The URL can be used to link to this page

Home My WebLink About15515 , C ��G�� CITY OF DIAMOND BAR GU��v/v� DEPARTMENT OF COMMUNTfY&DEVELOPMENT SERVICES 21660 E.Copley Drive Suitc 190 � " -'�" (909)860-3195 Fax(909)861-3117 ��`' PRESS " '` ��•""w -��-- "' � $iJII.D,ING l'ERIVIIT APPLICATION �_ FIRMLY . � � A _._ . o� JOBSITE ��/�� .�j.��,_�� ,,,: ATEICATION � NUMB R ��...� g/C ADDRESS l-�1�� '��&- � APN � ISSUE /� ��/ TYPE OCC T�T DATE � �r CONST. GROUP p OWNE '� " ADDR SS � �(, ZQNING SETBACKS �� '� CITY � h_� - L�ZIP�' ��+' EL. � REART RW Op APPL ANT TEL. E'` � SI�E/SICE STREET RW ❑ � CONTRACTOR '��-a�t: >��.-Lz.�- SIOE ❑ � CITY ES G�/ ` ZIP� EL. PROPOSED USE O o ARCH/ENG! � DESIGNER NO.DWEL. NO. NO. ADDRESS UNITS_ STORIES BEDROOMS � CITY ZIP TEL. � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREfWALUATiON p� OWNER-BUILDER DECLARATION SFR/ADDlREM O p 1 HEREBY AFflRM UNUER PENALTY OF PERJUFlY THAT�AM EXEMPT FFOM THE CONTRACTORS LI- � Garage/Carport W CENSELAWPoRTHEFOLLOWINOREAf,ON(SEC.7037.6BUSMESSMlOPROFESSIONSCODE:ANYCITYOR C.� COUMYNh11p1REQU1RE5APERMtTTOWN3TRUCT,AI,TER,�MPROVE,DEMOLI3H2ORREPAIRANV3TflUG W patio/Deck W TURE,PNIOR TO ITS ISSUANCE,ALSO PEQUIRES TNE APPLICANT FOR SUpi PERMIT TO FILE A SIGNED .` STATEMENT TFIAT HE OR SHE IS LICENSED PURSUANT TO tHE PROVISIONS OF THE CON7RACTORS LI- � CENSE UW(CHAVTER 9(COMMENCINO N%TH SECTION 7000)OF DIVISION 30F THE BUSINE55 AND PRO- � PoOUSpd FESSpNS CODE1 ORTHATHE ON SHE IS EXEMPTTHEREFROMANDTHE BASIS FOR THEALLEGED EXEMP- TIDN.ANYVIOLATIDNOFSEGTION7031.6BY�NYAPPLICANTFOHAPERMITSU&IECTSTHEAPPLICANTTO Z RB-R001 F A CML PENALTV OF NOT AAORE THAN FNE HUNOREO DOLURS(f500).): � ❑I,ASOWNEROFTHEPROPERTV,ORMYEMPLOYEESWITHWAGESAS7HEIRSOLECOM7ENSA710N, ComfflOfGlal -- Wlll DO7HE WOfi(,AND 7HE STRUCTURE IS NOT INTEND6D OR OFiEREO FOR SALE(SEC.7044,BU51- O � NESu AND PROFESSIONS COOE:THE CONfflACTOHS LICENSE LAW DOES NOT APPLV TO AN OWNER OF = VROPERTY WFIO BU�S OR IMPqOVES THEREON,AND WHO DOES 3UCH WORK HIMSELF ORHERSELFOR Q iHROUfiH Mt5 DR HERONM EMPLOYEES,PROVIDE�THAT SUCH IMPHOVEMENTSARE NOT INTENDW OR m QOFFERW WHSALEIF,HOWEVERTMEBUILOINGOflMPROVEMElYTiSSOLDWITMNONEYEAROFCOMPLE- � TKKJ,THE OWNEREUILDER WILL HAVE THE BURDBd OF PROVIN6 THAT HE Ofl SHE DID NOT BUILD OH = IMPROVEfORTHEPURPO5EOF5ALE1. W ❑I.ASOWNBiOFTHEPROPEHTV.AMEJ(CLUSIVELVCONTRACTINGWRHLICENSEDCONTRACTORS � TO CONSTRUCT 7HE PROJECT(SEC.7a4.B1151NES5 ANO PROFESSIONS CODE:THE CONTRACTORS LI- ValUatlOn ADJ.AREA� CENSE UW DOES NOTAPPLY TO AN ONMER OF A PROPERTY WHO 8U!LDS OR IIAPROVES THEREON,AND � WNOCONTMCTSFORSUCHPRQIECTSWITHACONTRACTOR�S�LICENSEDPIJRSUANTTOTHECONTRAG QUANTITY DESCRIPTION FEE � 70qS UCENSE LAW.J. O ❑IAMEXEMPTUNDERS�G. 8.8P.C.FOflTHI5REA50N U � � LL DATE OWNER � Z W ¢ UCENSED CONTRACTORS DECLARATION �j O[ I HEREBYAFFIRM UNOER PENALTV OF PERJURV TNAT I AM LICENSEO L'NDER�ROVISIONS OF CHAPTER � . � Y(COMMENdNO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CADE,AND Z LLI �UCENSE IS M FULL FORCE(MD EF�ECT. � �� LICENSE C � � �� L�C.NO. � �� .� J V DATE / . CONTRACTOR a w ( , f_.,, � WORKERS'COMPEHSATION DECLAfl ION Q � I HEHEBY AFFIRM UNOER PENAISY OF PERIURY ONE OFhIE FOLLOWING DECUflATIONS: U C� Q O _IHAVEANDWILLMMNTAINACERTiFlCATEOFCONSENTTOSELF-INSUREFORWORKERS' _ � CONPENSATION.AS PROVIOED BY SECTON 3700 OF THE LABOR CODF.FOR THE PERFORMANCE U �� OF THE WORK FOR WHICH TNIS PERMIT IS ISSUED. � O W _I NAVE ANO WILL MAINlAIN WORKERS'COMPENSATION INSURANCE,AS FE�UIRED BY SECTION Q 3700 0F THE UBOR COOE,FORTHE PERFOflMANCE OF THE WORK FOR WHICH THIS PERMfT IS ISSUED.MY WOFKEFigr'COMPENSATbN INSURANCE CARRIER AN�POLICY NUMBER ARE: CONSTRUCTION � CAFRIER t�°R-.�"`?�� PLAN REVIEW � POUCY NUMBER t p`�7 e� ELECTRIC � (n+tsSEc'naaN�r+oreemr.nereoaFrr�e�arosrqro�torietiwroaEooa�nns�sioo)oa�Ess). PLUMBING Z I CERTIFYTHAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PEFMIT IS ISSUEO,I MECHANICAI ('} SHALL NOT EMPLOVANV PERSON IN ANY MANNER SO AS TO BECAME SUBJECTTO THE � WORKERS'COMPENSA7pNLAW50FCALIFORNIA,ANDAOREE TIFISNOULDBECOME / INSPECTIONFEE � 5 THE WORNERS'COMPENSATION PROVISIIXJS OF TION 37000F THE LAB R� S �WITHCOMPLYWITHTHOS VISION ISSUANCE .� � SMIP p OATE: ' � - APPLICANT: ,:'�� , W ENERGY P/C -6 I l' � A�t WARNINO:FALURETOSECUREWORKERS'COMPENSA71Q�N� VEFAGEISUNLAWFUL,ANDSHALLBE 7 py LL SU&IECTANEMPLOVERTOCRIMINALPENALTIESANDCIVICFINF_SIIPTOONEHl1NDRE0THOUSANO ENERGYPERMIT �t�� F.T'��j�R � DOLURS(5700,000�IN ADDITION TOTHE COSTOF COMPENSATbN,OAMAGES AS PROVIDED FOR IN J'� �,�+ ,.�r�� SECTI4N 37oe OFTHE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. RETENTION FEE: �'��d./�{��" �e A S:Ci l T O CONSTRUCTION LENDING AGENCY pREALT FEE: 7 R��J� ts��z� �i,�� 1 HEREBV AFFlRM UNDER PENALTY OF PERJUFlV THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PE1iFORMANCE OF THE WOFK FOR WHICH THIS 7ERMIT IS ISSUEU(SEC.3097,CIV.CJ. Z W � LENOENS NAME F_ LENDER'9ADDRESS � ICERTIFYTHA7IHAVEREADTHISAPPLICATIONANDSTFTETHA77HEABOVEINFORMATIONISCARRECL TOTAL FEES '//�� W IAGREETOCAMPLYWITHAILCRYANOCOUNTVORDINANCESANDSTATELAWSRELATINGTOBUILDING '/�� ,' � CON TKKJ,AND HEREBV AUTHORIZE REP SENTATIVES OF THIS CAUNTY TO ENTER UPON THE �> � E-ME IONED PROPERTY fOR INSPECTIO ruaaosFs. COMMENTS � � }, � -�.--_- m P M E NNI (PRi, Q / N � SIONATUREOFPERMITT - „ , � RECPT.NO. : PAID BY �� VALIDATION WHITE-0epartment Copy,YELLOW—Finance Copy,PINK—Assessar Copy,GOLDENROo--Fle Copy,GREEN—Applica�Ys Copy , �T � � .. . ., ,.... .. , . �: _ ... . ;:;• �� `�� a '.� � . � .. :,._ .,; , ::a,, .��. :. ..�. ;; 3'S :„, . _: ...... .. .:�.. � � � � � 1 . :. � �:,.� �. �� _ � ��_ � :: �. �°' ..:�.,'� ,�>.,:.:..:.».�.. .... _ .�« . : .�.� ...._.. . .�.�.,.� ...,.... �. .m�.r,. � ... . r. �.._:. .. .., :' ,: ^ "' . -- .. .. _. _ R :a�"i �"5�';a� ! �LC�C�t`�e��'f`a�` a ,. 4 . >.�:. ..... �.„_„„„ _L_ _ ___ _ .__ a .__�._ _ . �. _--_-.__. _.__.� _ _-_ __ _____ �� ry { �1"�,+�..1� ��@SIl:`�:��`F�� ! Fi e�, r1�.�a��s { � .. � _____ _...__ __ . .. .__._ _---._.�._____ ___ ,._ ---.-_� � �[_E ��6�';�. ��i�'`�,''��` � i � L��t�� F�C)�F� C?gJ�°�" � _ _�� _ �. ._._____ _._ ��.__..�..�.__�..___. �. _ _...___ � ��xs��., 3�`°� � .��s��:; I � � IJAI�3EF's r�C)��,�€E�€��1T , � _ --- --._ �.�._ �__ ____.�_��_�._ _._ .�.----.-1_._. _.. _._____.____.�__.._ .._t _� i ,�°si�'�+-a�,�oU�'�= ' ____m_.� _,_.._ .�._._._ { �I��C��aU� �C� �§�I:;lc�"�+t'�. _ ._.��..�.. � :_____ __.�__`------3 i�"�?1+r�-'�}`a��.r_ 8 � �,T`�aCF�a�s`��G��C��t��??"�P�� _...m n_ _� _. ,_____��.__.___m___._._.�.�. ___ _____._� —_�_.�__.��.. � _ �.._m t�i;��"��-.Fr� �t= � �EG F-fi�t. �-'��i�E3 i��! —�--- � �_�__ ___ _� ..�..v________._ ---�,-�;� ._ _...�_ _._ _ � �C��}� s�-��`� t�a� j i F f �� t'�tf�";��AP+� ._. �_..�. _ _ .._ .,�_ ��. �~r � �._.__.____� ��___�� ° ��=,� ��,�- ��_ ��?.�� i ; r=��l�,L� 3�i`� ��¢�� -��,� � .__ ._.� .__._. __ ____ _�_ � . ---- ._._.�_______.�. .------- �;�} ��- �a�� ,�_�___C'uR��d�.C�i��; , �___ m_�. �i�C�r€ t�� I �� _ ..��_M�..P ` 1 ��i��'r-(E�� __w__-- i _ TM #'`�ry��t"`i-��`� �~(ro-�'�@¢r� ' ' -tl-�-t—g�=�'y--_J�.�� ..._�____.___.�..__.._!._�_,__.�__---_ __n,_ '�_��] (^p—� po SlL.1 X t i 6, '"18 � . m � p §""'V�1�2.3�6��`f'4l�JCf�'°..3 � � .••».••.• p—. ___.�.��_ T.._ ___ r— _ ___ � _ (1 _ _ _�.� ' �'�Ga'e� .� r� ��.��Sa�i�_ ` __.____ ,. ..�__.�, ��' �'i�',�"v,E{i�F��[�.!'a � '-- _� --- c'"�''"�t'��i�t�`�' t M;;�'�' i ��:'7�.V��L�`i';'�a�`, � _.. ..�_ _ .�..___..�. __...n.__ � .� � ��'-� d m�"�-,. ^-,� t� �� -'��_��`'��3C�`.� �"� � _ _._._._._Ir. � _� �_�� _ --_.__..___ ___.----_ ____ ._____ ..__,.s � �'£�C31.� F1��i°� ` i�;.�'3.�s"�� :i�".� . - $; _......_..._ �_____ „..� .„�,._ ._ „,y.o. _.w m... ___._w�__.j �. C:�:�L}s��' ��'� s� ��a��t l ! i C�F�"��I� l��'a. ,. �q �_.�_�__.._.. — @ _� � .__.__.. __�.�. �:____.. � � �i.xeac��;�- — - 7 �0 9�;�?"p:°��v.�� a �' � � �'` �__ __ __.__ 7 � 4 __ _..�_._ _—_.___ _ -I-- ._ ._------_ __,__. .�jYt �5,�� - �«'i?[ 1kv,,,} f ��t � .m.. ..w....._. _ .. . j � � L L��. ... ' { _...�... �__ _� _..._.__�.,,_ .._� m.. .�.._ -a�_,__ .. _.� _._e._. � ;_*��°i`i� t'�� i ' �'��f ,t1�,'i'�.��tr. 3 �.. p a_.�.....___,._ ...,-. ...�. __.__ _.�_�_....__ _�. .._ . .__. __......... ,�...� � . ._...e.@.m.._. � .._..w� ._..._Y_ W� _-- ' i i �x�-�-� ;�/�� ' , C�°� �"T� ��F's. � ;^_x..� _ g? ._�_�m___i_ �__,_ @^�� gy ,q _a._ __�. _ _� F &.��S�� :b..'E� j .�....�»......-�»�.«.�. @ €9 3ri� �..fl.Jk�.Bd�`i'::,n . . . .....� ._...v_ ..._..v.... �.�..._. .m.�..,.....u_ ,.__........__ �_�..�.,m .� �_,.e . . . .._.__.........�..�.___�.-,.. .. �.... � f w.___�___...,.... _...._._ ...a........_'__'.,.._._-......,.( I=�� '°��a'�,i.. q �e i��'�. �'� s�~€��6��. .......__ .�,.F.._.____.___.._.�.___.t_.........____�..___.r__...�__..._._.. .[. 3'�x�3� 3tn�i;�i .�: i. _..._..� __.m._..._.m..__ I }��r�( �z..: -�C� €. �'(s<;[�P_ . .I. ._.._ .._�.__. . . . .___._.......�� ......__.,..,,.,�,...... ............._ . �n ^q �__'" .____.._...'�..�'_ ..__...,,.... ........ .� ..-� p� . Y�._ _.. _. ��;d�l;Y s,.,L:«4»�I�it_' � f �P::i1. ��t�`�t�'$�i.A�"'_.,,�.......��.._.__ .�...... ' .e..�.�...a. W�...e..e.�.e.._.'�....._.. �. _�...��.... ......_..._. ... ......a.,,m..w_�.e._.e.......�. Q .e p � ' � �"��'�€��..�"'�._��r��`�s:»�' � 1 �i��.�+,�.�� ` i :.. .�..__..______ ..._.m.._ .�.._w _____.___.�..._..�..�.. _._._. ._.�........___ _.._..,._._ _....... � �.....!____.,....�.__� � ._..m..�....—__�__�..__....___.�____._.�—�._..,. _ : � ._.._..�.�--- .._M__._ ._...� `.�'_ ms � � . .: �". . - . ;::��.. �--:. ...,:,...,......��...._ >»...�.......................R.�:...__...... v.___._m........_: ..,..: .:.,:;: _.__---___._._.__.,_ _�_ __.....�.�... �( `s,�.,,§� �,�rg�..';�q..;'�, { �;i�:.+'9?Y�3,'�F B,:5.>.7,� �§' �::,d....«....�. ..,._.._..,.�,�.::_<:,..«.....................................F....a.�.»...:�_«.,.....,..__.. _��..._...........,.,.,..e.....e.-.---.._..........,..,....w.....,.._..�._�.,..m.e,,..,_�...-..._<.,.�..�..e..e��-..,....._..._._.,._....._... ,...._..____._....a...... :..««.�.....,�._.. ..�.�.a.m...,..._.�...-.,.«. ...�.��..v.._a_.m.e..e......_.�._..,..,_a.:�....�.....�.........___._. - �' . ... .e...._ , . . . . .... . . . . _......,. _ �.."_'_.�.-......--_...m_., ._..._......,_,...,,,._Y ______....__..._.__............._....__�_�__.._........_."___ _._ w.n..._____ __"_ ...._.__.... � — .,m..�.-._�......e. _..a.a..e. .........._..._...... _.�.......................�..».�....s..,...,,...,...._.... ., .___.._....._.. _........,........-�... .�.w.�_ � .F.�.......�.-.......�........N,. ......�� T.._...._._-- —_�_�..__.._.. . . . ... D' ' . . . .._.....e.......W_. ..e.._...... .._._.�...._.�... _.._.�.........._,.T. .............r... _._... �..,...... , . .. . . .. . , m��_�_ 1 _ j � .e.�.�.....��R._ ...:._._. .._.��.....� �_ � � __...�......«_....._�............�. ......_... " � .:. . .. . .: : . ... . .,. . .. ..... ..... � � n. _.,...>,........n— . . _ ' .T____ "..L.—_....._.....�e_.�.... .,. ."' ._. - _ 'i . .. _..' _�:e.._............ � .. '. . - . . ..... : .. . . � i.. ..-.-....... . .. � ... ... : : ,. .,-. , .,.: ,.. .� . . ..� � � ��'�,z"�I4�� f � a�L..4"'.. c�'§`i i 15...� �s,°��.� " . - _...,_.._.�.m . .. ._m.. ._.�....__.._ _�t � .�.�w.��.� . @ �� ,� - �� ` ' . . - '__�_. ,... . .._ .. ,� ,,�,fr. � ._.___�__e.�.,.....�__,.........�..__ . ._.�._� . . . .. ..._.{ � ...: . �� . • .. ��_ �� : ......._...._.:...._.........._............................7.._._».y_...,...-�...,,.:........�,..�.,...,..�...,._._..._._._.......�..._..__.._"". ........�.....�.�.._�.._..,,.,_.__...,,,..........._...�___._ � � � g`�:�� ' . . �� E , y ...,,� � �;� � �,.. ° � a'C�� . ....��,... ...._..,.._......_.._..�__.._..�.�....................... ___.. � _.-__.....,..___... �..,�.. _............_....._._..._...,....___.m.........._....._{ .3 '� W� � ��4'::. • • ... . . . . � ��..: , ' __......................«........«..,.-..._....�......._......�....___.............._._..._..__.._.._ ._.._..,._........_.__'_______._._____�_.....__�.._.............._._.�._ _..—_�____._...._.--`_' �� x f � "". i $ � � � � �i ....e.d.e....... .._m.,,......_..._.._d...�.�4.....__.__.._..�..�.._..._�...�.�.rv.............«....... .��:: �� y ,::.€%pp .: : »....._ ..............�......«-.-._..«...«.....««...__.�..«.,.._...,u....__...__"_"'a.,.....b......,...__... ._.._._., a ... P ..:: � � . . ,'::.: ...va:� B .::. � =L. . Im .., ......._.._...... . ..__._ ........ .........._.. �.. _.�....._....._.._ _� � ::.... . ...: ____ __ ,...._�.». ... �� ...m.