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HomeMy WebLinkAbout1098 , '"` CITY OF DIAMOND BAR pRESS ` 'a' QEPAR'TMENT OF BUILDING AND SAFE7Y ` -� BUILDING PERMIT FIRMIY JQBSITE �} `�___ APPUCATION�^ PERMtT SE ADDRESS �� i ��11 �U!IC-�� i 1� DATE ✓"��� NUMBER � CODE issuE p rv�' occ. i APN LOT J_TRACT DATE �7"'' � y' �� CONST. GROUP � CROSS STREET ' ° ��, r � v = SETBACKS "AiO'�'�"'S ° OWNER �l -:"-T ZONING �OM � � o ADdRESS �j`� ��-'�f(11 ^ REAR ❑ W CITY `'�' ZIP TEL.�� SIDE/SIDE STREET RW ❑ o APPLICANT ;7�Y�"YYl _�� �ec TEL�� . SIDE ❑ � z 4 CONTRACTOR SEWAGE o ADDRESS DISPOSAL � �BUC PMT# W GTY 7EL. ❑ ���T� SQ.FL!100 GAL z STATE � GRADING ❑CU.YDS.EXC. CU YDS FI�L y LIC.NUMBER �Q� � �q�jp p� Ap,1:AREAN AT10N y ARCHIENGJ W 1 � DESIGNER � o ADDRESS !wL 2 = CITY ZIP TEL'.T_. (� 3 � PROPOSED USE � L Z 4 � � GARAGE o NO.DWEL. NO. NO. j PQqCH y UNITS TOFiIES�BEDROOMS �p s LOT DIM�NSIONS �� J�- I Z� UALUATION ADJ.AREA c NO.OF BLDGS � HOW OUANTf�'Y D�f"GR{pT"�QN � W ON LOT USED 4 �,j �� r } s W � � t � r ~ UCENSEO LONTflACTORS OECLdRATtlIN-I here6y�fiim th�I am Gcmud uida pmvivais ol ChapYr 9 Immmmcinp . � wilA SKuon 7D[7�1 0�O�mson 3 of the Busineas antl Aafessrons CoOe,and my�emse is in fuH lo¢t a�tl Nfn't W 3 � W � �NfN�&11LbFH�ECL4RATIfMr�I herehy affirm�hat�am exmp�Irom the Contrxmr's t�cense law la ihe lallowiip r¢ason(Sec 70315,Bua�ritsa mC Pro�es�ons CaEe�Airy dry or counry wlpch requires a pnmil ro conmuct (7 - Oalter impove.demolish,or rzpair a�Y Aiucture,prwr q n:rssuerice,dso�e7uues the appircant for seth pwmn 2 h� m fJe a signea sia�emem ihat he is Ikensed purswm m�he prwisions al Ihe Canaatnr's Li[eirs[Uw(��a Q� pC 9lcommmciig with Stttion 100010�avmon 3 01 Ihe Business and Prahuroix Ca4)u mal he is ammpt tlwefrpn � d, and ihe has�s for the alkged eumption.Arry vidatian ol Satian 70315 6y eM apMicaM for�perme whje[tt � W the appncant to a eNil penalty N iat more man Irve huMred dolbrs(55�11 a � ❑I,as ow�re�ul ihe proFerry,a my employees wiM wape:as the�sde compmsatro�,will Ao tAe wmk,mtl ~ tbe siructuro rs no1 mtrnded or otfere0 Im sak ISec.1044.B�si�ss and Prakssqns Cade The Cmtracta's Lcrose q VLaw aoes iu1 apWy m an pwner of propeny w�o 6uilds a unproves tlureo�.aM who tlnes su�h wort hunself, V W a 7hrough his own employees,prwided Ihat such im0�ove�nis are not maiMed or olfered Im sak If,hwve�er, y m �he bwldmg m improvemem is mid wrtpm one ymr ol completwn,the ownerbnMer w�tl harc the 6urden of qovire Q � that he Uid no1 Wiltl a imD�o�e for tne pwpose ol sa4.) Z t� r/a ❑I.as owner ot�h¢popeny.am erduvvety camracnny wrih IKensed contra�twa to mnsuu�l th�prqtti iSa. W 0 7044,Buvriess aM Professmna Caee.The Lonvxror's ticense lnv Caes not�ppty to an owner of p�aperty wM � huAdS m�mpmves ihereon.and who comntts fa such Dro�ecn with a ro�nutor(sl��Msed qxsuant ro tlw Cmtrx�d't liaenu taw I TRUCTION � � 'J �,�W,. ❑i am�nr�m�sK e mu�a a�� PLAN REVIEW i-`z� : -�""L 0 oa'° ' LECTRI � T 5 9 � J � woRKEas corar�usaT�o[aaRanox i n.«nv ain,m m�I neve a ttrnficau af��sm�m:en��:�,e,a g�NG a cen�f¢ate ot Workni Compensatron Inswance.or�cnulieU copy thereof ISec.3800,1a6.C.i. ` ❑ee�oi�en��ur����eM r��snw „�j MECHANiCAL o O cerni��e��r����ka w�m me e�aa��M:o�u�o�arm�.��a oeoumKm Q Gf� !NG ..� � � CERTIF�AiE OF E%fMVTttIN fRQM W1W1(EflS'C`3�1PENSATIDN INSURAWF m�e,K���e�m n��o�+�e SSUANC ' y d Me pnmit is im one�undrea(5100)u less 1 cerUt�re�yj I��e of iM1e worl fu whch Ihis , i = permrt u rssued.I shalf no1 empby a�ry person in a�y man�ip_�'a1�.N byy 1 W IM 1Wrkers'c���� � MIP l � o i.,,.5�i cai�m,��. n �:," ; . ` ' W PARK FEE � od" "0°�"'"' u- SCHOOL FEES W AIOTICF(0 APPLICANT:H,�iter makimj t�u Ca�ifkau ol fadnption,you sho�k hecame su6ject m Me WorYer's � Compensativn prorrsims of Me Lshor Cak.pu�y�,y���.•�.+y�wiy�Q�rsam a this pemiil�1aN hednmMrevoknd S_j�� � 'i �.J.,;�SI a � pVISI[IN Of INDUSTPIAL SAFETY PfFlM1T CERi1FICAT10N� a O ❑i ne�eey�enay ma�no ernvemn tiue/��ee��mm ker,�n}hah�inro wiafi i pi�sun ifs6qiiRrad m descnd. ¢R witl be made m conMciwn witA work aut6a�d��b�th�s pM�lt.aMAblira"W�Wq`strirctwe.'acol�ulAing.fal�w�qrA, a demulmon m dismmHing thereol.wAy mae'ihan'Mu�l"1M 1361 he��Aph:�Ciyp.��.?�.�QGp 2.An 2.Sec Z� 341,L1k8,CA.C1. l—�..;,._..,.._ . ,.,. W 3 ❑ns o�c.nuiwe�.i w�n noi myiey anpne ro Jo work wl�kh wailA reyan i pnmt Nam nr tiun.�a 1.. Indosinal Sahry,es roted�6me.un4ss sucM1 pera�n hes e pem�n ro da such wark from the divbion. W ❑°""°"a'��""'S*"""m°"° TOTAL FEES � � �����E�����w����n�,�.�����«�.�� = ol ihe work fp wAeh this permil�is iswA 13ec.3097.Gv.GI. y p temei s Name COMMEWTS m Lender's Address '� CERTIiICAiE OF COM7LIMCE ANp AUTNON�ZA7UN Oi ENTRY�I«efy 1 h�rod Mis�p�calm id�hle h that 1Ae inlmn�0on pven rs tprxt.I qae ta canply wvh aY sble 4ws rd�iry orOimKes nlniop ro MiWq yconstrcetm.�M wilror¢s a rrpeyniatne oi Me aprimMt d&itlup ni Sdely 6 mM�iM tlr pYp1�ry = foi which 1 Aave app�+d b�Ibh pxmn 1 u�pox ,m�tinp insperims. 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