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HomeMy WebLinkAbout10532 (5) CITY OF DIAMOND BAR COMMUNITY DEVELOPMENT AEPARTMENT :.•C 21660 E.Copley Drive Suite l90 (909)8643195 Fax(909)861-3117 PRESS ^""', BUILDINGPERMITAPPLICATION FIRMLY � JOBSITE (� /�, I�, I APPLICATION PERMIT P/C Q ADDRESS �� ` (� �� (�� i�rlJS r 1 L lI DATE_ � l t�I Q�NUMBER 10, S�Z A � ISSUE �/ � ° TYPE OCC APN LOT TRACT DATE CONST. GHOUP � OWNER �' L f�— ADDFiESS �q� ZONING SEfBACKS � CITY I�M ZIP TEL. � D REAR . Rw p APPLICANT I��t- TEL B SIDE/SIDE STREET RW ❑ � CONTRACT OT C� ��iL SIDE ❑ � ADDRESS E E q pqOPOSED USE 6 W��I / �S � CITY �' ZIP Q� TEL` 3 / / G —L r o ARCWENG! V r. � . � DESIGNER NO.DWEL NO. • • N , , n. ADDRESS UNITS STORIES �� BEDROOMS � CITY ZIP TEL � u� DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � OWNER-B�ILDER DECLARATION . SFR/ADp1REM O � I HEPEBY AFFIRM LNDER PENALTY OF FERIURY iHAT I AM E%EMPT iROAA THE CONTMCTOi15 U• GBfBQB/CYfpOh W CENSELAWFOqTHEfOl10WNJGREASdJISEG70.71.68USINESSANDVROfE5510NSCODE:ANYdttOR (n � U COUNTyyMICHREpUIRESACEflM?TOCONSTiIUCT,JLLTEi�11IPAOVE.OEMOUSH.OflREPAIRANYSiAUC. �jJ P8110/�gCk ' � TURE.PRIOR TO RS 65UANCE.AL50 REOUiRES TME APVLICuli fOq SUp1 PEIWIT TO F0.E A SIGNED � � STAiE4EN7 TW�T HE OR SHE IS UCENSEO PURSUMff TO TME 7NOV610N5 OF iHE CON7MCTOi15lF � CENSE UW(CMMTER Y{COMNENp10 WRT1 SEGTION 7000�Of DMSqN]OF TME BUSINE55 AND PRP � P001/$p9 ' ' '- � � fESSIONS CODEJ OH TUi HE OR SHE I5 EKEUPT THENEFR041HD THE BA515 iON TME�LLEOED EXEUP. , � TON.AN'IV10LA710NOFSECTION70.t1.SBYAN'/APVLICAMiORAOERMITSUBJECTSiNEMVLICANiTO Z Re•Raaf � ' � �,,,, ACMLPENALiY OF NDi MORE iHAN FNE MJNDREO DOLLARS([SOU1.): . � 04ASOVMEROFTHEPROPFRTY,ORYVEMPLOYEESWITHWAGFSASTHEIRSOIECOMPENSAiION, O Cammerclat . . ' - . . WILL DO THE WORK AND THE STRUG7UqE IS NOT IMEHDED OR OFFERED FOR SALE(SEC.70N.BUSI- J � NE55 AND VROFESSIdJS OOOE:TNE CONTRACTORS LICENSE UN�DOES NOTAPPIY TO AH OWNER OF ? , . . . iROPERTY WFfO BUILDS OH u1ViqV'S TNEAEON,/NDYNIO DOES SUCII WOPX HIMSELF OR HERSELF OR Q 7HROUGIIMISOqXERqVNEY7LOYEES.OHOVIOE�THA7511G11MPpOYCYEMSMENO7MENDE00R m � OFFFREpFOq9ALE.IF.HOWEVERiMEBUID�NOORMPFlOVEMEMIS50lDNnTNWONEYEAROFCOMPLE. �• ' ' � Z TION,TME OWNER�BURDER YnLL IUVE TME BURDEN OF PROMNO T1NT ME Ofi 5ME OD NOT BVM Oi1 � W PROVE iOfi THE VURPOSE OF SALEL W OtA30wNEROFTHEFROPERTY,MAE%CLUSIVELYGOHfMCTWOVATHLICENSEDCONTMCTORS ¢ TO CONSTRUCT T11E PR6IECT(SE4 70u,BUSINESS M1D PROiESSIONS CODE:7NE CONTRACTORS ll• VlIt181i0f1 /10J.AREA L11 CENSEUWDOESNOTMPIYTOANOVVNEROFAPROPER7YVrt10BUILD30RMPRpVESiHEpEON.JWD � M�OGOHTMCiSFOR3UCHGROJECTSYrtTHAWMTMCTOR(5)LICENSEDPURSUIUR70TMECONTMG QUANTITY DESCRIPTION FEE � TORSUCENSEUw.�. p O 11W E%E4VT UNDER SEC. &1 V.G iOR THI9 REASON � Q 3 �{� � DATE OWNEfl r \ , Z w � 1= � �.\ . . . . � LICENSED COMRACTORS DECLARATION W • � IHEREBYAFFIRMUNOERPENKTYOFVEIWRVT/ATIMIIICENSEDUNDERPHON510NSOFCHAPTER U. p. �(WMYENGNO W1TN SECTiON 7000)OF OMSpN 70F TNE BUSINESSMJ'J VROFESSiONS O00E,AND � Z MY LICENSE R W Fl!LL iONCEMID EFFECL � � ���sE�u S G-3 ��.�o. 6 g3a-�'i� � � V DATE CONiMCTOR � W � WORKERS'COMPENSATION DECLARATION -� � IHERCBV/fFIRA.IUNDERPENALTVOFPEiWFYONEOFiHEWLLOWNGDECUMTpNS: Z . � �_IHAVEANOW0.IYANTAM�CERTIFlGTEOFCONSENfT06ELF�WSUREFOHWORNERS' _ CpMPENSATqN.11S PROViDED BY SECTION J1000F THE II�BO1iC00E.FORTME VEHiONAANCE W OF iHE WOPI(FOq VMICM TNIS PEpMIT IS ISSUED. � G �111AVENAYALLMARRAW WORKER50ddPEN5AT10NIN5URANCE,ASREWIREDBYSECT�G1 � ]7o00F7MEU�BORCWE,FORTNEOERFORAIANCEOFTHEWORKFORWMId1TH15VERMtT15 n,/ �c_ ISSUED.WMK)RKERS'Cd.�PENSAT10NW5UMNGECANRIERANOPOIICYHUMBERME: CONSTRUCTION d y � a srn-i-f�v,V I� � CMRIER �.�/`� PLAN REVIEW � POIICYNUINBER I r}' T�T{�V,� � � . . . . Z ELECTRIC d � .(M1aSSEci�ONrE�IaiBEOor.q.E7EDOFTEVEw�isPo{tONEHl�imDd.u0.SRiao)aalEss� PLUMBING Z 10EN71FYTWVWTNEOE�7FORtAANCEOFiHEW0�7KfOqw/Ud/TNISDER4RbISSVED,1 MECHANICAL C7 SwLLL NOT EMPLOYl1NY PERSON N I1M'AWINER SO AS TO BECAn1E SU&IELTTOTHE y M/ORKERSCOMPENSATpNLANr50FCALIFORNt�ANOAGREETNATIFISNOULDBECOUE INSPECTIONFEE � � S SUBJECiTOTHEWOPI(ER4COMPENSATqNPMVI5iON50FSECT 7ooOFiHEIABOP ` 000,i FOAn�win+caev�rNnmr Eraowsior+s. ISSUANCE / -�O� • p W7E:��AVPLICAnrt: � SMIP '�T+ yt �'�� ib 0 W �a � _�V•. � � WARHINaFAILURETOSECUREMONKERS'COIAVEN5A710N EISUNLAWFU�MIDSHALLBE ENERGYPIC � SUBJECT�fIEMPIOYENTOGINAMIALVENN,T1E311NOCMLFWE PTOONEMMDREOT1qUSANO ENERGYPERMIT Od1AA.(f 7a0.0ao1.N ADDITqN i0 THE COSi OF COMVENSATIOfI.DAWIGES AS PRO'NDED FOR IN � - ¢ 9ECTION770lOFTHELABOROOOE,WTEREST,ANDATTORNEY5fEE5. - RETENTIONFEE: � ' � W GONSTRUCTION LENDING AGENCY V � PRE-ALT FEE: � � IHEREBYAFFIHNUlAERVENALTYOFVERM1IRYTMATTMEREISACONSTRUCTONLENDWGAGENGY � FOR TME PERiORMANCE OF TNE WOli1C FOR MMICII 1N15 PERAIIT IS ISSUED�SEG 7oY7,qV.G�. . � . � LENOER'S NAME C LENDERSADORESS � ICERTIFYTUTINAVEREIDh114AV0UCAT10NANDS7�TETUTTNEABOYENFOH1AATqNISCORI1ECi. TOTAL FEES f(JQ , �S � I AOREE TO LOYFLY N77H ALL CRY ANO COIMTY OROINANCES ANO STA7E Uw5 REUTINO TO BUILDiNG � CONSTRUCTION.ANDMEREBYIWiHORIZENCPqESENTATNE50FTHI5COUNTY70ENTERUPONiHE ABOVE-MEHiqHED PnOPERTY FOR INSPECT�WI PUHPOSES. 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FINAL-ELECTRI,C-�--- -- �- - ------ _,_.. -- -_ ;_.. --... - .DEV. FEES PAID .; . .... . , ..,,. :,.• • ; ' FINAL PLUMBING----- - �- --- - - - __ � - - _J"ENERGY , � , � , , . : • � _ � -• � . _ _.... ; . . , , i � cl_,�� �~"=`��-., . � .., ._ , , ;_ �� . .. i �: �_�_ �.l — —__ . .--..-- — -- -�----. .. .__.....— --- — . ..... .......:_.__._.. ... ._ . .� . ..... � �. , I . � � � � COMMENTS _. ._..... _. _ �. _ ; I ,. .. ,: .�: � : , ; , . .. .. , ._.. -- --...------ : ... -- ------ -- ---- --=- �--- � � , . , .. i . I . -------- . . ----- ----. .. ..----.---- --- -- - --- --�--- . - �. _ _ ; � ,,: . „ ., _ ; . . _ - ---- . _ _ _ _._. __ _. . _ ,. ,� { i ,; •.� -; ;•I,,•;: . . _� ; , . � • - - . . . ._ , ___. — _ _ .. ..__. .._ _ .- - -- - - - - • : .. 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