5EUW00E5NOTAPPLVMANOYMEROF j PiqPER7YYAqBUlD50RWPROVE4TNEREON,MlOVAi000ESSUpIwORKH�MSELFORNERSELFOf1 � � � TtqOUGHHISORHEROWNEMOLOYEES.VROVIDEDTNAT3UG/WPPOVEMENTSMENOiH7ENDEDOH m 0 OfFEREOFORSALEIF,NOWEYEFLTNEBUILDHGORIMCROVEMENTISSOIDWITHRlONEYFANOFCOMRF- . Z TION.TME 01M�EH�UILDER YVILL HAVE THE BURDEN OF PROVINO THAT NE Ofl SHE OiD NOT BUIID OR = MPROVE fOR THE VURPQSE OF 9ALE1 i .. W OLIISONMEROFTHEVROPEHiY.AMEXCLUSNELVCONTRACTIN�YViiHLICENSEDCONTMCTORS Q TO CONSTRUCT THE iROJECT(SEC.7d41.BUSINESS MID VROFESSIONS CODE:iME tONiMCTOqS LI- VeIU!(i011 ADJ.AREA W CENSEUWDOESNOTMP�YTOAN0IM�EROFAPROPEflTYN?10BURDSORMPHOVElT11EREd{/HO � MAIOCOMMCiSFOp3UCHPRWEGiSYY1THACONiMCTOii(S�IICEN9EDPURSUAYTTOTMECOHTMp OUMITITY DESCRIPTION � toas uceHse uw.�. FEE � O I AA1 E%EA1PT UNDER SEC. &t V.G FOR THIS REASON • � . . 3 � � , ZDATE OWNER � � � LICENSED CONTRACTOFS DECLARATION W � INEREBYAFFIR�IUJDERiENALTYOfVEfWRVTHATIAMLILEH5EDIIHDENVROVIS10N40FC1/APTER � , p„ a(Cd1AENCWON77N5ECT10N7aao)OiDMS10N]OFTMEBUSINESSANDVi10FES51ON5CODE,ANO Z �X NY LICENSE S IN FULL FORCEAHD EFFECT. m � UCENSE CLASS rJ LIC.NO. !+ � . V WTE CONTRA d �W 1�C WORKERS'COMPENSATION DECLARATION �?� � y IHEREBYAFFIRMUNDERPENAITYOFPE0.JUfiYONEOFTNEfOL10WHODECUMT10N5�• Z � _�M�YEANDWiLL�uN7TNNACERTIFlCATEOFCON5EMT050.F-IhSUREFORNORKEi35' � CGMPENSATION,ARpROVIDEDBV5EGT10N770oOFT11ElABOfiCOOE,FOqMEiERFORMNICE W Q OFTNEWOqKiORWHIp1TW5VERMITISI55UED. � � _I HAVE AND WILLIMMAIN WORKERS'COMPFNSA7qN INSURANCE,AS REOUIRED BV SECTIDN 770oOFTNELABOHCOOE,FORTMEGEHfOHMANCEOFTMEWOfiKiORN'MICNi/119iERMRIS = ISSUED.YY WOfV(ERS'COMPENSAT INSUIWdCE GRRIEH MA YOLICY MIMBER ARE CONSTRUCTION j c.��wiEa PL/W REVIEW �, ` � � POLICYNUMBER ELECTRIC � � (na55ecnor+r�r+arBemr.pttrmovncvw.�rswnar+EHuo�oOatuts{tim�oqtFss} PLUMBING Z ICERTIFYTHATRJTHE7Ei1FORYANCEOFTHEWORKFOqWH�tlITMISGEtWi761SSUED,1 MECHANICAL ' C7 SMALLNOTEM7LOYIWVVERSOHNANYMANNCRSOIISTOBECOMESUBJECTTOTME y VIORKER5COAIPENSATiONUW50FGLtFOM1lA,ANDAGREETHAiIFIS�qIADBECOYE INSPECTIONFEE S SUBJECTTOTMEWORKERSCOGVENSATqN7ROVI5qNSOFSEG710N77000FTMElABOR — 000e,i swui sor+n�wm�ca�v�r win�nqse vao�s�s. ISSUANCE O p p�iE: �pp�ICAH7: SMIP � � ENERGY P!C WARNU10:FALURE TO SECURE WOPo(ERS'COMPENSATqN COVERAGE IS UNUYIFLL,A1U SMILLL 9E ^ �y, SUBJECTANEMPLOVEHTOCPo4NAL/ENALTIES/NDLMLFWESUPTOONEFRIWREOT110USAND ENERGYPERMIT �' '�' / .r. DOLLMSI=100.00OI.NADORIONTOTNECOSTOFCOAIPENSATION.DALIAGESASPROVDEDiOqM1 _.� J� SECTIOH]7aOFTNEUBORCODE,NTEREST,INDATTOPNEY'SiEE9. RETENTIONFEE: " OW.. CONSTRUCTION LENDING AGENCY • � 0 PRE•AlT FEE: � IMERE9VAFFiRMUNOERVEN/LiYOFVEiWRYiIUTTHENEISACONS7RUCTIONLENDubAGENCY � � Z FOR THE VERFORMANCE OF TN[WORK fOR WMICM iH15 VERIAIT IS ISSUED(SEC faa7.pV.C,�. W � LE1mER'4 NAUE C IENDEfrS ADORE55 . � ICERTIFYTHA7IHFVEREADTIISAPPl1CATqNANDSTATETHATT/1EABOYEHFORMATqNISGOiiREGT. TOTAL FEES . d 1 AOHEE TO COYVLY Mn7N ALL CITY Mq COUNTY ORDINMICES AND STA7E UwS REUT WO TO BUILDINO � CONSTRUCTION,MtpMEREBVAUT/qW2EPEPRESENTATrvE5OFT115COUNTYTOENTFRUPONiME � � ABOVE�YEHTqNEO PROiERTY FOq PISPECTqN PURPOSEA a . 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