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HomeMy WebLinkAbout14255 (27) L� f�' �,� CITY OF DIAMOND BAR � DEPARTMENT OF COMMUNITY dr DEV LOPMENT SERVICES T� 21660 E.Coplcy I?rive Suite 190 � � (909)860-3195 Fax(909)861-3117 PRESS '^�'� BUII.DING�'ERMIT APPLICATION FIRMLY y JOBSITE �3�30 51��p h�r� �h APPLICATION i 2 - PERMfT �� P/C o ADDRESS_ DATE NUMBER � $ ISSUE TYPE OCC APN LOT TRACT � DATE CONST. GROUP � OWNER �-Y7'+� P p ADDRESS O � ' Y� ZONING SETBACKS "' CITY ✓►� IP Q ^ D FRONT RW O APPLICANT REAR p ��� SIDFJSIDE STREEf RW ❑ CONTRACTOR � U../ (h SIDE p � g A DRESS -'r � _ PROPOSED USE CfTYQf"Ph�+2,CC�, ZIP (QTE . � ARCFVENG/ • DESIGNER NO.DWEL NO. NO. ADDRESS UNRS STORIES BEDROOMS � CITY ZIP TEL �n DESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION p� ONMER•BUILDER DECL.AfiAT10N SFR/ADD/REM O � 1 HEREBY AFFlIiA UDER PEWLLTY OF OEiWRY f WU 1 AM EXd1PT FROA1 THE CONTfULTORS�4 G9fege/Ca�pOR CRISEUWF011THEFOLLOWNOREA40N�SEC.70J1.68USNESSANOYRCFESSWNSCODE:ANYCRYOfl (n OWNTYI�Mi�01REOlHRESAPER4RTO00NSiAUCLALTERMVROVE.DEMOLISM,OHHEPA1qAN`lSTRUG W patio/peck TURE,iR101t 70 RS 199UN10E,ALSO REW I11E3 THE MPLICANT FOR SUCM PERMIT TO FILE A SIGNED W 6TATEMEM 7MAT NE OR SHE 6 IICENSED%1RSUMT TO TNE VROVISIONS OF THE COHTMCTORS lF � CEH9E UM�(CHACTER Y(COMYENCNO WITI SECTION 7000)OF DMSION 70F iHE BUSINE59 A1�VXO� LL- PooUSpa fE5S10HSO0Ok�0ii7HATMEdiSHE19EXEA/PTINENEFPOAdANDT11EBA5i5FOR7HEAl1E�EDEXFJAP• C7 TION.ANYV10lAT10NOFbEC710N7o71.6BYANYAPGLIG�FlTFORAOERMI75UBJECTSTHEMPL1GwTT0 Z pe-Root � A CMl VENALTY OF N0T 40RE 7NAN FNE/R/NDRED 001LM5 ltbao).): O 01ASO�MlEqOF1HEPilOPERTY.Oi1MYEMPLOYEESNATHWACESA;iHEIRSOLECOMPENSATION, COrtIR10fC121 - � YMLL DO THE N'OFiK AHD T/1E STRUCTURE IS NOT IMENDEO OR OFFERED FOR SALE(SEG 70M,BU51• � � NEbS AND PROFE5510NS G90E:ME LOHTMCTORS LICCNSE UW DOES NOi APPL�TO AN OWNER OF � PROPERfY YINO BUILDS OR MPRpVES TMEREON,AND YMO DOES SUCF/YlJAK HIYSELF ON HERSEIF OR " � T}IROl10H W S OR HEN ONN EYVIOYEES,VHOVIDED iIUT SUCM MPROYEMENTS ME NOT MENOED Ofl m OFiEREO fORSALE F.FpN�EVER 1ME BU0.dN00R IYPIqVEMENT�S SOLD WfTHN ONE YEAR OF COAIPL6 TION.THE OWNE W&1ILDER M7LL HAVE THE BURDEN OF VROV W a THAT ME OR 6HE OD NOT BUILD OR YPRGVE iORTIIE VURDOSE OF SAL�. � 04AROMMFROFTIEPHOPEHTY,AMEXCLUSNELYCONiRAGTINONTTHLICENSEDCOHrMCTOR3 TO CONS7RUCiTF1E OROJECT ISEG 70N.BUSINESS AND PROFESSiON4 CODE:TME GJHTMCTORS LL Veluatlon ADJ.AREA CENSE UW DOE9 NOTIPPIY TO AN Ovrt�EH OFA PROPERtt WND BUILDS ON uAPROVES iNEREON.MID � N7�OCOHTRACiSFORSUpIPROJECfSW1i/111CONfRAGTOR�S�LICENSEDiURStUVlilOiMECONiMG pUANTITV DESCRIPTION FEE � tt7l+sUCF7�15EUw.). O IAM OIELIPT UNDER SEC. B.1 P.G FOR TFIIS REASON Q U u" DA7E OWNER U � J �� LICENSED CONTRACTORS DECLARATION w � INEREBYAFFYWUTAERiENKiYOFVER1UitYTMATIMILICENSEDUN'JFRiROVI5qN50FCHAPTER V. � �fC014ENpN0YYITHSECTIOH700010FDMSqN70FTMEBUSINESSMDGROFESSiONSCOOE.ANO Z MY UCENSE IS N fULL FORCE AND EFFECT. � � � u���s -3(0 ��.No. o � � o�rE J �O� corrrw�croa WORKERS'COMPENSATION DECLARATION �� / U � I HEREBY AFFlRM lAlUEN OEIULTY OF PEiWM ONE OF iHF fOLLONANO DfCURRT10N5: Z � �IlNVEANDWILI►uMNNALEHiIFIGTEOFCONSENTTOSELF-lISUREFORNORKERS' _ OpMPEN3ATqN,IISVRONDEDBV9ECT10NJ/000FMEL�BOiiCODEFOHTNECERFONAANCE U � OL iHE MlOHK FOR MA/lf]/THIS iERMiT 6155UED. � �I FIAVE AND WILL NARRAB!riOpKER9'COAAPENSA7IDN W SURW CE,AS REOUIRED BY SECTION 4 J7000FTMEUBORWOE�ORTNEPERWRM/NCEOFTHEWOfYCFORMMIp1THI5VERM1715 � ISSUEO.M1'WJfIKERS' P SA SURANCE HIERANDVCIICYM/MBEHARE: � . CO STRUCTION � CMAIER � PLAN REVIEW � ����R -� ELECTRIC /� � ` -V— � (Ms3EcnOr+N�wiB[OOMiEiFDaFhEP6Mt5FOfioNEh�uiotiEODalfits�t�a%OpLF55� PLUMBING 2 ICER7IFYTNATMTHEPERFORYANCEOFTHEVlORKFORWHICHTHISiEiU1RISI55UED,l MECHANICAL (� SXALLlqTEYPIAYANVVERSONNANVYANNERSO�STOBECOMESUBJECTTOiME y WOPoCERS'COYPENSA770NUN50FGLLIFOIWi/�ANDACFEETu71F15HOULDBCCOAIE INSPECTIONFEE n , �� S SUBJECTTOTHEMCKiKERS'COMPENSATIONVROVISIONSOFSECTqN]7000FTNEUBOR cooE,i sw�u Fonnr,nn�coMv�r vnn�nase vnowsaHs. ISSUANCE • O p pATE: ' AppLICqNT SMIP �w ENERGY P!C T?A rT� WARNiN6:F+UlURETOSECUREVAi1NER5'COMPENSATIONCOVEMGEISUN�AWFUL,ANDSHILLLBE -�=y� � SUBJECTANEMPWYERTOdiMINALVEN�LTIESANOCMLFNESUPTOONE/NNDREDT10V51W0 ENERGYPERMIT DOLURS(f toD.Dao),IN ADORION TO iHE COST OF COMPENSATqN,D/WAOES AS GflOYIDED FOit IN � SECilON77osOF7YlEUBORCOOE,ulTEREST,luiDATfORNEYSFEES RETEPITIONFEE: OCONSTFUCTION LENDINGAGENCY PRE-ALT FEE: �`�o`� v � IHEREBYKFIRAIUNOERPENi1LTYOFVEIWRYTHATTHEREISACONSTflUCT10NLEN0INOAGENCY FORTHEPERFORMANCEOFTiE1Y0iiKFOflWHIp1THISVEAGITISI55UE��5EG70Yf,CIV.C�. r H�� l�1 ♦ � � LENDER'SWWE ��i' Cs IENDEHSADORE35 !] w ICER71FYTHAi1HAVEREADTHI9MPLIGTIONMIDSTATETIUT7HEABOYENiORMATqNI$CORRECf. TOTAL FEES �j `�O I ACiREE TO COGPLY M77H ALL CfTY AND Cd1NTY OROINAl/CES AND STATF UWS NELATINO TO BURDINO � � CONSTRUCiION,AND MEREDYAUiI%)RQE RE7RESENTATNES OFTH15 CQRfT1'Tp EHTEH UPON TNE ' 1180VE•MEMqNEDVRDPERiYFOflINSVECTqNYURVO5E5. 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FHA REQ�ATS"{-- ----- �- - - - ----- - - -- ------ -----._. _... . IELECTRIC GROUf,1D . � "- _._ . _ . 'UtvDER FL.00R DUCT - --- ��; ' " ' _` ...---- , - � - - �GFiOUNDPLU":"BING � UNDERFLS��r�CO�,IDUIT�-�...1� ��,^ "- .� .,,-c.�- _ ., -. ��L.�RGRADE ._ . _.. � �I -.. .---._...� . . - '� - � FIREPLACE.FOU�JDAi I�PJ : ���' � � '- ,� �•. , � � � ITEi•:1P PO:"vFR ...... - . . ---- - - - -: �. ::. ' FIREPLAfi�'•60P��8E�tR'' - - �. . ,.,- -- . . ... . � . - . .� ,� i �,i• --- ;�^i;'1TER SFRVICE - - . . - �•� . . MID HT. BONDBEAP;1 . . ��� I . ••,; , ,' � .. 1 - . - i.._ G I. - 8 FL E3�P4D BEAht• - -'' T-'-j'- - ' R00. SHE�iTHING � �'` Ff?AP.11hlGNcNTtLIAflOt�f I �. � I FIN/`,L�BOND BEAM . -- I - . --." - `' . . , --- ;R7.')FCOVF_R ; • � ' = i PRE-GRADING � ..� � =- --- - • ._ _ 'R^J�^-.iH FiEATiNG - --.... . . .. .. . . � .. ' ..: . 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