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Home My WebLink AboutEP91-108f CITY OF DIAMOND BAR DEPAktMENT OF BUILDING AND SAFETY BUILDING PERMIT i� JOBSITE -IL" � 'I'll ADDRESS AL A, il, -- N PERMIT USE DATE NUMBER�L�-' I/ I "i-- - "2, e" L L r` "; CODE ISSUE TYPE OCC. DATE d CONST.— GROUP SETBACKS IMPROVEWNTS ZONING FRONT— RW— El — REAR El - - APN I0--+ R Ar-i CROSSSTREET— - OWNER ADDRESS CITY ZIP 1, 1 L L� TEL." SIDE/SIDE STREET E— RW❑ — APPLICANT 4V 3,v TEL. SIDE CONTRACTOR ADDRESS SEWAGE ❑ PUBLIC DISPOSAL❑ PRIVATE PEAT SO. FT/ 100 GAL CITY ZIPTEL. — STATE LIC. NUMBER GRADING ❑ GO. YDS. EXC. CU YDS FILL CID so FACMR PSF ADJ, AREA]VALUATION ARCH/ENG/ DESIGNER W i W U_ 2 ADDRESS CITY ZIP— TEL. 3 PROPOSED USE z 4 GARAGE -- NO. DWEL. NO. NO. " UNITS STORIES— BEDROOMS— LOT DIMENSIONS 5 � iORCH — ro VALUATION ADJ. AREA QUANIUY DESCRIPTION FEE NO. OF BLDGS HOW ON LOT USED . ....... .. M LICENSED CONTRACTORS DECLARATION[ I hereby affirm that I am licensed under provisions of Chapitast 9 lcononancing Did — — with Section 7000) of Division 3 of the Business and Professions Code, and my ficemse is in full lode and effect M -i IJUI — OWNER -BUILDER DECLARATION: I hereby allitin that I a. exempt Item the Contractor's License Law lot the foillitivinij Q. reason 1SAc. 7031,5, Business and Professions Code: Any city or county which mounts a pemm to construct, Aurn ,prove, demolish. or repair any structure. ofm to its issuance, also requires the applicant lot such permit 1. ilk , signed s lament that he licensed pursuant to the Provisions of the ContLicenseLicoe Law (chapter B canomin .,a is cing A Section 7000) of Division 3 of the Business and Professions Code) As that Its is nel theralrom and the basis for the alleged examotran. Any vitiation of Section 7031,5 by any applicant 104 a permit subjects the applicant to a Civil penalty of not more than live hundred dollars ($5001.1: L�11, as M., athe property, in my employees with wages as their sole compensation, will do the work, uAJ A i imis clure not intended of offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law root not apply to an owner of property who builds or improves thenecon, and who does such work himself, or through his own employees, provided that such improvements are not intended or offered for sale. It, him however, he building of improvement is sold within one you of completion, the ovemer-buiWat will have the London of proving That he did not build or improve for the purpose of safe.) Ell, as owner of the property, am exclusively contracting with licensed contlactions to construct the finjul ISH. 7044, Business and Pnofiessmans Code: The Connector's License Law don not apply to an ovener of picapartir who builds or unplioves thereon, and who contracts for such Projects with a contractors) limited pinswunt to the Contractor's License Law. gill —T .erg 0 — z LU CONSTRUCTION in 7` anger, El (Afthich qlApino Date- 'I i-) , All --- .,S! , � I I -, , 0 -, t� —Ovxnq cr) PLAN REVIEW ELECTRIC PLUMBING MECHANICAL 9" i" P� WORKERS' COMPENSATION DECLARATION, I hereby affirm that I have a certificate of consent to tell -ins I , a ternficane of Millers' Compensation Insurance, of a tabbed copy thereof (Sec. 3800. LA. Q. • ❑ Certified copy is full furnished, El Certified copy is filed with IN Building Inspection Department or —Durnotmant, CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section maid mil be contiplatial f'or le 8 permit is lot one hundred (3100) less I nobly that in the perfoinuarrice of the work for which this 1pertm �j 0 GRADING ISSUANCE el" t is issued, I shah not employ any person in any manner so as to become subject to the Workers' Campensinfiam Laws at California. Date Applicant W W U- SMIP PARK FEE SCHOOL FEES NOTICE TO APPLICANT. If, after making this Certificate of Exemption. you should become solipsist to the Wrxi Compensation provisions of the Labor Code, you must forthwith comply with such provisions & this Permit them be deemed revoked. DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: El I hereby ,utrily that no excavation five (5) a we final in depth into which a person is rotioned to descend. will be made in corinettorri with work atuffistrited by this pannin, and That no building structure, scaffolding, fishumeak, . demolition or dismanding thereof, will be more than thwtv-six (36) feat high, jChuil 3.2, Grp 2. AN 2. Sot 341. Title B. C A.4 Elks owner -budder, I will not entilloy anyone to do work which would rownee pearmal from the Division of Industrial Safety, as noted above, unless such pussion has a piston to do such wrong from thas Return, ❑ Division of Industrial Safety Permit No. TOTAL FEES J CONSTRUCTION LENDING AGENCY: I hereby affirm that Owe is a constructorWilliam spicy fist IN parkrocom of the work let which this paint is issued (See. 3097, Civ. C.I. Lender's Nam COMMENTS Lender's Address CERTIFICATE OF COMPLIANCE AND AnMZATM OF ENTRY: I cw* I him read dini application and slats that the informatern given is corract. I agree to comply with off sort, tows and tbi rebtang to boadding cwsIA)c�fior_us1 authorize a repnsentaoroe of fit Department al &-NWV said Sebriv to similar WA the priationty let which Lhave applied for, thu flat the purporsa of "it , 4 wq-t— RECPT NO. r PAID BY VAILIDATION— rims X Signal= of Applicant or, Agent am WHITE—Department Copy, YELLOW —Finance Copy, PINK —Assessor Copy, GOLDENROD —File Cc;* GREEN— Applicants Copy BS106-1 1/89