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HomeMy WebLinkAbout1288 (11) , '('� � CITY OF DIAMOND BAR PRESS ' DEPAR'TMENT OF BUILDING AND SAFETY �' BUILDING PERMIT FIRMLY JOBSITE ( APPLJCATION ADDRESS �� � ��1 �`� � DATE 7"- ��� ���NUMB R j z Y� CODE ISSUE ` APN LOT TRACT DATE '� �~ r �� "�C, CONST. GOUP � CROSS STREET ZONING SETBACKS ����+*S ^ OWNER Z-- FRONT pW (� o ADDRESS ��� � � REAR � W CITY ZIP TEL.� SIDE/SIDE STREET RW � o APPLICANT EL. SIDE. � z _ � CONTRACTQ�` " �� � o�'• o ADDRESS � v!� SEWAGE � PUBUC PMT# - DISPOSAL O PRIVATE SQ.F1'./100 GAL W CITY�� ZIP �� � TEL�. �� �� = STATE �j C�CU.YDS.EXC. CU YDS FILL y LIC.NUMBER `��[ � � GRADING '#'X�'E: . Q ;:F ::�� . :;, _At);�: R�f.'LUAa"� N :. , y ARCH/ENG/ CJ;1: `=' DESIGNER `-Etl 1 Sr.'�c� �C� J>�,e�• p /,DDRESS � ;Ctr: 2 = CITY IP TEL. • ;�; 3 � PROPOSED USE 1'��'���" C�`"" ` �-' �= 4 � ,� C.,��r ;�, O "� �° ;;;� 6ARAGE o NO.DWEL. NO, NO. ',-�^�,,►;. PORCH � y UNITS�_STORIES BEDROOMS ° °'` � LOT DIMENSIONS '�- VALUATION_ '7��U �-"' ADJ.AREA o NO.OF BLDGS HOW OtrA1Ma'�fY Q��`CrR1RT�C}I�J ;' FEE ;: ,, ,. W ON LOT USED _ � �, < � � LICE E[I CONiRACTORS OECLAAATION:1 Aerehy a(firm tha�I am Gcensed und¢r provuions of CM1apter 9�eomimncinp — Y wnh Section]000�of Oivision 3 nf the Busmass and Proieuions Code,and my licrose is in full force aM ekeet. "��'�� a ci,tit 3 � ='�y. LL OWNFR-NWlOEN�ECLARATION:I M1ereEy alFiim tAat I am eumpl hom the ConlracWr's Lkenx taw for Me Idbwing `�- x reason(Sec 7031.5.Business and Pmlessions Code:AnV city or caunty whicM1 iequires a permit w constmct, o alter,imprme,demolish,ar repair airy slriKtua,prior ta ila issuance,alsp repuiies Ihe app�icant for such permit ��;:��,� ¢ to hle a signed s�atemeni ihat he i3 IfeenSed Dursuant to Ihe prwisions o1 the Contractar's lieense law�Chaptp ;��.: p� 9 Icammencing wi�h SecUan 7000�a(Uvisron 3 0l the Busineu and Profeuioiu Codel a tha�he is eMempt Iherelmm ;.�', u Xand t�r.hasfs lor the alleqeA sKemption.0.�vplaunn at Seclan 703L5 hy any applicant fw a permit aubjects l.:�; � the applicant to a ci��l penalry ol nol mo�e Ihan(ive hundrtd.�hrs��OOYF'�i`�"`,!`. ���:�: �':;.:i .j�.;, i:. :: •:i �:Q. � ❑I,as owner of the property,w my employees with v�es ih�p saje±tyU'►�nmtpn.will do Ilw wnrk,a�d �� ~� the siniciwe rs net inlendN ar affered ip sale(Sec.7044��usineAs anBPmhssians Code:The Contnctai s License � q. �' � � Law dnes nm apply Io an owner ol propertp who buiWs or improves�ereon,ar�d who das such woh himcel[ ���'L�:.� � W or ihrough his own employees,pmvided ihat such improvemenis are npt mtend¢d a ollered for sek.If,Aowever, � � m the hwlding or improvement is solA wilhm one Y��of etim..�he�yner•ppldertyWl have the hurden of provinp �' _ ' y tha�he A�id not huiN or improve lor the purpose of sei���� v`i t,i"'t"�€� -� � � s ba=w��f vJ ❑t,as mvner M Ure o�ocerlv.am ezcWsrveN contia�tiny wiN hcerxed conUactws m eanslrutt ihe praject(Sea_ �0 70b4,6usiness and Prolessions Code:The Coniraetor's Licente Lew Eces�rol apply to an owner of prape�ty wlro `:;;�� Z Iwi;tls m impwves Ihe�eon,au0 wlw eontratls la�prpjeUs WiM,a,canlracto�ls)ticensed puf{uapt tp the Cmtr�etai s : Q LicenseLaw.) 1.�:: ? i:':• :-.,..•. `� • ,;:;:CONSTRUCTION `7)G� :` ,,. ,-,.� �� ❑�am e.empt under Sec. ''� � " ,8.6 PC.IAttah Ce�oticate�. .`; P�N REVIEW p Date �Mr =�'���=` ELECTRIC � W(IFKEflS'COMPENSATIOAI OECIAflATION�.I herehy allirm Iha�1 have a cenilicate ol consmt m seN-insme,a .i — a cerldicale ol Nbders'Compensatian Insmance,or a calrfied capy�hereof(�t.3800.Lah.C.1. "In�Y,'•PLUMBING Z ❑� �r ;;J, MECHANICAL Certilied is heie IurnisheA. vr: 4 �o nhed capV is Ii1M vnth the Builtlinq Insp¢tnOn Depariment or Ueparmrent. �;'Q�::.'GRADING W �,� CEBTIfICATE OF EXEMPTI�N FpOM WOqNERS'COMPENSATION INSIIR4NCE:This sectian��e��n��o�,��a � ISSUANCE �I :3 L`% r y if ihe perma is for one�undre0 IS100)n kss.I certify�Aa�m me per mente ol ihe wak for whkK this . permit is issueA.I shall mi emplay airy parson in a�ry manner so as ta a w6jxt to the Nbrtds'c����� ,�, SMIP � laws al Cal'rfornia. � � �CT� � PARK FEE - �j Oate �v�� Appiicant �;� " � NOTICE TO APPLICANT.If,after maki�this Cntilicate ol Exem �. �nana n�„�n�,„a,e,ob,k�; ���.SCHOOL FEES _+ ComOensation Drovisions of the LaOor CoAe,you must fathwith co wim such prmrisons a this permu shaN ' ^ � 6e deemed ievo4ed. J (" i.. ' s dVI51W�F INqiSfRiAt SAFETY PEHMIT CEIiTIFICAlION: �� � � � �'� ��� ❑I here6y urtily that na ercavatbn five(5)or mae leet in depth inm whkh a persm is requird�o dacmd. � " ���� ` �e-- OC wiE he made in cmnettion with wnri auMorued hy Mu pe�mit,and Ilut no WiNuq suutlue,stafklAinp,falfe�vork, �� � d a demotuion or dismaniFng the�eaf,wdl be more ihan thirry�six�36�he�hiqh.(Chap.3.2.Grp 1,An 2,Sec ' �Z� — � S�� �W� 341.Title 8.C.A.C.1. 3 ❑As awner�6uiider,I wiA rot empby anyone la do work whkh wauN rpwre�parmit iran the 6vision d : �; � �t— Indusrtial Safety,as m�ed ahoro,unksa wch person Ms a permit to do such waN from the division. �. � � ;.�t.:`• a- : W ❑pvisim of Industrial Safery Pormd Na � ?x d � CONSfptlCfpN LENDING AGENCY:I herehy�ifirm thai thne ia a construction kid'np apenq fa�he perfamame TOTAL FEES C� �� �� �r' Z af ihe wark for whkh Mis permii is isaued�See.3097,Civ.C.�. �., O ��$Na� COMMENTS ��� � p�p 4nder'a Addrcss 4 CERTIFICATE OF COMPlIA1�LE A!D AUTN�Po2 OF EHIHY:1 cetily I have read tliis applintion md st�te �s� y that Me inlametbn gven is wrect.I apree to mply wiMi all sta4 law:md ciry adewaa reptip to bW6np . y construc�ion.md auNoiize�rcortsen - ot Uepenmem of BuiNinp rd S�Mv m eneer iqm the prapnry ��. = for which I have applied far ths permil d makirq inspxtiant. � �: 1 1 ryrsE ...+-� �q >' 1-- v �.1/�.y'�.Ly � ��j , j Z � ( / y � Signature a Appl n o Agen� �au . 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