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HomeMy WebLinkAbout1068 (5) �'"� CITY OF DIAMOND BAR PRESS • DEPARTMENT OF BUILDING AND SAFETY FIRML -� BUILDING PERMIT JOBSI7E p� ' APPL1CATiON PERM i USE � ADDRESS ' o� ���� ISSUE �, G� TYPE ER ! �CODE�_ �: APN LOT TRACT DATE � ^ � ��� /(a � CONST. GROUP o CROSS STREET SETBACKS '"'�"�"B -� �° OWNER �,�L �_ ZONING �ONT RW O � ADDRESS REAR O "`Ws CITY ZIP TEL SIDElSIOE STREET RW � g APPLICANT TEL. SIDE --_ _ O : e CONTRAC�� � �b � �-- � SEWAGE � PUBUC PMT# o ADDRESS � � DISPOSAL � W: CITY ���tip ZIP 911 t O TEL.. -�� � PRIVATE SQ.FT./100 GAL ,; = STATE y LIC.NUMBER ��/����C.� GRADING �CU.YDS.EXC CU YDS Flll , ----- >. c� �r ��s ;: :� :; �v�. �iTi "; y ARCH/ENG/ •�!3_` ` , y DESIGNER ;�' � L B�� _ �4 o ADDRESS CI;;; 2 �`{ z, CITY ZIP TEL.�. 3 i� ,�, �'PROP�SED.USE E ��': 4 tw; : '. _` :�, GARA6F. o. NO.DWEL. NO. NO. ="" y UNiTS STORIES BEDROOMS <`�'' PORCH � LOT DIMENSIONS �` VALUATION � � ADJ AREA � o NO.OF BLDGS HUW ;QUANi►T�r ��°E3�F!TI�I!+� ` ' ' F�� ;'' "`` W ON L07 USED— _ Q � — ;,� � � � ,:�.. � LICENSED CONiRACiORS OECLAHATION:I I�rety affi�m Ihat I am liwnmd unde�D�ouieions of CM1apM 9�tummencitq �;:��, Y with Secnnn 7000)ul Oiv�sion 3 of the Business and Vmfessions Code,and my laense is in iull foiee and effmt. ,�::�; x 3 � ''j�: . � 04VNEfl-BUiLOEN UECLARATqN�.I Aerehy alli�m that I am evempt Uom tl�e Conl�azroi s L"xense law for Me IWbwing •-�-- `�. -�7 � - reasnn(Eec T031.5,Business and Professnns Code:Any dry or county Which rryuires a pertne to constrU[�„ � � L � �� o alter,impmve,Jemolish,a repair any sirm;hie,priw ta i�s issuaMe,also roquires I�e appluanl Inr wch permil �- �— ta lile a eigred s�aiement ihat M1e is licensed pursuant m the prwisians ol�he Cantractar's tRe�e Law IChapta� `��:�r , � 9 I�ommencing with Secoon 70001 ul Udsion 3 0l�he Busineu and ProFeavions Cade)rc that he is aKempt therefrom ::'�^'; d anJ Ihe basis for Ihe alleged exemD4on Any vidation af Seclion 7031.5 hy arq epplirant M�a pe�mtl wbjec6 j:."°.-�" � W t�e eppli�am ta a civd penahy af nol mme ihan�ire hundred dollars(5500LF ;.,� Q LJI,as owner ot the properry,o�iny employees wi�h wages as�thei�sde compenss6on,will do ihe work,2nd ����;; - � iM slmcmre rs imt intended ar alfered for sale�&c.7(144,Busineas end P�ofessions Code:�The tontmctp's LiCense ' V Law does no1 apply lo an owner ol prapertY who huilds oi impmves themon,and who dcea sueA wnrk himself, .���f,��y.�� '� or thmuyh his own emplayees.pmvided�hat such YnpiwemeNs are nat intended a ollettd for sak.IL howe�eC -<;�� _- Ihe WilCing or improvement is suld within one yeer af completion,ihe owner6uilder will have Ihe hmden of provinB '.:;Q;� y I�at he diA nm huild m improve lo�Ihe purpose ol sale.) �:���� �a ❑I,as owner ol ihe propeily,am exclusrvety camraciiny w�m iicenssC aonuaciars to cansuuct the prqvt�(Sec� ;,;'u;. 7044,Business ar�d Rolessions Code�The Comrxtor's luense Law dces not apply ro an wmer of poperty wM 't"�^ � builds or imD�oves thereon,a�who mnirects Poi wth Oi%eeis with a aonhacmr(s)iiunseC qnsuanl�o IhB Cantncta i • �1Ce�Se iaw� '>: CONS7RUCTI � _ � ❑I am exempt uMer Sec - — .B.fi P.C.IAttach Ceriificalel. �� %�;P�N (�EV�Ew q Daie ��� �� ELECTRI � ��C.� �r'�� WOHKEflS'COMPENSATION DEGLANATION:I heieby aflum thal I have a urtl�icate of�oasem ro zell-insure,a .'W;`.y¢ i�`� � a anikate of Worke�s'Cmnpensa�ion Insuance,m a cenilied copy thereol ISec 3800,lab.rC.l. � UMBIN � � U l ` � a ❑w��a�ee<�Y�s ne�env�����h�a. '� ECHANICA d,:�c� • _ emfied�opy is hled with Ne BuiWing Insptttiun Deparirrent ar s�• a�w«m. :'�: ING `, � � f,ERTIFICATE OF EXEMPTION fROM WORKfPS'COMPENSATION WSUMNCE This uttion need no�he campkted ISS 7� � � � � �� ;y i(the permit is fnr ane hundred�5100�a�ess.I certify Ihat in Ihe perfamanee M IAe wdk la whicM ihis � � � f' permit is issued,I shall mt employ arry permn in anV manner sa as m hxame w� t la�he V.hrkers'c�o���� ���c�'" SMIP � � � = Laws nl Cdilnmie �- � 0 1_�lq� �PARKFEE � oa1e �P0'"'^' SCHOOL FEES W NOTICE 10 APPIIGANi�il,aflei makinp ihis Cedfia�e„,o�.��xqnption,you s uld hecoms sub to tlK Workei s ��' � . Compensatinn provisions o�Ihe LaEar Gpdx;�yo, t4 rtli';cm�ply w' such praisions tluE pemid shall � � he deemed revoked. �� �f�' J . � pVISION OF INW5fRIAL SAFETY PEflMIrCER FICAl10N:` d ❑I heie6y certify that no excavatian five(5�or mve feet in eaptn inta wh¢h a pe�sm is repuireD m 4eseeiW. � � will M made in comrecicn with»%�ed yy tNs�perm7��l�t rro Wildxq aVutlure.tcaHotdlnp,felnavak. � . el a demal'ition m dismantlirg Iher m�r�tl�8n tlti��idy'jsW(y�)����I�V�3.2,Gry 2,l4t P.Ste ; W' 341.Title 8.C.A.f,l. x 3 ❑As owner�huilder,I will not empby anyone lo da�yoj.k,whieh wwYl.(eq�&a permil Uan tlie Diruian al : �— Industriai Safely,as nared ab�q..yul�sa�uC6�;R��1�';{ptreuf to�Ao�iuck'�Lorli(rom the diwmn. . � g t ' ^, . ....v:. ;R '.`:. _ W ❑ansion of InAustiul SaleSp k n�•;� �� ���-� — TOTAL FE�S � d � � CONSfflULfqN LENDING A6E I hereby aHum Mat iMre x o wqrtuttion kMinp apenry far the perldieente 2 ot Ihe work la whi[h Ihis permit is issued(Sec.3W7,CN.C.�. '� � Leneer's Name —— — COMMENTS �-� �� "` mLender's Address Q CEflfIFICATF OF CaNPLNNCE ANO AUiHdtlIAT�I OF ENTflY:I rerfily 1 Mre tead tho appliralion and shft � �a tl�at the intamaaon g�ven is caien.I apree w mmply wnh atl stah laws md eiry w3�a�r�rdehp to hiiYtinp � . y consv and ihorite a rpreaematrve ol the De�arvrent ot BuiWinp eM SsMV m e�r�qon ihe praprry = In wh' I have a lied for ' permil hr Ihe p�pse of inekrtg inspectiona. � X - .�� � ��D. �� `, sgnai e o� icam ar m p�r RECPT NO. � - PAID BY VALJDATION WHIT —Department Gopy�YELLOW—Finance Copy,PINK—Assessor Copy,GOLDEWROD—File Copy,GREEN—ApplicaMs Copy 8S706-11l89 � . . �. ....r _ ,_ _ , _. _ . _ : ' � � , � ,� � �� i � � � � I � � � i i � i � � i �� C ( � ' � �. t : � g � � 7 t i . . � I E � ( t � d � ( i . � � � � : i � � � I . � .�I . � � � I i �' ' , � � , . �,. ¢ ' . , i , , � � . � . 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