HomeMy WebLinkAbout1061 (7)CITY OF DIAMOND BAR PRESS
DEPARTMENT OF BUILDING AND SAFETY FIRMLYBUILDINGPERMIT
JOBSITE .-
y I APPUCATION PERMIT
CODE
ADDRESS 1 CAMO(1("
ISE
SSUE f_ (,I
NUMBER-
TYPE OCC.
APN LOT TRACT DATE CONST. GROUP
o CROSS STREET/-Ca SETBACKS E"E"LS
OWNER / Y-/R vtJ-
ZONING FRONT RW
o ADDRESS s/4 n tri"' Z4I _REAR
W CITY- O-A ZIP 974f1 TEL 6- CO SIDE/SIDE STREET RW
o APPLICANTSIDE
z
CONTRACTOR SEWAGE
o ADDRESS 9/'l / # 3t)1
PUBLIC PMT
DISPOSAL PRIVATE SO.Fr./loo GAL
W CITY 4 • 6tea , r.Vit? ZIP__q 113° TEL.t) -Err
STATE
LIC.NUMBER C -KS GRADING CU.YDS.EXC.CU YDS FILL
TYPE I SO FT FACTOR PS ADJ. AR ALUATION
H ARCH/ENG/ co
1 l ,U0 elft. ;(1 72,soDESIGNERW
r
a ADDRESS LL. 2 r t Ian . f12-
Z CIT ZIP TEL. 3
PROPOSED USE IA •f-&// t' {
Z 4
GARAGE
NO.DWEL. NO.. NO. S PORCH
y UNITS STORIES BEDROOMS
t= LOT DIMENSIONS
m
VALUATION ADJ.AREA
o NO.OF BLDGS HOW QUANTITY, DESCRIPTION FEE
W ON LOT USED Q
ec U
i
l•'— LENSED CONTRACTORS DECIMATION 1 hereby affirm that E am kcnud under provsins o1 Chapter 9(commencing
IDe with Section 7DO01 of Deviation 3 of the Business and Professions Code,and my kense a in hull forte and elfect W
3 W
i±- OWNER BUILDER DECLARATION 1 hereby alhtm foal I am e,empt from the Contiactor's Leenae Law fa the following
reason(Sec 70315.Business and Professions Code Any city a county which reports a permit to taeilfuct. (7
o ate, mpmve,demolish.Or repair airy structure.Dna to its ntuaoee,also repuues the applicant list such perms Z
t= to file a signed statement that hers licensed pwsuant n the prwisam of the Cannactoi a License Law(Chapler M
Q 9(commencing with Section 7000)of Oais on 3 of the Business and Professions Code)Or that be is esenpt thenehom
a and Me basis far the alleged eumption.Any violation of Section 7031 5 by ary applicant fa a permit subjects
the applicant to a(nd penalty of not more than fait hundred dollars(5500)1. J
oar IL
o I,as owner of the property,or my employees with wages as their soft compensation evil do the work,and
the'tructure,s not intended at offered for sale(Sec 7074.Business and Professions Cade.The Contractor's Q
Lrw does not apply to an owner at property who bwWs at improves thereon,and who does such was bmull, _U
of IhrouSh his own employees.goaded that such mprowments we not intendc7 Or offered lot sale 11,hawewn, Z
m the building at anprovernnl is lad within one Vex of completion,the owner dikes wet have the bwden of proving Q
h that be did not build or improve for Me purpose at sale I 0
y 1,as owner of the property,sen et[IUs-ty conlnac+my with literaed cntractms to construct the project(Sec Eli
em 7044.Business and Piolesswns Code The Contractor's License Law does not apply to an owner of popnty who
a Wolds os n,improves theneand who contracts la such pmpcts nvWithaexm4emmnla) sed pusunt Ma Cnvastnr's
License Law)CON$IAUCT 0N- t3 •
W I am ese of under Sec B 6 P.C.(Altxh Cerakarol PLAN REVIEWt—
o Dalt OwnerELECTRIC
WORKERS COMPENSATION DECLARATION.I hereby allum[list 1 have a certificate of canmt to set inswe,a
PLUMBINGacertificateofNakedCompensationhnsaarce.a opyaeethlrcdcthereof ISec 3800.Lab C)
4 Ceibhedcc"isherebyfumaled J MECHANICAL
e=; Ceuled copy is bled with the Building Inspatwn Deparment Or Department Q GRADING
W 1x
If the
LATE OF EXEMPTION FROM
I
MARKERS'COMPENSATION
in
INSURANCE This eeOf need rot, completed SSUA J
d the Pont is for one hundred IS1001 a less I ceruly that in ON perlormarce of the work br,which thisn
perms is Issued.I$half rot employ any Denson in any man.,so as b omit fublect N I/le- rkni Compensatin SMIP
laws d Calibrwa
Wo PARK FEELSteApplean
o
Nero
U- SCHOOL FEESWNOTICETOAPPI .N aper mak np this Certificate of Eampt ,you should kcame xklecl m Me 1Vaker'f
Compensahn provision a des Labor Code.you mint Iw rth with such poris,om or this perm*shelf
u be deemed i.ok&I esm..
J p11S10N OF INDUSTRIAL SAFETY PERMIT CE }'
ft''
h
a Q
im`.
a + .,
W 31 hewer sootily that no e,avunn Lae( a a het m doth into which a person is rpuind to descend.
0fz wit be made m eawt[len with way authorized by Mu perms,nit thatroe buildingenuctue,ICON".Irdsrwvrk.
w demoknon a dismantling therrol,wit be mar:than thirty 3331(361 tact" (Chep 3.2,Grp 2.Art 2,Sac
341.Tale S.C A C 1.
Jhy
W
ea
J1
4 195WS
3 As owner budder.I will not IMID Ro to wok which wuuN repine a permit horn Me Division of
e. Ldntiol Safety,as noted above.Imles such person has A permit 10 do such work from this envision.
M- Divisor of tdustul Safety n r T.1 y}. 1 i.l iiD c-AR
W TOTAL FEES 1 .a
CM CONSTRUCTION LENDING AGEfIC I1MnebyTslllrtoltlSY7 tlEwf{sy mpgutalEA.lerdx Waacy be•M pwhKmarceZoftheworklawhichthispenalWishie619ec'3WY,Cit.0.
o
LmdefaNeme COMMENTS
mLender's Address
e CERTIFICATE OF COMPL1AIICE AND AUTHORIZATION OF ENTRY-I ostfy I Dave Now On appkcatin and Ito
S2 Mat the wfw_l_oven is correct I agree to comply With oro state kwi and e,M ardnaKn nknp to hiildp DATION
h tonsuucim. auMave a representame of the Depxement d i ng and Safety 10 m-eon the pmpany VAU
M whth 1
H
appke b petmn`oE 6a•vaoyle of etwkvq- tnru PAID BY
C/t/
RECPT NO•EN-APWiCants Copy
o.te File COPY•GRE
nnweof Appt[ant a Agent GOLDENROD—
WHITE—Department Copy.YELLOW—Finance COPY.PINK—AS yes9or Copy
INSPECTION RECORD ,
19, 9; ri 'll C 1 +# l,n `s i s 1.t`,,F, d.*
SET BA ,rc i FLOOR
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CONDUIT' -
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FIREPLACE QidO PEAM
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PR C C ADING
F.CiU E EIE.A11ryG
II J.. .R: i !_ I ROUGH GR1b .G. L , t I
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FINISH Gr AIDING.
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T I i'SID1 J_. i vL)i_r=E_r'1Clla,
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A1YFi DEPT. FINIALFINALH=ATING HIbC . FEES PMD -_-... - ----- --....
FINAL PLUMBING. ENERvY I
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SEPTIC-I'ANIK SIZE
SEEP PIT/U SIZE- _.__:___.......
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