HomeMy WebLinkAbout1370 VALLEY VISTA (70) � �D-��
, '"` � CITY OF DIAMOND BAR � RESS ;�'� . : �
x � ' DEPARTMr���F B ILDIN �1,�,,$AFETY F�RMLI�'`�
T�L.a►�i. R E aLT*�1 f'Q'`' `�
JOBSITE -/ L"�� �AAPUCAl10N ,q[� NUMBER , �Gti.
ADDRESS ��D��L1�� VIS �'LZ�►.1�TE �SSUE r TYPE OCC. '
► APN LOT TRACT DATE CONST. GROUP
4
o CROSS STREET ZONING SETBACKS '�''"�AAENTS ��
°D OWNER CA�T.G�6nT. '�i�'Q�3ES FRONT RW ❑
� ADDR�SS 231 � b�ANG�C x.. REAR �
,� CITY �l 1�12��nti ZIP�I.ZEOL.�TEL. SIDE/SIDE STREET RW ❑
e APPUCANT TEL. SIDE ❑
a
� CONTRACT�R � ��T«— SEWAGE
o ADDRESS f"���Q���s�' DISPOSAL � PUBLIC PMT�
� CITY��a ZIP TEL.�.� 0 PRIVATE SQ.Fi:/100 GAL
z STATE GRADING ❑ CU.YDS.EXC. CU YDS FILL
y LIC.NUMBER �y , SQ ACTOR P5 AbJ. AREANAIUAtIOM
y ARCH/ENG/ W
"' OESIGNER •
e ADDRESS (g�323 �nLIS�'��C G h1 �� �,Wj„ 2
x CITY2it��n]� ZIP�'�-�1��TEL. 33'M*� � 3
� PROPOSED US � ' Z � 4
� � ? � GARAGE
o NO.DWEL. � =�••�• � PORCH
y UNITS STORIES BEDROOMS
s LOT DIMENSIONS � VALUATION ADJ.AREA
a NO.OF BLDGS HOW 4UANTITY pESCRIPTION FEE
� ON LOT USED ,�
ac U
� �
LICENSEO CUNTflACfORS OECLAflATWN I M1ere6y dhrm Ihat I em icensed undei provrsions ol ChaD�ei B I�ommencinp �
¢ wi�h Secuon 1000)nf Oivision 3 M the Business�nA Protessians Cade.mE my 1¢ense ia m full k¢e and Nfect �
c � w
u- O�MJEH�BUILOEH DEf1ARATION�1 here6y atfirm thet I am e.empl Imm Ihe Canrectai'a Lrtensa Law for Ihe Mlowfnp
Z reasan Isec 7031.5 Business and Pmteesmns Cade A�ry aty or counly wh¢h reqwros a permrt ro tonatruct (}
O alter,�mprOve,demolish,p rep�i��iry structure,prwr m iu issuante.�Iso rpwies the applicant Inr sufh permil r2^
F= ta ide a signeA s[a�ement that he rs licensed Dursuant to Me proviaons af the Cmtractoi's License Law IChap�a p�
� 9�[ommencing with SecBon 70001 Df Orvision 3 0l Ihe 8usinesa iid Rotes�iant Code�ar thet he is enmpl there�rom �
d, antl tha hasa For the allepetl eamption piry viWauon of Se[cion 70315 by anY appiicem fa e Deimrt mb�ects �
yxj Ha aDO��cant ro a crvil pmalty ol nai more than five hwdmd dallars(S50D11 a
� ❑I.as awrer oF the propeny,o�my Bmployees wnh wages et theu sole compensavon.wdl do�e Work,Bnd
the stmamre is not intmtletl m oilered to�sale ISec 7044,Business and P�ofessions Code The Caneract«e license �
�j L+w does not epply ro on ownei of property who 6mlds or�mpraves therean,ind who dces such work himsell,'. O
' or thraugh his own employees,proaiAed that such�mDravemems are nat mienEed or otfemd foi eale Ii,however,i �
po the 6uidmp o�improvement is snM within one year ol canpleuon,the ovma�-builder will have the burden ol prov�rp t �
y tAal he did nat hmld a impiove for the Wrpose ol ule.l � �
� ❑1 ae owner o1 tM1e properry.am evdusrveH contrachny with licensed contNcrors to canstmcl the prqe�[�Sx.' µ�
0
7044,Businees enU Rolessione Cale.The Contractar's Lkense tew Aoes nol�pply to an owner of pm0eny wM �
6 hutlds or impiaves iherean,and who conlocls for sucA pmlects wrth a contmttDrl�l Ikenaed pursuant lo the Cm�netor's
Lrense law� N
c
� ❑I am erempt under Sec ,8.6 P.C.IAnech Cer4fitahl. PLAN REVIEW I
o Date �^ef ELE I
� WDRKEAS'COMPENSATION UECIARATION:I here�y affirm Ihat I heve o ceruhcate of eansent to seN inswe,d pLUMBING
a aruhore af Nfurkers'Cmnpens�twn Insurance,or a ce�tPoed copy thereal(Sec 3800,lah C.I
0
� �ce«�,�ea�ovv�:nareeY����gn.e J MECHANICAL
Q
`p ❑Certdied copY�%filed wtth tFe Bwldmg���b;���a�,�'t o OparVrenl ;� GRADING
_
� CEHTIFICATE Of E%EMPTION FNOM WORK�S'o9n'.PE Y�I INSIIHANCF Thn x�oo�need nm 6e tompkted ISSUANCE
� �1 tha permit is ior one hundred IS1001 v les: I cerely Mat in the perFormmce of��e wak Iw whKh tMs
permn ia issued,i shall rot empluV anY perwn in any manner so�s ro become su6lecl b tlre N4�krs'Cmqenuhon � SMIP
o �s o�c.iao,"�e ^�( 1�90 W PARK FEE
p Date �` !, �Applilant ':W'
� WOTICE TO APPLICANT.M,alter makrtig Ihi:Certifiute al Exenpuon,ynu should became suh�ect m Me wnrter•s 'V- SCHOOL FEES
—� Co�npmsanon prwisions of[he La6ar Code,you musi fathwnh,almply wNM1 eych�prmrsrons a IMa pe�mn ah�1
� 6e deemed revaked '���.w.•...� i.+�'�•��
W dVISIpV�F INOUSTRIAL SAFEi�,p�ryAM��R71F1CATI0R.`�„j �,. �� .�1
� '" �
e- ❑I heahy certdy thet no ezcavzi n hve�51 or more Irel m depth wh which e persm u reqwred to deecend,
s will 6e m�de in cmnecipn with wod wthor¢ed hy M�s permn.and Ih�l nn buildinq ftruclure,sulfoldmp,NlseworY,
� a demolinun p dismantprg thereol, will he mare ihan�Mrtpsu(36�het high(CAap.31.Gry 2,An Y.Sec
W 7d1,T�tleB,CAC1
S
3 ❑As owner6uildn,I will nat�mpky�nyone to do work wh�ch wwld ieqwre a permt hom Ik Orviawn d
1.-. IMusviel Sa1My.es noted�6ove,mless aucF penon has e perm2 to do such vmrk hom Me Anfsnn.
�
W ❑ansm d IMustr�al Sahq Permit No T4TAL FEES
� CR:SfAUCTION LENDING,46ENC'!.I he �Hvm tl�e1 IMrr u�eonstuetion kndin t far IM
2M o+GM v p�tarm.nre
Z of the wark loi whch ll�rs permi��s Rtced�Sec 3097.Cn C.I�
� LeMei a Name COMMENTS Tk-''f I�.�t S.�C.�F^CLlrr�
m L�ndei s Address
Ec►�uTs�d�
4 CERTIFICATE OF COMPLIANCE AND AUTFmiiIZATI0P1 OF ENTIIY:I crMy I Mre mad Il�u�pplicetion aid Om �`� //�
vJ Uin the nlarmaton yven's eorren I qee to wmply wrth all sn�e Iwvs end eiry arbnanca nlaunp to huildmp (�L�-ni.� L ��Z^�d
y Con3lru[Uan,e��utlaiite�rep�euntetrve of tM Oep�rlment of Buldin0+�d SainY n mur upon�he qoperry
= lor wh�h 1 have applb r M�s permu iw Ihe�u te af making i1specuo�.
H p Q -�!��
��,u�ve o�ppp�icr�t or npem �' p�te -1 O RECPT NO. ��L.�PAID BY����� VAUDATION
WHITE—Department Copy,YELLOW—Finance Copy,PINK—Asaessor Copy,GOLDENROD—File Copy,GREEN—Applicants Copy
�a.�.-�r.tm�,...._,,,�„.,..r•-".r.rN,�»...wr.�.�...�,.-_..�o.. �-v.�..,......_.....,.... . ._.........-.. , ...,.,.'.--�--_-_.�._ .._ ....._-..-.. -.r,.. .,,,- �.�— ---•• . --�.�-r i R.-.... --__. .
t .�
, ,_ -, !- � .,
. � .i: 1�'_�!�) � ! . . � .'r. :-. . . . .
'`� ' !' s�lr, ..1' ... - . . 1 . .� . � . ..7... ,`. � ,. . ..
. __ . . . � F . .. . .. .. ...I. .>
,. _� . .� . � , , ' . .. i . .
, 1 _I . �. . _.. __�. . . . .... .:s .. .,
• � , . . � , -• • i�;i.._ 1. .
.r .. �.. , .. . .�. . .
�� �, . . . � s .. . r. 'i
.. .. , � .
. � ._ ... .:l .,_. ,..,_. ._.. . .
��rr��r+�r+�,n�
".,�,r.w,�.
r^ , .
. ..., . . . . . ..,:i�� i�� �
4
, . ., . . ,. � � �_ . .. .
. . ' . . � 1' � ,� � . • ' .. � . ,' .., . • .