HomeMy WebLinkAbout1515CITY OF DIAMOND BAR
DEPARTMENT OF BUILDING AND SAFETY
BUILDING PERMIT
PRESS
FIRMLY
JOBSITE
APELATION USE
15X5 CODE
ADDRESS
DANUM13E OCC TYPE
-I
3o 0 GROUP3
APN LOT — TRACT
DATE CONST.—W—
CROSS STREET
ZONING SETBACKS
OWNER A4 &4` -,— O-Z�e 7-t
FRONT— RW_
ADDRESS J "Z '7 Ll tr 7 1 1,-",A
REAR El
CITY 10i TEL
h4tA'
SIDE/SIDE STREET RW_ ❑
- - 10UPTI TEL
APPLZANT42-.&sZ,,M t L
SIDE F1
CONTRACTOR -
SEWAGE❑ PU13LIC PMT A
ADDRESS Ad""Y&? it'
91SPOSAL C3 PRIVATE SQ. FT/ 100 GAL
CITY ZIPOZEIL TEL. Z�
GRADING 0 CU. YDS. EXC. — CU YDS FILL
STATE
LIC. NUMBER.
C0
TION
TYPE 6U FT FACTOR PS F ADJ. AREANALUA
ARCH/ENGf
LII
1
DESIGNER
LL
2
ADDRESS
CITY ZIP— TEL.
(9
3
PROPOSED USE
Q
GARAGE
NO. DWEL. O. NO.
PORCH
UNITS— STORIES— BEDROOMS—
Q0
VALUATION 7 e, ADJ. AREA
LOT DIMENSIONS
NO. OF BLDGS HOW
OUAWM DESCWP-TION FEE
ON LOT USED
LICENSED CONTRACTORS DECLARATION: I Mildly affirm that I gm licensed order obsessing of Chesser 9 hasmirmiceseine
with Section 7000) of Olivinin 3 of the Business and Professions Code, and my hicteme, is in full for" and effrict.
LLI
9L
F❑
OWNER BUILDER DECLARATION: I herstiv affirm that I am rommirl from offer Cwtuscissr's License Law for our hectoring
to
IF
mason (See 7D315. Business and Professions Code; A" city or county which requires a parrit cossulsixt.
alter.irlowis demolish, or repair my structure, Prior to its jSftM, also requires the apsoficam its such pornnit
PF
to file a sidned Scalew,, that be is licensed pormol to she provisions of she Comirrelor's Lam Law (ChIllber
9 (Corronemnig with Sethi TWO) of Division 3 of the Business and Professions Costal M to he is stamps their @from
am the basis for the alallegedetrintion. Any violations of Section 7031.5 by my applicantapplicant-For a seems scibeacts,
the aplucam it a -d penalty .1 not more than I. hundred dos (4500)_):
k Eli, a, -w of the property.or mY errommes with wages as Start Nolo compensation. well do the wink. and
the 'fixture is not intended or offered for salts IS&c 1044, Business and Prolessions Cade: The C21,14001's loceirreas
Law does not jPPIV to an owrfur of froperafty who builds or onprivirus Thencii, and whis does such work himself.
or thloofsh his — treplovess. avoided draft such -Prowi -in not usundild w Of*W fir, sale, If,
N busiting our improw,rent is tried within ort, year of corniffirtion, it& awfew-buddier will filter off Ifurdem of prairersit
that he did not build a improve for the Portion of sale.)
Eli as owner of ft progeny, ret enlutuitiv contractmir with licensed whetstone to c"fild the Prisliest-ISK
All
7044. Business and Profinuors Curtis The Contractor 3 License Lath does not APPlY to an "m Of PfWnV who
of im"m therein. am who confirects for such fritnectif with a kennel isoussaint to " Cwhescieserr 3
E Wolds lin
1_r. Law I
t0ffSTRUCTION
s
a 0 1 .. .—of unit. See Is PC (An't"C"fiff"n)•
'PEVIEW
LANIR
Date Owner,
ELECTRIC
PLUMBING
WORKERS' CONIKAISATION DECLARATION: I thereby affiern that I hanie a ovistificate of raiment to soll."unt-
a certificate of Workers Constitution Insubsocc aa carded copy ribervoll [Sec 38010. Lob. C.I.
Certified copy is W* furnished.
MECHANICAL
i 0<.vired copy is filed w,rh the Building lossissictson Dissistrinsest or D"tlwt.
GRADING
Id
w CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE; This section need not be completed
�U A N
4 the permit i for one hundred ISIOOI off Ifess I c"v vI the whomencei el ft warl,
punt is I she# nor sterility ans, sols to hamR&AM Is the Wx*3'��
�
MIP
Laws of California.
PARK FEE
a Date Assistant
)UL
SCHOOL FEES
NOTICE TO 4PFILICANT it, after Aklrq this Certificate Of ExOMom. YX sham subsets as the vvxw,3
Compensainoprovisions of the Labor Cade. you must funt. such strans"ass or on permit *d
be deemed re'voled.
DIVISION OF INDUSTRIAL SAFETY FIERNIM&CAJ110111:
64 Ell hereby nutify that no eveavation five (51 9 mea find in depth into which $,PMO of nQumw to ilmscrared,
;1
.1g connector wed work A99-20 bv 111s; pow- allies the so k4ft "Wis. scatisawn I",esek,
or demuilrbort ce db-.dq themcf, byr, nicres thin thimij- - 13811 -JVD. j[Desis 3.2. Sip Z. An 2. See
w
34 1, Title 8, C A.C).
ElAs ---use&,, I wifno' erow anvism to do work which waited fom a PNM (no the Division of
Industrial Safety. as noted stores. wins such person, has is Islam to do such work fasee the diwassen
E
u❑Ormasin of Intlijoad Salbety Permit No.
r
TOTAL FEES
CONSMUCTION LOOM AGENCY: I herebyAffirser did these 4 & w -WO" filled" MM IN deePuts'new""
D:Q
of the wevic for which ilk parol is Issued ISM, 3097, QV. Q.
Lender's Nam
COMMENTS -—
Afton
_CIDLender's
es: cEffnFrATE OF CONIFILIAKE AND AtfirmazArot OF ENTRY I cortily I have rad " application and state
010 A+� L
As that the W ifinvot a correct. I " be cismisly with ad slass, Issue and city villiefivests f** to bjiilbq
construct sucharuis a the Department it d BW&q as Saillely Is was vem the lervinlyOVA
I • —jes of sea"
�2x INJ
for seselifieth- pmwpm
f
RECPT NO. PAID BY VAUDATI
Soarturt sit Appeal 0 Attend Bob
WHITE -Department COP)& YELLOW -Finance Copy, PINK-Ainswr Copy, GOLDENROD -File COP14 GREEN- A00HU-11I
FIST 06-11/89
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