Loading...
HomeMy WebLinkAbout13490 (25) ��_ CITY OF DIAMOND BAR f� DEPARTMENT OF COMMUNITY&D�VELOPMENT SERVICES l�/ : � , 21660 E.Capley Drive Suite 19D (909)860-3195 Fax(909)861-3117 PRESS ��`'�^'� BUII.DING PERNIIT APPLICATION FIRMLY QJOBSITE �Q' �n ' A�A�CATION NUMBE�� t� � ADDRESS I S J a Sa / ���rc (�n� � APN OT �- TRACT ���� DATE c�'��T / � ONST. GROUP S OWNER n . _ ADDRESS • µn ZONING SETBACKS � CITY AZIP • TEL. I ' I R�RT RW p❑ APPiICANT TEL. SIpFJSIDE STREET RW O � CONTRACTOR f • SIDE ❑ g ADDRESS PROPOSED USE CITY ZIP�t TEL -d' O � ARCWENG/ DESIGNER NO.DWEL. NO. NO. ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. y DESCRIPTION SQ.FT. FACTOFi PSF ADJ.AREANALUATION ,.. ¢ OWNER$UILDER OECLARATION SFR/AOD/HEM O I NEREBY AFFIflM UNDER PENIILT'OF PEltA1RY TNAT I AM E%EMPT FIIOM TF1E CONTRACPDHS LI� GeRgB/CarpOR CFJfSEIAWWFTNEFOl10WINGflEAAON(SEC.70.97.68�INESSANDDROFESSION9COOE:ANYCINOR (n COIAl7YYYHICN11E0U1NESAPEAMRTO00NSTttUCT,ALTERb1PROVE,OEAfOUSF�.OflREPA1RANY8TRUC• W Petb/DOCk TUXE.PRqR TO IT8 RSUIWCE,AL50 REOt/1RE5 TME APPIICANT FOR BURI►EWAIT TO FllE A iIONED �TATF►1ENT TFM7 ME OR SHE IS LICENSED PURSUANT TO lME vpOVISIONS OF TNE CONTRM.'TORS ll• GENSE LMH(CHAPiER�(COMMENqN�IM7H 6EC71ON 70ao)OF DIVI910N]OF 1HE BU81NE99 AND PRO � �CC�D� iESS10N5 OODE)OR THAT ME OH SHE IS EIfEYPT 7HEREFPoOM/NO7ME BASI5 FOR iHE ALIFOEO E7fEMP� TIJN.ANVVpIAiqNOFiECTIDN7D31.6BVANYAPPIIGNTFORAGEWARSUBJECT57HEAPPIIChMTO Z Ra-Raof � ACML PEN�LTY OF NOT YOFE TFIAN FlVE HUnDRED DOLLARS(i+Wl.l: .. 04�.+^�'1EqOFTMEPROPER7Y.OFMVEM7lOYEE3WI7HWA[iE51l4THEIHSOLECOMPENSA710N, ❑ COf11f1�SfGlfll WII.LOO T1E WORK MD THE STRUCNRE IS NOT IMENDE�OR OFFEREO FOR SA�E(9EC.7oN,BUSi- J NE55 ANO PNOFE6510N5 WDE:IYIE CONfMCTORSIIGENSE LAW pOES NOTAPPLY TO AN OWNER OF = � PqOVERTYNM1iOBURD50RMPROVESTMENEON,ANDWFpDOESeUCHWORKHIMSELiOFHERSELFOR � TNAOUOIiW50RMEROWNFlJPLOYEES,PIIOYIDE�THAiBUCNIMiROVEMENf9MENOTIMENDEOOR � OFFERm FORSALE i,HDNIEYE0.�SUILDINOON WPR04EIJINT ISSOLO WIT71N ONE YEAROFCOMPLE �TION,T1E ONRIEH�UILDER MALL MAVE THE BUROBI OF►RONHO THAT ME DR SHE DD NOT BU0.D OR IIAPROVE FOR 7XE PURPOSE OF 8/1Lfl. �yJ DA�BOWNEHOFTHEPqOPERTY.AIAEXCLUSNELYCOMfUCTtlVOW17HUCENSEDCOMRACTORS [[ TO CDNSTRUL7 h1E Pi�OJECT(BEC.7oM,BUSINE95 AND PROFESSIONS CODE:THE CONTPACTOflS LI- V01U0[IOfI ADJ.AREA �J.1 GENSEIAWDOESNOTAiPLYTOANOWNEROFAP110FERTYWF109U1LD50RWPROVE3T}1EREOIlAND , F WFqOOMMCTSFOR$UCMOH0.IECTSNnhIACONTqACfOR(9)LICENSEDRIR4UANTTDTHECONTRAG pUANTI7Y DESCRIP71pN FEE � TONS LICEN9E LAW.). �I AM F.XB�AP�11NDEfl SEC. 9.l P.C.FOR THIS RERSON U 1�.. � OATE OWNER .V � LICENSEO CONTRACTORS DECLARATION � � W 1 NEREBYAFFIRAI UNDER PENAL7Y OF PE0.IURV TMAT IAM UCENSFD UNDER PROVISIONS OF CHAPTER � Y(COLIMENGINCiWfiF19ECT10N700o�OFD1VI510N90FTF7EBUSINESSAHDPflOFEBSIDNSCODE.AND Z W I�CFNSE�IN FUIl WRCE MID EFFECT. b � � Lw � UCENSE CU1SS LM..NO. �/1 �� � > � onrE '� - carrancroa�.��!1f_Za� a WORKERS'COMPENSATION DECLARA710N , ^ Q y1 MEHEBYAFFlRM WDER PENALT/OF PEHAIM ONEOFTIIE FOLLOWING DECUMTIONS: Z Q � �_IIMVEANDWILLMAMfTAWAGEqTIFIGTEOFCONSENTTOBELF�N3UHEFDIiYpRKER3' _ r COYPENSATION.ASPRONOEDBVSECTION37ooOFTHEtA90NCo0E.FONhIEPERiORMANCE U d � OFT1E WORK iORYMlq7 TI115 PERM�T 191SSUE0. � I NAVEAPID N7LL WVNTM7 M�ONKERS'GOYPENSATqN INSUMNCE,AS NEOUIqEO BY SECTION � �7000FTIE LABOR COUE.FOR TME PERFORMANCE OF iHE WORK FOR WNICHTHIS PERMIT IS ' ISSUED.MY NNRKERS' PE TpN INSURMI(: GARRI/�R ANO FOLICY NUNBEP AAE: CONSTRUCTION � CARRIER /�e N �q!� PLAN qEVIEW � roLICYNu.�Ep C—�e � ;;0 1 ELECTRIC 0 �sEcrpNr�rpreeaa.w�rman�vew�rrswRorveruronrnoaLwstna�a+�ssl PWMBING - - Z 1 CEi1TIFY TFUT W 7HE PERFORMANCE OF T11E riOPo(FOR WNIp1 TH15 PERMIT IS ISSIJED,I MECHANICAL �'"���-`"' SM�(L NOT EMPLOY ANY PERSON M ANY MANNEH SOAS To BECOME 8�1&�ECT TO THE � WOPKERS'COMPENSATqNlAW30FCALIFORNU,ANDAGREEiHA71FI5HOU{.DBECOME INSPECTION FEE S S1161ECTTOTHEWORKER4'COAAPENSATIONPROVISIONSOFSECTION97000F1HElABOFl WOE,I 6/4LLl iORhMAT/COIAPLY WI7H 7HO6E PROVISIDNS. �SSUANCE R e(��� ^. �!�'+^A � � {��� �N SMIP �it-9�`'-�v�iJ p OATE: r-u-� APPLIC/WT: �Q�s_(n.ard �Il.�'c�l f/T' . . � ENERGYP/C $ i 4 •'�������'"� •', ^'' �'F.r�.T� WARfJINO:FNLUqE M SECURE WOfiKERS'LUMPENSATION COVERA6E IS UId1�WFUl,ANO sHALL BE -y 7, t � BUBJECTANEMPLOYERTOCRININALPENALTIESMIDCIVILFINESUPTOONEMUNDREDiNOUSANU ENERGYPERMII�''�`�''1-'���`���r :�1I^+k��:r..j'�';.A � OOLLARS(C100,000),W ADDIT10N TO iHE COSTOF COMVENS�TION,pAM11GE3 AS PROVIDED FOF IN � EEC710N�7olOf1HELAB�RCOOE.�NTEREST,ANDATfORNEY3FEE5. RETENTIONFEE: � CONSTRUCTION LENDINO AGENCY PRE-ALT FEE: � 1 HER[BV AfFIqM UNDER PENALTV OF PERJURV TH�T THERE IS A CONBTRUCTION LENDINO A6ENCY FORTFIE PEHFORMANCE OF T1E WOFK FOR WHICN TNIS PERMR IS ISSUED(SEG.ioY7,CIY.G.J. � � �EN�ER'S NAME � LENDER'SAODRE55 � ICENTIFYTIUVTIHINEHEADT113APPLIG�TIONANDSTATETIATTiEABOVEINFORMATpNISWNqECT. TOTAL FEES d IAfiIiEETOCOMVLVWITMALLCRVANDCOLINTYORDINMICE5ANO8TATElAWSRELATWOTO8UILDINQ � CONSTqUCT10N.ANDHEREBYAUhqRIZEREPFESENTATNE50FTWSCOVNTYTOFNTEHUPOIVTHE ABOVH.IElf10NE�PROPEPTY FON�NSPECTION PURPOSES. COMMENTS 9 �i C:C'lCtr� �• �Q �181�1 � PERIAITTEE E(PRIN'n q� � / /�--r��I S-ll-'_t_ �j SI�NATUR R�EE � DATE � RECPT.NO. PAID BV VAL1DA710N WHfTE—Deparlmenl Copy,YELLOW�Inance Copy.PINK—Aasessa Copy,GOLDENROD--File Copy,GREEN—ApplicaM's Copy C{TY C)F Dl�t�l�UtdD BAF� IFvES��CTiU4� F�ECORC? �, , , ... ,,�� .:,� .,. ,�.,� ..� - - �,� �.: . �„� ��`�`IR��.. ���� ���l��k � �� . 1� c � - R�� '� �'� � �: f � . .= ► .. " . '`: .. .�. ,.� � �„�, �. �..,�,,;�,. t �r � r6 � ' . j ��oa��oEs� . _ ____ _ . _ __ _ _ __ � ..._--��-- — � E TCaSI{ Q�i".A�+�TEc` � _ .__ _ _. _.._, . . � FNA FiEQtJfTS __ -------------- _..____.__-:_ -.-------�----. ------�------ ----. _....- ..._.. --- — __._.. ! �-_LEC i fil�C�R<Jt,1;J�? I, i ` !i IINvFFi FLC70f� biJC T _ __ � � _ _.. ..__ .- - --- �---- � - .�..—__. ._,...---.. �� i, ', Ni {��ar,-,F,,�, � UCd�EFt FLOsJR CC`�DUlT � - F_.. ,-- - . . ___..----- __.....__ ____.------ ._ T _-_----, n ..-..------ __�.____ �. .------�--------- . _.__ �._... _-- ----------- -- � , �,i;,c,r-� stif; ; { F I�Et' _A�E FO�SNDATION � � � _ _ .-- --- ---- - _�__�.._ ._......_ G...- - _ i�=t�'�' f.14'�Jr�i FiFEP�ACE c3nf�D FiEI�Pw" I --,. ... -------- ----...�---�---------.__._. .�...--- ---- �—�.._- ------------ _..---�� l�r�i FR �,E�V9C , + i Mtp H7. EaOND E3rc�r,� � . ' . . ... ... ." _"' ""`_"'_..F__" , �."_'.. . _........ - .."" '_",.._'_ _"" I _' .. .�_. . ..'""'.__ C t� � � ' _� r � I II�"C BCt�D BE�1N! � _ . -,.----- _ �..�_ _ _ _ _ —T. ' 1_ _ _ __.._�_._._ -- -+ --- Fi'JAt BOND�3E�f5�1 . _. ,-- --------._... . . ------. ..._..._.. .. _ . __. ___ __ ___ E � _ -.� r�tlsa� ��';"> A1 i!x f�TIfJY'.1 I -- ---�-- �---- -�----------_._— c, -; � w,r , f �? ! ' PRE-vi�f�DIPJG _.._. �__ ...__....._____.r-._—__—_.--•-----------�-�- -- - - ;•-- -_...... ;---------_.____.__._------ ---�. ' f��i hal"�"�1P31 � � 6EIv{�hlt�ia ---- _ ---. - - - ------- i .,.._ .. .��....._�._,.__ 4 ..__ __�.. ......_ .S-__. ___ ' '_' __'_ .+v.�_._—.'___ _�_..'._'____"..__"'__'____ I�'".�..a!� �'LE� i FsIC ! � � ; f1011GH GF�ADtNG ' .. _... . _'..... ._"__ .. .`.. ..—. a__..__ .._. ._.._ .._..._..._ _ _..._.... �. �-- .-_...L._._._'____....__._��..'__.�.._._,...__ �;:��,::��� �������;;�� � r����5�—{ ;:,�A�s�u � _ _._�__.__ ._--------- --------------_---_._._.__ _ _--- ---- , r.:� vcr.'+"Jt�TE.�'.�T i ' POOL EL.ECTRIC �.__---------�---- � .. _ . . .. _- --- � _-�---- - J---...._.___�.._.-----�----._,,__----------- --�------ - --------- -� �:. r f"�-� �.,IDiNG i � PCU�F•ERfCING ' : ; _. , - -----___. _----- ----�---�_---- --------•------.. ---�--- --- ---�--------------- . � tlt;"t, 1;�a�:J',��TI�)^� � ' ; POOL Fi�lAl � --- -----�-----�-- ------_-- ---------_____._ _ � __ T �___ .—_; C -i� f��� l���l.'L�Tf�Pa ' QF SI I t !h"PS. __----- ------._.�.�.---..__ _.... --- -------. ._. . }-. _,_ . , ...-------- . ..._i L`r';'t4'J�,t L�J�ti.eN�x , D�DICFa"'iC3hSS 1 _ __ _ �- --- �— ----_ _..� ..__ ..-- -_,_—..�_ ._. '_ L '""_".�__""""_'____'_._P , �,t'i",+ ? ; y ``�.� � FIC�;�`,L�NCa i ' _ _._._ �- . _ _ __.___ ---- _., � __ .__. ._ _.__ _ _ � . r� o°��<I': ! Lr��"�1D��'��F-`IF1fZ+i' _ � _._.. � •- -- ._----�-�--- _ _---_ -- -- - 'i:i.:.r' v�lir'�.L, �' ; I CC�Si"f�.ICv?F�r>. � _ ___._ _._.._ ------ � ...........__..._""'��..._..__._... ..._..'_'�:.....,._..._..__..._�.._..,."""___�..__•_ _........-1—d.Y..._'_'" ---..-- ----- ----•----.__,. ---- -- .___.,,.__ __._._..__.-------- ----------�-j ,�tiL �'.1�1 �.L=�7 - I - 'E���_������ .. �, y .. ...... ... .....__..._ _.....,.._....._._..,_"-"""_._..�._._ ._..__._._._ ..._.._._....,..._____..,__ _ ....S"_.__._..._......... ,_.._...._... ..... . : . ... ....... . ...._... .... .......,.. "'....__....._.. ..._.... ..����._.. _.�,�..�geti:i. � I .,,. 1-�1���. i.�iih'i�. {'IraA,1 . � ,. _ .. ..._ _.._._. ....___....-'- '---'----��----'--...... _..-'---._----- . � ...__ . ..........._ . ......-- - -._....._._......_...._..... _._... _...._._ �-.. . _ ................... .._.._..,..... -�._.._!. " 1 r � iC. ! . F+Er1�.i i L7Fr" ril�1!'€ '. . '.. _. ..__ .._._..�_.__---- ..__-_. __---�----------.__-----....___ ,...;.�--- -...., .__-----..._ _ ,. _..... _ ------- ' ____ _---___ ___..__ __, � ;��r t .i.E.�C�"�'r,€; • 1 DEl'. "r�=r4 F,'�.if:) ._.- ----------- ---- ---_._.__. .._..___..---.._ �._.. _, -----..___.....�__ . ...._.------- ...._�,_----.._ . ...._. , _... ., ._..; . ti' 4 3{ 1 7�,. ��Lv4. � ���4.��?'f � . ......... ..._...,-._�_.._'�_'_.__,...._......_.""_.,,__'.._..___"__.�...._'_"'_..r."._"_"'_._... ._...!.__..-_._"..._._._._._. _.,_.._""_"__.._ ........__._;.__..__."_"_""""""_....._..._.._.._._— : , � i i � ___. _ . ...,'_W__. .. r_,�._ ..._'�.. ...._.—..�,_..._'__._" „�' ,� .. ... ... . _ . . .. ... ..... - 4 .�g�-I� .i..� ... 1 t � �x ;h� E'�F�I I ' .�. . ...'"_'"""'_".__.._"'�_._.._.'..�.�_._"_""",�_.._....��.............._'"'�._v���',..,f;?Rx:;��^rsr.��+k. . . .. ...._. ..,"'__'"" ._..........,..""__..' ' � '."__"_'___._. ..,....__ . . . .. . . . ' . ... . . _ _ _ _ . I . ...e'1,�':,���:'ei�'���-� 1�� � . ._____ �'"—_""_._._�__.._—._...____._..—__._..._.___'�_.___.� .'—__.�.__'___.__"___'__—'______'._ _"___._.. . . ...._._.--------'--�--...._..._,--'i( i --..._.....,......._._......�.____..._._.._._.....__..__.._..,.._.------------------_..__..._.__..__._....__..__..._..----......._-----......_�_�-------..___....__._...----..._.._..._..------..._......._-._.____.._.._�.__...._.._.__.....-----...._.� ---.�_-..._� ._..-- �� _.---__.------------ ------.._ _. .�__ .. __ _.._. ._...,._..-----...._. .. .. .... ... .. ....... ....- ---..��._.' ____.._--------�` _.---._....._----.__.._.__...---._...--_.._.—..---.......-----_.---.._,__._._...__.__...__-----._.__..----..........._......._-...-------� _ . � .._._._ _...�.. _._..._, .�_.. ...-----�-•-----_..__.-----...w._ __---...._, .�__�.�_..- �---�---- �--� --- - - -.. _ __.. _ _.. _... _...._ -----._-----____. _...... _.._..., _.. i . ._..._ _...:_, .....,_..----.. _._-----.----�, ..._..---. __._ ._.._..__.... ..------.._,._ _._..�.. ----- - ; _........ ., . .... .... ... .....-....... _.---- - ._.� - ______-----------.�_____--___�._.____._..._------------------�--..._.�_.------- ....__.. _._.._._ ___--------------- ---- ! 1 i � ......_ „ ...._._.. . _......_ ...._.--- _ __-- - ----_ _____-�___._. ___ _ __-- ------ __ _.. . 1 ;. ._._... - --�_... . -----_.----.. _.__..___------ -..,_..____.._�.---...-.___. _.---.._--- - --- t - -. . _ ___... .._.._._.. ..._--- . .__ ._..., ., ...-- , ��...,.;..a�.;-�-ftR!!^�. Si��. " � .. :�'.�., � • ---- _.. � c;�r:�, �a!�/;� c� �- --..,..._---- _� .__._.._-_---- •---�-- _..—........_..__ . _.... _ ., ....._. ._ ..._._... .. ....__ . .--- --. � � .. ._,_. .. . �,.?.:_ _ _..__ ------ „. ... . ..... .... ... I,...., -- r , ,� ... .._.._.__._ _._... . ._... .__.___.---� --._—._...----- ... _ ._...... __. _..._._. ---- . ...... _ _ _�,_ . . , � c � � __ ___.._.._ _... . .-- --.___- ----�-�------ ____.---.._._....._ __._._. _. ._...., G � i . , , ___. __. . __.. . _.. 'IV . ..... .._... p `r , I'. . � " _.V'"""' '", . ,_. ....._ ... .... .. ' "�_�, . _.. �._.. ..... . _..._.., I � .��� . � II � I`I�� . ._'_"�""'_.__�......"_...._._..�. .. ......_.._.__._.._. ............,..,_.. ..._...._..._ . ..... ....... ...._...... . _.... . ..... . ............. .........._._ . _�._� P � I � � t � c� ---'.....�__.._..__.__. ..._..........., ._. ._.._....._.._.___....-'--..... .._ . . .. ... ..._..____...... .._.__...............__.._...... ._.__......_.... ........ ._ ._.._........._...__ _.___� 4 ,.. � � '-. .... __....,.._..�.._...--'..__......�._._ .....__..-'-'--_..._.._.__,.._..._.___....... ..........._. .. .. ,. ..-�---...._._.........-' : _........... �._............_ ._.._� .� i . I . � ��� _._. , �, � . 4 �.:_. , . 1 . � ... .... .. , .. . .... . •-__.._'__"'-._.�..� ....,.._"___'_._......___'_'..._.__._—..,_.""'__...,, .,...._...�_ ... . . . .. .. . .. .... .__ ' '._.._, ._.._,..�..._. _,__.._...�...___.�.___.___.__...__..__.._._._ �i