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HomeMy WebLinkAbout1529 � GITY OF DtAMOND BAR �J�G �� 3� } ' } PRESS ������` DEPARTM�NT OF BUILDING AND SAFETY FIpMLY �- ' BUII.DING PERMIT JOBSITE n APPLICATNJN ` PERMIT E ADDRESS �2-�'�� S. F-�7`V �'V (..til�.v:'� ��A�E ' '� ��ER ,�a �CODE � APN LOT TRACT DATE ��S �� CANST. GROUP � Q CROSS STHE T .aa�nE►ns ZONING SETBAC4(S °.' OWNER }''�1C-, / �c,/L5 FRONT RW ❑ � ADDRFSS �'r�l�-� S. a!JdJl'Z�t11+1 (pt��� REAR ❑ ,� CITY r �t�i G�'i� :"�;'��r� ZIP �'� r`7 TEL.-�`S=�-'> SIDE/SIDE STREET RW ❑ �a APPLICANT ��i'-�-�'r���-� TEL. -`>>�-�=v SIDE ❑ � CONTRACTOR_��`�!�''�� ' `c�'—`��''��+«��' SEWAGE o ADDRESS `-i�"7`.�s L'� . �= [�►,`A.s'�'�7 DISPOSAL ❑ PUBLIC PMT# .� CITY.`-j�;3� ir_���,t��1 � ZIP C�d.� TEL. �'� -�`�s'=��7 ❑ PRNATE SQ.FT./100 GAL i STATE d UC.NUMBER t�C�.�[�^L�'�. GRADlNG � CU.YDS.EXC. CU YDS FILL y ARCH/ENG/ . � TYP� SQ FT FAGtQA R�, R : REA�/. N = DESIGNER �� ( v.,zSc�Lf��`� L�'••'t>. W 1 '3?. .�(� QADDRESyyS /J�c,'�;� ,r`,,s�a.: �t'���':,j;'�'_ix, �.�Cc.'!'}�`'A--) � 2 u+ la�L-��'1.4FI.(--x�1� �`�.1L. "'�.w.�P t .c � CITY�_ '•_ . ZIP TEL.:.�'::.--�.'.i: eV 3 � PROPOSED USE -'`' 1 � 4 o d w �. �y' ' '� � faARAGE o N0.DWEL. NO. NU. � p��H � y UNITS � STORIES � BEDROOMS�,� m s LOT DIMENSIONS VALUATION ADJ.AREA c NO.OF LDGS HOW QUAwFm ClE P'�C3M P� W py r USED � � ~ L�ENSED C01liRACfORS DECLAAAT1011�I Ae�eby atfirm�ha1 1 am 6censed unde previuonc of CAeWp 9 Iconnvncirq � � � '�'� ¢ wnn Setnon 70L10�of Divisian 3 af�he 8uainess ard Pmhssbns Code,and my�rmse is in fWl foru�od eJfat � 3 � W � PNNER-BUILDEfl OECIARATION�1 hereby alti�m that I am eae�t Iran the Conirxtor's Liunse ln�ta i6e ie�lmving , reasan(Sea 70315,Business and Prdesswns Code-Any ary or camty which requir�a prmit m crvWruct, (� oaiter,imp�ave,demolish,a repair mry s[ru�iure,prior to its issuairce,alm rzyuies Ux applicant for such permit .� 1- m lik a sigred stalement that h¢is Ircensr�pursuant m the prwisiens o1 Me Conextor'S l�enae tav(Chip7w �j s9�commencing with Section 70��of Divisio�3 of�he Business and Pro4ssiom Code)or tl�at M is e�emp��tsirom � d and Me hasis to�Ihe ailegM?xamptinn A�ry viidatinn nl Section 7�31 5 hy arcy applicam Im o petmt su6jetn x �hc applicam m a civd penahy of�ro�mo�e than irve hurdied doWars IS5001 b � W � ❑I.i5 OWMt 0�111!O��rtV.Or Ty lmP�%'E8S W�I�WMJlS#tA/ir 4dB CUmM�SAlIOn.Wali M lAB MC�k.i� the siructure is not intendeA a oftereC fa 5ale I�[.7044.Business aM Prdcssiwis tatlt:The Gmtratmr'S Liunse � \ � � c-. � Law does�wt apply to an owner af propeny wfio 6uiMc or imprwes ti�ereon,a�d wM does such wor4 himseff, �� �+ or tMaugh his axn emD�Wees,providad that such imprmemen[s are na imeMed a olfered im sak If,hvxsver, � . O�O the EuiNmg m improrement is told within one yex af canp4tion.tk o+vner-buibx will have the 6urden of prwi�p � � that�e OiG nm WiW a improve lor me purpau of sak.� `n U tn ❑I as ownei ol the properry.am e:clusneM connactiny wiiA licensed comncrora�o censtruet the prmec�(Sec. {U O 7044,Busi�xss aM Professions Code:The Conuxtor's liceine Law dats�rol�pp�y m an owner ol prapxty wlm z bmlds or Imprmes Me�eon,anA whn contracta tn such proiect:with�comrxtor�si liem:ed qxsu�m to tlu Cmtartd's �_� ` ��°e°�'°",� COIVSTRUCTIOIV" ��� .�`7 e y� W ❑�am esemD�unan Sec ,B.fi P.C.�Anxh Certrficate�. PLAN REVI�EW '�'" ��TR— 0 oare �'^� ELECT —T � t--t{� � WOPNER$'COMPENSAi1pN DE0.ANATION�I Mrely affirm ih�t I hwe+cxMiuk ol cansmt to stll-insure,a a cenAiate of Workni Compensarian Insurarce,or a cmii�ied copy iherem 15ee.3s00.�zb C I. P�.UMBING 0 � ❑�,��y�,,,}���,�,hA���,� ,.� n��cHaNica,� `� �� o L3}'F.ertilied rnpy is h1eA wiN Me BwNing Inspection Owxtment w o�mK��. �[ GRADiNG W = CERTIF�ATE OF EXEMPTION FRp�A WORKEH$'CD�ENSA710M INSUflAN��.Th�is uttion need not be completed SU�� � � � d the permit is Por orie AuM�eE(S1IXlI a kss.i cer�fy Mat in Me perlormrrte ol Ihe worM�a wNch-Ihis - - cn � permit is issued.I sAdl m1 EmpiOy any pa1ton in a�ry manrcr so as to blcome w6�t 10 Nr Nbrtrs'Campensation S,`M� .'7 o i�,:o�e��r.,��W. � � pARK FEE p �dte_(y.JZ/��' IIQQYtint f. }U� � AqTICE TO APPL�ANT�.H,alur m�ag fhis CcMicete of, ,s�he�ome w6ject ro Me Nkr4n's �+- SCHOOL FEES � Cmmensanan wwisions ol He Laher CMe,yeu must tnr�yipi ynq:sud�,provn�av a tMs pnmi�s1uA � he dee��evdW_ J p� pVIS10N OF INDUSfRIAL SAFETY PERMIT CEHfKICAl10N�. W Q ❑1 herehy cetdy tlut ra ettaa0on Fiee(5)er�aR leet in dqrh nro rd�id��ppwn q r�ind ro Aaced. ae w+�be made in ca�nec�ion with wwk ruhavM by�q,�d.and tlqj m h��p�uCtua.snlldd�p,I�nwk, d a Amrolnion or N�mtYn9 tl�aeof.wi�he mart-Vhin�nirryai.1781 hej i�l,'1�aP 32.6ry 2.Ah 2.Ss W� 341,TiMe B,C.AL.1. 2 3 ❑As owna�build�r.I wiA rot emp6y nNane'eido-wnM whih-xnWd.rrNire a p�mil han Ihe Oivison ol � r I�strial SaMy,as mhd ahove,uikas suilt aerSod Mt t"permi�to dd.7ut�yYDrlt Irqn�Ae MritiM. . W ❑�,�d��ma��.ry��� '�'- '-� �; _:. `.;.. TOTAL FEES �'�� �D �. �, ca+smucraN�e�i ncFNcr:�nm�hy.n�rm ny,n�.�:.cann.ction Nna,q w.�r�d.P.a�w = of ihe work f«wliich 1b¢pnmit i:i:swd 1�.3091.Gr.C.1. c � LaMEr'S Ilnm! C.��EN�. , c �i L �j LeMer's AAdrest � CFNTIfICATE OF CUMRIAICE RlYI PUTNdtl2ATIp1 OF ENiNY�I araly I hwe naA tbis�ppliMim nd�qMe VJ UW IM MIfp1111I1W1�IRII R GQfCI.I i�Y IB CpR�'WM iN SI/Y I�Wi Md Gir 0lYIMIICp IWINp 10 bI�M10 y cm�tructian,and ar�lwix a rpsmtaMe d tlr Dqruu�n�d Bui4i�p aid S�My m nMr q�on tln pqrry � ta which I ha�e apqed to�Mis qrme Iw tYe pupue d m�ki�in�pcpons. x � _ �%'�� t,, �' ^ — RECPT NO. `� ��, MUO BY " '�`��WWOATION e d Applinnt a Apa�l UM� . 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