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HomeMy WebLinkAbout1395 (17) i '"` C17Y OF DIAMOND BAR PRESS �•� -' DE6�ARTMENT OF BUILDING AND SAFETY F{RMLY -� BUILDING PERMIT JOBSITE � � • ,\ APPUCATION (� � �� F'ERMIT �. .i USE ADORESS ���',>� � .1 .1C~ ,h�' .{.�1-� ;1--�1 , bATE �,�1�NUMBER�CQDE - ISSUE �r_/� TYPE OCC. � APN LOT RACT DATE �"" `��`"�{u CONST. GROUP � CROSS STREET G�`-''��' S�''���'�5�C./a 2(��o Z�N��G .SETBACKS ""�"'E"'S =' OWNER��-'� � Cn�`-s mo2�'t,�S Fi�OWT RW � o ADDRESS�-�'�3►� ��22�'-' YJft' aREAR� ' � ?' W CITY���y"�`^'� �p� ZIPr1l�1 'y�'_TEL�b� clkfr3 SIDE/SIDE STREET RW ❑ f o APPLICANT ��---� -TEL. SIDE�. O � x J""'-- � CONTRACTOR �G �� SEWAGE C) PUBLiC PMT� o ADDRESS DISPOSAL � pRIVATE SQ.�T./100 GAI.. W CITY ZIP TEL. ` = STATE GRADING ❑ CU.YDS.EXC CU YDS FILL ; y LfC.NUMBER y ARCH/ENG/ �, .T.X{�E SQ Fid1GT�.R fj�`r. : AQ.1:::I�REAIVALUA71f?N �' DESIGNER 5• �- '�SS 16�"� LiJ' 1 �� ,, �' � ADURESS7AR5 o r�.ran,�,nosA (��4-ZS� c� �' (1;, 2 i w LI',K.aS tSLSI•.+e ft .._ 2 CITY ZIP TEL. ;.(�; 3 - � PROPOSED USE Y%1!Y1`'�. £- r}'1� � Z= 4 � -' �•. GARAGE a NO.uWEL. NO. NO. �;. ppRGH y UNITS STORIES_�__BEDROOMS '�- s LOT DIMENSIONS m VACUATION ' �� � '� ADJ AREA i. o NO.OF BLDGS HOW QUANT"tiY DESF�✓R#PTI�. F„EE,` , W ON LOT USED Q i � . s � � --- U s �; � 5. (� � ~ ICE ED C[1MFAf.ID1NS OECLAHATION�.I herehy aNinn Ihat I am IicenseA wdn pmvisans of Chapter 9(�ommen[mg � Y w�lh Section 7000�nt flivisinu 3 ot Ihe Business anA Pmlessfons Cade,anA my laense is in fu�l forre ana ellett "�� %W 3 [� y'u ! fR�VNEfl�UUILUEF OECLARATION I heieby aflirm that I am erem0������Comraclar's License Laxr�oi�h�e idlowing ����� , , � reasnn�Sec 7(1315.Busiiress antl Professinns Cade.Any tiry ar caunry which requires a permit to consUuc�. .%:(�': O alrei,iarymve,demu�ah,or repau any slmdme,pnor m its rssuance,also requi�es Ihe applicam Por such p¢unii ��:';2��� , Q to file a siqnai siaiament that he is licensetl pnrsuam m the prwivans of ihe Cantracror's litense taw(Chapter :���m.� � � � 9 I�nmmennng with$ectian 7000�ol Oivision 3 0l Ihe Business anA Profeasions Cade�or that he is exempt thecefwm �,��:'��.: .. y anJ the Lasis for ihe allegeA:iemytion.Any violation al Sttlion 7031.5 6y any appliwnt for a permi�subKus .?.�'- � � �� � Ihe apphcam m a cicil penahy o1 r.at mare Ihnn live hundied dollars(5500Lh �:'0. �:�� � LJI,as nwnr,r ol!he propenY.nr my employees weh wages as IAeii so�e compensation,wll do Ihe wnrk,and � ~ Iht ShutW�C i5�IOt I��PnAEd Di o��ered lor sale ISec 7044,Busness aM Piotessrons Cade.The Canintror�s License � �4� V Law does nnt aDUly In an mvne�of praperry w6o builds ar impmves therean,a�d wha dor.s such work himself, .j-(,��: - W or tlimigh liis uwn emqayces,provided that tuch impiovemenis are not intended oi oifered�ar sale.It,however, �:�:� = ihr.Ixiilding or inpro�tment rs sold hin one year of complelinn,the owner�6vilder will have�he hurden ol pro��ng :t.;;Q� y i6ai he did not hutltl ur impmre f th D���Dose at sak.) '�r2•- ua ❑I.as nwne�uf the pmpeny a IusrveN mraatiny wnh licensed minracmrs to consiruct Ihe v�o;mt(Sea �;:��{��. o. 7044,Busmess and Vmfassioi � he Cnn cmr s C ense taw aes not apply ro an owner af propeny who ��5� �- LwIJs ar mproves theieon,an a irar.ts�o A p�o i a mrac�m�s)licensed P�Suam io ihe Conuanor s �- —�-� lv.enselanl _ G'I�NSTRUCTION~i -"`�`,�� ��"�t"��-'--'--- - ----------"--" ;,. � ❑�am exempt under Se , e&PC.�Auach Cerofiearol ;: PLAN REVIEW ""�=�' __,_ � Q Oam Owner = E f _-� � �' � W9RKERS'COMYE45A71UN�ECLANA710N:I here6y alliim that I haae a ceni�iCa�e ul cansem�n self�insme or -,�� � a r.e.nAicate ol Workers'Compensaiion Insunnce,or a cxtitietl mpp ihereol ISec.3800,Lah.C� �Pt-UMB�NG ¢ O ce�or�a�oov�5 i�e�enr r��;snea. =�; MECHANICAL p. ❑Cenilied capY is Ided whh the Buildiny Inspecho��e0ertmenl ar Uepxlment d: GRADING _---�-�— W ~ SUANCE� :'7`lp ��� Z CERTIFICAIE OF E7(EMPTION FflOM WOIiKEHS'COMPENSATION INSIIRANCE:This section need not he mmplettd " � if the pennit fs Inr nne hundreU I5100)or less_I cenil �5a�in the . ( — y y performance o�the wwk}or which thrs '���� �:.�- permit is issued.1 shall ibt employ�ny person m any manner so as W became su6�eci m tAe N6he�s'Lompensauan t �� �� "�l(3 o� L�ws ot California, f`, ���• PARK FEE \ ti �. o: o"` `�"`�'t ' �` SCHOOL FEES W� NOTIf.F i0 APPLICANT:N,aher maNin9 Ihis CeildKate af fxemDnan,yw shouW hewme subl��to Me Nfxker s �� ComDensanon provisiuns oi the Lahar Code,yw must lonhwith coiryh with such prwisiairs a tMs permil shdl ".` iu deemeA revaked. 2: Y .. " .�; �� qNSION OF IN�tISfflIAL SAFETY PEflMITy'�.,jl',sATION: � . ..�,:S,� ,�C. �� 5: � — — �' ❑I here6y cer1AV ihal no evcawlron frve�5)or mae leet m aeplh nlo wAKh a pertm is reQured to descenA �. wdl he inade in conneciron wnh wo k authar'ved hy this ye�mrt,md Na1 na huilGng guueture,swlfddinp.IYsework w demalitinn nr dismanthng thereof w!p,b¢more thqn thirrysuv 1781�1eit hiqb'IChap 32,Gry Y.Ari],Sec I,,"-:. = 741,iineB,C,ACI ., . �' ���: _ . .,. , '.'.. �:. ' ...'-: . i �:. ��.'° 3 ❑As owner-huAUer.I will no1 empbµairyoce to dd'wa�Y wh¢h wdAd reqmre a permit hom dx G�uion ol ��; �--. InNsVial Safely,as noted above,uMess:u��per'son has a permrc ro do such work fram ihe division. +;�:� � � ,. I ' ¢ 1 I�..,� � ❑a�5,o„o��„�.����sa�ry��m,��. TOTAL FEES � �k�� .� CpJSTRUCTpN LEN�ING AGENCY:1 herehy atfirm tl�a�theie is a mnrnuction iendinp apenq lor tM perfoimente Z of the work fa wh¢h Ihis permit�s issued ISet.3097,Gv.GI. -��-' � lenAer's Name � � �]�,� �� COMMEN7S _��C C,��v �1� n r'; m Lender's Addrzs �� Q CERTIFICATE F UANCE ANO AUTHOPoZATION OF ENTHY�1 teuly I heve rzad Hiis appliution md stau ��.�� : y that the inl me ven i cure[t.I agreo to co ph/witA all slate laws and ciry oidi�wttes rohtinp ro huiltlirq ��;� y �onstructi ,a arue repre Mat Depulmem ol BuiHinp aM Salety m enter iqm tAe poperry = for which e ied f �s pe� il sA of making inspectiona. Ir. � � -� '; /_ � �_ � RECPT NO. � �` PAID BY VALIDATIO Signatue al Appisant or AgeM Drte . . WHITE—Depanment Copy,YELIOW—Finance Copy,PINK—Assessor Capy,GOLDENROD—File Copy,GREEN—Applicants Copy � B5706-11/89 � \` _.m .. - ri �� � _�. � .__ ��s r i r � •r:.§��� � "'� - � a �� F i 1 '.�q��� � ; � � �� ,,�� ��'€ ' ;� .� ;,� � . � �� ' � ,�� ,� � , � � ��� � � �� ` f ��, �, _�° ��� �� ��-_� �„ � �,��" � � _� � �°. 3 �� � r r. � � �€ � � ' � � �.� � ��� �s x�K� �, � �r, �� �� .:� � � 7° ,��� � �g � � � � � � ;,, �n d z �;..� ,�i � • .. � � � ,..; ::�� - °6'� �s�, � � R�� �h � „ � � ' ' ��� � ��..1 ' _' i� �� . ti � . � � r \�,,�,�\' .�y 's� -�; � t�v �ti, v��� - , A ; n - � > .. :. :i' �: �\)�. \ \= i »�' �t . � � . , : ",. j . ' '�;. di€ ��. ��. 3 . , . , � E ' , � ' E '., g��� : _ " SN � ',.. ' '�,. 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