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HomeMy WebLinkAbout13429 (25) _ . . .. . _ � CITY OF DIAMOND BAB � -- DEPARTMENT OF COMMUMTY dc DEVSLOPMENT SERVICES 21660 E.Copley Drive Svite 19D (909)860-3193 Fsx(9d9)861-3a 17 PRESS ���'� � BUII.DIIVG PERMIT APPLTCATION FIRMLY ` ADD ESS I j r� � APPLICATION PERMIT 1�/I�� �JC p DATE NUMBER� J�r � APN lqT TRACT pq� Gr� �—�� NPE OCC CONST. GROUP � OWNER _ ADDRESS_ Standafd PeCifiC Cofp. ZONING SETBACKS W �� 1565 W.Mac Arthur Bivd FRONT Rw ❑ � APPLICANT_ Costd Mesa,Ca.92626 (714)546-1161 REAR ❑ SIDE/SIDE STREET RW ❑ CONTRACTOF Aliso Air,Inc. SIDE ❑ 11�DRESS_ 29736 Avenida de las Banderas � CI7Y Rncho Snta Marg.Ca.92688 (949)589-2021 PR�PoSED USE _.. ... -----�...-- � ARCHJENC� DESIGNER NQ.DWEL, NO. NO. ADDRESS UNlTS STpRIES BEDROOMS � CITY ZIP TEL � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREA/VALUATION � OWNER•BUILDER DECLARATqN � SFRlADD/REM 1 MEREBY AfiINM UNDER PENALT!OF iERIURT TMAIIAIA EXEMPT PROM T//E WNfRACT�RS L4 (;e�ege/Ce�pOfl CENSEUWFOHTI�FOIIOWWOREASONI9EC.7o8f.68USNF5SMqPROFESSqHSCODE:lIHYCRYOR (n �OUfRYWFMLMREGUWESAYEFlYRTOCONS1AtICf,AL7ERMOROYE,OEM�LISH,ORREPlJRAN'l6iiNC. w P8��0/DBCk . TIRE,7RIOR 70 RS 69UMICE.AL80 REOUIqEB THE MPIICANT FOR SUCM PEAAl1T TO FRE A SWNEO BTATEMENi TIAT HE Oit SHE 16 LICENSED NIRSUANT TO iHE PROVI810N8 OF THE CONTMCTOAS U- CFNSE lAV1'(CMMTER i(CqAMENCING YVITH SECTIDN 7000)OF DIVISpN 9 OF TNE BIJSINESS AND PRO- � PoOUSpfl FE88qN5 OODE)OR iNAT NE OR SHE 19IXEMM 1NEREFiIOAI AN�TNE BASIS FORTHE ALLEOEO:EYEAIP- TqH,ANYYIOlAT10NOFiECT70N7W1.6BYANYMPLICAN7f-0NA►ERMIT6UBJECTSTH6AVPLICANTTO z Re•Rool � AUVIL VENALTY OF NOT MORE TTiIW FNE MUNORED OOIAARS R�).1: -.• ❑4��'�NERpF1NEPROPE1ttY,OR1AYEMPLOYEESNA7HWA0E3115THFIR80lE00A1PEN5A7qN, CORInIBfCiel NALL DO 1HE WORK,AND TNE STRi1CTURE IS NOT IMEHD6D pR OFFERED FON 6KE(SEG lOM,BU51• � NE33 AND PqOF�SIONS COD&:TNE COHiMCTOR3 110ENSE LAW OOES N�T ADVIY TO,4N pNtNER OF = � P(qPEHiYNHOBULDSORIMPROVESIHERCON,MIDMAi0O0E56Up1'NORKHIMSELFOHHENS4FOq � hYlOUOIiMISORHEROWNENPIAYEESPROVpEDTW17A1['.MILfPROVEMENT9JIRENOTIMENO&DOR m OFF6Rm FWi BALE IF.IIOhMEVER 1NF BULDNJG OR WPROVEMENT IE SOLD WR1#N ONE YFAROFGDMR6• TGH,TliE OYYNER�BUHDER WILL 1NVE THE BUIIDEN Of PROVINO THAT HE OR 811C OID NOT BtNLO OR IAIPADIIE FOR 7ME iUNPOSE OF EALE} � . � 0 L As CVINER OF 7HE PiIOPERTY,IVA EXCLUBIVELY CONTRAC?NO WRX LlCENSFD CONTMCTOqe TD CONSTRUCT TFIE PROJECT(3EG 7DN,6USINE83 ANO PfpFE5910NS CODE:t!E CONfRAGSORS U- V81118tI0Il AGI.AREA CENSE UWY DOES NOTAPPLY TOAN OWNER OF 11PROPERTYYVFID B111L09 OR IYVROYE9 iFEREOt{MID wHoaonrn�ara�euaivnaecravnn+�conra�croWs���nsEnrunsuk+rTon�cw+tn� pUANTITY DESCRIPTIDN FEE � 7D0.S LICENSE LANL�. � O IAM p(EMPTUNDEH BEG B.i P.C.FORIMIS REA.SON � �L F DATE OYMER V . . . � LICENSED CONTRACTORS DECLARATION � r W GC I FIEREBYAFFIRM UNDEH PENALTY OF PERJURY TNAT IAM LICENSED UNDEH PFOVIS�ONS OF GXAPTER a f � S �ICOY4ENC4JO WfTX CTION 7000)Of UM91ON J OFTNE BUSINESS M10 VROFESSION9 E,ANO / LLJ ���9E 6 W ORCE F m � ^� �� � F LIC LIC.NO. ' ""' � / J OATE COHTMCTOR � �f a � = WORKERS'CpMPENSATION OECURATION � y I MEREBV�1FFlRA1 UNDEH PENAI,TY OF PERJURY ONE OF 7FIE FOU.OWINO DEClAM71DNS: V � a • � IYNVEANDW�LLMAINiA1NACERTIFICATEOiCONSENTTOBELFINSUREFORNlONNER6' _ COAAPENSATpN,7S PROVIDW BY SECTON 970o OF TME U80R CODE,FOR hIE PENFORMANCE U OFTIE WORK FOR WMICN TNIS VERMIT IS ISSUEO. � �S /}� Ml, I MM'E ANO 1NLL MAlNTAW WOiiKERS'COMPENSATKKJ INSURANCE.AS REOVIqE�BY SECTqN � 97W OF 71E U1BON COOE,FORTME PERPDFMANCE OF 7HE RK FOR WH 7MI5 PERIAIT 19 � 159UEG. 'CM1 I NC N �BERARE: CONSTRUCTION ] CARRIER PLAN REVIEW � POLICYILM9ER "j' ELECTRIC � (Mggty'11pdNE�PpigE00FFlE'�pFT1EpQNfIBFppONEFUrpR6pppUlAS�StaqqiLESS) PLUME3ING Z 1 CERTIFYTHAT W THE VEHFORMANCE OF THE WORN FOR wHICHTHI3 FERM�T 161 UED,1 MECHANICAL 81ULL NOT EIAPLQY ANY PERSON W ANY W WNER 50 AS TO BECOME Sl18JECT TO �E � � WORNE 5'COMP N6ATqHUW30iCAlIFONNIA,AND�AE TIFIS BE INSPECTIONFEE -�-- S BIBJE TO ERS'0041PEN OVIS TqN]7000 TX OR - � ISSUANCE ��'a��` � ' MIP � DA ' P NT; WMNINO: AILUHE OSECUREMIORKER3' ENS COYEHAfiEISUNLAWFULANDSFUL4B ENERGYP/C �--����1,����. A � lUBJECTAN EMPLDYER TO pYMWAL PENALTIES AND V1l i1NE5 UP TOONE HUNDPEDhpuSANO ENERGY PERAAIT �'i r.�.1 + � %`1� DOLLAAS({10D.000�,IN AO[IITIDN TO THE COSTOF COMPEN91ILION,DAMAGES AS PROVIDED FOR N --�- '['' Z S.{ � BECTION 37G OF THE LABOq COOE,IN7ERE5T.I1H0�TTORNEY'4 FEES. RETENTION FEE: �. t:41'�`.,.1}T•' ',1'�7 p. 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