HomeMy WebLinkAbout1682 (39) �
,�,±
� � `� '"` CITY OF DIAMOND BAR pRESS
� DEPARTMENT OF BUILDING AND SAFE7Y F�RMLY
� BUILDING PERMIT
J08SITE ` APPLICATION PERMIT � USE
a�" � U ��.(�� DATE NUMBER CODE
�� APNRESS LOT TRACT DA EE /�� ���� CON3T. GROUP
a,
o� CROSS STR�ET , i � • ZONING FRONACKS � O"'g
`-° OWNER—W�4yQ�G,,� ��2.5—
o ADORESS 1�'s �-'�'�'�-'��"'�� Dk) REAR ❑
W_ CITY ZIP—�—TEL. SIDE/SIDE STREET RW ❑
o APPLICANT' ��'S�-�"'�� TEL.�f,�L�� SIDE ❑
2 OC12.�
a CONTRACTOR SEWAGE ❑ PUBUC PMT#
o. ADDF�,SS 1 t���' DISPOSAL
W CITY 1-�• � ZIP TEL.� � PRIVATE SQ.FT./100 GAL
= STATE �r'�.'�r�¢�7 GRADING 0 CU.YDS.EXC. CU YDS FILL
y: L{C.NUMBER -4"''� L
� ARCHIENG/ (� TY�'� �Q � �C�� p� AL3J. AREAN LUATION
`—',DESIGNER �'� W �
o ADDRE�S 1 � ' u�. � 2
� CITY � ZIP�L��7EL.� (j 3
� PROP05ED USE � � � 4
� � GARAGE f
o NO.DWEL. + NO. NO. � PORCH _J�l,..
y UNITS STORIES�..._.BEDROOMS --
� L07 DIMENSIONS � VALUATION g" � "" ADJ.AREA
o NO.OF BLDGS HOW QEtANTITY DESC�fPT10N FEE
� ONLOT USED �
� U
� �
LIL SEO LONiHACfOBS DECLAPATION.I here6Y afhnn Ihat I am licensed under Drovisions ol Chapftt 9 I�omm¢ncing
Y wnh Secuun 7000)of�imsion 3 ni ihe Business and Pwfesswns Code.and mv IKense�s in tull lorce end elfect W
¢
� ❑ J
�
u- O�VNEA�BWLDEfl OECLAflAiION�I heiehy atfi�m ihat I am ezeinD�hom ihe Coniracmr's Laense law fo�ihe fdlaving
reasnn ISec 7031 5.Busir.bss srid Profes>�ons Code AnY���Y o�cwmy whrch�equues a permn ro canstmcl. f;}
Oaltei,nnpmve,Jemul!sh,nr repau any stmclme,prior to its�ssuance.alm mauires ihe appliwm im sucL peimil .,Z
1- lu IAc a signed slaremem�hat he is licensed pursuam io Ihe pr�vis�ons o1 ihe Cont�aclor'S li[ense Law�Che0ler .m
� 9lcammencmg with Seclmn)U00�nf Orvrsmn 3 at�he Business anA Pmfesaons Cadel er ihal he is eaempt Iheietrom "�
p. anJ Ihe basis fnr the alleqeA?�emplion dny viotavon of Setuon 1031 5 hy airy apphcam fm a permit suh�ecis ��
w the apph[am In n ciml penally af na1 mare than fr�e hundred dollais�55001 I� "a
� ❑1,as nwner ct ihe DmpertV.nr my employees wnh wages as their sole campensatqn.wtll do the wark.and
ihe structure a nm imeuAetl ar uHered loi sa@�Sec 1044.Bnameas and Pmfessrons Cade�The CnNactor's L¢ense �'�Q ,
V Law dnr.s nul dpply to en owner af pmpetly who 6uilds oi improves Ihereon,and whn dces such work himsel�. ��U' — '+
W a tLrnngh lus awn enployees,prov�deJ ihal suah nnpmvemenls are nm imended a offered far sak If.hawever. ',� {
� ihe Luddmg or im�rnvemem is snld wilhin ona yea�of tomplaum,the owner�Luilder wdl have the 6urden ol praving .�Q 1
y Ihal he did nm huild oi imp�ave kr Ihe purpose ot sale.l •,� _
� ❑I.as owne�ul the prnneny.am exclusrvery conuac�mg with hcenseA contraclors to consliwt the pro�eet�Sec
�
7[ICd,Busicess and Pmtessions Cude.The Cantractnr's Lkense taw does�ot apply to an owne�ol piopeny who S4
6 butlCs nr unpioves thereun,and wha conirans for such pm�ecls weh a wntiacmr�sl��rensed Dmsuam to the Comntlor'S ,`
license Law 1 CONSTRUCTION .
� ,&B C.G�Anach Cenilitalel P EVIEW
❑I am exempt mkei Sec
o Uale — �^ef . . , � ELECTRIC _
¢ WOflNENS'f.OMPENSATIIXJ�ECLAflATION I hereM affirm Ihai I heve e urOFicale ol corisenl Io sell-nsure,or '"
} a�endreaie of Nhrkers'Gampensatnn Insura�e.m a cntified coPY Neieof ISec saoo.�en.e� � PLU MBING _ — �
x _—
4 ❑f.rrtdied copy is Lere6y lurnished J MECHANICAL
p f.¢nd�ed npy is IJed wilh Ihe 9miding Inspecuon Depaitmenl or DeOartment � (7R
... .
z CERIIFICATF UF EREMPTION FBOM WOAKERS'GOMPENSATION INSU . his secuon need nol he compktal ISS�ANCE . • .
� tl the permit is lor nne 6undred�5100)ar lesx I�erufy thal m perfor re ol tAe wwA t rth tAis ��
y permit is�ssuetl,I shall�nl empbY any persun in any manm�so as o 6ecome s rin pensalion (���� ���
= Laws ol Calilomia y�—��y��
O i""` ' '—`-
p Date ������ /+uv���a�� � u- SCHOOL FEES
W IJUTICE TO APPLICANT�II,after mabny ihis CerniKate of Exem on,yw thould 6ecnme euhj¢t to ihe Waker'a ---
J
� Cumpensahon ponsions ol the La6or Code,you must fatAw�lh comply with such provisnne a�M1is permi�shall
LL hr.deemeA ievoked �—
� a
� pVlSION OF INDUSTNIAL SAFETY PEflMIP CER[IFIfAT10N•� _
W �: 6 , '� �
� ❑I heie6p cerirfy ihal no e�aavanon Irve I5�or more�eel m depth mto whKh a peison is repuired ta desunq
p�e will be made in cannenwn wiih work au�iwr¢ed by ihis permrt,aiM thet no Wildinq sUucturt.scatfobinp,falsewoik,
�" a aemohunn u�dismant4ng thereof,wdt be mae ihan thj�rtY�sq�36�feet hqh.(�V�32.Cry 2.An 2,Sec _ "
1'+�'�5
z 3a,.t�ne a.cn.c.�- ;•,�s`t d' �' y,,., �.. � ���-
s 6:�., i ; �. ��.•' �`-r
3 [�]As owner-budder,I wdl no�empby anYo�to do worNew�ah wouN�equ��e a perrtril hom tlrc Onsm al
t.. Indusinel SaM1etY.as noted above,unkss such person lua e pe�mil to do such work i�am Me tlNeion .
� , . . .. .� , . ... _ . 1"';. _
W ❑Grismn o�Induslrial�ery=�.m„No. .� TOTAL FEES
d .
� CONSTRUCTqN LENDING AGENCY�I herehy aflirm Ihat there7s`a�wnstiucuon knding apmcy fo�tlie p+rformance _ � ��
x ol the work Mi wh¢h Ihis�permit is issued(Sec,3097,Cn C1.
a lende�'s Name COMMEN n`'
m Lendei s AAdress �3 ��
Q CEflTIFICATE OF PIiANC ANO AUTFIDId2ATIGY�ENTPY�1 urti(y I ha�s�ead tlAs�ppleation and starc
h Ihal ihe int n 9iuen is ecl I agree to co wrth a�l slate It.vs md dry ord'uncea rd9�inp l0 6uiIM`q
U
y cnnst�uc and authorae re �ue ot 1 tmenl ai BuiNinq zd Safety b m�er�qM 4k pnpe�ry
= ta�wh�h �re appl�ed s rt lor 1 oi makirvg inspxironx
r v l�,��.Q�
�� �v RECPT NO. �� PAID BY � VALIDATIO
Signetue of Applkant or Agent Urte
WHITE—Depanment Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Applicants Copy
85106-t il89
�... ... _ .. . . _.. _ .. _. . . . .. _ ... :.. ....... .
_
Y - ,
_ :.
, ; ,
. �f; . . . . �. . .
_ .. ,,. _ ., . . . . � . . .
. ' . � � ' . � . ' f � . ' . ' , .
.. � . _ 'Y' _ .. . � - � . . � • , ,
. . . .-!�. � . ,
,. , _ ,�� ". . , . . , , „ , .
- . . • - � . .'�- � � � � . � .
�� : :. . . . . .
's ' _ '..... .m'_'r..>. ,
.�. _ ,
k
. . . - . � . . , I� , '.
. . ' . ' � � . . ' �. � , " 1<_g„ S :�
, ' . .. .ffir.. .v � . : �`�. ✓r
, .. ' . .. � ' . . ' � - . - ' . �- *�
� . . .. ... ' ' . . � "
... .. . _ . . . . . , ' �. .
: ---- .' _' . ' .�. ' • -.. . _' . '. �.� ; ;... ' . � - �-.-« � -,
� .. . . . ' . . .. . ' , ., ' � '