HomeMy WebLinkAbout1117 (5) . ,. �,
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� '"� CITY OF DIAMOND BAR PRESS
�-. ��`" ' DEPARTMENT OF BUILDING ANO SAFETY
�^' BUILDING PERMIT �IRMLY
JOBSITE APPUCATION PERMIT USE
ADORESS :Z0�7[? f. rLrni4f�1 D/� .Dra.Ka,ro DATE �"'z-� S�O NUMBER CODE
4 APN ` LOT�_TRACT 33 3 D TEE_ ���CONST GROUP
o CRpSS STREEL ��Fk'n( SETBACKS � •���
°.' OWNER�2'�✓An/ �!' (.A f Z.P/J��n Z O N I N G FRONT Ryy ❑
� � ADDRESS G� 7 D E� [ ;y�5�� . REAR ❑
W CITY-�rQr+c�,A 13 A� Zip 9 t7� r"" SIOE/SIDE STREET RW ❑
cn. _�TEL.�„a.,U—�G 7
o APPLICANT_2f,anr -i. �a�'P�1.rr� '�L:�4�-s"c�l SiDE �
2
` CONTRACTOR tt� �v' ` �+
SEWAGE 0 PUBLIC PMT#
o ADDRESS DISPOSAL ❑ pRIVATE SQ.Ff./100 GAL
W CITY ZIP _TEL.
= STATE
y LIC.NUMBER GRADING CJ CU.YDS.EXC. CU YDS FIt1
y ARCH/ENG/ � TYPE SQ FT E/LCiQf�P� AE1J:"AR�ALUAT1Q�t':
V' DESIGNER t1! 1 2 � s S-o,
o ADDRESS (� 2
� CITY ZIP TEL. � 3
_,
� PROPOSED USE �c T�-.a. �l1 a.-,1/ .5�� Z 4
o p
�' :� GARAGE
o NO.DWEL. NO. NO. �.; pORCH
� y UNITS STORIES BEDROOMS
� LOT DIMENSIONS � VALUATION � ADJ.AREA
o NO.OF BLDGS How o�arrr�rr p. CI�1P`°Ttal� .:_ � FEE
jI W ON LOT USED U
i = � �
~ LICENSED COYTRACTOflS OECLARhT10N:1 herehy affirm that 1 em 6censed undu praviuons af Chaptn 9(commendiq {.—.. .
Y wi�h Secuon 700�)ai Dirision 3 of±he Buvness and Professions Cnde.and my lirmu is in lull fprce and eflac ,;.�_ �
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�+- OWNER�Bl11L�ER OfCIAftAT10N:I AereGy alfi�m ma1 I am eumpt imm�he Coniracmr':Lia�ce Law lar the fdiaving .
� 2� �eason ISec 7091.5.8usress and Pmfessuns Code:Any citp or county whsh requiies e permR to ronxtru[t ��{} - .
o alre� imp�we.demol¢h,of re0ait airy slructwe,O��ar Io i¢issudn[e.alw repuues Ne applicant.frc wch permn -�2 -
I a: m hle a signed statemeni that he is licensed pursuant m Ihe provinons al Me Cmtt�cmr's Lueme law�Chapta :r�= . � _
s 9;canmenbnq with Section 7000;ot➢ivRion]Cf the Business ar.d Roleu�ans CodeJ a ihat be b um+pt tlrcrd�om �.:
�� and�he 6asis ior the alleged-exempuon.Arry vialation aF Section 70315 6y any�pplicant fa!i permrt wbjectt .�;�- - -
� the apo6cant tn a rnil penaltv�f not r,wre Ihan Irve huroied Oollars(5500�.�. . `:-1" �
�� -�- as mvner oi tFe pmperty,or my employees wiM wages 1s their sole camponu�ion,will do Ihe work and �a�.
thz s:iu-!c:z is nof�atr:ue�or ofle�etl for sals�Sec 70q4,Business and?ro:essians Cak�.The Conlnctm s Lcenx �.
V law does rwt app�y to an owner at property who 6u Idt ur�mproves iheredr,anA who Aoet wch wo R himul�.
W or thrnugh his own em0�oyees.proviaed ihat su[h imp�wemems are no[inu�ed w ofk�ed Mr sak.II_however,
m ;he tullding or impwvemen�is sald wifhin one yea�ol cano�ehon,tM rrvrner.Cuilder wdi have Ne fiuAen of pmvi� .1:Q, �
-y� that he ditl rot Omid m im0�ove fm the puryase ut sak.l ���S'...
�� ❑I.as avur.er of the pmpeny,am extlusvely cnmracting w�ih IicensM contracmn ro conmuct the prqece ISec ��:�:��y,{�-� �
0 703G.Business aM Professians Codc Tk Contrecmr's Gce�se Law daes nol apply to an pvner pl prupe�ty wfro -� . -
4 6u:lesar imp�wes Mereon,ard who cannacl5 lar su[h D�lecis with a camrattor(s�LcensM pwSuaN ta me Cmtractw s .
L1e"��"", '. CONSTRUCTION Q 2,S
ti� : PLAN REVIEW � 2 G�
•.. ❑1 am eaemD�unAer Sec. 8. ..C.IAtlxh Cettificate6 �
.� G iJare (�F�J S')17 Owner . ..
ELECTRIC
yyy � iNONKERS'COMPENSATION OECIAPATIpN,I hereby alfirm that i have a cenfiaace of tansem m sNf msve or � �
� a ttrpf�a of V�rkers'Lempensalicn Insurance,o�a an�ified capy thereaf($ta?800.Cah C.). � ��PLUM�ING
� ❑c���rea�onv�s n�,�n,r��sn�a. � MECHANICAL
o ❑Gunf ed copy is Fi:ed,vith the Building Inspeciion Oepartment or oePu�ment :�� GRADING
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3 � CEPTIFICaTf Of EXEMPTION FROM V�OANEflS'COMPENSATION INSUfIANCE This settian ne6U noi he compk�ed ���` �SSUANCE �7j � �
.y. if the De�mn is lor one Aundied(5700�w less.I ctttifY that in ihe pwformance af q�e wak fa whkM this
� permn is issued,i shail m1 emplay ary person in any manrer so at to 6e[ome mbect ta t7q rihlkns'Campensarion :~' S(��P . �.. b
- = laws at Callfwnia.
0 oare � cant (jj_�� l L'_G.'pV � S'G
�� NOTiCE TO APPIICAM:If,afcer making this Ceriifica���r E�u,p�.�:n�ne oec�:�ni���o m�w�r�r: �--SCHOOL FEES
� Compensatian provi3ions at�he lauw Cade,you must IaMwim compy wiM sucM1 prwninnz a thia permrt shall �
� be dcemed ievaNeC.
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� qUlb1Q+1 Oi IHWSfRIAt SAFETY PENMIT�E�FI�70H , -
�+a �(`:,,'__'�6L�S_:+;L ����,'yJ
� �i hereGy mtldy Ihal p0 BktlWtWn t�(h'p mpb�-1py7pP�h into whicA a pusan is rcquiad to Gtsten0.
� wdl Ce rrade in conntt�wn with wprM authof¢etl hy Nu permit,a�d that iro 6uddinq sttactuie,sc�f}oldiip,I�Isewwk .
a demo4tien ar dismamlirg Ihercoi,will he more than thirry�si��36)leet h�qh.�puD�3.2,6ry 2.Att 2 Sec
� Z� 741.Title 8.C.A.t.�.
W ��� � � ���
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� ❑As ownc�huilder.I will not n,�p de wm yl Id reqare�permt hom the Onom ol
�—. Industrial Safery,as nmed a6ove,unless such person has a permit to do sueh wak fmm llrc divisiMt.
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- W ❑p�ision af InEustrial Safgq.Pe'miyNq-- .�.• - ;, -:- ':'j
� CONSTRUCfqN LENaNG AG�,H�Y:.lhseh�aMwn that;aMen sz'tMSIIteEE�`UMinY aOMCY la Ca PMoimaxx TOTAL FEES �
� 2 0l ihe wort tor whkA this D?�hmS`�SssFued�Sa-��7;�Sia.&i.".•. ", � �.
� � lem�er's Name _ COMMENTS �
mlender's Addresa
Q CEFfTIFICNE OF COMPLIqNCE ANO AUfFqRIZATIW OF ENTpY:I catily I have nad this�ppticatian yd st�e
� rii �haf fhe inluma0on given is[u�M.�aq(K t0 cOmph/with all state laws and[iry Otd'aia�cea«latrp lo OwlOirp . . '
y canst�ucum,and authmue a repreuntative of Me Oepartment�i BuiWi�q aid Safely tp en(e�upon fhe proptrry
� tor wh¢h 1 tave applkd Iw Ws permil IoytRe q�ppu of making inspxtpns. yy
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� ---�Synawre ot p�cant a�A�� p�� RECPT IVO.rS����C�-:---L--�-�?AI�BY VAUDATION
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� wHi7E—�enartmset Coov.YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Appicants Copy
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