Loading...
HomeMy WebLinkAbout16492 _`� CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY&DE�ELOPMENT SERVICES ¢ • 21660 E.Copley Drive Suite 190 PRESS .,. (909)860-3195 Fax,(909)861-3117 ��%����_ �'. BUILDING PER1�fiT APPLdCATION � FIRMLY � JOBSITE ��/J RPPLICATION `� PERMIT C�` P/C o ADDRESS � ��S GC. �C� G DATE .�`� i� NUMBEFj ��� # �� ��� °� APN LOT O TRACT 2'7i(q ISSUE '' TYPE " ' OCC DATE CONST. GROUP p OWNER ADDRESS ��,'/ ZONING SETBACKS 6 CITY�,,[�t�_— ZI -�•TEL.�'�'°��1J " REART . RW ❑❑ c� APPLI ANT TEL. � � � CONTRACTOR SIDE SIQE STREET RW� ❑ � ADDRESS ' PROPOSED USE � CI7Y ZIP TEL. w AHCWENG/ � ADD ES R��� � ��� ��d� UNITS STORIES BEDRO IVO.DWEL. NO. NO. ' OMS � ;C9TY ZI TEL. � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUAT N � OWNEP,-BUILpER�ECLARATION SFR/ADD/REM ° a � ,� ' � 1 HEREBY AfFIFIM UNDER PENALTI OF PERJURY THA7 I AM IXEMPT FROM SHE CONTPACTORS LP - GHl3g8/C81pO1f °"�� �y;, �W CHdSELAWFOfl7HEFOLI.OWINGREA50N(SEC.703},58USINESSPNDPROFESSIONSCODE:ANYCINOfl (� . � U�, .COUNIYWHIOHHEOUIRESAPERMITTOC�NSTRl1GT,ALTEF,IMPFOYE,OEMOLISH,ORflEPAIflANYSTRUC- W PdtiO/OBCk ,�,. ' ',,: C�' , C� '. � CENSE UW(CHAVTER 9(COMMENCMG WITH SECTION 70ppCANT FOR SUCH PERMIT TO RCE A SlGNED w ' 9 �, �, STATEMENP TNAT IiE'OR SHE SnLLiC�N.SE�Pl1RSUAN TOLT�HE PROVISIONS OF THE CONTRACTORS LI• �� �� ACIVIroLPEN�E'OFNOTMORETHRNFIVEXHUNDREDDOLL4R5(S�HEBASISFORTI'EALLEQEDEXEMP' , �...�OOI/Sp2..... ..._ '.'.' + ,.,� , , . TION.FNYYIOUTIOMOF3ECTION703t5�BYpNYAPPLICANTFORAPERMRSUBJECTSTHEAPPLICANTTO - R@-ROOI " �.i '.' �' " ��� ' �,��� �I,ASOWNEROFTHEPflOPERTY,ORlNYEMROYEESYVITNWAGESASTHEIfl50LECOMPEN5AT10N, (] ' ' � WILt DO THE WOWt.AND THE STRUCTURE t5 NO7 INTENOED OR OFFEFED FOH SALE(SE0.7oaa,BUSI- J Commercial i � �;� NESSANDPHOFESSI(NJSCOOE:7HECCNTRACTORSLfCENSEUWDOESNOTAPPLYTOFNOWNEROF � " '- � ,,��., . ,���,�"�'�, �,� '� �. PROPERNYhpBUILO5CIRMPROVESTHEREON,ANDWHObOESSUCHWORKNIMSELFORHERSELFOR = "�, ��, 'THROUtliHISORHEROWNEMPL.OYEE&PROVI�EDTHATSUCHIMPROVEMENTSAREh'OTItdTENDEDOR � ' ' � ', , �u1, ,OFFEREDFORSALEIF,HOWEVER�BUlIDIN�ORIMPROVEMENTISSOLt1WfiFIINONEYEAROFCOMPLE -� � �� i ', I .,�� �','�7�ppy�'[}{E O'MNER�BUILDER WILL HAYE THE BURDEN OF PROYING 7HAT HE OR SHE DID NOT BUIID OR ,_� ;9A9Pfl04E FOR THE PURPOSE OF 5ALE). , ' � �� ❑I,ASOWNEAOFTH'cPROPERTY,AMEXCLUBWELYCANTRAOTINGWITHLiCEN5EDC6NTRACiORS �. li ��� �Q';� ?O CC5NS7fiUC7 THE Pii0.1ECT(SEC.7o4a,BUSINESS MD PROFESSIQNS CODE:THE CONTRACTORS LI- j V21Uflti0ll � I�� ADJ.AREA� � ' .W"�CENSELAWDOE5N05APPLYTOpNONMERdFAPROPERTYWHOBU1LD50RIMPRWESYHEtiEON,AND ' �� ', � ,YhiOCONTRACTSFORSUCHPROJECTaWfTHACONTRACTCq(5)i.ICENSEDPURSUANTTOTHECONTRA(? qUANTiTY DESCRIPTION �.�I R-�� ' FEE I'�� � '��NflSIlCENBEI,RW.). - . . �9 o�,' 6 iIUA EXEA9F^TUNL1EFi5�C. 6.8 P.C,fOR THIS flEA50N Q � J ��I � I ' �,.. . . . , � � „Z �. � ,. ,ai �I,. LL' DATE ONJNER �' y �, i Z �U � � � " ��'�b i i I oe[ LICENSED�ONTRACTORS DEGLeARAIION �� � �.'�,��,,, . I�"- 'I ' CL� IHEREBYAFFIFIMUNDERPENALTYOFPEFiJURYTHATlAMLiCENSEDUNDERPROVISION50FCHAP7EF '�.'�'� "�, d e(IXIMMENCINO N'I'IH SECTIOP17c1(fP)OF DIVISItlN3 DF THE BUSWESS AND PROPESS:ONS COOE,/v"JD Z . � "�,�� !G MY LICENSE IS IN FiH.L CUPCE EFFECL � m ' .I, , .. I,r°°drx l8 p� � Q LICENSE CLASS___ Ar�LIC.NO.� �.�[ � �� j' ' �I , ., �Y l _ �1� - U DATE CONTRACTOR_ �� - a- sry �� � 11!� . a�^" °�/' �. �i �y�"'�" WOR4LEFiS'GOMPENSA.TION DECLARATiDN Q S �" � ��� I HERE V AFFIRh4 UNDER rENAI.TY 6FPERJUftY ONE OF?H�FOLLOWMG DEGLACtA710N5: � �I � ���` IHAV'eAh1�WiLLMAINT6.iNACERTlFlCATEOFCQNSENTT05ELF�IPISUREFORWORKEflS' Z . � CCdMPEMSATION,ASPR/3VIDEDBYSECTON370oOFTNELA00RCODEFOP,iHEPERFORMANCE U � FTh{ENfORKFORNbiilCiiTHI9PERMITISISSUE�. � � y"., � '�, W . . -� \s �HAVEANp WILL M�.,FlTAIN WORKERS'[;Ofi9PF'dSATIQN 1NSURANCE.AS FEQl.1RED EY SECTION (� ��y1 �i � � 3'i�tOG76iELABORfYJDE,FORTNEP6RrOHk1ANf.EOFiHEWORNFDFlW4ICHlH;SPEPMITiS P �I�^A-� � J ISSUER:k7Y WO K�R�'�C%�P�PF�NSATfON 9NSUF,ANvF CAfiKs�ER AND POLICY Nitli�ER ARE: . CONSTRUCTION ;/ I ¢ �$o �.' . y CAeiRIEfi� � a V'G = � Pi.AN REViEW � ', Z, PaLICYHUMBEft� - - ELECTRIC - .a' a y�'� � � • '�W [] ��sEcrr.xiNEa�taoxsFocx�w..ETEooF'n�vEt�r�swaoNeHwcF�rpu.u�s�sioo�oa�ess) PLUMBING e � i CERTI�Y TiiAT Itd TH�AERfOAMANCE OF THE iYORK FORYIHICH TN15 PER�AIT IS ISSUcD,I MECHANICAL i I� (3 SHALLNOTEMPLOYAN`(PERSONINANYMAMNERSOAST06ECOME5U3JECTTOTiiE , � y WCRKERS`COMPENSATIONf.AW50FCALIFOPNIkANDAGREETHATIFISHWLUBECOME INSPECTIONFEE � ' SU&iECT50TNEWORKERS'CGIdPEtdSATIDNPflOVISiONSOFSECTION37 OFTHELABOR / ��R'.� �e � S'ADEISHALLFO�'}iWiYHCOMPLYWlh1T SEPAOVISIONS. ISSUANGE f' ���� � p DA7E: PPLIGANT: �SMIP W � � J. WAqNING�.FAILURETOSECUREWORKERS'COMPENSA710NC9VERAGEISUNLb.WFUL,ANOSFiALLBE ENERGYP/C D , � .�p yy SVBJ[CTANEMPLOYEP.TDCRIMINALPENAITIESANDCIV!LrINESUPTOONEHUNDREDT40USAND ENERGYPERMIT __ � J�^t•�"� OOLlAF3(51fA,0�),Iid AOOITfONTO hiE COSTOF COMP@lSATlON,DAMAOESA9 PROYIDED FOR IN >- ^� I � SECTION37090FTHELRBOftCODE,iNI'EAEST,AN�ATTORNE'f5FEE5. ,q�'ENTIONFEE: ���'�..b.l����. � CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O ' �� I HEREBYAFFIAM UNDER PENAL7Y oF PEAJURYTHATTHERE i5 A CONST UCTION LEN�iNG AG'cNCY � ' I � FOA THE PERWaMANCE 6F THE WOPK FORtyRfI�H IS PERMIT IS ISSU (SEC.308�,CIV.C.). � . , I W �p`� // �.f j l l V / I � �� N 'S NAM YW l�fs . , � I LE DEA E � 'k. _ :III� � F_ LENDEfPSADDFESS ' II � TOTAL FEES J 'd�� I � I CERiIFY THAT I HAVE READ THIS RPPLICAYION AND STATE THATTHE ABOVE INFORMATION IS CORflECT. ��� � .� I AGREE 70 COMPLY WITH AI.L CITY AND COUNTY ORDINANCES AND STATE LAWS RELA7ING TO BUILDING !�'� �I CAYS7HUCTlON,AND hIEREBY AUTHORIZE REPRESEMATNES OF THIS CW NTV 70 ENTER UPON THE . I',;� ABOVE-MENTIONEDPROPEflTYFOP.INSPECTpNPURPOSES. I I ' ,li .. Z COPAP�iENTS -� "`� � �� . . C1Q. _ _ . .. + ' _ m PERMI ENAlAE{PR T� . I� Q CJ7 � � 51 A'NREOFPERMIiT DATE � � � II _ � RECPT.NQ. PAID BY VALIDATION" ' H , T � . � WH!,E De artment Co YELLOW—Finence Co PiNK—Assessor Co GOLDENSi06—File Co GREEN— licant s Co . P p. UY. PY. PY, APp PY Y � . ���'az`� ��� ��.���k�'����� �,�.�. �� �° � � �,� ���;�~�. ;������� � ����a� ,�.�� ;�: �.�� ` .�,'��`����� _ � �"�"a`. ��* �- v �'�� +�"� � ..$ r ��,.�"�r"`�.�:��-s� �r� ,�N �e"�.. '� �,�.,��^ ;'» i �m` � It �""'�' �.��:"'� � • � � � �,'�.�°, �"�' �1�� �Y � w n�� � � ��"��� �� ��% "� �� a P. �' `"` �t � $a��� � +��� � �� � � kl . � � �` '�"i r ;�,_�;�'-`:.,{�*�'.���,.:.�,'�_ ���c,. ��` _�,+:��"��'� �` ' :sr� ��� ' ���"�a�,���at��"��- . �� �_:;� �d�`r�'���»� �`�;�,�������a.��,���'`��� � �� �.•�� � �.w ,�^ � � �p ;�r�. �,.t5' � . � fl� r � � -, .._ __.__;_ _- -.._�.. _____m_ �,�, � ��'� a! L9€.��tra`� .t"�__°—' ( �� � �� � s '_"'" — < _L_�_� .�� �,,.e�, �, � r��.� �_�___.T �__.m.. �.____ .._ _—�-�--__ _ .._..... � __.._ _. __._ _.._ .. _.__€ _ _ .. _�,� _..w ��.�+�:t ;�(�'v�$� ���:� {- � � ���"j;�-� F; ,�,}����5�' , , {'� 1 _ �_ __ � � ' $ '�.'7 T"'�k 1J� �t)�@ �L f P:�i 1� .���G.�C�i - �� I C'.�@ g �LV '°3 t"(, ?..`�S i` S 9,;"' ......_... .. . __., ._,...............,._...__ ..... � ....,._._ � _._�..,,. I �, � ,�° _ _ _ _ __ _ �_ __ _._. � _. _ — ' � , _„_ _ _. :,,t�-�,t� ��.`s' I ( , ����� � § � �„��,� g�i+ , .........,.w.-..-_....__.��, ......._.._._...__.___.____._�_._.�__ � <,V�.�. ,_:"i,.:.�a_a��SL, .v..,_._a�,�� v._ ; ...;...,�.....�.._�_.._. � . v ...... �°.l��'"� ..��� �' ? � �. �- � � �..�.._._ _.. __:.._._.__._ . . _..._ + _.W...��_.� .__._.__ . ..__ ._� _.� _�._ ` _�m_�_______i_.___. � �:._ . ..�. � ,� __ _. "��x� �-��\�ic " i € �r�.� 's� ^r r��; � i �� �. : . � ~� d� �� ,� .�. � _ � . _..... .� ._.. .._. _ ._.___ _..___ __�_ € i?+:.3�'' �E�t-� �'_� € ��' /�� '' € �.�`� �,„�.k��'�� ��:�E � 1 _._ � -�-'=F���- �w1a��"*'��'".��.��---- � _ _ .� _- _.__ _ . ��i"�T.:;�i��6������'a� s @ ,.,6�a C��s�, �� � � q I .:.���i �.P`��,� a }�€F-,y� � � . � ...._ _�_�..._._.__. ..__._._. _ ._.� r �`�`q _ e _k_ _ ______m..___ _ ; S--«-....._���.,��""'M'�� .Y . ....,�.,...... � ..e.«.,_........ _.m_..s._..._._.�..............._.... �_..L....._�.�"@.. 5...�.3��5�(.w'�[�`:� ........ . . 3 . . _�.._...,,�,....., ..__..._-._.....«....,......_.�._�_ ........._.. x — _4 ���dk@a��{���ya t�R�� �! € a ��� _ `s�kt�a� -} "i ,w __ ..a_ _ ..u. . __ ,���.m_._.._.__�._....__..m.. ._.....�._.3 __..�.._._._.�___�_._.._ ! ��°���at�s �_:�C'l��a'� i � i ���,�.1 � _:'�"�*�'' �._____ ___a. i i i..� ...... .._,,. ...._..._._... _.�..._N.,......�. __._.._._�._,._.�...._e_..�...�-1-.. _ - ___.....�...____—°--__..�.,,_...�.�.,�.._..W__.._...�. �...,�;,�w,i^e �ti'��-����iL�l� . .�� �. � � ^•��s.��.��`.€€ <%S"da�tr....}��!(.„�; . .� 1 . .� _ ..,— �._ _..W,......_.. ' {p_,_ �......w..._.,...,_.. y '�^" ,�"°k "x ,v '�3� �F�� � � .:_.�... ' .,.._.._.___... _._ �w._.. _._____._ _ k �- ..�,.. ��ph� .._...�..... � ___-..-.— -.-.,— _._.._._ � ... .�..,_..�...... ......._..�_ . �i ��"+' f�i L../�s..�i'YA,.X.:�, i� . '� �. � - --'. ... ,.,g.,t�' �„'��.e€�'tit� � ., � f . . �-...����—. ����a" . ��. _ ....,__. ..w.., .. .�,�� Y"1�l� ° 1 3 '3 i ..���� � ' / ° �tq t,�.�� ; �� { . � . .... .�... .�__........�._ ...... .�.�__....._..__........... €._.,. ._.,_...... _._._...._..�......._...»,........,�.�_.._. � : 'r . . �wM4 i 4 ..-.._.. ,.,« ''4 ' ' . . _.-,_._j � �km;' vf` �4 bs ..<.�7u� � �� ; v�" u. t���..��. S � . . "______�__ _�_��___._ ,___;—_ _. _.._..__.._.___.._� �__�,�_L.—`._ _.:....... __,__________:_ c ........ ,__ __ _______ _,...... ---- � .k��� + -;Y� � �r��: ', � : ; j � '� ; �1`�;s c� r i � �..,_ . ,.....�..... . _ �m -.�..�-. . _ ..._. .... . _._._ � r._ _ _ � , .... ! - g r.5�� �r�. � �i ����...,'�.._.�..�...� � � � �.:y..;,€� r 11a!:"� ��� . . E ..�..p. .....,- .......�. .,,_...,.....�.., ....«...... . . � ._.�. _..:.....«. .... _ ......... . f 9 .�"p� �r e;",i':`x � � � "��.ib� �'���.3 e� a"a"�.,- �.... � . . .........� g d ( ,._,.,,„,�,,,_W� ._,,...,_{ ,v.�. ...... .......__ _�.....__. .,...� ...... ...,,...._ ... .. Y ? T t�m � .. '... . �'? .3 s k" ��.s� �� ' . y _ �.0 _ _:_._ �.. _ M_ `. ,_.. ___. 3 � _ � . � . ` � � �.-.�� �,_ ° �� ! � ,,s � , g�� � _ � _._..�.._. _ w .. ,4F �7'�? i. ' i � `" � ` ��� �.�. � " rt'�____._�.._,_.__ .�.� .� _ .._.__. _ ._.__.__, ______�..___..._.�__�e___ _,_, � . _..._ Y ��', 'x:.7 "+.� '�"_.._...m..� 1 .. '. � . � }"..rvu A � _ � ',..k.� € . : . � . -,- , �-.- / ,.______ � ._ �� _ _ __._ _ ___ _.,,,_ � ¢ f � ; _.� � c= r � _ _ 5_.� f;;s p_�_.�..._._ ��.. � ��..._._ _�,__ —.— _ pi�"�.. _.___ ___._ 3—_ _�,__ , � - - -- _ , _ ; y �{s',� s$6..t.�r,..1'.P i4td1 1. . �,.. . I ��',�"� S..Y . - . � ' ._„..�......:.............._....,.........._,._..__..a�____.'.�._ _-._�.._A._' __..��..�.�. ..........._.....m_: ;�......._................_........m...�,.,..,,.........,..»........,...,......,y......_..�_�. __...._.....__....._.. ._.............. ... _......_.,_. _... _ . ] � � t 'G__ � � _.._,_. :..,.._...�. .�___ --� _.._._ � �_--____w_---- �- �,�z�"`�"r����� �".��� ' .. _�.___,_._ � . _._. � . � . . �'`�:�+y � ��� t'` �''��a�`u'� �s: a . �:. ........._�.._......�....,. ._ . . . .. -- _�.�,..._. _....�. ,;���s,i�'e.:�y �'k.:re. *�,..�a,�°�.a�....5 x...��N3___..e..__,.___._._.__.,......,_._.....,,.,.�._...._...,....._. _ •- . - ,x^a� 'a . ��< .�, - . .. .. , . _ , . � . . � '; ��'a,+`�.���xt�.a`�. � a;,� . ., �. �. _ .. ,., , ;, ��. - �� . . . . .. �. ' ' �� . .. .., . , ._ . �. .,':��..__...,.-M._ .�_......:........._,......,,_._.,.,............_..�._...._._,�...._.�._..�._...__..__�_.._,_..:._...:_.�:._..W.__._....,.....w�,...�...,�.,.�_._._......,_._._,.�. -....,-- . i _ . , . . . ...._._.... ,._,.,_.__�...-.�..._.._....�_m.._., .__.____._.�...��._...._ h� - . . . . . � . . . . , . . ' , � y..». - ._....,.,_._......:.........................,.......-m__-�..,,..�..�.m�,.,__.._..._..,._.._.__,�.....-,.---....,_.�...�...._.w........._.....__�._._...,....___�__�__�.._.___...___._�.�__..._.__�_.___....:.._.._.__.,...._._._..._._._..........�__.__... ... ._.,,__.., ._....._� i,' k �.. . - . .�. . .. - . . �,-�,...v.._.......,.._._:.................�:..,......,...........m_.____,�__....__�.____ _...._..........�....,._.,�._.._...__�.a...v_,..>...��.......__._.........,._- ,.t ...._......_.................,��...___."_____. ....m._.�...,._._............,....�...................:.............._._._......_._...g > " 6 _ . .. - . � . . - - @ � �....-....,._-.�.........«..........,.,�__�_.,.__..................,-................:........................._ ..._._�_._.,"_'__ __"�_�_.._...w.._.._._ t ..__ __.____' '__'._,—_._..__ ' ._._..�.___.. _._._..._. ..- ._,._...�. _"__ ""_"__3 .. . . ' , . , ' . , � g . , ... .�. . a �.._._:......e�...._...p....:_..�...._ _ ___�....._.:...:.,.._....._,...,_...�..�.._.._:. ......._......................,..........,�........_�...., � __.................................._.........�.........._.,_.,.._, .._..,-._....�._._..._�__�..'"'__.'"_�._.......,.. . ....__......., ..!. __. . . . .. . . . . .. . , . , � -k,._.�...�...._�.�............._...._.�� ..._.,...�_...�..._,.....,._.�__�...,...._.._,..,......._.,.....__.�..,.. � _....._..,._�.,.,.._............_»_.....:.........._............�...._..,,...._....W....;_."___,.��.._.�..._._..... ', ,� . . ... . .. . . . . _.........�._.... ._ ,. ' . - ��'.,-,.::,..._,_..,....�.:..,�..».�,..._.�..«..,_..�....,.......:_ _-ww:w...................._.,..,.........._.....:.,.,.__._._....._..��.,...._,......,........_.._._...__,.......m._.,.....:_........._.._.._,....___ ..___......_._..... ._._.,.._.........__............_,,......�.. - . _....____.. _� . �� ��aa"P" '�a � ;,"r-- � . , . . . . � � � �� � a f'� n �.,. ��.._. _ ___.,._........._.._...,. � � �: ', c : �:�1 3 .� _�?i � R�.._._ ..�.....,_.....:.____.�.�.._,.. ._._.......M.�� ..._....._�,_..____»�_�...n,..._.,..........,...,..............�._.,,.__._.,_�.,.____..___..__._..m_____.._. .__.__...�__..._._____.�u ry � p ..r��.«,d...� �a: es ��" __..::,.___..v_.._..._....�. . . � . . , � . ' � s� �'`°°�'�S�-���`e�� �� rk .� �� ... ., � . .. , ._._,� .. _ .. _ _ . . ._. .. _ .�... . � � �� � � a'��� .._ �..... ..� ._ , . . �,�" �:+�����.��x�.��� ��������,� . . I._ ... . � . . . 6�*�" � . ..3�� a"a�a a �Rti' z' .._._ . � - �._ _ �...__.. __.,.. ., __,..,.. ..,..._,�,.......__.�,..e._...,a..__._._...__.�_ . ._.. . . _.__— � " ���� -�3 ��k�����} - � - . , . � �"�, � �r��'"r�:� ���-„�'"''*`� � z� 4.� a � �; � .�. ..:........._ ._.....____,:._.._ .� , ..... _.. .._�._........�....�,._....._,_._.e.__._.,._... �,_ �.,._ . . . . ' , �" �'�a c-a:� �.r�- t�'� , ' � .. � € . �� � � ��� �������y� � ' �'`�i�"���„rv��:�4�,����*���'�"h��� s.. -.._....._..: ,__� .__,..�....__..,_._. ,�.____—,__�__..___: ._..�.:.u.� .,______»..�....__.__. e ,._ .�._._,.. _.�.,.,_W. �...a � ����'��*;s���a`a���' �'�� � �. ��`�����"�� �"� �v� € { � , �"3f ����s�����°� _._ v__. ..._ _ _._. _ _�__._. �._._ _. .. , . _ ' � � '� � a �� '*� ���`����"�&#����"'�� �� � � ° � �� ,� ��° � �� _...___... �.__ .�__.______.__.__________� ��+������,���a�,..�.��' "a-�;'�s� .. ._v.. _..�....W.W.�...__...,._ . :.- � � , . . . .. .,. �� �������.��x��:�,�;���.��,��3 a�"�,�'�� . , . . .. . �' . . .. � _. . � � 4, .,.�.. . .. . .__.. .'_. . �. ......_._. ..... . .. .. . ... . .._ . _ .�........_,...�,.