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HomeMy WebLinkAbout14256 I � �r� ��_ CITY OF DIAMOND BAR P , . • DEPARTMENT OF COMMUNITY dc DEVELOPMENT SERVICES a 21660 E.Copley Drive Suitc 190 (909)660.3195 Fax(909)861-3117 PRESS � ��'' BIJILDING PERMTT APPLICATION FIRMLY o ADDRIESS I� i(l(�'w/•�-G�IQ( p� pA�CAT10N �'L-� NUMB R � � APN L�T T �SSUE TYPE OCC � OWNER d V� PATE CONST. GROUP ADDRESS ZONING SETBACKS CITY Z�p FRONT RW ❑ APPLICANT t_ REAR ❑ SIDElSIQE STREET RW ❑ CONTRACTO SIDE p Q ADDR SS PROPOSED USE � CI7Y ZIP � � ARCHJENG/ DESIGNER NO.DWEL. NO. NO. ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. v� DESCRIPTION SQ.FT. FACTOH PSF ADJ.AREANALUATION p� OWNER•BUILDER DECIARATION SFR/ADWREM O i�nesr,�ww uroEa r�rr oF nEauav rria i,u�ocEeacr Faor�n�e ooNrw�crau u- GeregelCarport CEHSEIAWFOR7HEFOlLOYVIhYiHEASON(SEC.7a9t.6BU5WE39ANDPROFE5510N5CO0E:ANYp7YOR (n OOUNfYIVHKNREOUIflESAPERAIRTOCO1tlSTAUCT.AITEiIIMPROVE.OEMOL151{ORREPAIRMIYSTHUC• W PB�IO�BC�C iIJRE,PRqf170 ffS 169UANCE,K80 REOl1F1E9 iHE lIPPLICANT FOR 8Uq1►ERMIT TO FILfi A SIGNEO � BTIRE4ENT T}NT NE OR 3HE IB LICENSED PURSUANT TO iHE VWDYISIOHS OF THE OONTMCTOR9 ll• CENSE lAW ICMAiTER�(COMM[NCINO MIITH iECTqN 700D)OF DIVISION 7 OF THE BUSINESS AND PRO- � POOVSpd FES4I�N5 COO�OR THAT ME OR BXE 18 EXEMPT TIEREFROM ANO TME BASiS FOR 111E ALLEOEO E%E4P• iION.ANYVIOLATIONOFSECT10N7o�1fBVANYAAPLICANTiORAVERMIT3UBJECT8TFIEAPGLICAN7i0 Z pe_p� � A CML PENALTV OF NOT AIDiiE THAN FNE HUNDRED DOLURS�tGaO).�: 04�30MRIEROFTHEPROPEHTV,ORMYEMPLOVEESWI7HWAGE6ASTHEIASOLECOMPENSATION, 0 CORIIIIB�C181 WILL 00 7HE YYCRK.AMD THE STRUCTURE IS NDT IMENDEU qi OFFERED iOH S�LE(SEC.7Ma,BU51� J � �ERfYYYF10BNLDSOHNP�qOVE�EREQI,ANDUYYNODOE BUCHWORKMIMSELFORHE 9ELFpR � iXR0U0H 1M9 OR HER OYIN EMPLOYEES,VROVIDE�7'FIAT SUCH NAPROVEMEHTB ARE NOT WTEM�ED OR � OFFERm FOR SALE F.110WEVE0.7HE BUIIDIN�ORMPRaVEMENT IS BOLDMAiNIN ONE YEAR Oi COMPLE iION,7NE OMTIEX-BURDER WILL NAVE TY1E BUROEN OF PqONNO TFIAT XE OR SHE DID NOT BllILO di YPFIDYE FOR 7NE PURPOSE DF SALE7. O L AB�NMER OFTHE PROVERfY,M1 fiXCLUSNEIY CONTMCTINO MA7}I LICENSED CONfRACTOR3 10 CONS7RUCT THE PqOJ£CT(BEC.toM,BUSINESS ANO PROFE5610NS CODE:h1E CONfRACrONS LI- V81UplfOn ADJ.AREA CENSE U1W OOE9 NOTAPPLY TO N!OVINEH OF A PROPERTY WFiO BUM.OS OR IMPNOVES 7HEHEON.AND vmocaarw�crsPoneuarvaaecrsvnn+�carrrucronca�uceNseorunsu,wrrotrieoonrrww QUANTIIY UESCRIPTION FEE � tuRs uc�vse uw.�. 0 I AM EXEMPT IMDEH SEC. B.i P.C.FOR TMIS REASON � �= DATE OWNEFl F- � W LICENSED CONTRACTORS DECIAMTION -� � w I NEREBY IIFFIRAI UNCER PENALTY OF VERJUfiY T1U1T I AM LICENSED UNDEH PR4VISIIXJS OF CHAPTER � �(OOhVAENCWO WI1N 8ECT10N 700010F OMSpN 9 0F 7HE BU51NE5SAND PfiOFE5510NS CADE.M!D Z W UCENSE 16 N FULL FORCE AND EFFECT. m � LICENSE S � LIC.NO. � O j OA � CONTRAC WOFiKERS'COMPENSATION DECLARATION I[.�. � � N V, V N IHERE8VIIFFlRMUNDERPENALNOFPE0.IURVONEOFTHEFOLLOWINGDEQAHATqNS: Z � _IWNEANDWILLMAMTNNACERfIFlGTEOFCONSENTTOBELFiNSUREFORWORKERS' _ COMPENSATION.AS VROVIDEO BY 8ECT10N 77000F iNE LABOR CODE.FOR THE PERFOHMANCE W OF TIE WORK FOR WNidi THIS PERMIT t5 ISSUED. � 0 _I MAVEAND N'ILL MIUNfMI M/ORKEHS'COMPENSA71oN IIISURANCE,AS RC-0UIRED BY SEGTION Q �7000FTME ORCOOE,FORTMEPERFOfW�.YCEOFTMEWOFiKWRWHICHTF115PERMRI3 ISSUED.MY M1iK RS'Oa,y�EN3ATIONINSUa�.�JE CARRIERAND ICYNU -RME� �ST UCTION y cu+wEn �r '��- PLAN REVIEW � rouerruueen � ELECTRIC � - �.- - i f /] � � [MssEc�IONP[�wreEDOM�lE7maFnEPErMfsFOtiONEFi�REDOOLL/u's�S�mlattFsS� PLUMBING � ICERTIFVTHATINTNEPERFONAIANCEOFTHENVIIKFORNMN7ITMISGERMITISISSIlEO,I MECHANICAL (i 6HALL NOT EAIPLOY ANV OERSON IN ANY MANNER 80 AS TC1 BECOAIE SUBlECT TO TNE � WORKERS'COMPENSATIONUWSOFCALIFORNI�ANDAOREETMATiFI4HWLO8ECOAlE INSPECTIONFEE S SUBJECTTO THE YYOFiKERS'OWIPENSATqN PRONSpN50F SECTION 97aoOF THE UBOR cooe,i sHui sonn�wrm eaav�r wirn rrwse rnohsaNs. ISSUANCE l � SMIP p DATE: APPLICANT: � ENEftGY P/C WARNINO:FAILURETO SECUfiE WORKER9'COIdPENSATION COVEHAOE IS UNIAWFUI,ANO SMNL BE ry 9U&IECTAN EMPLOYEH TO CRIMINK VENALTIES AND CIYIL F�NES lJP TOONE HIMDREO THOUSAND ENERGY PERMiT DOl1M3(t7oo,000�,IN ADDITION TO 7HE COS7 OF COMPENSATION,DM111GE3 AS PNOVIDED FOfl IN J 9ECTION770!OF THE LABOH OOOE.R17ERE5T,ANDATiORNEYS FEE& pETENTION FEE: � CONSTRUCTION LENDING AGENCY PRE-1LLT FEE: 1'�rr�ar�.-..,a .��� rl A T 1 HEREBY AFFIRM UNDEH PENALiY OF PERJl/RY iHAT THEflE 13 A GONSTRUCTION IFN�INO AGENCY ��r�rPC����E Z FOR TIIE PEFiFONMMICE OF iHE WORK FOR WNICH 7F115 YERMIT 16 ISSUED(SEG.9W'i,qV.G). W � LENDEH'S NAME � LENDEi1'SADDNE55 W 1 CERTIFY TFUT I NAVE NEPO TMIS AP7LICATpN AND BTATE THATTHE�BOVE WFORMATpN IS OORRECT. TOTAL FEES � � 1�(iREE TO COMVIY WITH ALLCfTY Alm GOUMYORDINANCES ANO 6TATE IAWS REUTINO i0 BVILOMG � �.�� CONSTRUCTqN,AND MEREBV AUTNORI2E REPRESBJ7ATIVES OF TMIS COUNTY TO ENTER UPON 1'HE � ABOV�ED PROPERTY FO INSPECTqN�l1HPOSES. � GOMMENTS � � C/1 6 PEiW ENMA (P(UHTj e/� �./��( � fn � - V t �1^ / � FWIITEE OA7E � RECP7 NO. PAID BY VALIDATION WHITE--0eparlment Copy,YELLOW-Fin�nce Copy,PINK-Jbsessor Copy,GOLDENROD-File Copy,GREEN-Applicant's Copy �w,o..o..-�....� --- . , ��t�-.. ,��.�, +P�C.� R��� . . . r . � . •, . � . . � 1 � ih�:�����:�::at�p� ��'F=,���� , , ,. w . . "€„u ,�: ,rf s .�.. ..... ... .... ' - ���t'��• �AiV .., a Yf il�IEr��; .��„ �e,°�'w�P-;�ute;��t��� ., �4��$�:b`S!4��5��� Laaki�°."�..i _. .��l:�;". ��'. �'�<��� '.'e.. .. - ; ,.• � c ,.,,.....r--.a-..... .. .....--. .�..�.,'—w..--•-+----�----�+-+3�+�t—._..,-r-,..< .� .,.. „...�._� � . :.� .. +...� w- ...:—�--'—=•— —,�.�.. ..._ . 3 � �- k... r.s _r ,.,.. 3 I ' F 'C:'�T . ; ,,, . ,.; �:. �O . . 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