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HomeMy WebLinkAbout1221 (19) '"� CITY OF DIAMOND BAR t-'' ' DEPQRTMENT OF BUILDING AND SAFETY F RMLY BUI�DING PERMIT JOBSITE APPLICATION PERMR SE ADDAESS Z��, 7 �(A�N� g A� ���E ���1^a� TM�ER��CODE t APN LOT THACT DATE �� !�""�� CONST. GROUP � o CROSS STREET ZONING SETBACKS �aE►E�s. �' OWNER 1S�[ak�tA�, �"� /'�GE FRONT RW ❑ o ADDRESS '�-� 56 rlo F�TE V ISTA bj'�. REAR ❑ W CITY Cl11 Nc NI t-LS _ ZIP TEL. SIDE/SIDE STREET RW ❑ g APPLJCANT TEL SIDE O x 6 CONTRACTOR ���4 C�1 M/�L H v �' s� S� SEWAGE ❑ p1,18UC PMT+� � o ADORESS O o �C 6 L � � DISPOSAL ❑ pRIVATE SO.f-T./100 GAL W CITY �InlAk-N vT ZIp '7 �� T r = STATE N LIC.NUMBER 3�6 yS 4.f� GRADING ❑CU.YDS.EXC. CU YDS FILL y ARCHfENG/ � T`fPE SQ FT FACTDR PS ADJ: AREANALUATION � DESIGNER W 1 a ADDRESS � 2 = CITY ZIP TEL (} 3 _ . - ---- � PROPOSED USE S D To GO -- � 4 � � GARAGE o NO.DWEL. NO. • � PORCH _ UNITS STORIES BEDROOMS � LOT DIMENSIONS m VALUATION ADJ.AREA o NO.OF BLDGS HOW ouaNrrrY DESCRIPTION FEE W OV LOT USED � ❑W � IILENSED CAHfflA6TOfl5 DECLAflATqN I krtby dfi�m M�I I rn 4msed wda pmvitims ol CMpw 9 Icomrwiurp ¢ weh SKtan 10D01 0�O.ivon 3 0(Me Bus�es:�nd Prolessona Code.xd my kmu u in hl lorte�nd dlect ' .- . . 3 p . . , � OWNffl�BULO[R DECIAfiATDH I knEy�fliim tlwt I�m tampl imm Mr Canvstoi t limq l+w loi Mt 1o11owinp rcason(�c.70�15.Business�nd PialesHon�Code Arry nry oi county wAsh repxrn�oermn to�onstruci, (� S�� s � o dlei,impove,dmw�sh,a repar Nry stiulv�,prio�lo ns bwm[f.Nso repuwe�tAe�[xit Id tu[h pnmit Z ��O�� �I F= b I�le+sipned sntemenl tl��t Ae u kmuE Wrswnt m Ihe pwi�iont of Ihe Cmsx¢i s Iiceme liw(G�pn m ¢ 9 Icommmnrg wn�Sec�an 700010l Dws�an 3 0l Rrt Basircn ud P�ofesirons Codel a Qa�k y�ampi thndrom � , p., nd tlu Wsis la d�e�EtpeE�rmpDon.A�ry vbl�tion ol Se�tion 70]1.5 W�iry�pplKant la�perml wh�r[o � A '� �a"t"� � � ��DdK�m m�cnd penaiiv of ro�mor�ih�n Ibe hurdred doAa�i IS5001 I: a . `" E TR '7. `;� � Di,,:ownn o�m puxny.«erv empor�e:w�m waGe:,:tnnr:de�mpw+saooa.wa m me»n,�,rd ~ Me sbrttme it mt inieMM a o11erM Id tile�Sec.)OM1d.BuLnes�Me Rdessons Code TM Cmu�cmr's t�cense �,~j law Caes rot apply m n owner o1 p'openY N�builds a mpwes 1Mem.�nd wM das suh woik hmsell. G 'S L. �� S 1 l , �++ Q Muugh h�s own emplorees.p�ovided tlut tuh mD�o�anu s�e nm intendeA u olhsd lor tNe.1(Mw�.er. m da OmNinq a imprartmenl if told wilhM pne yw ol[ompknon.Ilr omKrEuilEer wJl hm Ne Durdm ol ponrq . y tl,�u,t/M1ey�rot bnM a xnpove lor die Ou�pou ol s�le.) . sn �}JI,ts owMr al�he proDeity.+m exlusrvely eonitsctiny wa�IKonM tanlr�tton b tansvixl tk prqect(Sat . 0 7044.Buvnss W fiofessans Coda ihe Conlntmr�licmte L�w das mt�pqr m�n pxui el poperry who = WiIE�a imprwef tMean.�nd wla contrxu la a[n proRtls wiM�tonu�ctdlsl btenfed punuanl ro tAe Cmtr�tior's '` �•°^u'""� ; CONSTRUCTION p . �++ ❑i,m.�m�m�s� .e br.c�a��n�,ur�,u� pLAN REVIEW � � O7e °i""" ELECTRIC T HqINERS'COMPENSATD!DECIAflATUTi I henM dG�m ihn I Am�muhnta ol eaxnt to sd4newe,a �� /� �cem6eam d SW�Yni Wmpens�tion Insu�rce.w�canfed wpy Mned�Sec.3800.1�0.C 1. � . l l __ , . ......_ ; —� ❑wurKa owr y M,.cr��.��a . . ,.Nj MECHANICAL d ❑Cxol�ed topv��L4d wiA Me BuJd�nq Inspenan OeDy�^�� avY�. Q GRADING � W ' � CEXTIFCAiE OF EXEMPTqN fROM WONMERS'COIAP{NS0.jtlNr.WMA1[E.Thf+ectnn ireA rol h carpkM ISSUAN � y ��he pnmil u lo�one AmdiM If1001 a kss�l.e�ulj Cw;m}k prlamn�e ol Oa wat ta whicA Iln .,., . pnmi e osied.I tha�ro�emplar ury person in��ma�'sant0.bsanr abpct m Ihe NtrYwi e�v���,� � SMIP o ��o�����a�+ W PARK FEE i O�te W � NOTICF TO APPLCANT M,altn malup N� Sd oFcaAve�Fdnv�����6aare mbMn m d�Uw�er i SCHOOL FEES ��„ Cmpemanon pro„snns al tM l+Eo�Cod1�y/�J A�pt k�hw�cnny�j.wRb ne�povis:Ms a tlii�prma thd � 6e Eeemed rerdM ' � OMSIOH Of INq1SfNULL SAFETY PERMIi LEpi61LATqN � � �!�"�F r r r.F,...,�.. � .�`� o [�I hneh�artly d�rt ro e.waen 1xe(51 d��mon•ket Yr tleT�ntd J�rl��i p�ndn o nq�nd b dacmd. ac w�1 h m�de in cmnecten with vark w�Ma�d"M p�W�.4d Mq iio MJd:y'��a�(n wlkUmy,Wwwark. . �- a demolnan a d�anan�Ynp�hereal,�wh!c�iiw�'dun'tf:rry��a'�76)`IK�AipA.��dup S.t.Gry t.An 2.See . . W 36I.7nkB.C.ACI. x 3 []Ils ownr�0ulder.I wil rot mVIoY r�yme m da wal whrA�w�M nqrn�pnnt hm Ihe Q.nm d F- IMistrul Sikiy,�s mted�mre,unkss fu��permn Nf�oe�me t do wrli waY hom tlr liri�un. � ❑�„"'°'`'°""y'�.'`"`4""""'° TOTAL FEES ° � o0 � C07SiNU,TDN IfNONG AfifMC!-1 M�eby Mlirin Ih�l IMi�is�nnfrtucDon MM+q aancy ler IM prbnnrK� s = al tlr wal lu whc��n oamn e nwN I�.3LL9Y.Gv.GI. � �"i°"�'N"" COMMENTS mtMa�.•.aaa,.�, � annru�a co�wwucE��o nunnwzarv�a cwrm:i�.+ar i n.y.�r w..�.�a.r nw �f dut tlie ofamaom qrven u tartn.I Wa m eomdY wnh N stN�Mt ud tM Mdnnea nheiy 10 hr1liiy . � emsvucuon.�ne witlwire��epRr�m.we d tlr Uiare�rm M Bid+9 rd Swtp r�r�M 7�4�h � fa wh��I Mw�ppled lor IAis pmm�tor Oe prpo�M�Wiq nfpeoau X "—' 7 �1 I�� RECPT N0.1.�11_�PAID 8Y�VAUDATION Sqna�r�d MNirn a Aqm Lrr . WHITE—Department Copy.YELLOW—Finance Copy.PINK—A4sessor Copy,GOLDENROD—F�e Copy,GREEN—Applicama Copy 85106-11/89 ._.. .. .. _ ., • ; .,...... . . . • . 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