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HomeMy WebLinkAbout1141 . ' '"` CITY 4F DtAMOND BAR PRESS � � �i ,! ) DEPARTMENT OF BUtLDING AND SAFETY F�RMLY "('" � BUILDING PERMIT JO�SITE APPIICATION PERMIT �uE ADDRESS �37� �- l6 �DTZ • ISS�UE TN,YUPEER �CODE � APN LOT TRACT DATE CONST. GROUP � CROSS STR ET ZpNING S TBACKS "•'�'�""$ = OWNER�. Fi.S _ FRONT RW ❑ � ADDRESS q�� W�LSN'1'hLL �l.�hD.'�t`�01 O REAR ❑ W CITY L� C.h'�..1{/ ZI�_T�!�1. SIDE/SIOE STREET RW ❑ o APPUCANT TEL. SIDE ❑ z � CONTRACTOR � SEWAGE o ADDRESS DISPOSAL ❑ �B� �� W CITY�B1t�.�— Gf��.-� ZIP �2� TEL ,3' � ❑ �NATE S(].Ff./100 GAL i STATE y LIC.NUMBER I�e I�I•$7r C�I�o GRAOING ❑ CU.YDS.EXC. CU YDS FILL y ARCH/ENG/ � '�PE 5Q F�' FAC7DR PS AQ.1. AREANALUA7'ION ¢ DESIGNER W � � ADDRESS L� 2 0 = CITY ZIP TEL.,..�.� (� 3 � PROPOSED USE Z 4 � �_ � GARAGE o NO.DWEL. NO. NO. � pORCH y UNITS STORIES BEDROOMS � LOT DIMENSIONS m VALUATION ADJ.AREA o NO.OF BLDGS HOw aunHrirr DESCR1PTkON FEE W ONLOT USED Q � W ❑ � N LICENSEO CWfHACfORS OELIARATqN:1 hercOy�Ihrm tha�I am 4unaeE mGer proviams o1 Glupw 9(wmmencinp � wnh Sttuan 7000)al pivision 3 M tl�e Bwiness�nd Prokssians Code,rid my Ir�nse a in hY torc�wid N1¢t w � � W � V`VNEN BUILDEfi DECLAHATqN I ha�eCy dLrm Ihat I am eumpi Irom ilw Comnc�or's leenu Law for Me lolbwinq �esson ISec 7031 5.Business an0 Praleesmns Catle Any aey or countY wh¢h rpmns i permit a[On7Umt (J o �Iiei �mpiove demohsh a�[p+���rry�Iructwe.D��or to ns uawna,Aw�aquues Ilx�pp�ani kr SucA pmm� � � ro file a signed statemem 1M1at he ia YcroseA pursumt to Me prou�sians ot t�e Contrxmr�LKeme Lnv ICA�p�e p� � 9 icommencmg mih Savon 70001 of Uvison 3 a1 Ihe Business�nd Pmfesepm Code)a Nut he a Inmp�1Mrdmm g d md IAe h�ns lor Me eNeged aemphon A�ry nobtmn ol Seuon 70315 6y my�pplranl tar�permn WE�etla � a W Ihe apphnnt to�cnil penaliY of not mon than hve hundrN dollars(35001) � � ❑I.as ownei at tM property.w my rmployees wnh w�qn u the�r sole rnmpenauon.will dp�he xrork.sd �he slrunme�s nat mte�dea ar o11erM id!ak ISec 76C4.Busiiuss antl P�olessans Catle Tht Contnctor's L¢ense a V L�w does nal aD4�Y a in owner o1 property who Wdds m�mprova thxem.+�who dx�w�h warY hmvell. (� �++ u through Ms own employees.proviEed M�t au[h imD�wements a�e not mundM a e11enA for s�k X.howew�, � m cle W�Idmg or imprpvement is mld within o�e year of completion,Ihe owMr�6uldei wdl MYe the 6urden of prwmp 4 � tha�M did ml hmM a improve lor Me purpaze ol sak.l � h va ❑I as v.vner at Ihe prapeny.am e�dusively conirxuny wnh IKemed mntnamn ro construct tht P�qal(Se[ �J 7044 8usi�uss rd Prohss'ions Code TM CanlncNr's Lcense L�w does nol Ipply m in aww ei prope�lY who �. = Cmlds or imprwes thereon,end who cmlwcts Iw such pmlects wrth a mntrxbrlsl�i«sed pu�swm w Ihe Cmlocror's " L1Be^°°�w� CONSTRUCTION c � � ❑I am e�empt mder Se� .B 6 P C IAttxh GrtAiuRl N REVIEW 0 one ��� ELECTRIC � WORKERS'COMPENSATION DECIARATIW I hreM+Ilrm Mn I have�pruRuq of eonsmt io sNf�m�ue,p rnnbrore ol Mbrtui Lampensatron InsmaMe,or�cwtdied copy rhaeo!�Sx 7800,lab C) PLUNlBING i ❑Ceruled copy rs herehy fwnrshed � MECHANICAL G �Grutre copy�s hleU wnh tlu Budtlmq In:prcuon Oep�nmem a Opu�mem Q (�,7R W _�„ CEHTIFIG4TE Of E%EMPTqN FppM WppNEflS'COMPENSA710N INSURANCE This,ecuon need nm 6e wmpkted ISSUANCE y d me Dermn rs kr one hwAred IS1001 n Mss I eeroFy Iho�n th�prlammce ot Me work ta WhKII IM6 permrt u isaued.I ahell mt employ�r perwn�n�ny menar so o Mcome au6�e W 1he YVorkeri Campenss�ion SMIP oi�w�oF c�ra/pr��a �"'' W PARK FEE p Oah / �'� • � ADOhw ��—r ��.. � NbTCE TO pPPLILqM M,eller makin�m�Arc ��.w,:now ex��o��ro�wak.�� SCHOOL FEES -� Compensahon pornims d the LMw u/II�ui9,,�h►tith�mply w�M rveh pwntpne a tlne parme�hMl � 6e Ueemed rewkeG `�'"�;;�:' � � `'Y" � pN510N Of INIX1SfRIAI SAFE7Y PERMR CERiIFICATON � ❑I here6y urtdy that no eyu I �51 �mve ket m depth nto whK��qism ro rpmred W/nceM. � xdl 6e maEe m conneciwn with I��ve��I¢oe ei m a.ia�m�n�re.xarom��.r+yewaw. o demolmon m diamantYnp�he�eaf,-wil'Es�we$an t�y��361 he�Aph.ICh+p �2.6ry 2.An 2.Sae W 3t�,Titk 8,C A C I s 3 ❑as�«�n�ae�� i�d�,1t^d�.=:me�•a�wo�w�n�b m���s.��w a.m r.nYa�a r Indusinal Salny.n nooed�pov�,uqlEss fuM1 bWmn Hss i�permil;pr d9 auCh/i�rM hom tlw divi�wn C.:Ji:_i�1:1a�^' ' s.•' �.. • � /'.�'._: „� � ❑v������,,,y�s.�����.,mR� -'•r., :' T�TAL FEES � CWSIRUGTION IENDING A6E1CY 1 hereDY Hfi�m IM tlrre i�t constracYon YndmY pCCV for Ik Y�^�e 1 = ol ihe work Ip whrh tlYs Ovmt n ia�ed(�c 3091,Ciu GI- � u.,�a�r:Neme COMMENTS m �r: '� CE TE DF COMPLI NCE ANO AUIHOItl2 T NTRY: rMy 1 M�w rW Ihis�ppfic�ion rd eme h d� �amnion ec[.I apee� a nh d� Yws wd enY Hdiiwxa�tn9 ao MiY4ry y :vuciwo. uu{ e a �h tm�m ild.g rd Sdery r rir�qan h P�v — vAich 1 N�e�pp 1hu rons � O RECPT NO. 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