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HomeMy WebLinkAbout1077 ; .—�._.r _—--.— '"� CITY OF DIAMOND BAR � pRESS DEPARTMENT OF BUILDING AND SAFETY F�RIVILY BUILDING PERMIT JOBSITE APPLJCATION PERMR E ADDRESS 3184 FALLOW FIELD I��E Np�ER��T� OCCCODE � APN ' LOT TRACT DATE �� � CONST. GROUP � CROSS STREET � OWNER MR. RORrNsnN ZONINO SETBACKS �"�"� FRONT RW � o ADDRESS 31 R4 FAT.� F'IELD REAR � ,� CITY DI�MOND BAR �p 91765 ��. SIDE/SIDE STREET ' RW � ' o APPLICANT BOB KELLER TEL 594-5100 SIDE O : a CONTRACTOR P�TERSON JONES o ADDRESS 3190 E. WILLOW SEWAGE � p�Jg� p�� DISPOSAL O PRIVATE SQ.FT./100 GAL W CITY SI'GNAL HILL ZIP 90806 7EL:2/988-00 z STATE • „d LIC.NUMBER 528710 GRADING C:] CU.YDS.EXC. CU YOS FILL y ARCH/ENG/ '�:TYPE,.= ;�FT�FACTOR�PS ��::i��A .s�:AREANALl1A N<'�,,.,F:�: � `—' DESIGNER W: 1 o ADDRESS � `W` � '� 2 = CITY ' ZIP TEL. � "'3 ' � � PROPOSED USE '�' q �7.- � • . � «� GARAGE o NO.DWEL. NO. NO. ;�' pORCH ' : y UNITS STORIES BEDROOMS s LOT DIMENSIONS s� VALUATION ADJ.AREA . o NO.OF BLDGS HOW ;",.: ounP(trLv '�ES IPTION:�;;�' 9 '�`: �:FEE�` "� r,..� ��x`-,;'<� ..:FC . W ON LOT 1 USED ='U' � W S ?t�. ~ IICENSE�CONTRACfOHS OECLAf1ATqN:I herehy dfirm thet I�m Gcennd uda pwipau ot CMpir 8 lwmnercuq . � with Secuon 7000)of Oivi�ian 3 0l the Bwineu end Rokuimn Cude.yd my I[ense is in hdl lpce aM eNecl ?���'.� � s � � ❑ W: l �±- OWNER�BUIlOEH OECLANATqN:I herehy elfirm IMt I xn uempt Irom tM Contrxtor's licenn Lwv Id IM tdbwinp .��- . = aason�Sec.7031.5,Business a�PrWessione Code:Airy ury a canty which rpuirn� ;'� � �� O ahei,im we,demdish,p r 7m�°'� �tunttruct 4�,� p epeir arry structwe.pior ro its uaarca.+Iso r�yurei tle�ppinm for sieh prmrt 1— tn fik a sipned statemmt tlut�he u kcensed puwmt m the provisions ol the Cme�tmr't liume La�y(pupte ' � � s 9(commencinq with Sation 700Q)of�ivisim 3 0l the Busuieo W Rofeawm Cadel rc Mn he n�ampt tliaArom „:�;� . ' � and Me hasis Iw�he atleged e.empdon.Airy videtion d$ecrion 7031.5 hy�iry�ppliunt lo��permq wCpcb ,:�. . ' , W tha applic�nt�o e civil penelty of irot mnre tlun fna hundred dnllan(55001.1: ti�, '. .. � ❑I,as owner ol the propenY,a mv emplWees with wpes es tler sab compen�ation.Mrill do IM rark.md ` tl�e st�ucwre is rrot intentled m olfered fa sab�Sec.7044,Buuroa�ud Pro�es.�ioiu Cod�;TM LmV�ctar'i L�anf� � � Law daes not appYy to en owinr o1 propeny who builds a inproves therean,xd wha das sufi work hm+ell %.(�-, � ' or tivough hrs own employee:,p�wided Mat wch mprovements ve not intenA�d u olhred fm uN.11,ho�wver �:;�:.. m the huitlirry m impwemenl u sdd within one yex al cpnpletion,the owror�datlm wil hn�IM 6vEen ol pan�p 'Q y ttwi he did iro�huild u impove for tlu piapou of sde.) .. �r) . ro y ��' . ❑I,az awner ol the propeny.am eYcW�ivefy contractiny wiN Icemed mnaxton m cmutruct the praj�c�(S�c , 0 70A4.Busirou aid Wolessiais Code:7M Contr�cWr's L'aense Lwv doa mt�pply b�n a�wiw o1 papMy who :i�.:. , � 6uilAs m imprwes ihewm.and wAo contrxts lor veh prapcts wiM�canv�cmr(sl icenied putun�eo Me Canvuar� �`°°�°`a'"� 4'���` CONSTRUCTION � ❑I am emmpt under Set. .B.6 P.C.IAtUM CqM�u41 `�f.; PLAN REVIEW o a�« ' ay� 6EG�-RI�._, J x: � WOHKENS'COMPENSATGIH OECLAHATIpd:I Aeredy aH'rm thn I hne�cer6(ote of cmunt m t�d�iuu� u "'� •���. - �1 � . a cer�i�cate at Workai Compeiue�ian�nwu¢e.a�certilied capy tlweo((Sec.3800.(i6.C.�. b:- {�--1 6 0 caui�a��:naenv i�,�nea. ;�,> MECHANICAL � o ❑.cmiifiee capy is Ned wiw the BuiWirg�nspauan Deprtmmt or o�,.u�„. Q GRADING W � CERTIFICATE OF EXEMPTqN FHOM WOqKfpS'COMPENSA710N INSUMI�F:Tlis sectiun nxd not ye compyqp �SSUANCE . y il the permn is Im airo hundred IS100)a less.1 prlify ttut in IAe perlumriu ot�he`q1i�p whicA Mn .`�: . , � permit i:issued.I shall ro1 empioy nny perwn i�am/m�mier so�s m bumr w6pc1 m tl�NMteri c�..o� �3:; SMIP = lm�ol Calilunia. - � �� PARK FEE 0 . � NOi10E TO APPLICAIJi:N,after makiiq thi�� :�FI�� �,,,,,b e,�,,,,„b;�,„�„,nb,,,,� LL; SCHOOL FEES �w �. � Canpenm4on prwuions al the 4bm Cod�. mu�F�fnrtl�wphicd�iply wiN a[fi povncm a tles permu N�G t�' �. � be deened rewked. . ni�. . a ;� ' � ONISION OF INU1SfRIAL SAFETY PERMR CERIIFICAiI�/: • . � . . W �nhh/y �''% --T � ❑I nxeW cntily ihat m ewv�lion�� lat in d�1ri��pewi e r4�d m duand &4:: . . • s wil he mede in con�cclion with work tltis �aA �''oo ttrYtlun.rcdloldn4 4kw�vk . �. . n' «damlitim a dismandnp-tMcai.w' mue Nm tArry'm(38)lect hiyi.(Qup.3.2.6rD 2.M 2 S�c ;zr�:�; ' � = xi.r�s.ca.c.�. ,,.,t (aEt '°:; • _ � 3 ❑As owna-budder.I will noi epp1t��oyon�,lb'dor'whrY�whKh�iwlJd.'!9"tTc'�'p!""il�kan�r Qivem d °:;. , . � InAishisl SahtY.n roted e4ow.uSlni lut�l De�m Miy p�mdt`Ib�tp�ti�wt�fioln Ar diinam. ���;�: . - . uSln , � G3UiLt;s�v� r.� :. y�,� ❑Onn5i0n tll Indulbql SLIt�Y Plfmn N0. ' . � TOTAL FEES � `" ��� casrxucra+��rowc r�wcr:i n���rr�uw a�.a.�m��aro�u�n ra a■o.m�.w `��• � = ot�ne wnr►�n wnicn mis penm u issue Is.c 308�,Cer.c.6 � . . � - � LmM's Nam� . . . .r. ' m �r:aem�a COMMENTS • � CEHI1FIfATE OF CWPLWCE ANp AUTIpYUTOI OF ENfIIY:I praly I hM md b�ppinfim id thb . . V� Mat the infmnatim pVsn u arrut.I qe�ro ca�pp wiN�0 um hws md ciry adirce rd�ep 10 h�ap ywn�ructim.end ytliave�repeenu6ve d tM Depruent d Buldiip�d S�M1y m�nr�qm tlr pqnry . � far whih I Mi i�Dl�d fu tliu permi�lor tM ryat m�teq i�ps4mt. . X �r�-- �� RECPT NO. swni.e n�ptc��a noem mr PAID BY _VALIDATION , WHITE—Department Copy,YELLOW—Finance Copy,PINIhAvaesaor Copy,(30LDENROD—File Cppy,pqEEN—Applleant9 Cppy .: BS106-11189 � - . ..., .,..... .. �� ..-. . .,. .__., . �:�,-.,...�,,... .. ..:;, .� .. '�••cr.:i�Y•'�' '��1 u�,•JrF: �a�u...... . �.� ,�i .... � ....��:7 . . . , . ..t • � , • � r � . , . . . 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