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HomeMy WebLinkAbout1404 (14) ''�` CITY OF DIAMOND BAR PRESS �� DEPARTMENT OF BUILDING AND SAFETY F�RMLY •� BUILDING PERMIT JOBSITE � ^� j� J � i � {�/' / APPLJCATION PERMIT �CODE ADDRESS ��`7' S C'�� etft!/C�Gv 1 DATE .�� �,l—r���-� NUM6ER ISSUE C;, TYPE OCC. � APN LOT TRACT DATE � -� �� -- �� CONST. GROUP a CRO$G STREET_f�v/' F" �/ i SETBACKS rvr+wE'"E"'S = OWNER��7 i�/GL�" � .P,'�! ZONING FRONT RW ❑ o, ADDRESS �✓ REAR ❑ ,� GITY IP TE SIDE/SIDE STREET RW ❑ ,z Q APPLiCANT ��e tl..�"�TEL. SIDE ❑ �.z ;.Q 9 a. CONTRACTOR SEWAGE ❑ PUBUC PMT� �o� ADDRESS 2 � ' DISPOSAL :W CITY ZIP TEL.' ❑ PRIVATE SQ.FT/100 GAL � STATE �/�'��� y LIC.NUMBER 7 GRADING ❑CU.YDS.EXC. CU YDS FILL � ARCH/ Gi � TY1'E SQ F'7' FA�}R PS AL?J..AR�RNALUATiON `" DESIGNF� � � �..� Q" ADDRESS `�-��` I,WL 2 � CITY ZIP '""~-�-- TEL. (� 3 � PROPOSED USE z 4 � � H ' fl GARAGE � :o NO.DWEL. A . NO. m PORCH Y N UNITS STORIES l BEDROOMS `s LOT DIMENSIONS VALUATION +•� • ' -% '� - �- ADJ.AREA o` NO.OF BLDGS NOW �?�a�'�+�Y QIESC . PTION FEE W� ON LOT USED � — �.. W: h I ICENSED COMHACTORS DECLARATION�I Irerehy affnm ihat I am hcensed wder pmnians ol CM1aptn 9ltammencing � � wnh Sx�ron 10001 0l Dirision 3 0l ihc Busmess and Pm(essions Code,and my I�cense is in full for[e ard e(tect ,W 3 [] W �- UWNF.N&111UER DECLAflATpN:I Aereby aftirm Ihat I am erempt imm t�e Camrattor's L¢enta law lor Me fu�imsir,g ieasnn(Sec 7031,fi Busmess and Profesaions Cade:Any uiy or coun�y whKh requires a peimd to conttruct, (} o allcr imprnve,damdish ur iepair any slmc7ure.pnor tu ils issuance,also reymres Ihe applic�nt(or such pe�mit �.� F- to fde a signed statement that he is 6censed pursuant ro the prwiuons uf Ihe Cantr�cmr's lioense�aw(Chapter � Q 3�wmmennng with Seciron 7000�ol Unsian 3 of Ihe Busmess and Pmlessons Code)or Ihat he is exempt Ihuehom � y antl thr.6aais foi Ihe alleged aMempuon Any vidation of Secuon 7�315 by any applicant for a permn subjects WthetaDD�icant ta a crvil penahy ot no�moie Ihan(ive huMred Aollais IS500�.�. 0. � lJl as owner r,t the pioperty,or my emploVeec w�lh wages as their sde mmpensaeon.will do ihe wark anE the snucmie rs not inlended or nHered foi saie ISea 10a4,Busmess ana Professwns Cade.TAe Lmvacta's license Q � Law doe.s iwt apyN�o an owner ol yroparty who hwids ar impmves iAe�eon,and who Aaes sudi work himxll. '.(y W m thmugh h�s nwn e.nryloyees,pmvided Iha1 such impravemems are nol�mentleA or olfereU Iw sak�f,hawever, .Z = IM huddmg nr imprwement is sald wrthm ane yeu of compleoon,the awner�Uun�wdl Aave ihe Gurden of pmvmg « ; � Ihai he did nut hudd a impmve lo�Ihe pwpose of sak� �� "1 y ❑I,as owner o+Ihe pioDeity,am exclusiveH�a��reehny wnh Lcensed caniracto�s N tonstmcl the pm�ect�Sec �} I 7044.Busmess and Pralessans CoEe.The Contrecmi s Liceme Law daes not apply to an amei ol propeny who •'�' '� hudAs m imV�uves Ihereon,and who cantm�ts fa sudi pm�ects wiM a�onlrxtOrlsl li[ensed puuuanl N�he Canuaclor's ��—� ; / 1 f-- �^. Li�enselaw.l �� COIVJII'7VCTION (_�� r ' -��`�� __ �o '_'___...__. - W �I am exempt unAer Sec. .B 6 P.C.(A�lxh CerufKatel � PLAN REVIEW 1-- o Dare ��ef - : � ELECTRIC � WOPKERS'COMPENSATION DEGLARaTION I hereUy aftirm that 1 have a ceni6ta�e o�consem io se���inswe.a �� ' PLUMBING a ce�lAicate af VJorkers'Compensation Insura�ke,or a cerut�eC copy iheieol ISec 3800,Lah C 1. 0 � ❑Cerofrod capy rs here6y IurmsheA. � MECHANICAL 4 -- o . CerniWd copy�s hled with the Buiiding Inspeeuon Department a Oepxtmem_ Q GRADING W x f,EHTIFICATE�F EXEMPTION FPOM WOHNENS'COMPENSATtON INSUfiANCE.This sedion need not he compkted ANCE...._. I ����. C.%�....�' � i�ihe permn is for one hundred�5100)a less.I cerOfy ihet in Ihe peJo�mmce of IA¢wak lo�whch this � �----� y permit is issued,I shall not employ airy person in any mennei sa as ta 6ecome sub�eci�o tla H6rkers'Compensa�im S`M�P A y�-� �` = Laws ol Calrfornia "� o � PARK FEE � �re AD°'"�^� � SCHOOL FEES W NOTICE TO APPLIGANT H,altei mak�ng this Lntilcaie Af:E�npfion,yo6 sMuld,become subKc�ro me Waker's --�-� Compe�Ton prouisiom of pre Wbor Code,yau musl fd�Avnlh'codpry W1�Il SIK�P10Y13A113 m Ihis pe'mi1 shall � he Jeerned�evoked. %'� i: ........ . J pp qVIS10Al OF INWSfRIAL SAFETY PEflM1T CENTIflCATION W � ❑I heie6y aertdp that no ercavatwn�rve(5)or�nqe.het m Mmto Whkh;a�pe�sm is reqwreL ro OesceM, c will be made in conneciqn with worM wMmued hyfihis peml�t,an�thei'�ro b�ilCirig;squtture.scatloldinp.laluwak, � or demoXnnn or dnmantling thereof,wdl Ee mae t�e�Ihirty�sit(16j leet�gT_}Gap.32,Grp Y.An 7.Sec _ W 341.TitleB,CAf,) _ . 3 ❑ps awner6mlder.I wdl no�empby aiNtlnf"Yo'�da:l'voik�which iYailE itquire',q pemMt'Noin the Oryubn ot � Ind�stnal Safety,as naled a6o�x,unless such,delabn has S permi(t6 da;uch�k from the division. � ,.:�.'. . ......... . ..•. - .::.� _ , i � ❑a.�,��������,a�Sa�ery��m�Na TOTAL FEES � , W � CONSTIIIICTION LENf11Nfi AGENCY.I hereby alfirm that there is e wnaGu�tan kndinp�gency la IM perlameMx x a�ihz work 4x wh�ch Uiis cermt is iuued 1�.3097.Gv C.�. i , � � lender"sName COMMENTS ��'�''l\��.1 (�:.�� `.'J\-:�� . -�-= e.- /�. �;��`� � � lender's AAdiess r� m A l� , — — I 4 CERTIFICATE OF CDMYLIANCE ANO AUTHORIZATpN Of ENTflY:I cetily I lu�e rtad tlws applratim md sbh �` -- - - --- - I � that the�nfwmatwn given is carecl.I apree m mmply w�all state laws aid ciry adiiwiea rd�6q ro hutldinp V _ _ y cunsuuclwn.aM aulhot¢e a repieunt�txe d the OBpatmenl M BmNinp anA SoFetY m mar�pm tle papeiry iw which I hav apph �ihis permrt far � e ot rtuY inspetlo�p � .,,_._ ' � _ // � r^ �1 � / I'.. 9gnature at Apd �o�Ageni / y aa RECPT NO. `�' ` � PAID BY '� ' t�� '_VAUDATION,` WHITE—Department Copy,YELLOW—FinanCe Copy,PINK—Assessor Copy,GOLDENROO—File Copy.OREEN—Applicants Copy � 69106-11/89 � . . . . . . � , . . . 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