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C1TY OF DIAMOND BAR COMMUNTTY DEVELOPMENT DEPARTMENT ...� 21660 E.Copley Drive Suitc I90 PRESS (909)660-3195 Faz(909)861-3117 '""' BUILDING PBRMIT APPLICATION FIRMLY JOBSITE APPLICATION /A PERMIT �J' P o ADDRESS 2720 SHADOW CANYON DATE � "' NUMBER/// / N � APN LOT � TRACT 30289 �SSUE TVPE OCC � DATE �� CONST. GROUP OWNEp TOM & CRYSTAL TSAO ADDRESS ���,���j;���� ZONING SETBACKS 8 CITY TA1T1TiSTRV ZIP_91 74STEL. 21 FRONT RW ❑ �jAPPUCANT F' ANK T . MARTNT T��, 59—"'i33� REAR ❑ � SIDFJSIDE STREET RW ❑ CONTRACTOR • � • SIDE ❑ � ADDRESS RESERVO R PROPOSED USE ���]0 �,,�,1 il-t_� � anr -��e�T� iiP s1�b�re�. ��0-i-�-��Q �. � ARCHlENG/ DESIGNER NO.DWEL NO. NO. ADDRESS� - UNITS STORIES BEDROOMS � CfTY ZIP TEL. DESCRIPTION SQ.FL FACTOR PSF ADJ.AREANALUATION p� OWNER-BI:ILDER DECLAAA770N SFWADD/REM O [� I NEHEBV AFFIRIA UNDEF PENALTV OF PEiWRY 7NAi I AIA EYEIAPT FRdA iME WNTIt4CTOR3 LI. G9�Q8/G�pOR � CENSEUWFORTFIEFOLIOWWGREASON(SEC.70.11.68USNE38MIDVROFE93qN3CODE:ANYCmOR (n COUMYWHIpiRE0URE5AVERMITTOODNSTRUCT.AL7ER.IMCNOVE.OH+lOLI3H.ORREVAIRM1YtTRUC- W P!t{OIDBCK 7URE,PR10N TO IT!q9UANCE.ALSO REQU WES THE APVLICAN7 FOR aUp1 PERM�R f0 FILE A SIONEp W � BTATFJAEN7 TMAT NE OR SHE IS LICENSED RJR6UNIT 70 TI1E VROVISIONS OF TNE COMRACiORS L4 �15E lAW(CHAPTER�I�MENCING N77N BECTIDN TaOoJ OF CIV1610N�OF THE BUSINESb ApD PIiO- � PO�V$p8 FE851DI1S OO�EI�17W1T NE OR 9HE IS E7[EMPTTFIEREFqOM IWD TNElA316 FOfl T11E AlA.EOED E%EMP• TqN.ANYVIq.�TqNOFiECTION7a71.6lVANYAPPLICMJTFOqAPERMIT9UBJEC79TYlEMPI.MANTTO Z Ag-Rpp� � ACML iENALTY OF NDT MORE iHIW i1VE MUNDRED DOLLARS(i5oo�.� OL��WNEROFTNEPROPERN,ORMYFIAPLOYEESNnTMWA(7ESA9TMEIR80LECOMVENSATION, O CpmmBfCl81 $ WILL00 7NE WOqK,M1D THE BTRUC7URE IS NOT INTEN�ED OR OFFERED FOR 9ALE(SEG.1w.BUSI� J � I�E55 AND VqOFEB5tON5 OOOE��NE CONTMCTORS LJCENSE UW OOES NOT APPLY 70 AN pYJNEP OF j PROPEHTY NF10 BULDS 011 MPiMVE3lNENEON,AND NM1p DOES SUCN WORK HIMSELF pR HERSELf Oq � 711ROlIGHNISORNENOWNFA1PlOYEE3.DAOV10E�7NA75Up/WPROVEMENTSMENOTMENOEDOIi m OFFERED PDR S/LE IF 110WEHE0.TME BU0.01NG OR IMPFbVEMENT IB SqDWITHN ONE YFAROF WYP�E- � TION.TNE OWNER6URDER N1LL W WE ME lURUEN OF YROVINO TINT ME OR 3HE DI�NOT BNLD Oq IAIPROVE POR THE CURP06E OF S/LE1. W ❑I.ABOWNEROFTNEPROPERfY.AMEXCLU8IYELYCONTMCTNOWITNLICENSEOCONTRACTORS � TO CONSTRUCT iNE PRO.IECT�BEC.7M4,BU91NE55 AND VROFESSION9 GOOE:iHE ODNTiIACTORS LI- y`�ye��p� 11DJ.AREA CENSE lAW DOES NOT APPLY TO AN OWNER OF A PROVEHiY H?IO W LDS OR NAPROVES T1IEREON,MIO NM1OCONTRACTS FORlUCH ORQIECTS YIATIIACONTAACTOR�S)LICENSED OURSUANTTOTMEOONTMG ,o��ceNse�.Wa. ouaNmv oescaiPnoni �e � 0 1 NA EXENPT UNOEH SEC. B.�P.C.FOR THIS REASON 6 U 4' MTE ONMER � Z ��[ UCENSED CONTRACTORS DECLARATION � q I NEREBY JIFFIRY UNOER PENKN OF PERIURY TFUT 1 NA LICENSED UNDER PRONISIONB OF CM�IPTER � � ��COYIIENCWOWfTHBECTION7000�OfOMS10NfOFT11ElU81NESSANOPROFE4SIONSCODE,AND Z VJ ��ENSE IS Nl FKl FORCE AND EFiECT. m � LICENSE CLASS B 1 �,�.r,w. 2 8 3 7 2 4 � � o,�� 1�/41 /9R caar�ucraa PTF.RMAR7N� F.NT 3� � WOqKERS'COMPENSATION DECLARATION i2'?J1� � � I MEREBYAFFIRIA UNDER PENALTY OF PERIUNV ONE OFTNE PDLLONANO DECLAMT�ONS: G � Q X IMAVEANDWILl1AAM7AINACERTIFIGiEOFCONSENTT06ELF-INSUREFORWORIlERB' Q COMPENSA7qN.l13PROVDEDBYSECTIONa7D00FTXElAB01100�E,FOAINEPEHFOR►4WCE W Q OF THE WOIiK FOR WHICH THIS PERMIT IB ISSUED. � �INAVEAHDWILLMAINTNNYYORKER9'CDMPENSA7IONIN9URIWCE.ASI1EWIqEDBVSEGTIDN � �� Qn a7o00FTMEl/IBOR00DE,FORTHEPERFOiUAANCEOFTNEWORKfORYYV11C317N19PERMITIB ISSUEO.MY YNDRKERS'COYPEN6ATION INSURANCE CARRIER AND POLIC`/NUMBERARE: ONSTRU �/I .�.� A �' r � CARRIER PtJ�N REVIEW — � � POLICYNUAABER " �r ELECTRIC (�1a6sEc110NNEED�a7eEm�.1PLE�mOFTEPEtxttsi0apE11l1�FiFD0ot1MSR�oolptLFS�; PLUMBING � f CERTIFY TNAT W iHE VERFORMANCE OF TNE HK FOR WNiqi THS VERMIT 181g5 MECHANICAL SFIALL NO7 EMPLOV ANtl PERSON W MIY MANN 80 A5 TO 9ECOME 8 .i+TQT (,/� �MDRKENB'CMdPENSATIONUN�80fCAlIFO i,ANOAOREETH �� E E INSP FEE SUBJECTTOTMEWORKERS'COMVENSA SIO M?16�OF1HEI,ABOR �� OE,1 TH COMPIV — � p DATE:'�APPLICANT: 5MIP ' � WARNMO:FAILURE TO EEpJRE WORKERS' PEN AOE 16 UNtAWFUL,AND SFIALL BE ENER6V P/C �--��cI�rr—�,) � SUBJECTANEMPLOYENTOCAIYINALVEN ESAND MLFNESUPTOONEMUIJ�RE�TIIOUSIWD �� ` V W�� '.. ��$Ii700.000),R!ADOIl10N TO THE T OF PENSATION,DAMA�ES A4 PNOVNED FOR IN ENERGY PERMIT „J lEC710Nl7oeOFT�LABOROODE,M7ER ST,AND w�^a�Es. qETENTIONFEE: � � CONSTR 10 LENDING AGENCY PRE-ALT FEE: �IL AI �.� � 'l�.�C? t's's�� �—... � I HEREBY/�FF1RM WDER PEN�LIY OF PERJURY TFIAT THERE 16 A CONSTRUCTION IEN�W6 A6ENCY FOfi T1E PERFORMIWCE OF TNE WOIiK fOR WHICH 7M13 PEN��T�6155UED(BEG 70W,C�'.C.A � LENOER'S WIME S � LENDER'SADDRESS. /� � 1 CERTIFY T1MT FUVE qF�p TI{IS ATE iMAT iM FdYAAT�pH 1$pOppECI: TOTAL FE ES /D. / • 1 AOFEE TO PLY NATH AND GOUNTY ORDNANCE9 MJD S R£LATINO TO BURDINp OOMS7 EBY HIS COI.NTYTO EMERUPON TIE r � v SPECTION PURPOS 5 COMMENTS � � rE E h��'�1 � � 6 NA E OF PER�NTTEE D E RECPT.NO. } PAID BY G s YALIOATION WHITE--Deputment Copy.YELLOW—Financa Capy,PINK�1leaessor Copy,60LDENROD--File Copy,pREEN—,11ppltcanPs Cq�y __. ._ . ...._.. .---�,.� ,,,--,.�,.. .._.._......__.. ,��.:;,. .. . .�.........., .._. ., , . . , . , .. . • ,. ..,,.,.,.r„�. ..,:, •� ... . . 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I i � COMMENTS .--=---- ------�--------- -- --- -----�---------...- ------- -- - ------- - - - - _...--�----._ . .. _. . _ -�- „ � _ _ , — =,--�---- ---- ------..�_.____.._-�----._...- �- ---- - - --�--_...._---- ---- -- -----------------------�----------- ------- - - - -- ---�-----�-------- . ._ . .- --- -- -- - -- - - -- - - ---...--------�- - -�-�- -- -------� ' =-----------------�-�-�-----.._�.--=------------� � -�---�---- �-.._� ...... � — --------�--�-----------------�-�---- _ _ _- -- ---,�_...:--------. ..--------- . � _ _ _ . . -- ---...--"-------- - ------� - - ------- -. . . . . . . . . . -.- - -- - -. --; , - -- -- - _ . .. .___ �- ,.� , ° ; .�.. , - ----._._...._--- ----- �- ----�-�---- -.. .� � . . , --------- ----.._..--�-�-- ___�-�:�-*'�- ---------- -- -------�--- -- -• . � —---� --------�------ , -----�----��--- -- --. .. ...- ------�-------------------- SEPTfC TANK SIZE, ._�_.:_.,;_ . SEEP PIT/U SIZE -------- '._,_. .. _ ..------ ._ .. ... _.. ------ --- -----.... .... .......-----__, — - --— �------------- . -=----------=-=--.--�----� -.._._. ..._..---.._.....�---___..._. ._..... _.... ._ .__ _..._ _. , �....�.�.��__._.—.��.�_�....���.�_._..._._'_ __ __ _____'__"_... __".__—_.' _"_.__�...__- _—�_.._...,.�.,i . ...—::..� .. e . I � . _"_'_'"___'"'_""'"'_'_"""'_..___._.,._� ..._. __.."'._ ""'_'__'_"""_.'"'_._....'_'_" '...._....._�.._ .__ ._....." ' - - ` � -`��� i --- �, �, , , , . . ,. ; . .