HomeMy WebLinkAbout1424 �"` CITY OF DIAMOND BAR pRESS
'-�' ' DEPARTMENT OF BUILDING AND SAFETY
BUILDING PERMIT FIRML
JOBSITE APPUCATION PERMIT SE
AODRESS DATE NUMBER CODE
ISSUE�j r 1 J.. TYPE .
4 APN LOT TRACT DATE � 1 CONST. GROUP
o CR�SS STREET ZONING SETBACKS ''�f°"��
°-' OWNER �tJ�P ,.�- �i�_ �°�t� �ucor� �orir Rw O
o ADDRESS�L�C'�` ��'-�r-14 L�/1�� REAR �
W CITY a }��� IP,9/�TE SIDE/SIDE STREET RW ❑
o APPUCANT �-+ !� TEL,9LF/-stii� SIDE �
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a CONTRACTO � SEWAGE � pUgLIC PMT#
o ADDRESSL�s DISPOSAL � �Nq� �,�����L
W CITY ������� ZIP�TEL I �
z STATE
y L1C.NUMBER ��`��,� G-"L24 GAADING 0 CU.YDS.EXC. CU YDS FILL
y ARCH/ENG/ � TYPE SQ �T 1�:P ' AC�1. R�;AIVALUA'�'IDN "
=' DESIGNER � �
� ADDRESS LL 2
0
Z CITY ZIP EL (+f 3
� PROPOSED USE � 4 �
� � GARAGE
o NO.DWEL. NO. NO. � PORCH
y UNITS STORIES BEDROOMS
s LOT DIMENSIONS � VALUATION ADJ.AREA
o N�.OF BLDGS HOW �UAN?fiY .I�E P�`IC'�E �EE
W ON LOT USED Q
s ta
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NSEO CONTPI1CfOHS OECUIRATIUI:1 Meby alfi�m 1Mt I am GcdinA uMe pwidms d Chprr 9�mmmerciM
Y wrth Sec4on 7000)���3 of the&aiircss and Prafessions Code.and xry license ia n IuA laa sud efhct ��.W
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u. OJlNER�&RLOEfl OE0.AflATIIXi�I hmeby alfirm�IW I�m e�mnq Imm tAe Contracror's lixme L�w la die kbw�g
Z aason ISec.10]7.5.Buaness wd Prohasons Cade�A�q ary rc tdnry whi�h nprira a ynmil�tmstric4 :�
O alter,impraue.demdish.a repair a�ry Slrutnre.p�or n its issuarce.�Im requrec 1M�pp4rm�tw wch pr�l ��Z�
t— m tik a signeE staxment that he is bcemN pusw�t ro thc prwisions d ihc Cantrxtor's Lice�ne law IC�wpar ;�
s 91cwn�ci�g with Section 1000)oi avision 3 d drc Bwaieu and Proieasiw�s Codel a ih»Fe e ermpt tl+xefran -'�..
� a�d tf�e bas�s Im the adeged emip�n.Aqr vrohtian d Secbon 7031.5 6y airy applemt tar s permit tiqxn ..�.:�
W the appkcam ro a crvd penatry oi not mwe Ua^fiue M�MreE dopars(55�1.1: ..a.
� ❑I,as avner ot th praperty.a my anpbyees wid weges sa tnev sde cdnpen�aton.wil do tlie wmk.and .�...
the atraw�e u nm inlm/ed m uffved fa sale ISet.7D44.Business a�d Rdessians Cude:Tlr Cantntrer's liunse ..'s[ _.
v law tlae�s1 M a�ly to m aixmr oi propeny wha builds or�mprwes 1M1nenn,and who does sud�wak hinwN. (,3
W W NwWyI M1K OWII BIIIPIOyCLS.D�WIAlJ Md!AILA PnPOVNM�IU M!110�M$Ildld 81 OHlrtA IW Erl.II.�BWM�. -�,.T.:
m Ih!blllbllig OI 1111pfNllilMl i9 80b W1�1111f dl!Y!Y 0�[OIIIpEIIdI.ihR OMI1IN��Ikblf WIM hiYQ 1�1!�0�OIP/910 .'�
� eut M eb rot mde a im�xove for the w�oou d sMe.l
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�s ❑I.es owner ol 11k PWtt�Y.am excFemeh tonhutm�l wiM IiccNM tmtrxtora�canshucl tle Mq�(Sec. -�JJ�
1044.Business and Prohssias Code:The Conuxmr's Licwrce l�w das not apply m xi aunu M pr�erty xMo -:.;�-
s Mulds a enqaa Mneon.aid who caitrxts fa acn proKen wiM�cmtnc�ls)licrosed PRauwit m 6u Canvctr's
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`_ °a� °i""�' ELECTRIC
� NRAIKEflS'LOMPENSATION DECIAMiIOM:I MreM+H'rm thN I have a anificm ol canfent ro uM-imve.n "
� a aruficate al N6rtda'Comomsaioa Insurmce.a e�a�ifieu mpv�Iwed ISa.3800.1+b.C.1. .^`- PLUMBING -.
6 ❑c« �a�r p nMer twM�a. a J,�/� MECHANICAL
10 �aiied capy u fi�ea wlm me Buadlnq Mspstim oeprm�m,a ��. :'`�: GF�AD
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� CEflTIFCATE�ENEt�TqN fROM WORKEflS'CMIPENSATqN INSURANCE:Thie secam mb not b�aiqleenA NCE �
y d Nie D�mit is la a�e hudred if1001 u kss.1 tatilY thH m 9ie pe+tar�rre af Ihe wvY fa whih�qif .
. Perm��is i:wed.1 shd M e�ndM�M Pmmn in am'mimer m as m b[tame wbl�Cl q NR Warkeri ra�lim . •
o �a c�. /�1 K FEE
p Oaa� .'�l ~�7 v ppplicmt �' �w
� Iq710E TO APPLICANT�M.�makinp tlis Cetifr,M M Eremption.yw shod �ca�e s�n n m�+r�n�«'s �- SCHOOI FEES
� Ca�ensanon prwisiona M the U6a Code.Y�exnt larllnritlr cmpM wi�h wch povisims a dMs pmnd shdl .�
� 6e deend�evoie0.
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� DMSION OF INWS1PIAl SAFE'fY PERMNT CEflTIFICA110N�
e ���r anitv nwt m euaa6o�lawe�5)«mas�et ip,�,inm whidi�msa a i�w�e a Mrana.
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¢y MriN he m�de in cankaion vrah�wort�uUiarce�6y�p�y;m�1 tliYt pb�ldiiy ibu[Ire.u�lolAiip.I�IM�rrt. �
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a demoXlion u aunmtRq iMreot.wiW 6e mae t¢M th�rt�`hrsel136thet��.I�P.J.2.C+0 2.M 2.Sac
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3 ❑As mms�budae�.i wfA ro�e�+iryu+a!o wort whih waid nqum�pwme bwa i�Oivi�ien�i
r kdumid SaMr.�:noad a6ow,udeu wd� p�a !o faph�,wryak hae ihe aiuiven. '::�
wd�� n�t+o �,.,�t� �
n �0rvi�°"°�`�tr��`"'�"0 + �� TOTA FEES .
ry CONSTRIICf10N IENdNG AGENLY:yhe�eby fut Nw�b�[enstrmtim 1�1ing��1er i�e 9rtennna
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z d nr wort fa wAih e�n�b'bsie!I�c. . i:Gf+;t.4;,<.,?:,.,,r,.. �`
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� �.s� � � � :y},'.._�' ��c .t.. : " COMME — -
m �,s� .,. �.,-.�'-.-j'_°( ����i�i/�/� .���
t CERIMIU7E OF C11�wuM10E ANO AUIIIUtlIAi101 OF EIIIHY:I urih I Mw mi M's�ad sbb .
v! tlw Ve intamaim O�b w�sl.I qr m mmplr w�i stile Iws anA cM wir�ne�ni9��"7
y conavunim.�nA aitl�aiie a apetent�vn d dM Wpmnmt d Bui6iy M1 S�My!erYr�qn 4n 9ra0wb
g hr wFich 1 hrw MOM4 far tlus�iv tlr ar d nekm/iqpetiani
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-���--�a RECPT NO. PAID BY D �,�
Sqn e d Awka�l a Ap�m Dw . "
WHITE—Depertment Copy,YE�IOW—Finar�ce Copy,PMlhAssesaor Copy.GOLDENROD—Fls Copy,OREEN—ApplicaMs Gopy
' BS106-11/89
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