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HomeMy WebLinkAbout13-681 Z'! g CTTY OF DIAMOND BAR ----� DEPAR"I`MENT OF COMMUNITY&DEVELOpMENT SERVICES % 21810 CoQley Drive,Diamond Bar,CA 91965 � . 909 839-7020 Fax 909 861-3117 Building Inspection Hotline(909)839-7027 � PRESS ����� BUII,DING PERMIT APPLICATION FIRNILY � JOBSITE APPLICATION �7 �� PERMIT ���/ P/C I o AODRESS Z S DATE � NUMBER � A � ISSUE 7 l TYPE � OCC APN LOTt s TRACT pATE CONST. U i�'1- GROUP p OWNER � o ADDRESS Z� ba1 Su�s�� CrDssir�a 1?c� ZONING SETBACKS W CITY �iomc�d gGlf Z1P 11 S TEL.�2.(s-(e7�'�oZS�f FRONT RW ❑ � APPLICAN7 �otv.r. C�hr� ,rQi TEL�j51-241^C87C-. REAR O n SIDE/SIDE STREET RW ❑ 4 CONTRAC70R �IYY1Cf'�-CAl R��{sc � �1.+.�..�,�� SIDE ❑ ADDRESS(0895 nQ�u C'r �i E pROPOSED USE o CITY R.,n.�rwt�A.�- ZIP QDb'�\ TEL��'c��1-��1Z w ARCWENG/ w DESIGNER NO.DWEL. NO. NO. a ADDRESS UNffS STORIES BEDROOMS � CITY ZIP TEL N DESCRIPTION SQ.FT. FACTOR PSF ADJ.AqEA/VALUATION � � Q OWNER-BUILDER DECIARATION SFAlADD/REM ' O , 0 1 HEFlEHY AFFlPoA UNUER PENAL7Y OF PERIURV THAT I NA EXEMP!FROM hIE COfffMCTORS LI- G0299ICef�Ort W CENS£UWFORhiEFOLLOYN�CiREA50N(SEF703138USWESSANDVROFESSIONSCOOEANYC(TYOH (n U G�UNfYW111Q7REOUWESAPERWTTOCONST/iUCf.ALTER.D.�ROVEDEMOUSN,ORREPAIRANYSTRl/G W Patio/Dec1c � Z TUqE PHIOR TO RS lSSUMlCE,/�LSO REOUIRES THE APPLICANf FOR SUCH PERMfI'TO FllE A SIONED � w STATEI.IDIT THA7 HE OR SME IS UCENSFD PURSUMfT TO 7HE 7AOYIS�ONS OF iHE COHiMCTOR9 LL � CENSE UW(QU➢TER o(COIAMENQf10 N7TH 5ECT10N 7000)OF OIVISION�oF 7HE BUSWESS ANO 7R0- LL' POOVSpe � FESSqN5CO0E�ORTNA7HEOR5HE196(EMVTT}IEPFFROMMlOTNEBASlSFORTHEAUFIi�EXEA/P- � � 71pN.µyV10lATIONOF5ECT10N7Wt.68YAM'A7VLICANTFORAPEiWIT5U61ECTSiHE�p71.N'.N1TT0 Z Ro-Roof � A CNIL PENALT'OF NOT MORE hUN FNE MUNDRED 0011ARS(3500).k � ❑4A50WNEROFTHEPROPERTY,ORIiYEA4PLOVEESWfT/iNUCESASTHE1R50LECOAIPEN5AT10N, � COITIIIBICi2I � Z NnLL DO7HE WORK AND T1�E S17iUCTURE IS NOT MTFNOED.OR OFFEAFD FOR lI1E(9EC.7o+s,Busl- J NESS I�NO PROFESSIONS OODE TNE CON�fUCTORSIJCENSE UW DOES NOT A7PlY TO AN OWNER OF � � PqOPERIY'/✓rIDBU�L0.SOi11MPROVES7NEAE0ILNNNMODOE54UO�NbFKHWSRFORHERSELFOR � � THROUGNIiI50F7HERONTIEMFLO'YEES.PROVIDEDTHATuUGIWPROVEMpfTSAREN0T7RENDmq1 m W OFFEFiEDCOHSALEIF.HOW6VERTV1E8U0.D11WORSAPROVEMEN�1s5oLDWfrHwONEYEANOFCOHPLE- � T10f+.THE�wNER-BU�L.DER MrtLL fUVE THE BURDEN OF.�ROVW(1 7MAT HE OR SHE OID HOi 9UttD OR Z PIPROVE FOR THE PVflPOSE OF SAIE} _ ❑l�OVMFA OF TTiE PROPERTY.AM E%0.USNELY CIXITMCTND VRT1i LiCENSm GOffTAhCTORS W Q TO GONSTRU(.T THE FiIOJEC715EC.7aN.BUSINE55 ANo PRDFE5510N3 COOE 7HE COMAACTOR9 LI- V21Uetlafl �✓ ADJAREA W CENSE UW DOES NOT APRY 70AN OWNER OF A VROVERTY WFI�BU1.05 OH W PROVES THEREON,AND . � NM1fOCONfMGT5FOR5LG1PpQJEGTSWfTYiACONTMCTOR(S�IJCEN.+EDPURSUANTTO7HECOHfMG QUANTTTY DESCAIPTION FEE � Y TORS UCENSE UW.�. Q Q O ❑I AA1 E%EA�PT IWOER SEC. B.8 P.0 FOR TWS PEASON � U oc LL DATE � �N�NER Z ' W � LICENSED CONTRACTORS DECLARATION � w � CL I HEHEBY AFFlRAI UNDER PEW�LTY OF PERAIR'/7TfAT I MI LICEHSED lR1OEA VHONSqNS Of QIADTER d a�GOA//AFJ�CP70 N7TH SECfION 7oao)OF OIVISION a OF THE BUSfNE33 NID PROFE5510N3 ODOE.AND Z � 1� ( X MI tJCENSE ts W filll FOfiCE AND EFFECT. m . � ucEr+se� s L'�J b uc.r+o. q 2 8�04 4 � f i x ` r- }-- y�s v o�re 21 'I 1� c«rrancroA/�m�r;-L'n1 � aJ. S G w � WORKERS'COMPENSATION DECLARATION � � �yy � I HEREBY AFFw./UNDER PENAITY OF.PERIURY ONf OF THE FOI,LOWING OEG7:ARAT10N5: U � Cn � O _IHAVEAN�WILLMNNTAWACEATIFlGTEOFCONSFM7OSEI.FWSUREFORWOPo(ER5 '� C011PQISATION,A'f�ROVID�BYSECTON17o00FTHELABORCOOE,FORTHECERWRMANCE � Of TIiE WORK PoH WNIq1 7HI3 VERMIT 19156UED. � � SS w IlNVE ANO WILL MAINTAW WORKEfi3'C�AIPENSATION Rl3URANCE A4 f1EpJIRED HY SECTION . Q J7oo OF THE LABOR COOE,FOR THE iERFORMIWCE oF TME WOPoC FOR WHIO/TitlS PEiD,GT i3 ISSUEO.MY WOPo(ER5 COMPENSATXX/INSVHANCE CAiiWEH MA P0.1CY NUMOER ARE: CONSTRUCTION j CARAIEA�ctr�4e\ �i�s C�. - PLAIJ REVIEW � vaicrrairaeEa 1'�11�G C�AQ.3770-OZ ELECTRIC � (f1CSEcnoNNfmwieEoa.PlE1�CFtrEVE3yxr5wRu+EHHx�auwRSlrmlwlEsll PLUMHING � Z 1 CER7GY Tui M 7HE VEFlFORiJANCE OF 7FiE WOPof FON WHfCFI t}11S PERAYT IS ISSUEO.1 MECHANICAL LJ SHALL NO7 EMPLOY ANY PERSON W ANY MINNER SO AS TO BECAME SU&IECT TO THE, � WORNEHSUN.�VFN5A7qNUWSOFULIFORM�ANDAGHEEINATIF151iQUlD9ECOAIE INSPECTIONFEE ? SUaIECTTOT1tENOfV(EFiSCOMPEH5AT10NPAOV1510N40F5ECiqN�7o00FTH£�UBOH . CODE.1 fffHN/11HCo1/PLYW17f1n1o5EVHo�n9�DN5. ISSUANCE � � SMIP p DATE APPLICAM: . . . � _ J WA{W W4 FASLRE TO S E WOPoCERS'COMPENSAT%7N COVERAGE�5 UNLAWFU�ANO SHlLL BE ENER�Y P/C � SUBJECiM!FJ,IVLOYER 70 CRIMW.LL vENALTIES M!�CIVIL FNES tn 7l)oNfi MINORED�T10lAANO �.JEp(3Y PERMIT OOl.LM9(SIOO,Oaa�,P!�DDITION TO THE COST OF COMPENSAiION.OAAU�E9 AS PftOViD�FOR M J SEGTION�)Os OF iNE UBOq COOE NTEAEST.ANO ATTORNEY$FEES. .. Q RETENTION FEE � O � CONSTRUCIION t£NDiN6 AGENCY. PRE-ALT FEE � � 1 HEREBY AiFlRM uNOEH PEHALTY OF PEfUURY 7HAT TFIERE D ACONSTRUGTtON IENOviA AOENCY Z FOR T11E VEAFOHiJANCE OF hIE WOPo(FOR WHItl�hll9 PEHArt719 ISSU�(SEC]OGf,dV.G} W � LENDEASnANE 1— LENDEA'S�ODRESS q � ��EA�„�.����i„��a,��.,��sT�,TE.,,�T�,,�aF�T��g��,E�T. TOTAL FEES 21 � �� 1 . w 1 AGREE TO COM7LY WITH All C/TY M70 COUNf'f OqD WA!lcEs AND STATE UN9 R9J�TM9 Tb BUIDINO � CONS7AUCTION.M1D NEAEBY AUfHORIZE RFPFESENTATNES OG TMS CWMY TO BITEA UPON 1HE Z �BOVE-A7EMXXJED 7RODEPTY FOR INSPfCTION PUMOSEB �MMENTS � � ��'��rPYI � r�c[YT . m �EiUaT7EE NutE(VRINn . � .su vL. �.�-1 � ���I 3 � Uj SK3NATURE OF P£RNRTEE DATE = RECPT.NO. PAID VALlDAT10N , / ~ ' ' WHI'fE--0epaAment Copy.YELLOW—Flnence Copy.PINK-Assessor Copy.GOLDENROD---Ftla Copy.CiREET�-ApplkanYe Copy . � ' V j.�+9�� 'Sr 1_�a i_�a ^����,i�4�'�1 i`•:t�� ._J:�n�S a'.i _ . . �q »- 9��:i�; .�h.,1 i.�i~'�J`. ,...:'�.�,��G•i�.� � i '� d u y��. ��a �. y �< �' I �i._�( ���. �. 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DR'(b�/ALL P•1;aILING i DEDICATIONS ------------------ -------------------- ---._... -- -------_. �E4�/ER �FI��lAL ENG. SEPTICTAf�lK I LANDSCAPE!IRRIG. SEEP PIT,�L.L. OPd SITE IIViPS. — — ------ - �------------ -- GAS AIRTEST FINAL ZO�IING FINAL CONST. �FIRE DEPT.FINAL FINAL rIEA�Ii�1G i HEALTH DEPT.FiNAL - " FINAL ELECTRIC I DEV.FEES PAID FINAL PIUMBING � I ENERGY FINAL PLANING FINAL ENGI�IEERI�IG ^ '� �• r��a - - - � ; COMMENTS SEPTICTANK SIZE - SEEP PIT/U SIZE