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HomeMy WebLinkAbout14116 (29) i .. �\ CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES Zi�o E.c���y na��s�u i90 PRESS "'�����` BUILDING PERMTT APPLICATION FIRMLY o ADDRESS 7'��/� �`vr! APPLICATIO � ���/ �^ PERMIT /C �r! �!/�IN �� DATE `� �� NUMBER N � ISSUE TYPE OCC APN LOT-�;— TRACT DATE CONST. GROUP p OWNER ,�'�1 ��c�V p ADDRESS�7- n�k�f�ti� / � ( ' ZONING SETBACKS W C�7y i � �21P TEL. FRONT RW ❑ � APPLI NT TEL. REAR ❑ SIDEJSIDE STREET RW ❑ � CONTRACTOR �� � � �.L SIDE ❑ � CIDTDrRESS,�. .���..., ZIP ` —TEL.'. � ,�� i It' . ✓��' � f�i�1' � "� • � , PROPOSED USE J J�Li Ec-�-='"t�c ' � � l� � ARCH/ENG� _ .. DESIGNER NO.DWEL �LI �t ] � . I` '• 7 � ���. ADDRESS UNITS � STORIES �/ BEDROOMS.,�_ � CITY ZIP TEL. � DESCRIPTION SO.Ff. FACTOR PSF ADJ.AREANALUATION N Q OWNER-BUILDER DECLARATION SFR/ADO/REM O 1 HEREBY AFFlfW LNDEH PFfULTY OF FERRIRY T1uT 1 AN IXE4PT iROM iHE CONTMCTONS U• GHfH9�C0tp011 e CENSEUWFOfiTNEFOL10WM10RFA.�ON(SEG70]1.60USWESSFNOPRCFESSIONSCODE:M1YCIiYOR (n C� OpU/RYMMKi1REOl11RESAVERIARTOLONSTRUCLALTERMP��.DEM0U5N.ORREPA:RM1YSiRUG W PatidDeck u� TLJHE PRION TO R9 ISSUANCE,AL50 i1EW INES THE MPLM,l1lfT FOR SUpf iERMIT TO FILE A SIGN[D W � STATEYENT tHAT HE OR SHE 6 110EN5ED RIRSUMT TO TME PRONSIONS OF TME CONTRACTOR4 L4 � CENSE UW(CHAPTER 0(COMMENCHO YVIIH SEGTqN 7000)DF DMSION f OF iNE BUSINE55 APID DqO. � PooUSP� FESSqN3 COOE)OR i/NT NE OR SHE IS OCEM7T THEREFFpA AND TIE BASIS FOR 1HE ALLEGED E7fEMP- T10N.ANYVIDLA710NOFSEGTIOM7o7i.68YIHYAPFLMANTF011AiEfWITSUBJECTSTHEAPPLM.l�NTTO Z Ra-Root � ACMIfENALTYOFNOTMORETMANFIVEINNDFEDDOlURSlfsoo).): — ' � OlIISOMTlEROFTME7NOPERTY,ONMVEM7LOYEESYnTMWAGE5Ai7HEIR50LECOMiEN5AT10N, CORIf1101C13I MALL D07HE WOHK.AND THE STRUCTURE IS NOT NITENDED Of1 OFFERED FOR SILE�SEC.7os1.BU51• IE55 M!O iROFESS10N4 COOE:7HE CONTRACTORS LICENSE LAW DOES NOT h➢PLY 7D IV!OwNER OF N ppOpEHTYMM1tlBU0..D50HwPRDVE3THERfON.MIDVA1000ES5Up1W0(iKNINSELFOfIMERSELFOR � (t 7fWOV�HHSORMERO�NJEWLOYEES,VROVIDE�7H�TSUtl1M7ROYEMEN75�RENOTMENDEDOR � OfFEHEDiDHSALEF.HCNEVE0.T1EBUlDWOOqMPROVEUENTISSIXDVfITHNONEYEAROFCd1RE- TION.THE OwNEfl-0ULDER MnLL HAVE TNE BURDEN OF PROVINO TWR/1E OR SME DiD NOT BUIID OR = pAPipYE FORT1fE iUHPO6E OF SALE). 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