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HomeMy WebLinkAbout15431 (9) I _ I . _ .. Q- —1S __. 1� CITY OF DIAMOND BAR � DEPARTMENT OF COMMUNITY&D�VELOPMENT SERVICES 21660 E.Copley Drive Suite 190 (909)8603195 Faz(909)861-3117 PRE$$ ����� BUII.DING PERMIT APPLICATION FIRMLY � JOBSITE APPLICATION I � PERMIT r5�3 P/C oO�� o ADDRESS LO 9�+S t�iCC1"f�4'� 11`n�LZ. '��_ DATE NUMBEF� x � ISSUE TYPE OCC APN LOT" TRACT DATE CONST. GROUP � OWNER T�c .�r-i� ��q L, �G�'i�E " A�DRESS 2323 W. '3K[�/4DW�`f QtE tao ZONING SEiBACKS Z CITY SI�NTR rWM ZIP qZ7r�L TEL.'�I4-S�{I��I REAR RW O g APPLICANT TEL SIDE/SIDE STAEET RW ❑ � CONTRACTORT• L S. i3Y �F t([aN SIDE � Q � ADDRESS3zo"� MAQbd/ Tit-YD• — CfTY a�'M� ML�Sq ZIP�fi TEL� PROPOSED USE � ARCH/ENG/ • ^ DESIGNER t+� T 1►u W j��S t!e ti! [ 2�c s P NO.DWEL. NO. NO. ADDRESS.��!v �-!r►re��t r'�niv r 7 i2.. UNRS STORIES BEDROOMS � CITY /k-vv�'�NG TQN ZIP�rT/u t TEL""►��3 �►G'��IL�I � DESCFiIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � OWNER-BUILDER DECLAFiATION SFFVADDhiEM • O p 1 HEREBY AfF1iW UNOER FENAC7Y OF PE0.AIRY iT1AT 1 MI EXEMPT FNOM 7HE CONTMCTORS U• GafBQa/C0�p01S W CENSEUWFOf1iHEiOLLOMANGFEA50N(SEC.7a7�.68U5iNE55INDPRJFF55lONSCODE:ANVCfiYOR (n (� COU!liYW}11UtRE0U1RESA7EHMRR7CON5TPULi.ALTERMPROVE.OEMOUSH,ORfiEPAIRMlYSTRUC• W P8t10/DOCk b 7URE,MiqR TO RS ISSUANCE,AL..O i1EGUWE3 TME MPLICANT FOR SUCH VEf7MIT TO FILE A SICNED W � ETATEMENT iH�T HE OR SME IS LICENSED fUR5UAN7 TO iHE VRO�'�SIONS OF TME CONTMCfORS U• CENSE Uw(QUPTER 0�COMMENpN�WITf1 SECTiIXJ 7000)OFOIVISION]OF 7HE BUS�NESSANO PRO• � PooVSpa � fESSIONS WDE)ORTFIA7 ME OR SnE IS EXEMPT TMEREFROAt AND 7ME BA515 FOH TME/�LIECE�E%EMP• TIDN.M/YVIOL�T�ONOFSECTION70]I.SBYANYIYDLK'•11NTFORADENYITSU9IECTSTHEAFVLIGNTTO Z Re-Roof F ACMI VENAL?Y OF N07\10fiE TIAN FNE MUNDRED D011ARS(f 500�Y ' ^ p1,ASOWNEROFiHEPROPERTY,ORYYEYCLOYFESWITHWAOES/STHEIHSOLECOMPENSATION, � (�`pTTOf�IgI � � MKLDO iNE WORK.AND TNE 51PUCTlINE IS NOT IHTENDEO OR OFiERCO FOR SALE ISEG 70µBU51• J NESS AMD OROFE5510113 COOE:T1�E CONTiUCTOfLS LICENSE UW DDES NOT AVPLY TO AN OYlNEH OF • � N PROPERTYMM1IOBUqD50RMv{10VESiHEREON,ANDNM1fODOESSIKM�NORNMIMSELFOHMERSELFOR = Q Titll[%1f3HH50RHEROMNEM�LOYEE5.VR0VIDEOTHATSUG71WFflOYEYCMSAALNOiNTENOEDOR m � ,OFTEREDFORSALEIF.NOWEVE0.111E9ULDINOOiIMPpOVEMEMISSCYDYATMMOHEYEMOFCOIIP�E� � TION.iHE OWNER$UILOER WIU NAVE TME BUROEN OF YROV7q TMAT ME OR SME D�D N�T BUiID OR W PfqVE FOR T7E PURPOSE OF S+LLE4 W �t1lSOWNEROFTNEVROPEHfY,AMEXCLUSNELYCOMTHALTNOYrtTT1LICENSEDQOfliMCTOR3 � TO CONSTAUCf TNE PRO,IECT(SEC 7oa1.BUSINE55 AND VnOFES5�ON5 COOE:THE WMiUC70R5 lb V01U2tb11 ADJ.AREA iil CENSEMWDOESNOTAPPLYTOM70`MdEROFAVflOPEflTYYnqBU6D^uDRIMPFlOVEgn1EREON.FND � WNOCDNTMCTSiONSUGI7ROJECTSVnTHACONfMCTON�4�LICQ15EDiURSUANTTOiHECONiMP OUANTITY DESCRIPTION FEE TORS 11GENSE Uw} J OIAMEXEMPTUNDERSEC. B.iP.GiORTHISREASON Q � l � 3 � /, � DATE OVMER U F�J `/ O UCENSEO CONTRACTORS DECIARATION W w Oc/Td / L � U-O � IHEREBYIIFFIRYINDERGENILLTVOFGERJURYTNA7IAYLICENSEDUN�ERPROYI510N50�CHA7TER Vr _ � � �(COAAMENCw01MTM5EGT10NT0001�DMS10N]OFTHEBUSIHESSANDPHOFESSiON5CO0E.AND Z ?C W UCENSE IS N ML FORCE AND EFFECL . m S L � � LL �{ ��[''' � UCENSE CLA55 �/ L1C.NO.�'�^� � . ' � ��r�'.r� --�o0o eorrtAacroa� F -i'1 � WORKERS'COMPE�SATION DECLARATION �-�bf a �.� 5 � G Li N IXEREBYAFiVWUNDERPEN�ITYOFOEMlMCNEOFiHEiOLLOWINODECUMTIONS U - v, 4 '�r= S�i L G _IMAVEANDWILLMAPITNNAGEiRIFICATEOFO0N5EMTOSELFaNSUREFONWORI(ERS' 2 � COUPEN5AT10N.0.S PRO�DED BV 6EC710N 7�o00FTME U�BOR CDOE.FOR THE VERFORYu10E W OFT11E WORK fOR VrtiICH iMIS PERMITIS ISSVED. � � �IHAYEAHDMALLYAINT/LNNKINI(ERSCOMPENS�TIONWSUfLwCE.115RE0UIREDBY5CCT10N Q Y/pppF717Et/1BORCODE,FORTHEVERiOiL.W�CEOFTMEWOPKFORNm1CHTM5PERMRIS ISSUED.YVM9RKER5'COYDENSATqNINSURANCEGIRRIERANDFOLICYNUMOENARC: CONSTRUCTION � � CARtUER CO U •C.`—v � PLANREVIEW �I �_ � Pa.icrruueEA �- �' ' ELECTRIC � � (R�65EC110NIE�NDTBEOOA4tEfmCFi1EPEN.�T6fORONEHl�[XiCD ;S�O�ORL65) PLUM8ING � Z 1[£HTIFV TMAT R1 TNE FERFORMANCE OF THE YKNiK FOR WMIq1 THIS iEpM1T IS ISSUED.I MECHANICAL (} SMMLNOTEMP�OYANYVERSONMIwvMANNERSOASTOBECOUE6UBJEGTiOTNE � YVOPoCEHS'CdA7EN5ATqNU'NSOFCALIFORNiAAND�GREETM�TIF1511WLOBECAME INSPECTIONFEE SUBJECTfO7HEWON(ERS'COMPENSA710NiROVIS OFSECTiIXJ�7ooOF EUBOR ocooE.is�coaniwin+couvirvnni s¢r �a+s. • ISSUANCE p DATE: ^� APPLIGM: � /,��'� SMIP ►+� ENERGY P!C �� WARNiNa:FULURETOSECUREK'Oi1KERS'COUPENSATiONCDVE EISUPlAwFUL,ANDSHALLBE � SUBJECTIWEMPLOYERTOCRiMINILLPENALTIESANOCIVILFWESUP700N[HUNDR[OT/qUSAND ENERGYPERMIT DOLL�RS(t100.000�.W ADDITqN TO TME COSTOF CdADEN5ATION,UANAGES AS PNOVIDED FOFi IN ¢ SEGTION77DeOPTf7EUBORO00E,INTERESi,AN0A7TORNEY5FEE5. qETENTIONFEE: pW_, CONSTRUCTION LENDING AGENCY PRE- L o J � INERE9YAFFIRMUNDERPENALTYOFPERNH7T1uiTHEREISACON57flUCTIONLENDWOAGENCY FOR TME PERFO WAANCE OF 1HE WORK FOR WHlp/TXIS FERUIT IS�uUED(SEC.70V7.CIV.G). � � LENDER'S NM�E � LENDER'S/iDORE55 . � ICERTIFYTMAi1MAVEREADTH�SAPPLICA7pNANDSTATETXATTF,EA80VENFORMATiONISCORRECL TOTALFEES ' �- - � ��% L_ W IAGREEiOCOMDLVMA7HALLCT'ANDCOUNTYORDINANCESANDSTATEUWSRELATINOTOBUILDING CONSiRUCT10N./W0 MEREOY A�MORIZE flEPqE5EMA71VE5 OF iHiS COIRlTY TO EMER Ui'ON THE C /'/+� {��+��� ZABOVE-YENTIONEDOROOERTYFORINSPEC710NYURPOSES. COMMENTS /��� � �^-+�` . � " , � •� � GI/I L L/ LL ''�.-��-'—��OZ7��� m FERM VA `_^/ ^ N / � 0�0�J �y.. � SC�T F iT1EE DATE � RECPL N0. PAID BY_ �VALIDATIO� VYHITE--Department Copy,YELLOW-Finance Copy,PINK-Assessa Copy.GOLDENROD-File Gopy.GREEN-ApplicanCs Copy . .I , .. . . .,,,.. .:....�.�,,......,�•�,.��Y S . ..� . �.��.��_- � . • . . " � ' .. •r�•., ,��r-, . •, .-_....... . .. _ r ..,. . , :� ' i. � , CIT� OF DIAMOND BAR , , , . , - ,1 IfJSPECTi iON RECC�RD � ' . , . _ � : � ,, ;- _t' - .�.�-�� �.:�..., � �c�; ����� � ' i s .1.�`.� .l@ ► M���!�.=�. � •�►.f-'���3�ryc)��� • � . . _ _. _.. .� .. .� :.�.�_.:,��...r..,,..a:.��..�;.:.. _. �SET BACK� : . . • � '� ' ', � . �;' '. �' FLOOR JOIST • 'FTGS/FORMSlSTEEL - FNA RE�]MTS. _.,: , _ '. _, . . . ^ . _ . �ELECTRIC GROUND � : .. ' -"' • UNQER FLOOR DUCT �• ' � • , � ;GRDUND PLUMBING I U�JDER��LOOR CO�ID111T,�`,-.., : � '- � ' �� '�' ' '� . 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