HomeMy WebLinkAbout1904 - 1370 VALLEY VISTACITY OF DIAMOND BAR PRESS
DEPARTMENT OF BUILDING AND SAFETY FIRMLY
BUILDING PERMIT Y
JOBSITE
ADDRESS C� V Z4
APPLICATION PERMIT USE
DATE NnUM ER CODE
ISSUPE
APN �!'A I�'7Gt6fTRACT
DATE: CONST GROUP
CROSS STREET
OWNERi(la(YL^�P-u �C7(�
SETBACKS 1klFIX kaEIrM
ZONING FRONT RW ❑
ADDRESS c-�'��
CITY ZIP G+74R TEL I I
REAR ❑
SIDE/SIDE STREET RW ❑
APPLICANT TEL
SIDE ❑
CONTRACTOR a
ADQRES ~P
CIT ZIP TEL
SEWAGE ❑ PUBLIC PMT
DISPOSAL ❑ PRIVATE SQ. FT / 100 GAL
STATE JI C
UC. NUMBE
IC. NUENG/
GRADING ❑ CU. YDS. EXC. CU YDS FILL
TYPE
FT
FACTOR PS
ADJ. AREAIVALUATION
DESIGNERUJI
ADDR S 56 2-0' QD y
U-
2
CITY �R ZIA Z? I L11 1 TEL. "A
3
PROPOSED USE
4
0
GARAGE
NO. DWEL. NO. V NO.
UNITS STORIES BEDROOMS
LOT DIMENSIONS
PORCH
m
VALUATION ADJ. AREA
OUANTTTY
DESCRIPTION
FEE
NO. OF BLDGS HOW
ON LOT USED
r
DO
LICENSED CONTRACTORS DECLARATION: I hereby dfirm that I ore licensed under provisions of Chapter 9 (comni
with Section /D00) of Division 3 d the Business and Professions Code, and my Inane is in full farm ard dlec
i a
r ��
OWNER BUILDER DECLARATION I hereby affirm Min ta at I son from the Consi«tor's License Law to, Ma falwinglo
salon ]See 7D31 5. Business and Professions Code Any city or connty which requires a permd to construct,
alter enplow. demolish. ar repair say struciwe. prior to as issuance, also requires the ins icant so, such peed
to file a Plies!statemeaf that tie u licensed put cent in the Provsrns of the Coolest 'a License Law (Chapter
9 (commencing with Section 7D00) d dwsken 3 ofthe Lomas and Professions Codel ar dul M a exempt th«drom
and the basis far the alleged exemption Any violation of Swim 70315 by any applicant for a permet wblecls
the appbmnt m a civil penalty of net more than five hundred dulkin IS5001)
plawes with wages sale compensation, will do the work, am
I. as owner at The property. ar my amas trial
the structure is not intended in offered be sake (SIC 7004, Business and Professions Code The Cntraclr's License
Low does not apply to n owner of property who builds ar enprows Mien. rid who class such ways himself.
ar through his own employees. provided chi such improvements are not intended or offered for sW If, however,
the bowing ar improvement is sold wrthm one year d cpmpletmn, Ili owver-bwdar will have the burden of Proving
that he did not build or improve for the purpose of tale.)
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Ofas Owner of the property, ere euchmwhy contracting wilt licensed contractors to construct live prey«1 (Sae
7Dd4. Business and Professions Code The Contractor's License Llow does not apply to on owner of property who
ludds or improves thereon, Bad who contracts far such protects with a cnlractor(s) hcemed pursuant to die Cnaseter's
License Law l
LU
CONSTRUCTION
❑ 1 am exempt order Sec. B 6 PC Winch Combiner)
<
PLAN REVIEW
Date Owner
LEC I '�
PLUMBING
MECHANICAL
WORKERS' COMPENSATION DECLARATION I hereby affirm that I blow a ciohcile d consent tat self-ssure. or
a certificate of Workers Compensation Insurance, in cabtied copy thereof (Sec 3800. Lab C I
❑ Certifed copy -a hereby f«coshed
Cernhed copy is filed with the Building hupscbm Oapartmnt ar Department
4
GRADING
DE (LATE OF -EXEMPTION FROM WORKERS' COMPENSATION INSURANCE This aaction need not he completed
id the permit is for one herded (S1O01 re less. I .st m the pert«main d the work he which this
permit s issued. I shelf net employ aN Prison tin airy niters In tits fact la tier keri Compensation
L f rimer
i r 7- Q� -
rem Ilpda.n,
W
, U-
UANC 1 O
PARK FEE
SCHOOL FEES
' lf
' NOTICE APPLICANT. N. alter ="Cg des Cerbhcate pf E fin, thou timid became subsist as n tlm 0 shelf
Campentatxw provnrona d the labor Code. You mud turthwith, reply urn such provisioner as this permit chap
be deemed nvded. .
f VISION OF NOUSfRIAL SAFETY PERMIT CIATIFCATION
i
; ❑1 hereby cerldy that n aaavden foe 15) «more lad in dpth into which a person is required M dsscad.
will be made in cennmw with work ittbveM by Mu perma, and Mt no gilding s rwire, acdlofdins lelsow«k,
w demoklun ar dismntAng thereof, 8-ba were -dun d«ty-da-136)` t high (Chap 32. Bop 2, Art 2, Sec
3e 1. Tale 8, C.A.C.I 17
❑As owner buider. 1 wl lei'e'ppby prune to do week whch wouN require a picot him tier Division of
Induatnat Safety, as noted ebova, urilesb such person has a permit to do such work have tun /union.
❑fYnsin of Industrial Safe ty ►erred No. -
TOTAL FEES 3. $��
s CONSTRUCTION UMM AGENCY: I hereby affirmat shoe is a construction loading age" One du parlannce
of the work far which ties permit s issued ISac. 3097. Civ. C.I.
I Larder's Name
COMMENTS
j Larder's Address
c CERTIFICATE OF COMPLIANCE AND ALITHMATION OF ENTRY: I entity I have real dis application and sloe
t that the mlarmatmn given is carrect. I arm to comply with all sure laws sod airy oNina«as missing to kdldin8
partment d Building ad Ssfagr to nta Din h properly
a .�hmwOied�,3F�or
r d amkk9 inspections.
12--
RECPT NO. ��L ✓ FAID BY � VALUATION Q0
Sipnatrn d Applicant « Agent (Yee
\ZAITE—Department Copy, YELLOW —Finance Copy. PINK —Assessor Copy, GOLDENROD —File Copy. GREEN— Applicants Copy
EIS706-11/89
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