HomeMy WebLinkAbout1300CITY OF DIAMOND BAR PRESS
LT 1EPARTME BUILD NGT OF I PEIRM TND SAFETY FIRMLY
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ADDRESS o` 1 J�Gm��
ADDRESS
APPLI CATION
NUMBER 00 CODE
UE TYPE OCC.
DATE �� CONST GROUP
APN LOT TRACT
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OWNER 2--7 flLct �d c
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APPLICANT <614 la TEL �U�/�/
APPLICANT
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CONTRACTOR nLt Jv% a Av VA I A -
ADDRESS
CITY ZIP TEL.
SEWAGE PUBLIC PMT #
DISPOSAL ❑
❑ PRIVATE SO. FT./ 100 GAL
STATE
UC. NUMBER
GRADING ❑ CU. YDS. EXC. CU YDS FILL
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TYPE SO FT FACTOR PSF ACJ. AREA/VALUATION
1
ARCH/ENG/
DESIGNER
ADDRESS
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CITY ZIP TFL
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PROPOSED USE
GARAGE
NO. DWEL NO. NO.
UNITS STORIES BEDROOMS
LOT DIMENSIONS
PORCH
t0
VALUATION ADJ. AREA
DUANTITY DESCRIPTION FEE
NO. OF BLDGS HOW
ON LOT USED
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LICENSED CONTRACTORS DECLARATON I hereby &[firm That I am kcrosd Soder prwisiors of Chapter 9 (commencing
with Section 70001 0l pvisrn 3 of the Business and Professions Cade, and my license 6 in full lace and effect
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NER BUILDER DECLARATION 1 hereby affirm that I am ecenpt from the Contractor's License Law to M following
reason (Sec 7031.5. Business and Prolessrns Code Any city a county which requires a permit to construct,
otter, imprm, demob h, or reprr any structure, pia to its issuance. also requires the applicant la such punt
to file a Signed statement that he is licensed pursuant to the provisions of the Conoxta's License Law (Chapter
9 icommmcing with Section T000) of Division 3 of the Business and Praleuions Codel a that he is eaempt theref cin
and Me bas's for the alleged ertmptm Any violation of Section 7031 5 by my applicant la a peat subjects
r applicant to a end Penalty of not mom than true hundred dollars 1$500))
❑ 1, as owner of the property, a my employees with wages as their soft co.•npensa'ion, will do the wok. and
the structure's not intended a offered for sale (Sec 7066, Business &Id Piofessens Codoo s e The Controclicense
Law does rol spD4' 10 in Owner of property who builds or improves there., and who does such work himself.
! a Ifrough his own employees. gwided that such imgwements are net intended a Offered for tale F, how"'.
the building a improvement is Sold within one yes of eariipletrn, The mwrr-builder, will hive the burden of Timing
that be did mat build or vnprm for the purpose of use.1
❑L as owner of the grpertY. am exclusivelycontrsctag with lensed contractors to construct the project ISec.
73". Business and Pi0fetL.$ Code The Contsocmr's License taw does not apply to an owner of property who
tractor(t) licensed pursuant fo She Contrsce
builds of improves thereon, and who c.uuts a such protects with a c.u s
License law )
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CONST-RUCTTIQN
❑ I am esemq urdes Set ' B b P.C.IAttach CertiRcatel
PLAN REVIEW sn , on
i Date D"ne'
ELECTRIC
PLUMBING
WORKERS' COMPENSATION DECLARATION 1 hereby affirm that I Nue a Certificate of [.sent to sed -imus, a
a certificate of M6ikers- Canpensaim Insurance. or a testified copy thereof ISec. 3800. tab. C.I.
❑ termed copy, is hereby furnished.MECHANICAL
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i ❑ Certified copy is filed with the Budding Inspection Deprtment a Orpartment.
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GRADING
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CERTIFICATE Of EXEMPTION FROM WORKERS' COMPENSATION INSURANCE. Thissection read not M Completed
i it the permit is I out hundred I$IDO) at less. I Certify Mat in the pe4c,mus ce of the wok for wtch Ibis
permit is issued. I shall not tmplaf any person in any ma.er so as to become abject to the Nbrkeri Compensation
a Laws of Caldani
a
' Dam Atgkraml
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ISSUANCE
SMTP
PARK FEE
SCHOOL FEES
a NOTICE N APPLICANT N, alter making this Cestilutr of Entmption, you skald become sublsct b dr kVMkes'$
a
Compensation prowsrns of the labs Code. You 'swat faIhwnh tMpty witholsch pwgians a this permit Shelf
be deemed rerokd ?y :'•:'.
CIVISION OF HOUSTRIAL SAFETY PERMIT CERTFICATR]h 1; i.-- v vim'
i
❑I Meby curdy that no tttivatdn Fine (51 a mat Felt in deprh into which a parson is rspinsd to deuaM,
.1 be made in comectm with work authorized by Mit permit. aidat So buidiy stricture. ualloldrnp. faBewak.
' a deetum a dismantling thertol, wit be me MsdZ36yeat 3.2, Grp 2• Art 2, Sec
341, Tide 8, CA.D 1 �� I�.JJ I.iJ ,J
.
.
[:]As swvrr.bui[der, I will not airplay anyone to do work which wouW require a pRml hon IIr Oivision ad
liidnvial Safety. as noted show. unless such pert. has a perms 1p cepyitR wink l(M t/r 111002101.1
C9"iY �e: UIJ ld:'vF�a� r.:
j ❑O. m as Mustin[ Safety Point No. ^ ^ r
y CONSTRUCTION IEICING AGENCY. I hweby affrmi'tH,-dn: if rr construction 4n6rq apwicy For IM perla.anee
of the work fee which Res prrml is issued (Sec 3087, ria. C.).
TOTAL FEES is
'+ Lender's Naar
COMMENTS
lendes's Address
C CERTIFICATE OF COAOLIAPCE ANO AUTNgg2ATIN Of ENTRY: 1 earth 1 have nail hs application and $tae
a Shot dr information given is tarts. I agree 10 comply with N $tell Iwo$ and city endurances raon" So Milling
a [.111.1 n. and arRwve a reprnarttaae Of fr Oaaertrnein Of Budding and SOWY b ansa apse fir MWtY
= H which 1 Hie tippled Ia s mit la the purposes el arkitp inry/cp°�s, �f
I �42 4 � 1� �' ZU� `-
-gratue want w Agent Pao
/� 1
AxX
ECPT NO. _ PAID BY v ` VALIDATION
WHITE—Department Copy, YELLOW --Finance Copy. PINK—Assessor Copy, GOLDENROD—File Copy. GREEN— Applicants Copy
BSI DG -11189
MaMov, DO BAR
114 aPEC 1Ot,41 RECORD --
I SET BACK: ( I � FLOOR VO!, TS � ` , ` it' \
TGS.t i`fi�.1 !aTr.i-t. 4 `HA RE :�.1 � S" i >
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ELEC,TRIO GROUN15' I I U"JDER F1,00 i DUCT k -, }• I /.
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S' Af3 GRADE
FIREPLACE f C3UlIDAT[Oil
TEMIP POWER 1 FIREPLACE BOt4D tai-ld:Y.l iI
V'vr•t IFR SERVICE Pi;ID HT. BOANO BEAt,4-_._..._....___.i
ROOF SHEAT HIND_ it F T 13OND BI: A
i FRA wliNG VEN I ILATIQN 1 { FINAL BOND BECAM I
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Rool". GOVEfi( PRE -GRADIN i
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' ROUGH EATING B-EN—C-H'-I-NT^
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if`%iDl�HOU H ELEr Ovi
ROUGH PLU"A iIF:G I 1 I FINISH GRADIING I i
_._....__...__......._..._.....................__....__._
SHJ',Vr:f?tTUB TEST POOL ELECTRIC
--_._..._._..._........ I 1
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EXT. LATi L'SIDIPIG ' - ! -'-'_--- POOL FEN�I.NG
_ _ _ -.._ .............
V,fALL INSULATION 11 POOL• FINAL
1
i CEILIPJG iiJSUt..ATION I fioF�= SITE (PAPS',,- i
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C:I=iYV.'At_L NAILUNG 1 _ ( DEDICATIONS
SEY"JERL ENG.
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_ ..__.._........._......_--__ _ ...._..... - -
i SEPTI; TANKLA NDSCAPE:IR RIG.
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I SEEP PIT/L.L. I I I OIN SITE IMPS.
CAS AIR TEiT I I I FINAL ZONFING
1 INIAL. CONST. I FIRE DEPT. FINIAL;..�___..._._..__...._......._. _. l HEALTH DEPT. FINAL
.. JAL HEATING IND
I FINALE LECTRI0
DEV. FEES PAID
._........_._........-.---'-__-'-- -._.._.......__._ ......_.__...._......_.._.
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COf, NIENTS
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SEPTIC TANK SIZE
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1 SEEP P ITJU SIZE
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