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HomeMy WebLinkAbout1368 (657) �'` CITY OF DIAMOND BAR PRESS �. t-•' ' DEPAF�"TMENT OF BUILDING AND SAFETY �- BUILDING PERMI'T F'IRMLY JOBSITE -�� � �P�n� PERMIT �E ADDRESS � O ���U�-' �SVE /� G� TYPE ER �CODE � APN LOT TRACT DATE � L7St ! � CONST: GROUP � � CROSS STREET ZONING SETBACKS '"'�i01E"'�"'S °� OWNER �- K • �1� P��� FRONT RW ❑ o ADDRESS '`11�1 S� "3 H�/L�`'� � � S 0 • REAR ❑ W CITY DN t� G1k-ZIP���TEL. SIDE/SIDE STREET RW ❑ o APPIJCANT TEI. SIDE ❑ � CONTRACTOR ��"��� ��"' � ❑ p1,18LIC PMT# o ADORESS ��� t''f���-d' �cV� SEWAGE W CIT`/'�'�'�•� ���% ZIP��L TEL�� � pISPOSAL ❑ pRIVATE SQ.FT.!100 GAL z STATE y LIC.NUMBER �O�'L� �j G- '�'(7 GRADING � CU.YDS.EXC. CU YDS FILL y ARCH/ENG/ ,� NpE �Q � ���R PS �• ,ADJ. AREANAtUATiON ¢ DESIGNER W � � ADDRESS LL. 2 0 z CITY ZIP TEL. (� 3 � PROPOSED USE Z 4 � � GARAGE � o NO.DWEL. NO. NO. � ppqCH y UNITS STORIES BEDROOMS ae LOT DIMENSIONS m VALUATION AOJ.AREA o NO.OF BLDGS HOW ouANTrry QESCRIPTION FEE W ON LOT USED � c ❑ W � H IICENSEO CONTRAOfORS OECLARATpN I hereCy dhrm thn I�m Ycensed uda qrnuans of Chap4r 9(wmneircup . �p wnh Secnun 70001 oi avisnn 3 of�Ae Busness snd Protessions Code.�nd my liunse rs in full lorn�nd dle[t. w , 3 LJ W ' � 1�.. . . � OWNEB BUILOER DECLANATqN I here6y dhrm Ihal I am e.empt from Ihe Comr¢�ai's Lcense L�w Iw Me tallavmp . reason ISec 7031.5,Busmesa onG Proleas�ane Code A�ry cny w ewnty whKh rpuu�s�pumn q contlruq, (� � o al�e� implWe,GEmohsh,of lepair i�ry AruCNre,pnor b ilc issuma,Nso requres the�Wuan1 lor such permn 2 f- Io lile a aqned se�remem thai he u Iken7ed Wrsumf to tht pwmons af 1Te Contrxmr'�LHense law(CMpta Q� � 9 lrommencmg wtlh Sechm 100010l Ovrswn 3 0l Me Busmess md Profes:ions Codel nr Hu�Ae n enm0��he�ehan '� � aM Me basis lor Me�Weged exemptwn Airy r�dalpn d Sxnon 7011 5 by Nry apphwnt Mr�permn whpN � W �he�ppi�r.ane to a crvn penelty ol rot more th�n ine hundred doliazs If500!I ¢ � ❑I,�s owner of ihe papeny a rtry emDbYees x+tM1 waqes�!MMr sde tompensanun w�ii eo m.wan anE tAe strceture a not inlenAed or ofhrcd M We(Sec 1064,Busmecs ond Prolessions CoAe The Cmtrttld's lKense e.[ 1"� � Law tices ro�pp�Y a+��'�e�a�V�W�rty wM10 bmMs ar improves tl�anm,�nd who dus such xvrF h�ma�N, V �++ or tlirauy�his Own emo�ayees,prwided the�wch xnpiavements re nm mtcnded u oihred hi sak 11.hv.vever. � = ihe EudOmg a improvement is sold wiMm pne year ol tomD���.��a'+na�0uiltlx wdl�we IAe DuAen ol povmp — y Ihat�e Aid na�Mnld or�mprare lor Me purpose a1 sak) � ti ❑1,as pvne�ot Ihe propeny,am ta[Iwiuely mntrscuny wiM Ircensed emvuton 10 mnatru[t tAe qqxt(Sec �J,� 7044 8uanxss�M P�olesswns Code The Cantnctor's la�nse L�w does ml�pply w m ow�er et qqwrlY who '� � Zbmltls or improves therean,and wha comncu ta such prolecls wiM�rontracmrl+)licmaed purswnt p�he Lm�ncror's �^�� 6 Laenu law i ONSTRUCTI J 0 1 � ❑I am exempt uMrr Scc .B.fi PC IAWch CnW¢ahl �/� l� � o°" °ixnef ELECTRIC � YAflKEflS LDMPENSATIOFi OECLAAA71qV I hrthy�Nirm IMi I hm�ardhcne a1 em�ant ta�Nl�inswe,a pLUMBING a cendia�e ol NNrAe�a'Compens�tmn Imuqnn,a s cetduG copy�hnea��Sec 3800,L�b C I ` ❑Cendietl CaDY i!Aereby furmshetl J MECHANICAL o �Cended copy��hkd with the Buddinp Inspec��on Oepnim�m a oro��e�.m 4 GRA �NLi W `O� Z EflTIFICATE OF E%EMPTION FROM W�flNEHS'COMPENSAl10Ei INSUflANCE This�etuon ired not he tampleted ISSUAN � � il Me permn n For wrc hundred�51001 a Ntt I erWy M�t in the q�lormmc�d tM wwk far whch Ihi� y im�t is�ssued I shall m e � pe mpby ary permn m�m m�mer so n to 6ecant�ub�e[I to Ih NbrYrs'Lanpens�lion gMIP = l�ws nf Caldorn o � D i� • ' W PARK FEE p D�ro�y AWtI'r�ftr._ �. ••• N[ITICE tt1 APPL ANT II,d�er rtukm�aM,t{�te�cnf'a�,'Esv�,w vW.n�a n��. �,m nu na�•� SCHOOL FEES � Canoens�uon prwrsrons ol the i�bor L�tle;:�yo6`mut 11M1AwM r vnth wch prais a Mu pamn piNl � � 6e d!lmedleuaYed ��i jf u•'•�•;��' Y � pVISIpJ OF M1pUSTRIAL SAFETY PENMIT CERTIFICATW� i i4�1 ❑I hereEy cerfdy Nai no easvatron hve(51 a '�e �.'.qgpiqma whKA�qnan o ipu�rad m dccmd, �9 � w�A Oe meee m canMcuan wiM wor 1y.M�i�erm ,pA4tM no OdOinq suunW�.iettloWmp,hhe�wak, �*� IS N a demalnion or d:mantlirp therea��1�1 mae Ilwn iferry���1361 Nei IWh ICMo 3.2.Gry 2.Arl 2.Soc •z,• ]41.Tnk8.LRCl ..., ^.,•. x . ,,. �.:�: i..7',�: 3 ❑ps owner-hudder.I wdl not tmAby{�yens fo�.��vck.wM1kti V4auN..rpury�pamt hom tlr Oivum d � Indunn�l Salety.as roud a6o�e",�ay wlb�prsoh'lue;a:qrm�t Ytidv:i�kh,7Yoi4 Rom IN bvifwn. '� i 1,. 1�.+'� i`,i`• " �� ❑o.�E,����.�,,.�����;������'���•�_' TOTAL FEES I� , O� CANSfRUCTqN LENOING AGENCY I Irrehv dlum��tlrn i��mnmucmn ImdwO qe�+�Y lor Ihe lsrlamtKe = ol ihe worM la wAcn tlin perm�l�t iswed I�300T.Cru C.1. D � leneer•s Name COMMENTS • � ' � m Lender's Mdres� � CEpTIFCATE OF COMPLIAlCE AAIO AUTNORIUTpi OF EMRY 1 prMy 1 Imre mE rut pdiu�ian rM tUh t/s tha�Me Mfamnion puen ia canct I p�ee to ca�ply w�d slale Yws nd ciry edinmtu iWtyq N luldinq y conslrunwn.md rulhome��p�etempiva al tlie Mpalmenl d Buldnp m!Sfaty b Mi�er pun Ihe NaPM' ta whch I han�ppled la tlus permn M lle pupoe ol m�kxq o�pawna. � X �' v� a ����' '� �j so�a��a d Mdr or nuem o�n RECPT NO._�PN�BY �`✓�VALIDATION WHITE—DapaAment Copy,YELIOW—Finance Copy,PINK—Aasessor Copy,GOLDENROD—Fle Copy,GREEN—ApplfcaMs Copy 9S106-17J89 �,ir:- . , `+•. --r�, . `'crri:�e, - . 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