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HomeMy WebLinkAbout13414 (22) i CITY OF DIAMOND BAR � -��� �- DEPARTMENT OF COMMUNITY dt DEVELOPMENT SERVICES 21660 E.Copley Drive Suite 190 � � (909)860-3195 Fea(909)861-3117 PR E$$ ���. BUILDIIVG PERMIT APPLICATION . � FIRMLY d ADD ESS �`�� 7 n ��Q V�� �� • APPLICATION PERMff �P/C o DA7E NUMBER x � ISSUE �_��`�� NPE OCC APN LOT TRACT DATE "I CONST. GROUP � OWNER � 1'� � "' ADDRESS_�� ZONINCa SET9ACKS � CITY ZIP TEL. REAR � ❑ APPLICANT TEL. � SIDFJSIDE STREEf RW ❑ CONTRACTOR A'U� SIDE ❑ ADDRESS g CITY ZIP TEL. C PROPOSED USE - E ' � � ARC GJ • ` .._ . . .� - DESIGNER NO.DWEL i.,- NO. NO. ADDRESS UNITS �STDRIES� BEDROOMS � CITY 21P TEL. N DESCFIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O � i Henmr�Fwu uoea►ew�n oc veRum nuT i iw exeurT rAOM n�e oorrtw��croAs u- Garege/Carport _ CENSEUWfORi1�EFOLLOWINOREASON(SEG.1m7.68USNE55�NDVROFE55iON500DE:ANYq7YOR (n COUHttMRIK]1NEOUIRESAPERMRTOCONS7iNGT,OLTER,MFROVEDEM�L1911,ORflEVNRAN'lSTRUC• ' W PetIOIDBCk NRE,VRqR TO RS ISSUANCE.ALSO IiEWIRES 7HE AVPLICANT FOR SUL71 VEHMIT TO FlLE A SIGNED W tT�iEMEM TXAT HE OR SHE IS LICENSED PU0.5UANT TO iHE PHOVIS10115 Of THE CONTRAC70PS ll• � CEHSE UW(CHAPTER�(CA►NIENqH�N17H SECT10N t0o01 Oi DIVISION 70F THE BUSINESS/J1D PR0• � PooUSpa FE9SiONS CODE)OR THAT HE OR SHE LS EXEYPT T/EREFROY AND i11E B�3I5 FOit 1ME ALLE6ED E%E�P• TqN.ANYV10lAilONOFSECT10N7071.6BVMIVAVDLIGWTFORAPEfWiTSUBJECiSiNEAFPLICANTTO Z Re-Rool � OO. � � A CIViL PENAL7Y OF NOT MOF1E TUN FNE NUNDRED DOLLARS If so0).k � 04�4�'NEROFTHEPROPFRTY,OHMYEMvIDYEESMnTHWA0E5A3iHEIR50LECOMPENSATION, � �mmerciat - WM.L 00 THE WOP1C NID THE STRUGTIRE IS NOT RlfENDED Oil OFiERE7 FOR SALE(SEG 701�.BU51- J � NE53 NO iROFE5910N4 COOE:ME CONTMCTORS�ICENSE Uw DOES NOT APPL�TO AN O1vNER OF � PROPEHTY NMD BUR.OS OR MVROVES 7MEf1EON,MO YM1IO DOES SUG�1 YV7NK XIMSELF IXi I/EftSELF OR Q TTIROUGHM40RMEROYMELIPLOYEES.Gf10VIDEDiHATbUd11YPROVEIIEHTSARENOTN7EN0EDOR m � .OFFFREDiORSALE1F.IqWEYERTHEBUlDN00RMPf10VEYEHT5501DW17HINONE`IEAHOFCOMPLE- �TION,TNE ONMER�UIDER WH1/1AVE TME&1RDEN OF VROVNO TMAT HE OR SME DID NOT BUIID Ot1 4PROVE iORiNE WRPOSE OF 6/U.�. W D4�40MMEROFMEPROPERfY.AMO(CLUSNELYOOMMCTNONRMLICENSEDCONiMCTORS [C TO CONSTM1Ci THE PRO.IECT(SEC.ta1.BU51NE59 AND PROFESSIONS CODE 711E CONTMC70R5 U- V81UetiOn ADJ.AREA � CENSEUM�DOESNOTMPLYTOIHOWNEROFAPROPEflTYYAfOBUILD50RWPiqVESTHEREdtAND rnacartn�crsFoasw+vnaecrswrtr�carta�cTori(s)ucEnseorunsuurrrornecartrua pUANTITY DESCRIPTION FEE � TORSUGENSEUW.J. OIAMDlEMPTUWERSEG B.tP.GF01i7HISREASON U � � DATE OWNER V � LICENSEO CONTRACTORS DECW7AT�ON W J � W IFIEREBYAFF1iMUNDERPENAITYOFVEM1MiHA71AlALICENSEDUNDERPROVI510NSOFGHAPTER Vr S /(COAIMEHCINO MRTM SECTION 7000)OF DMSqN�OF TME BUSIHESS ANb VROFESSIONS COOE.IWD Z MY IICENSE 6 N FiJLL FORCE AND EFFECT. 2 m � ��E� ��.No. �i b � � � wh corrTrucron�.�7/�V��7 a WORKERS'COMPENSATION DECLARATION a y � U N �HEREBVAFFPAIVNOERPFNt1.TVOFVE0.AIMONEOFTHEFOUAW!NODECU.RAT10N5. Z � V INAVEONOWILLMAWTAn1ACERTIFlCA7EOFCONSEHTTOSElFaHSUREFORWGiKERS' _ Cd1PENSATION,ASVROYlOEDBYSECTI0NII000FiNELIBONCGDE,FORMEiERFORMANCE W Of TNE WORK FOR VlHlpl iH13 VEi1MR t3ISSUED. � � �I HAYE AND YIILL WIMAN 1WHXERS'CGMPENSATqN INSUiW1C[.AS RE WiRED BY SECTIpI Q �7ooOFT11ElABOACOD�E�F"ORTHEiERfOR1MNCEOFiHEWORKPoRwHILMTM15PERM1715 ���l't �/� I/1 � ISSUm.MYY.'OFi! RS't�7jN$�TIQIy URIWCEURRIERM10POl1CYHUMBEqARE: CONSTRUCTION �� _4�f u i J GP3CER (�(„'•'Y PUW REVIEW � w _ � ��'�Ep — ELECTRIC � �ssEenonrEIDwreec�.at�noFnfaew.rrswr+a+e �aqoa�ss� PLUMOING .nV (� �� `�`, Z ICEqTIFYTNATNTHE►ERFORAIAN EOFT WORKFOflWHIC M PEfU1iT i55UED.1 MECHANICAL � `1 +�Sf���t�L _++a► � MOpuERSTCOMPEN5�TI0NEUM50FClLL RNiRSANDAGREET MIFI�E� BECOAIE INSPECTIONFEE C `� ����l�� '�T1�1 lPY . N SUBlECTT T11EW�JRKERS'COUPENSAT P SqNSOFS ]7ooOF NEUBOR 'a• � I�• � t'j .� tNcouP�rvnn� E Ro�nsar+s. ISSUANCE � 1T �:• . � SMIP • �1 • L � DATE: � APRICANi. WMNING:iALURE TO SE RE WORKERS CdAPENS COVERAGE IS Uh1AWFUl.AND 51ULL BE ENERGY P!C �,I4'�`r `� ' ..�1�� � SU6IECTlWEMMOVERTOCRIMPULPEIULTIESANO MLFMJESU�TOONEHUNDNEDT1qU5AND ENERGYPERMIT `+n` �,���'ti�{l``.�l � } OOLLAFlS(f1ao.DaO}INdDDfiIONTOiHEGOSTOFCOMPENSATICN,CAMA7E5ASPROVI�EDFORW T `� -. 1 J¢ SECTIONi70eOFT11EUBORCODE.NTEREST,ANDA7TORNEY'9FEE9. � RETENTIONFEE: •-�%��' ���1�1�` a CONSTRUCTION LENDtNG AGENCY ppE-ALT FEE• C��y v �S rti 1�� � INEREBVAFFlRMUNDERPENALTYDFPERNRYTNATTHEREISACONSTRUCiIONIENONGA6ENM ��yU��� FOR iHE PERFORIAANCE OF iHE YVORK FOR Mn11CH 7H15 PERM�T IS i55UED(SEC.]oc7,pV.C.). � � LEFIDEAS wVAE � LEIAERSADDRE55 � ICERTIFYTMATIIUVEREADh115MPlIC�TpN DSTA7ETNATiHEABO`lEINFORIAATqNISCORRECT. TOTAL FEES d IAOREETOCOMPLYWITIIALLC(IYAND ORDINMlCESANDSTATEUNSREUTN6TOBUILDIN6 CONS7RUCTqfLANDNEREBY IZEREP SEN7ATIYESOFiN15COUNTY ENTERUPOHTME �MENTIONEOPR07ER F WSPECT WRPOSES. COMMC-NTS � � �� � 6 ru,�m¢E u�e�vwr+rl N .. y S�G E O D�TE � RECPT.NO. PAID BY VALIDATION WHITE—DepaAment Copy.YELLOW--Finana Copy, INK—Aswswr Copy,GOLDENROD—File Copy,GFiEEN—Applicant's Copy . • . . . . . � . . , . . ��. , ..,.. • .r �v... . ., � � , .. . �r� . ' .. � . , ., , .. , . ., ,.. _ • � . . . . ��. . , � _. � �. , CITY OF DIAIIrOt�D,BAR , , . , � .:, •,• . '; .,'�1FvSPEC i 10�1 REGORD � � -: . . � , � . � � . . . . .. . . � .. �,:, _ _. -.._.....-_.._..�.'�T '.. ...,_.,_ .�.�� ..". -*.....,r�.,.,....._.,....,,....:..... ..:..�I���);�^:c`���+l���a4_r �:����= i�►�E-'1:��.�,'-N�'� ^w'�'`t-�'��gxli.l��1►'�.....,_.:_.:. ..:��^�r�: ....�.����-'�N���i���, .. ��s_'r s�,cr .. ,.` ` ( ,...__I_� _.�..,�.. �. '�"� FLOOfi JOIST_rt r- � :., , �, y_�^,; ' . _ ..,�w.. x .. �F7GS'f"OR;�;S�'STE�L ' ' ' . � -.-� -� �.:- _;-- FHA R�QP�7TS - '- _:'.' _ -�- _ .. . �._ _ :: _._. _ __ I-.= _ GLECTRI�GROUND I -. '� . I.. � � - �• � U�JDER FLOOR DUCT - • � - - -'� ' ' G.!-i�UND PLUtJ161NG_ � I - - UNDER FLOOfl CdP�IDUIT - � � �f_, �� � ` ` � i �.--- S��E3 GR.ADE � � I -- � �� FIREPLACE FOUNDATIOPd • ; �� : '•' Tr:P:'� FOVJER • I - ' FIREPLACE 80Nd BEAb1 � • � � ------ , , . . . V