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HomeMy WebLinkAbout14350 1�_ CITY OF DIAMOND BAR � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES � : � � 21660 E.Copley Drive Suite 190 (909)860-3195 Fax(909)861-3117 PRESS �"9�'` BUILDING PERMIT APPLICATION FIRMLY � o ADDRIESS ���0� ���1����� v�EI� . DATECATION%�� - J � NUMBER� r ✓�� #/C � � ISSUE J TYPE OCC APN LOT TRACT DATE CONST. GROUP p OWNER `� " ADDRESS Z�L`�C�YZ� �i}J�5A'F--� . ZONING SETBACKS �0 �'"-� �- CITY_�.±i.c��,�iiJ is l�-(;2. ZIP TEL.�q",Z�=e � FRONT RW _ C7_ - APPLICANT TEL. REAR f� � SIDEISIDE STFiEET RW f-1___ � CONTRACTO�ei C � � •C;; e �- i�1d. SIDE _ !� ADDRESS /��'7 �`.. /�'!9���i ' '' 1 ` ^ -� y� p C��, •�ry�����` � PROPOSEDUSE � a��- /` �F � � ZIP 1' (9 TEL.'1!'�=5�72'� � . ,.,, � o ARCH/ENG/ ( z DESIGNER _. ! a ADDRESS NO.DWEL. NO. Z NO. � � N UNITS ( _ STORIES BEDROOMS � CITY ZIP TEL. g cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � p� OWNER-BUILDER DECLARATION SFR/ADDIREM �� O I HEREBY AFFlRM UN�ER PENALTY OF PERJURY THAT i AM EXEMPT FROM THE COMMCTORS LI-' G8f8QB/C2fpOfl � W CENSELAWFORTHEFOLLOWINGflEASON(SEC.7U31.SBUSINESSANOPROFESSIONSCODE:ANYqTYON � (n U CdJNTVNMICHRE�UIRESAPERMITTOCON5TRl1C7,ALTER.IMPROVE,�EMOLISH,oRREPAINANv5TRl1C- W pgflD/DBCk W TURE,PRIOR TO IT6 ISSUANCE,ALSO REOI11FE6 THE APPLICANT FOR SUCH PEHMIT TO F7LE A SIGNED W �� � STATEMENT TMAT ME OR SME IS UCENSEO PURSUANT TO THE PHOVISIONS OF THE CAN7flACTOflS LI•� � S CENSELAW(CHAPTERB(COMMENCINONAT}iSECTION70D0)OFUIVISION30FTHEBUSINESSANDPFO-� POOVSpB '� 7� FESSIONSCO�EjORTHATHEORSHEISEXEMPTTHF.REfflOMANDTHEBASISFORTHEALLEGEDE%EMP-, � -- jj �� TION.MlYVplAT10NOF5ECT10N7031.58Y0.NYpPPLICPNTFORAPEflMIT5l1&IECPSTMEFPPLICANT70' - Z Fie-Roof ;i r ACMLPENALTYOFNOTMORETHANFNEHUN�REDDOLLARS(5500).): 1 0 (:]I,ASOWNEROFTHEPROPERTV,ORA1vEMPLOVEESWITHWAGESASTHEIRSOLECOMPENSATION, � Caf11111BfCi81 '! Z VALL DO THE WORK�1D TNE STRUGTURE IS NOT INTENOED OR OFFEREO FOFi SALE(SEC.7044,BU51-,. . _1 f NESS PND PHOFESSIONS CODE:THE CONTRACTOR5 LICENSE LAW DOES NOT APPLV TO AN OWNER OF I � PAOPERTYNM1iOBUROSORIA�PROVES7HEREON,MIDVYHODOESSUCHWOPKHIMSELFORHERSELFOR � ` Q THflOUGHHISORHEROWNEMPLOVEES,PRWIDE�THATSUCHIMPROYEMENTSARENOTINTENDEDOR, m / 1 W pFFEqEDFORSQE.IF,HOWEVERNEBUILDWGORIMPROVEMENTISSOLDWITHINONEYEAHOFCOMPLE= 1 Z TION,7HE OWNER�BUILAER NMLI HAVE THE BURDEN OF PROVING THAT HE Oq SHE OID NOT BUILD OR � IMPROVEFORTH�PURPOSEOFSrLLE�. w f.]I,ASOWNEROFTHEPflOPERTI;AME%CLUSIVELYCANTRACTINGWIiHIICENSEDCOMRACTORS� ( •� TO LUNSTRl1CT TH[PRQIECT(SEG J016,Bl1SINE55 AND PROFESSIONS CO�E:THE CONTR0.CTOR5 LI-. 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' � PLAN REVIEW = �� POLICY NUMBER �I7a�Ia Ci l��.� ' (,� --..........__._ ; . � ; : — i ELECTRIC � � " � (�HISSECiaD7N�NOiBE0.�MPLEtE00FTHEPERApftSFOROnIEMNDRE�OowRS(51ao�oaLEsS). PWMBING _..---------.___...------ • w ..... .."__—'_'._"._ '11``Ri� z I CER7IFY THAi IN THE AERFORlAANCE OF THE WORK FOR WHICH THIS PERMI715 ISSUED.I MECHANICAL ._..._.._._—s�.3�_,.:=_.i� _'���a ('3 SHALLNOTEMPLOYANYPFASONINANVMANNERSOAST09ECOMESUBJECTTOTHE �!•� ��' � (n' WONKEfiS'COMPENSA710N LAWS OF CALIFORNIA AGHEE THAT IF 1 SIfUUL�ULCAME INSPECTION FEE __ _ ___ .'? SUBJECT TO THE WORKERS'COMP[NSATION PROVI NS OF 5 TIqN 3700 OF 7HE LA90R "`,��j"¢' :%=��''? "�--=-_, . „ .•.,��� 3 0 � • CODE,ISHALIFORTHWITHCOMPLVWITHTHOSEP VISIONS ISSUANCE _ ___ �O i - �' _ . . . • .. _.. F�'. 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