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HomeMy WebLinkAbout1683 ,� , ti 1�� Q � CITY OF DIAMOND �A PRESS � DEPAR'TMEN7 OF BUILDING AND SAFETY F�RMLY ��^ Bl11LDING PERMIT JOBSITE APPUCAl10N PERMIT USE ADDRESS 21604 Glen Peak Cove DATE NUMBER CODE ISSUE a� TYPE OCC. > APN LOT TRACT DATE ��_.Io(�CONST. GROUP � � CROSS ST,�iEET SETBACKS .�wvE"�"'S ZONING °.' dWNER �jeavers, FRONT RW � I �-' ADDRESS 21604 Glen Peak Cove REAR � � W` CITY Diamond Bar Z�p 91765 TEL. SIDE/SIDE STREET RW [❑ o APPLICANT TEL. SIDE C] � Q� CONTRACTOR Nock Plumbin � o� ADDRESS 11 IO Seaboard irele SEWAGE � pUBLiC PMT� � Stanton 90680 895-124 DISPOSAL [] pRIVATE SQ.FT./100 GAL i W CITY ZIP TEL. = STATE 511971 GRADING �CU YDS.EXC CU YDS FILL � d` LIC.NUMBER ;, y ARCH/ENG/ � TYPE .�t�FT:;F'�C�R�� . AC�1:�;A��t�lLUf4T1t�+#: � y� DESIGNER �- 1 � �:: Q;, HDDRESS � 2 � i' CITY ZIP TEI.. (�: 3 �' PROPOSED USE �' 4 � �' GARAGE 2 N0.DWEL. NO. NO. �' pORCH y UNITS STORIES BEDR04MS � �; LOT D{MENSIONS VALUATION ADJ.AREA ' c; NO.OF BLDGS HOW Qu�k�rrt�'Y ;C��S�Ft1�'1"{�I�t ;;.. ;� � --.` ` , W ON LOT USED � � u �- � �: � - � UCENSED WMflACTORS OECLAflATWN:i hea6y aNirm Ihat I am Iicensed under pmviaions of ChaD�N 9�wmmdminp �7, � ¢! wuh Section 70D01 of Oivisfon 3 af the 8usmess and Prnfeszionz Cude,and my Ikense{s in fuli torce and effect ,,_.W;. 3; � �" �� OWNEB-BUIIDEH OEC�ApAT10N�i here6y affirm that I am e�empt fmm ihe Comractnr's License Law far me fWlowing �� Z�- reason(Sec.1031.5,Business and Proiessions Cade:Any city ar county whi�h requires a permit to cunslruct �'� oi.aher,imprwe,tlemolish,or repair airy rrucmre,prior to it:izsuance,aim repuires the applicant for such permn �. 1 Water heater F-� to file a signed statemem Mat he is licensed pursuam to the prwisions ol the Condacmr's license Law(Chapter �J; • � �`._ 9 Icammencin9 with Section 70�61 of�vision 3 af the Business and Pmfessions Code1 a that Ae is e�empt iherei�om ',"Y�,; - } � a-: and the basis for the alleged exemption.Any vidation oi Section 7031.5 6y any applicam far a permit su�jects �': x-� the ao��Kanh ro a civil D�altv oi not more than five hu(dred daltars(55001.1: ¢! W-. �' ❑I,as owner of the prnperty,ar my employees wi�b wages as iheir sok cOmpenufion,will do ihe work,and ;� . �. the.stmcture is nm intenAed or offereA for sale(Sec.704A.Buciness and Rofessions Code:The Contractor's ticense �; . . - � � ��: Law does not avPly to an owner of properry who builds or impmves thereon,and who does such work himsell, s:�fs,':: - �++�� or through his axn employees,prwided that such impmvements are not inhnded or o(femd for sak.If,howeve� �i: � � m�. the 6uiiding or improvement is sold within one year of completion,the ownerhuilde�will have the hurden ol pmving �,_ y' ihat he did not huild or impmre for Ihe purpose af Sale.� . �` . v�� ❑I,as own¢r of the praperty,am eMclusively�contractiny with litenaed contractors N conslruCt the project(Sec �; - o; 7044.Business and P�ofeSsions Cade:The Convacmr'S Lieense Law daes not app�y m an owne�af properry who �� 4 j huilds ar improves ihereon,and wha conVacts for such pmjeets with a contractor�sl�c¢nsed pwsuant M ihe Camraetor'S �icense taw.� � t;CONSTRUCTION o' �' ❑I am esempt unde�Sea - .B.6 P.G IAttach Certifaate� ";,;p�qN REVIEW � o"e °`""ef �w:ELECTRIC �t W9flKERS'COMPENSATION DECIAHATION:I herehy affirm that I have a cernficate ai consent to sHf-insme,a � � �, a rertifica�e of Workers Compensation Insurance.ar a certitied copy ihereot Isec 3soD.�ab G1. "PLUMBING � ��- ❑Certitied c8py is here6y furnished � ,�;MECHANICAL � G: �Certilied copy is filed with the Buildinq Incpection Oepximent w Depxtmeni '�:GRADING ��; CEflTIFICATE OF E%EMPTION fflOM WOHKERS'COMPENSATION INSURANCE:This seciion need no�6e�a����n ;..ISSUANCE 13.�� y if �he permit is fo�me hundretl(5700�w less.I rertily tAat In the pertoimance of the wak for wh¢h�thi: , permn is issued,I shall rot emplay airy pe�son in any manner so as m became wbject to the lMirMers'Canpensation '°gMIP otaws ot Caiitomia. 'PARK FEE o -pate �n��7��n Appiicam T Nock �`� "�� NOTICE TO f+PPLICANT:if,after making�is Certitkate af EMemD��on,you s1wuN becane subject ro Ne Worker's �'�'";SCHOOL FEES �- Compensation provisions of the Lahor Cade,yau.must fw;hwith compry wilh such provisio�m�is permit sh�i 'i' -he tleemetl revokeA. �� � � K �,- DIVISION Of INWSffliAl$AFETY PEAMIT CERIIFICATION� -�`' '� � � W d ❑i here6y cert0y that no excavatan five(5)a more Met In OeD�h into wAich a p¢rson ia require0 to deacend � will be made in connection wiM wark author'ved hy,mis permiC and fiat nokuildiip suucture,swlfoWiip,faisewwk a o�demalBion or dismantlinp thereof,wil��¢:loae�Aaf�thirry-siX,136hfee�high.(ChaO�3.2,Gry 1.An 2,Sec W; 341.Title 8.C.AC.L '�. . � � ` . ` . _ . . 3 ❑As owner�6uilAer,I will nm empky anyoirc m da woik which would reQuire a permit 6om Ne Oivaion of � rc �— Industrial Safety,as nated above,u�kss,suc�persen has apwmit tE Ao suth watY'.frdgi th divirun. �� �._ . :.,� � - " ......, ".`:. . . . y�j ❑Dnisian at Industrial Safery Perm�t No' � r—„� ' ��� � TOTAL FEES GO•�Q � COWSTN11CfqN LENa�AGENCY:i here6y aHirm that thert is a construction IenJinp aqency 1a the perfortnmke � Z of the work for whkh Mis permit is issued ISec.309).Ca.C.1. ' p p +�(� Q(� � tender's Name COMMENT$ ����r C� ��f[-W���LQ I"����_!v p=p Lender's Address . Q CEiiTIfICATE OF COMPLIANCE At�AIffHOFdZATION OF ENTflY:I cntify I have read Mis applkatim arid stah � V.f Mat ih¢infOrmaUan given i9 tar¢tt I agree t0 Comply whA all srate taws aM ciry ordimrca�Wtinp ro 6uildnp y constmetiui,and authorue a repaxnM6ve of the Departmmt of Build'aq and Safety b entm�pon 9m praperry � - - . . .� fur whieh I�aue applieA fa a permrt 1 r th pupose af inekng inspec6aAt. - � � X ��'�,��, lO�Z�9O pECPT NO. J�C� PAID BY��YALIDATION Signature d Applicent w Age�rt Dok . WHITE—Departmant Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Applicants Copy . 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