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HomeMy WebLinkAbout13575 (1021) �� CITY OF DIAMOND BAR � DEPARTMENT OF COMMUNITY 8r.DEVELOPMENT SERVICES . 21660 E.Copley Drive Suiu 190 (909)86Q3195 Fax(909)861-3117 PRESS ���� BUILDING PERMIT APPLICATTON FIRMLY � � JOBSITE APPLICATION PERMR �P/C o ADDRESS I SClO vAtlEY v i�rA DATE ' NUMBEFi j�•�-- R �i� I LO l n � APN LOT_� TRACT 39 7� DATE � ��� ��� CONST. GROUP p OWNER " ADDRESS ZONING SETBACKS � CITY ZIP TEL FRONT RW ❑ APPLICANT TEL. REAR ❑ � SIDE/SIDE STREET RW ❑ CONTRACTOR C . G. SIDE ❑ � ADORESS • � ' � A � PROPOSEDUSE ON S�'T� I=1jLE SC.R�/�G� � CITY D}�RKC�.E,�GAZIP926G5 TEL. 7 • •� UND�(i V�D IPIN � ARCFUENG/ DESIGNER NO.DWEL. NO. NO. ADDRESS UNRS STORIES BEDROOMS � CITY ZIP TEL N DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � Q OWNER-BUILD[R DECLAFiATION SFFVADD/F1EM p 1 MER�Y AFF1fW UNOER PENAITY Of PEFWRI/TIUT I M1 E%EMPT FROM TNE COMiRACTORS LI• GBf3g0/C31pDR W CENSEUWFOitiHEFq1GWIN6REllSp1(SEG70.71,6BUSiNE55M17YnOFE55lON5CO0E:AM'CfiYOR (n C� COUHfYVR/1pIRE4UIHE$APEAAIRTOCONSTRUCT,ALTER�/�FqYE.DEMOl15M.ORREV�IRANYSTRUG W pa�i0/DeCk � TURE.7R�OR 70 RS 6SUANCE.AL50 REIX1YlE5 iHE APVIMlNf FOR SUCH VERMIT TO F4E�SIGNED w 9TATEIAENT T/UT HE OR SHE IS LICENSCO VURSUANT TO TMC OROYLStONS OF TN[OOtfTM[TOR9 L4 CFNSE UW(QUPTER Y(WIAMENqlM WITH SEC1qN 7000)OF DMSION�OF THE BUSINESS 11ND PR0. � PooUSpa FESSIDNS COD�DR iHAT HE OR SNE IS EXEMPT T1ER[FROM AND TNE&lSlS FOR TME ALLEGFD E%EMP- TION.N/YV�OLATIONOFSECTION7071-68YMIYAPPLICANTi01i�PENAIT6UBJCCTSTHEAPVI�CANTiO Z Fle-Haof � A GML PENA:TY OF NO7 A10qE TW W FIVE 10.1NDRED DOLLARS(i5ooj.): � O�/501N�EHOFiHEPR07ERT/.ORMYEMPLOYEESWITHw,�GE51l5MEIR5aLECOMPENSATION, 0 COf11fflBfLl�l Wtl.L DO THE WOFiI(.MA THE STRUCTURE IS NOT INTENOED OR OFfERED FOR SALE(SEC.7Du.BU54 J NESS MO OPOFESStONS OODE:if1E COHTMCTORS IICENS[lAW DOES NOT APPLY TO AN OWNER OF � PROPEN7`/1NVqBULDSORMVROVESTNENEON.IWDVMODOE55U(7/WOfiKNiA15ELFOi1MER5ELFOR = � TtliOUGHMISORMERO�M�Eu7LOYEC5,Pi10VIDE�hIATSUd1MPROVEMFNTSARENOTNTFN�E�JOq m OFFHiED iOR SKE IF,/qMEVEq TNE BUIDINO G7IMPROYCUENT 4`SOID N971nN ONE YF.N OF COMPLE , Z T10N.7NE OWNER-0UIIDER 1YLL MAVE THE BURDEN OF pppV7:O i11AT HE OR SNC DiD NOT BURD OR = MPROVEFOHTMLPURPOSEOFSALEl W OI.ASOWNEROFMEiNOPE�['Y./1AE%0.USIVELYOONTMCTNOW:THLK:ENSEDCONTMCTORS ZO OdC� [C TO CONSTRUCT iHE PRQIECT(SEC.7oN.8USINESS AND�ROFESSIONS COLE:TME CONTMC70R5 LI• V81u91�IX1 � ADJ.ARC-A lL CENSEUWOOESNOTAPVLVTOANOWNEROFAPf1DVERiYMT10BUlD50R141PFqVE9TMCREON.MlD � WVqCOMMCRSFOfiSUCMD{iQ1ECT51MT1ACDHTRAROR�S�UCENSC�PURSUANTTO7HF_CDNTMG QUANTITY DLSCRIPTION FEE � TOflSL1GEN5EUW.). . . . _ . . . . J , OIAMEXEMPTUtaERSEG B.IP.C.FORTMiSF.EASON Q � u" D�TE OwNER f' � � W F LICENSED CONTRACTORS DECUIRATION —� � � W IHEREBYAFiIPJAUNDERPENrLTYOFPERHIRYTIIATIAMIICENSEDUNDER7ROV1510N^uOFC11MTEfl � � •�CONYENCNOWITHSECT�ON70ao�OFDM510N]OFiM:8U51NE55��DDROFE551Wi5CO0E,AND Z X W UCENSE IS N FULL FW10E AVD EFiEGL m ltJ �+_t � LICENSE CLA55��LIC.NO. �D Z��� � . �j OATE � •11•9�1 corira�croRs�-��.1n1� ` a iT� � Y10RKERS'COMPENSATION D[CLARATION ��� a � � U � INEREBYIFFIRIAUNDERDEILLL7VOF7E0.NRVONEOfTHEiOLLO'MNGDECLARA'IONS. � Z Q � �IHAVEANDN^.ILMANTNNALERTIFICATEOFCONSENTTO3ELF�NSUREFORWD(LfERS' _ Cd/PENSATqN,ASVROV�DEDBYSECTION�7o00FTMfUBOHCOOE,FOR7HEVERFpRMM10E U �� MEWORKFORWHICHTHI57ERIAITl5155UE�. � C IH�YEANDY!!LLIM�MAi1N'OfiKE11�COMPF.N5A7qY1NSURANCE.�SRECUIRCDBVSECiION III111 ^ �� QO �7000F THE lA[10fi C00E,FOR 1HE VERFOR4ANCE OFTHE wORK FOR W�+�CM TH�S PEN.n715 /�YZ ""'1 ISSUEO.IAYNIX+U(E.Rb5COM�ENSATIONINS�UMN1CFGRRIERMlDVCiiCYM11A5ERME: CONSTRUCTION � L �� � � CARR�ER 1 F��CUT�F^�`�-rp'�- NS• �o PLAN REVIEIN �I�.� O� � VCUCYNUUBER��� �-} � EL[CTRIC �� ln/ � (fFC;SECIri1NEFDNOiBECL�f'LETmOf1lfPEta.fl6FOfiUC1u�AL�D�Ai�(Stxl lF^sl PLUh7DING �'Lr C1. 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RETENTIONFEE: ��� � / Q OGONSTRUCTION LENDING AGENCY PR � L 1 F E: � IHCREBYAFFlRMUNOERPENAlTYOiDER1URYTNATTHCREIS�CONSTRUCTIONLENDINGAGENCY FOR TME 7[RFOHMANCE OF 1HE WORK FON WHICH iNIS PERYI715 ISSL'[D(SEG 70Y1.Qv.C.�. � � IENDER'S WUAE C LENDER'SADDNESS � 1/ , ^ � ICERTFVTNATIHAVER[hOTM15APVLIU710NANDSTATE7NATTHE/�BOVEWFORAIATIONISWliAECL TOTAL FEES y�"'l 7 !/� w IAGREE70C�.��IYNOTHILLlC17VANOCOUNTYORDWANCES►NDSTATEUNISREU7INOTOBULDMO C% I✓ �X n' CON3iRUCTION,ANDNEREBVAUTNOiLZERE7RESCM�TIVE50F7HISCWNNiOEMFRUPONTNE S� ABOYE-MENTIONEOVROGEqTYFORMSPECf10NPl1HPO5E5. COMh1ENTS � �AT �sN� _ m PEqMITTEE �A� • � � ',^ � ►lt'`j� � SIGN�TUR[OFVERUITiEE OATE RECPT.NO. PPJD BY VlWDATION � WHITE—Oepartment Copy.VELLOW—Finence Copy.PINK—Assessor Copy,GOIDENROD—Fito Copy,GREEN—ApplicanYa Copy . _ . . .. .. . . .... • , . . , . . . . . CITY OF DIAfJiOt�D.BAR . , 1�' � � • INSPECTIOtd RECOR� � '��►`�i����.�`ri�a+�� o.};.��= 1�.�'i����-F'����� � �(,t=�:):�c���tW`l���C ��w��y_t�r��;N►��y.ic�.'=ei�7=� _ _ - _ _ _. . _ _ _: _ __w__.�_._.__.______.__..._._..._...........:............w.._,. ....,:. _ .. .._. �._..�..��. ._...__.__. _..__......_, __..:_.__.___w__.. .__.. __.. .. - *., �SET,Bt�Ct<,�l , �� -,.�._ ��.vFLO�R JOIST I _ - FTGS,'�ORP.1'S:STEEL - - ! - FNA REQ'��1TS � � �—:--j-----• -,---•- 1 ELECTRIC GROUND • � � ' � UNOER FLOOR DUCT ' � . ._ GROUND PLUFABING � UNDER FLOOR CUi�',��UIT " 1 —___..._ -- ..i 'SLAB Gr�ADE - - I FIREPLACE FOUNDATIO�J _ I TEP�1P POVVER I � FIREPLACE BOP.D EEAP�" � - j V`JATER SERVICE � t�91D HL BOND BEAA4 ,� � , • ' 1 ROOF SHEATHING � � � � • � " I ' F FT. �OND BEAF.1 ' ' • • FRAP�"I�dG�1,�EN7ILIATiOPJ � ' ' ' FINAL BOND�B�EAt�1 � � ���� I + flOOF COVF_R � PRE-GRADING � :ROtJGH H�ATING " BcNCHING � ROUGFi ELECTRIC . 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