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HomeMy WebLinkAbout1246 '"� CITY OF DIAMOND BAR pRESS � ��'' ' DEPARTMENT OF BUILDING AND SAFETY BUILDING PERMIT FIRMLY JOBSITE APPUCATION PERMIT 1� S ADDRESS ��IJ�� (�U 0 i.l l.1 t=."1!v i�UE ���TYPE ER�2�,�CODE ` APN LOT TRACT DATE CANST. GROUP a CROSS STREET k I OW� C,12t.'�T SF�EO ACKS � Q�� �° OWNER -g t-�YL►°�"L-F ZONING � ADDRESS `1 A'�� IJ t-11=,1D REAR ❑ ,� CITY �1�At1�►�0 B� �P 9��TEL � L SIDE/SIDE STREET RW ❑ o APPLICANT��:'Tl�� �su-)�`�S e.t�rcp"�'TEL �a SIDE 0 : 6 CONTRACTOR�'L`�ZL'n- busuJL�Si e,��vtp. At_uMou.��- SEWAGE o ADORESS 7__u2st1 pViS�a n��.. Pru�no DISPOSAL � �B� �# ,� CiTY W fi�t.IJuT ZIP��TEI._5z1°�l4 Z� ❑ PRNATE SQ.FT./10�GAL = STATE y LIC.NUMBER �lI b$67 GRADING 0 CU.YDS.EXC. CU YDS FllL y ARCHIENG/ � TYPE $Q Fi" FACTOR PS. AC1,1. AREAN/KUlAT1UN �' DESIGNER _ W 1 o ADORESS �w., 2 = CITY ZIP TEL. �r 3 � PROPOSED US� '��L=F'►_tlf.t:. t_.�[.[STI�� (:Yi-S SG'�2.Ut ' `� 4 � I�Li 1�t- tiO cWtiS.0 � GARAGE z NO.DWEL. NO. NO. � �R� y UNITS STORIES BEDROOMS s LOT DIMENSIONS m VALUATION ADJ.AREA o NO.OF BIDGS HOW 41UANTtTY �IfSGRIPTIO �EE ` W ON LOT USED ,z �; u � � t CENSEO CONfRACf0i1S�CIARATpN:I hareby aflirm that I am Gcmmd mda povisims d CFapw 9(commncinp , . ¢p wnh Sectian 7000�of Oivision 3 af Ihe Busmess aM Pralessims Code,aid my licenu is n 1uN Iwce aM Ahct ;W � - � ' � � � 3 � • �j _ OWNER-6UILDER DECLAflATqH:l hereby alfirm Ihal I am eiumpl�mm drc Conirxiw's Licrose lew la tlrc idbwiig _ �eason�Se�.7031.5.Busiixss aad Prohssiwis Code:A1ry tity o�county whsh requirts�perml b construcL (} O aleei imryrne.AemoNCA.m repan arty sUucure.prar ro its nsuaue.alm ra�ueta tM appli[ant lor sucA p�mt 2 4 m hle a sg�0 statemem MaI he is Iamsed pcwant N the prwisona o1 the Canrtanoi s LicMse law(Chapter �aj ' ��S,"�j F,]( ¢ 9 Icanmen�iig with Section]00�I of avisan 3 d Me 8usims a�Prafeuiom Codel�mat he is tYempt iherehom ..� O d and Me 6ans far Me aReged exe�tbn.Airy viol�lion d Section 1031.5 hy aM�pplicMt far a pnma nibjuuts -.� �LI/.�L, N- �n--1a x tne applicant ro a crvA penalq M not mme than frve huMM dolars(55001.1. a ' W � ❑I.at avner o�the pnperry.a my employeas with wages x drci�tab tompensarien.wiN do dx work.and ~ the strucmre rs nat intmded or ofFered fa sak ISec.)044.&nineas and Prokssions taer.The Lmttxmr i licrose �,~j Law dce�not apply M an owner ol praperty wha 6uilds or impwes Mneen.and who Ooes such work himself. �() W a ilxough his own employees,prwided that such impovemenu an na innrdd w oi(erad fw sek.N,however. -_-g� m Ihe huiN�ng re impauemem ia solA wiMin oix Yex el tompktron.Ihe mvnd-bw1An witl ba�e the 6udm ot pwug eC y mat he did irot huiN a imprave tor Ihe Wrpau of sak.� ..� v� ❑I.as anner ol Me property.m s.churvely contreni�wim IKemd connxton m eonmun ihe p�qect(Sec. ��W 7044.Busircss anA Professions Code:The Contrxmr"s Licenu Law Eas iw1 apply ro an oMver al propnty who '� I4 bmldl m impwes tl�ewi,and who[onlrMis ta such Dm1�s wi�h i wntraCl0fls)licensed qxaumt m tlrc Coniraciar'S ' �"`"x�'"'� CONSTRUCTION � ❑i�ex�a�mn s�. e.e r.c.ian:n eens�k�. PLAN REVIEW 0 oa�e �� ELECTRIC � K9RNEPS'COMPENSATION OECLAHA71p7:I herehy affirm that I have�cntificm d consem to sNt-nsue,ar a rerdfxate at NMkers'Campensation Inaurarce,or a catrfiM tqry there0l�Sec.38W,176.C�. LUMBING � ❑cKurka�oav�:n�.�nv���e ,�,� MECHANICAL p �... wr� � vac�'''b.d��»�'��'�1 o�+�m. 'Q GRADING Cerntkd� s filed witF the BuAdi Ms Voo �'a� Z CEiR6CATE OF ENENNTIDN FHQM WOftKENS':TOMP�#ISA"{�(Yl�IpSf1RANCE:This se�tion ned rot h tompletM `�A / � il the pcmit is la mx�uMrM iil�l a kss.I certiiY dut in the periqewice d tlie wort tar wlicA��Ais - 6'� y permit is issued,1 shap rot empbr pry permn in airy mem�er so as to besame a�pzt ta Ihe Nbrkas'Canpcnsatian �-� � i,,,�:�c�a�. SMIP � . � .I I� r��� ��i4� W PARK FEE p Dah � � NOTICE TO RPPI�ANT�.M,atkr mek�ng tlris GrtAiu�e d Eremprion,yau slwld M�mie auhj�t�ro die Ntrbr'a � SCHOOL FEES � Cnnpenatan p�wisrons ol the Le6m Code.you mmt fa�hwi�h mmfly with wch prov'nions a this pnme�II � � 6e deemed rewl�d_ _ r i'"" �h� i� _ � WISIQI OF pJq1SfRIAI SAFETV P,ENMYT CE�ifCR110N. .,�t'i.;�/ W Y..s+�_...�.... - ��f�.: �/ '.! � : a nereey ce��ily tlut m ertava�an hue I51 a mae hei In deptA nm wlicA a pdsm u npwed m deuwd. ¢ �6e made m ronnecuon with wmk author¢eA M tlns 1�h.wd tM ro Wildiq sdut�re.swibtli��triexiork. � n- or EemWifwn a Msmmtling ihereol,wiM 6e mae thm M"xMsn(361 het hiqh.IChW.32.Gq 4.An 2.S�c �: W- 3d1.TitkB.CAt.I. x 3 ❑ns vwna�EuiNn.I wiN nm employ myone ta m wort wAirh wmtl nWee a prmit hom tle 6visim d . 1— I�usuid SaleiY.as wid�hore,unkss wdi R�son hu�O�iml m do suh warA hom the d�ruian. s ❑Omsion d Mdurni�l Sah�'Pkrmit No. .��..�..�.. ; ���,,,��,��,�„c,:,,�,,�,�.,,�,.a,�,„�.,,�,,,��.� TOTAI FEES , '� z o+m wwk tn wncn n.s penm u itwee 1s.c.3��,cN.c.�- � lmxr's Name CAMMENTS p�p Lender's Aed�esa 4 CERTIFfATE OF CINAPl1AlLE Rlq AUf1�k2ATO1 OF ENfRY�I urMy 1 hw�md!e�ppiutoi rd sble va that Ihe infamaton gium n cvrttt.1 qee Po mmpq�Wi�h yl sb4 YwS�N ury al6wcn nbuN W bu�M y canstrucum.md suMarte�«pemnuiire d tl�e Dprurot d Bi6q ml S�My N MYr upon tl�piaprry = far wiac hrie app�ed tor M �mh 6or�h pryon d m►inA imps�uen+. ~ X Ld'f�1�,!l7?�9 rI— �c3—Irll RECPT NO.J,LL_L�PAIO 8Y �IV v� WWDATION d AppFcan a Apent Ow �TE—Department Copy,YELLOW—Finance Copy,PINK—Aasesaor Copy,GOLDENROD—File Copy.OREEN—Applicenb Copy 85106-11/89 ,:., . ,,,�_: :;.. . , , . :. ._: , , ,;:,, . .. , . . . .. , . 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