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HomeMy WebLinkAbout1154 '`''� CITY OF DIAMOND BAR ppESS `'�' �••'"' " DEPAFiTMENT OF BUILDIIVG AND SAFETY � -�° BUILDING PERMIT FIRMLY JOBSITE 2�J�Z o D�2��� p Q. APPLJCATION RMIT USE ADDRESS � DATE � � NUMBER CODE ISSUE � ,a,,.��� TYPE OCC. 6 APN __ LOT_._.TRACT DATE CONST. GROUP o CRQSS STREET SETBACKS "'"'""'E"E'"5 '-° OWNER ���L-�n� /�-d�.� 2�E� K�A-��.n1 S ZONING :FRONT RW ❑ o ADDRESS Z`�'32A bRdL21 1J �2• REAR 0 � CITY D(P+�A�� t�A� ZIP_�!Z.�7EL.ZL�-- SIDE/SIDE STREET RW ❑ o APPLICANT TEL. �'" 1 -- SIDE, ❑ e CONTRACTOR A'�p�� SEWAGE O PUBUC PMT� o ADDRESS 52�7 'rlZUM� - DISP�SAL w CITY_ G/�l Nt� ZIP�.�TEL. ��`�' ❑ PRIVATE SQ_FT./100 GAL z STATE .t �2 7 -9�3 GRADING ❑ CU.YDS.EXG. CU YDS FILL y LIC.NUMBER � ��7� �:� y ARCH/ENG! C� TYf�E S Ft FACTOF� S . ADJ..AR ' : AL ATIO " DE5IGNER W 1 + (,� �� p ADURESS t�L 2 �/ , � �-C ) r ., i CITY ZIP TEI.. _ � 3 � PROPpSED US �f�" /o(1�ry z 4 �; IlC f17Cf C.�= -� GARAGE o NO.DWEL. NO. NO. � pORCH � UNITS_ STORIES BEDROOMS "- s' LOT DIMENSIONS m VALUATION � -� • ADJ.AREA g NO.OF BLDGS HOW QUANTITY n�SGRIPT�IDN ". FEE W O T USED Q. ' W V r r �7 �. ��� JCENSED f.f1MR1CTOHS OECLARATION�I nerehy a�6nn Ihat I am Ireensed under provrs�ons ol Cfapte�9lcnmmencing �i wnh Seenun 70001 uf�ivision 3�il ihe Business anG P;olesslnn5 CcOe.ana my license rs in full Inrre and etkct. ._� .�+ � 3, [j is .�+-_„ PNNEN ilUILUFfl�ECIAflATI�N:I heretry aflirm�hat I am erempi fmni Ihe Comractor's license law lor Ihe lollo,ving - � ieasm�1•Sr.c 703I5 Busn:ess and Praless�ons Cndr Any ciry o;[ounry which�e0uiies a permil to cunstru�t {}.: o�..� alie� i111�lOVC.1IPTi1I1511.U reVair any str.2wie.Onur to itc issuance.also requires ihe applicant iar such peimit 'Z' Q� w fAe a s�pne�statemem thai Ae is IlcenseA pursuant m�he pinvisiws M me Lonttacmr's License Law(Chaptei ..�m� s; 9 I�mnwzn�in4 wn�Seavon 10U01 of Civision 3 of ine Husiness and Pmfessious Lode�m that he¢exemp��herzfrnm . �; a� anil tlre hasa ior the allegeA exemptiort Any violation of Stttion 703�5 Uy any apphcam!or a Dermn suh�eas �'��. °"��� Iha applicam m�eiv:i yenaily oi nm moie�iian five hunared aollars�3500�.): ���1� — W: a �'� UI as mvnei al ihe pmpeny.ur mv employees wrth wages as�hei�sole cnmpensation.will do the wmk.and - ~'. me svucwe is imi imenAa�r,r o!fered fo�sale�Sac 7U44.6usiness anA PrMessions Code:The CwVactur's L¢ense F�. ¢. V� law Aaes nat aNy,ly m an!iwne:of property who uuilds ar:mprnves�heieon.and who tliws such wark himsel�. ��U- W� ur thmu9n ha ewn enployecs,proviAed�hat suah impmvemems are not intenAetl or olfereA Im sale.tt,hnweveq „�Z. m;:, me hudniny nr In�pruvement�s soiA w�Ihln une ycar ol complelion,Ihc ownen�uilAer will have ihe nuraen ol pmving :�Q�� ��' �hai he JiJ no1 hudd m nnpruve fo:Ihc pu�pnse al sale� �.2� `n`' U yj �11 as uwcer ot�he��,�ope�ly.am exdusrvely cnnuact�ny witA licensed canvactors to cor�slruct Ihe pro�ect(Set '-�JJ' 0�_. 7pM1..,Busress aid Pioles4ans Code�Tt�e Comraetor's License Law Anes no�apply io an ownei ol pmperty whd. �� � hu IEs n�m puves ihe�ron anA whn cunuacts Po�such O�n�ecis wi�h e comrauoqs!licensed pursuant m�he Conuaclofs o; � �'�1^'� Cr,Qt�LS.Tl�U�TION __ _ • �:: �1 I am xxempt unaer Sec _ ,e.B P.0 IAnxh Ceiu(iwtel. PLAN REVI w � �, pi Datr. _ITrner �,,�.�.�.,.! � ' ��L.I H Il. ����, �NiHKERS COMPkNSATION DECLARAT;ON:I�ere�y alfinn Ihat I have a ceroflcale of�ansem m seil�inswe,or '.' � � a 'f¢ate oi Wmkeix'Cumpensallan Insnraiue,ur a certified mpy fhneo(ISec.SBOQ Lah CI ` PLUMBING ,�, ,_ Z a� L�Cenl(ied copy rs herehy furmshed. f��/>' MECHANICAL _ _ G'i: �i,undmA cnpy is hleJ with thx Butlding hupection Oepanmem N �eDarNnenl �7�.i�- C,7 W' v! CFHfIFICAfF OF EXEMP110N FHUM WOBNEBS'COMPENSATION INSUOAN��This seatiun nred nm he comyleled � � �S UANCE ' y:, ��Ihe permrt rs for one hundred ISiUO)oi less I cerlilV Ihal m the pedormance of the work la which this � � �" , permit ix issueA.I shall int employ any persan in anY man�rer so as lo e s h�ect to Ihe N6r4eis'c�,���,��, � � � SMIP � re _.. Wws nf f.alifnrma o- n/ `' �}�j�/�� . ��.� � . p� 17ate O I l v� ��O AOP���[ant �^'- —' �- NOTIf.F �(1 APPtICANT If,afier makmq tl s Ce 0(icetC.nf{x3mpt8i-youg�auW 6ecome su6jett m the WnrMer s �� SCHOOI FEES _ --+,: Go q;ensalian provisions nl Ihr,lalwr Cade you rt��;;}�atNwiJl�co�n�,wl�such p�ovlswnz or Mis peimit shall LL% M:Jeemed revnkM. bj <-� � -- --- �'. pp. IMUISIqY UF IND�STflIAf SAFETY PEHMIT CENTIFICA710N� W ❑I he�eby cendy Ihat no e�wvaton five�5�ar mo�e fe�inddepih i�wy+i 8�1BIS011 IS lPG11{/CA 10 ABSCMId p�e.; wtll be maee n con�ecl on with wak quihwve411��h�s per an�ythat��q��B strnclure,scalfoldiny,Ialse.vorM �. er demolnnn u�Arsmentl�g thereot.will he,�Jork,4iWn t�-s�i�1361 Iret hi9h.IChap.32 Gry 2.Art 2.Sec _ �' 741,iiik8 GAC.L � Ly , S. .... '. :. '��.4 — �.... 3. ❑Ae uwner�uilder,I will nm employ any,oDq�o aq�wo k�w4¢M1"y'vpA6 Yequire a EinMt[hom Ihe Oi�sqn af ��' �—. InMsi�ial SahtV.as roted atwve,unless{u'c6 qer3pn Ilaa§pelmn ta qa suchµprk•irnni IhP,drynwn ..., - • -,:'.. i r W ❑Ovisinn af Indusmal5alelY��mrt No: �' ;.� � �'��..i . .. - �:;: d TOTALFEES � CONSTPIIf.TqN LENOING AGENCY�.1 Aere6y af�m that therz is a cansM1uc�ion kndi�g apency�or�he perfaimmce � Z of the wurk loi wnic�ihis permd rs issued�Stt.3091,tiv.CJ. '� � lender's Name MENT$ � ��•' �;:: m Lende�'s Address � � ¢ CEFiTif�ATE Of COMPI.IANCE ANO AUTIIORtZA'fqN OF EN7NY:I ce.rtify I M1ave read Mis appliution and stah �i!,'';`� h Ihal the mtorma�qn 9iven is carect.I ag�ee to wmply with all state laws and ciry mdini�es relatinp to WiNiip y crosvncuun,and �e a reqeuntative ol Ihe Oeputment af Buikinq md Sefety W rnier upon ik papErry . � fni which I have ed fo� �s ma la�ihe DWW�ot makirg inspections. ;,F...; � /J�//� X � ' JL�L/ �� �U RECPT NO. � PAID BY � VAUDATION ��� � Signatme ol AppiKant nr Agem / Dft� WHITE—Department Copy,YELLOW--Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GFiEEN—Applican�s Copy BSt 06-11/89 _ _. . _ _. � �� � ��� '��`�`��� � � �, �.. ��� ,��� �� ����� �i � � . � �r � � � �� � � ������� N': ` �����,�� .. . h x �C. � �; � a� � � ; �. 3 _•� � A � �`� �B �� � F .��,a ��v . �'�� . �, _ �'�u �' � . �' # � `� a��E,€ �a :1����'����� �.. ����� � �- - ' . .. € . ... �F €I`.�..�. � .y�., ffig�-f �y�. . . . i,� �i� . 3 I� � � �� � '' � � � � .,. - ���� �. . . .� � � .. �..� . j ��;�«-_ . # -� ;. 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