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CITY OF DIAMOND BAR PRESS DEPARTMENT OF BUILDING AND SAFETY FIRMLY BUILDING PERMIT JOBSITE ADDRESS t)`� l?X©9� Two APPLICATION PERMITuse ISSUE NNUYPE ER CODE APN LOT TRACT DATE CONST GROUP CROSS STREET OWNER. ADDRESSL2 CITZIaCAxA P.sDAC ZIP TE ZONING SETBACKS FRONT RW REAR SIDE/SIDE STREET RW SIDE APPLICANT TEL CONTRACTOR r SEWAGE El PUBLIC PMT A ADDRESS I POSAL ❑ PRIVATE 80. FT./ 100 GAL CITY P� L7Q� STATE l BE�� LIC. NUMR � �" �'T GRADING © CU. YDS. EXC. CU YDS FILL t W UU. TYPE 1 SO FI' EAMIR i�S Am A:R:rwALUAnON ARCH ENGMBE DESIGNER ADDRESS 2 3 CITY ZIP TEL. (yj PROPOSED USE a 4 GARAGE NO. DWEL. NO. NO. UNITS STORIES BEDROOMS LOT DIMENSIONS NO. OF BLDGS HOW Z) m PORCH VALUATION ADJ. AREA OUANTTTY DESCAIPTION FEE ON LOT USED � W LICENSED CONTRACTORS DECLARATIDN: I hereby affirm that I ash licensed mda PaVW= of Chahar 9 (cwwnncing with Setton 7000) of Division 3 of the Busnwss and Professions Code. aid my tense is In full Imu and effect. - (} Z , OWNER BUILDER DECLARADW I hereby dfira that 1 am e.empt from the Comraciar's license Lew for the hllewirg reason ISec. 70315, Btsiness and Prohssfms Cda. Any city or tasty wish reprints a Prom to construct. altar, improve, dcmalish, or rash any strrctwe. Pin to its isflmnce, tiro roquirtl Ow applicant for such pnrral to file a sgned statement that he is kcensed pursuant to the provisions of the Conaecta's license Law ICMpter 9 1,--'ng with Section 7000) of Division 3 of the Business and Professions Will, Or That he is awmpl slneham and the basis for the alleged eampann. Any vitiation of Section 7031.5 I" en1' applicant far a Permit subjects the applicant to a civil Penalty of not more than five hundred dollars ($5011) ) ' El I, as owrvu of the property. or on, employees with wages as most a* compalalon, vvat do on wale, and the sRectrre n not mended a offered for slue (Sec. 7044, Business and Prtiaxion Cade' The Ceetncmr'a ns i taw does rot apply to an owof property who buRds a improves thaeen, and who does sack ware ' or trough his own employees, provided that such nnpwements area not intended a olbod forvk. ff, the building a improvement is sold within one Yen d completion, own ion, this wee have the bolder of is" I ' that he did trot build orimprove fordt pryose of sale.) ❑I, as owner of that property, an escisively contraatinP with licensed contractors to construct the protect ISa_ e 70". Business and Prolusions Coo: The Contractor's License law does net salt' m an owner of pro" who builds a anf roves maven, and who contracts for such Proems with a contrainis) kennelPwsuam to the Cemreew'I LKenst awl _. z _ W _ - - - a Q ONSTRUCTION ❑ I am esemP under Sec. B 6 P.C. Ifi uch Certificate). PLAN REVIEW i Date D" °f - ELECTRIC PLUMB I WORKERS' COMPENSATION DECLARATION: I finally affirm rota 1 have a aysNiva of caarant to satf-insnre, ot a certificate of Waters Compensation Insolence, or a certified copy thered (Sec. 38M, Lab. C.I. ❑ Certlied copy is hereby furnished. copy is filed with the Building Inspaton Department or 0g ranent.CERTIFICATE O E7(EhNT10N FROM WORKERS' COMPENSAl1MSURANCE: This sedan neeA nos De t'ompNkd if the permit is for one holdred (f100) or, kn I rartify that in the performance of the work kr whisk die . Perrot is issued, I " not employ any past in ant, no mis so a to become 26W to fear INIOWS Capes"im ' lean of California. W tE—CHANICACarthed NCE ' PARK FEE ' Da1e NOTICE TO APPLICANT: N, afw ;flap thi'lw✓`tharte oT Exemption, yin them holame .0. a the Worlarr't Conpnsaton provisions of she labor Cade. you mint forthwith wplY with such praaskm or this pahri sldl Il SCHOOL FEES be dented revalued. : OMSKIN OF MISTRIAL SAFETY PER Cti71 ATlaF. is - ❑1 hereby certify that no oWt'aan011 Ile Iij lX maR fora In depth into Whki a pearl 6laparad Or daltad. e will be made in connection with work w1horoal by dar paatL and to no *ftq #treats. eolk1ft fahlsyork, or danoition or dismantling shamed. will be mat that_ tNnryaot (361 fewe kigh. )dap. 3.2. GrP 2, Art 2, Ste C341, Title B. C.A.C). _ „, -• r C ❑As ovwher-budder. I will net d^gloY awnC'Po elp West r+ikth tyarUY spama a patlM ban tar Ovhian of Inus"M Safes, as nnW &have. hakq sale plus, ha a parole to do and week boa ono Gvidon. ❑oai.in of Indrsniti Safety Permit No. e CONSTRUCTION lENONIG AGENCY: I bereby affirm flat dare u a tomtruetin la ill song far der pwFaaan TOTAL FEES - �v O e of the work to w lath this permed is isaed ISwc. 3097. Ch. Q. j Lnda•s Name COMMENTS gte p Landes'. Address; e CERTIFICATE OF COMPLIANCE AND AMICRIZATIUI OF ENTM/: 1 cattily 1 hove and flat appicdil d Mora 4 Net rode adormtdon Inner k cnan. 1 agree to can* with d sine 11101 NOW MY erinmacte idadq to hd fig constnicmn. add joex" a rani m eve of do Il*trromnt of Building and Sahsy to aoa glass Propeeal C hr who I laid fee this permit la papa d snaking . RECPT NO. PAID BY VALIDATION � a Sitputun d Appisant a Aped Oa1e WHITE —Department Copy, YELLOW —Finance Copy, PINK —Assessor Copy, GOLDENROD —File Copy. GREEN— Apokents Copy BS106-11/89 SEPTIC TANK SOE .............._. _.� .._..... ,...... er DAILY FIELD REPORT No: Job Name: a"s - Project No: X; { Dote; . Location: Weather: Day Contractor: Foreman - Field Technician: Miles: 7 Hours: Equipment Working: Inspection/Testing of Summary of Operations Supervisor: Engineer: St Todays Yardage: Yardage to Date: LEIGHTON and ASSOCIATES IRVINE • WESTLAKE/VENTURA • DIAMOND BAR/WALNUT • SAN BERNARDINO/RIVERSIDE • SAN DIEGO • PALM DESERT 10IA (4.77) WHITE — File Copy YELLOW — Client Copy PINK — Field Copy GOLD — Office Copy CEN Eberhart-Axten and Associates, Inc. 2211 Winston Road, Suite F G Anaheim, California92806 (714) 991-0163 SIGNATURE: