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HomeMy WebLinkAbout1484 (20) '�'� CITY OF DIAMOND BAR pRESS <« .� ''��-" " DEPARTMENT aF BUILDING AND SAFETY BUILDING PERMIT FIRMLY JOBSITE APPUCATION �, �y_�� PERMIT � USE ADDRESS ���� DF.�:��-i �t� SSUE TYPE ER � �CODE � APPI LOT TRACT DATE �'���l� CONST. GROUP � � CROSS S�REET L���N ZONING- SETBAGKS > . ���� � OWNER N .FRONT. - RW � o ADDRESS��C.��J [�f'�'c��t-f t� REAR 0 ,� CITY__��1�1� �� ZIP ��TEL.g�+�� SIDE/SfDE STREET RW (� O APPLICANT cl�i t� ArrU��E�i'��f'� TEL. SIDE — � z Q CONTRAC70R�F� �iJli1.D SEWAGE o ADDRESS ✓'�� DISPOSAL ,; � � PUBUC PMT# W CITY ZIP TEL. C� PRIVATE SQ.FT./100 GAL = STATE �; � LIC.NUMBER GRADING ' '`C�CU_YDS:�XC_ CU YDS FILI y ARCH/ENG/ � TYPE S� . Fl�, F�f�F�_:;:. A �:Afi�tVA�.k1 �'IC?N �' DESIGNER �ii� `V�2�S"��11t)C�� ti!'. 1 � , Q_ ADDRESS �: � � � t . � � � �t.: 2 z CITY�-L�.iJ��� ZIP TEL. �; 3 o PROPOSED USE � �I� _P��i3 .� �'i � 4 � .STG��Y �, 6ARAGE o NO.t�WEL. NO. �1�- � PORCH � y UNITS�STORIES�BEDROOMS �: � � � LOT DIMEN IONS - VALUATION � DJ AREA o, NO OF BLDGS HOW � � ��JANTITY:D�S�.:RI�T`I� - �-' " =;'FEE-".:' i ' � ON�OT � USED �'�`,�������` �.,__ �� ��r�� C �� W:� � . .... . . . _. . . . . _ . . . . . . . . �� KF / S {,�" �'' LICENSE�COt�AACTOPS�ECLAqAT10N.I he e6y aifi that I a licensed under pmvisans ot Chepur�J(wmmenci�g . x� with Sec- 70001 at Drvisian 3 of the Business and Rofessfons Cade,and my luense is m full Mrce anA ettect ��- �- �� - ��j� `�� t�� o: �. �s M 3 1 ,°\ � �`3�, e� � :.C LL: OSYNER-BUILOEfl DECLAflATION:1 herehy affirm ihat I am exemp�from�he Cnntranor s license Law Por the fdlowing �• -- . - . . • reason(Sec.70315.Busineas and Pmfessions Cada-Any cily or county which requires a permR to construct �,' - - -o: alte�.Improve,demolish,w repair any slmtture,prior m iu inuance,also requires the applicam fot such p¢rmn ,-��- � _!-_'- m flle a signed:[atemem that he ie licensed pursuant to the piovisions o�the Conttacmr's license law(Chapter ;pj_. .;��: 9(wmmencing with Sectiun 7000)of Division 3 oi the Business and Pmfessqns Cade)or that he-is eMempt therefmm ;,a:�;; - �-y. and ihe hass for!he alleged=zemptian.Any vfolation ot Section-7�37.5 by any applicant Por a permit wbiects ..�'_ . W: ihe applicam ro a civil penalry of not mare than frve hundred dollars(3500�-1. - =��- LL.:. �--_ �� ❑I,as ow�r of the property,or my employees with wages as'their-sde compensapon,wdl da Me wo�k,a� ; ~- ihe stmaure is not intended ar otfereC fm ule ISec.7(144.Business atM Piofesswns Cade�.The Cuntracta"s ilcense �'`� /%J� fj �- -_ V' law does not apply to an owner of properry who builds or imprwes Me�eon,and who dces such work himseif j��. � �J "'" • f v - . �++` or thmugh his awn employees,pmvideG ihat such im0�ovements are not fntended w oflered far sak.if,havever �-�: m� :the building or improvemer.t is soW within one year of completion;the mner6uilder will.hav¢the hurden of prov� �i�---- Iy' -tha[he diA rv�t Ouild or improve for ihe W�OOSe af Sale.I. .- S:� - �Vs'-❑I;as owner oi ihe properry,am exclusively comraCliny wilh licensed coniractors to cansiruct tpe pmject{Sec �{j�-' - ----.- '- '�-7044.Busiress a�M Pmfessions Code�.The-CanVaclor's License taw daes not appty to an ownet�of prpp¢rry-who '•�--. - - - - - -,- - - �' buiids or-improves thereon,and who coninms tor tuch projeets�wfM a comrxror�sUicensed purtwni to ihe Contractw a �. Q; License WW.I . . .. . o� �ON i0 � -,.� ��❑I am exempt u�er Sec. - .B.5 P.C.(Attach Cernficatel � P� W �� 0 oa�e �^ef CECTRI ' ��� 5'I�'� - ���: N1)RRERS'COMPFNSATION OECIAFATION_I h¢retry affirm that I have a certi}icate of consem to sell-insurc,w � a certrficate of lM14rke�s'Compensation Insurance,or a cenified copy ihereol iSec.3800,Wh.C.). `:P UMB�NC.7 _ o: � ❑Cenified�opy is herehy tumished. - p, ����� • �; ❑C.ertified copy is filed with the Bmd�ny�sp�yon Oepol��t or 0¢p�rtmeM �,GRAD-- G _�` CERTIFICATE OF EXEMPTWN FflOM WA[II�A�S;CQMP,F,N,�ATif�l INSURANCE:Tnis sec�ion need rrol 6e mmpkled S ANCE -- �Q - . y� if ihe permit is far one hundred(E1�)a�55�Y.cEp�7�n-,ifibt in the performaiue of the wark for whzh'th�s _ � . � . �. permit�s issued.1 shall not employ any persnn in any manrer so-as to hecome su6ject m tice Ybrkxs"Canpenution � - � -. �} Laws of Ca�do��ia. MIP ��'�� _ o� � P `RK FEE o� t��e , . � �� b>� "' � { ` ti rya you ahouid hecome sub t to tl�e Workn s �--SCHOOL FEES �: NOTICE TO APPUCA It,afte+h rig.,`�ihis_enR te�_' on, �ec _ '�'; Cmmpensanan provision.c of the Lahor Code,you must tmthwilh co�ly wiM aceh pmisians ar this permit shall . . - `�- be deemed revoked. - � �a-: �- qVISION OF INDUSfNiAI`S,A�fT�PE6�11�;CE�IFICATNIIJ ... �.:=� - - W:: - ..: �- _ o- ❑I ne�e6y cerMy that Yw°e�tBvatWn}�.`{'�I oi mpe�eet tn:"Aepth into'wheh a persm is requfred m d�scaid - ��� will be mede in�onMctwH"wiih'iVoh Suth�r�ed 6y fhu pe�m`R�,a�thal ro hiriWinp struct�re.scatfolding.f�lsework `�'' or demolition or disman4ing.th¢reo1,w�l he more Man ihirty-Six�761 fett hi9n.�Chap.3.2.Grp T.An 2.Sx - ;W` 341.TiBe 8.C.A.C.1. >2". '3:� ❑As owrrer-6uilder.I will nat employ anyoire la da wark wh¢h wauld require a permit from tlu Oivisian ot � . . ;;H- Industrial Safety,as noted a6ove,unless such person has a pe�mif W do such uwrt irom the division. � ,� °:: £ ,y�j: ❑Dirisionoflndu5trial5aferyRermitNo. TOTAL FEES � � ;�; CONSTHI1CTqN LENIUNG AGENCY:I Aere6y aNirm Nat thre is a canstructron k�np apmcy for the perPoimmee J J ."2� ot thx wo�k fa which this permit is issued�Stt.3097,Civ.C.�. - 'J ,q � Le�weisName COMMENTS ����� C�C+'�r�(�4! /�?� �i7��� . `=m� lendei s Address � - ���Q CEHTIFICATF Of;OMPLIANCE ANU AUTFpRIZATla1 OF ENTNY�I cntiiy 1 have reeC ONs epplieation aid suh �' - € =-ti. mat�he intamandn g�ven is carett 1 agree ro co�ly witA all siate mws aid eiry wdiwnces rtl�tinp to huildinp - - � - canstruc�inn,and�wlhorue a r mative ol Department oi BuiWinp md Sahty1�eDar upon the p�ppe�ly ��/�y,/' - _ � fa wnich i nare' ' lo��t ot mak� inspec9onx C7 j/rj /� s .�� U'r�.J�E+—V� � �- ;�"G.[��' �td � � Signatuie j or nBent � �pate RECPT NO.--���PAID BY Y/��'j�•I ��`3VAUDATION en i . y WHITE—Department Copy,YELLOW—Finance Copy.PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Applicants Copy ` 8510&11/89 - m __ _.. _ � _.__ ����� , _ y � - ��� x�a ���� �� , , � _ _ �� �� ���� ���* :;�;, a i , � ��,� ��'S�� �� � l: „ � �3 � �� 1� �: � ; € ' _ � 9� �.�� � �, � �_- � >: �-, � �~� � �,,'�� `�f: �: �, "� ,�` � �- ; ����� ,� c - � �` „�� ;� a��'�� , �ti ,� ,r'� ' �� '` ` � �, ��- � ,se i� �� ,��� ,: � ��. , ; ,� ��� - i ` � ; �� :� �__ ���atM= �_�" � � E � � � � - �� - - �� ' . € ; �' . ; �;` �d o ��o��`e � ���e � > � ,.P � `� Q�`'� :� {�L, .�:Q � ��a�u� � ',� s � [ ',�v ',���1 � � i � �r�� � � � E � ' ' � ��`� � � [ �. , ; • ' 1 . ; ��� � &��� > E ,_,_ � G__ , E `� ��l �� ....__,��._w� 3 �,:.i _ , - . �: � : .,.. 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