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HomeMy WebLinkAbout171 (25) _ .�_ ,...,._-r_,.� __.�, ,,�. . . ..._..--.�-�. -��..., � -- --- �---_.� '"` CITY OF DIAMOND BAR PRESS ',•'� ` DEPARTMENT OF BUILDING AND SAFETY � BUILDING PERMIT FIRMLY JOBSITE APPUGATION PERMIT USE ADDRESS �-��7 ���1l�U CD1;L�z- iSSUE TM�ER ��CODE ` APN LOT TRACT DATE �.� � " `'�� CONST GRQUP o CROSS STREET�(�..�'�L�NG k�'IL- - - zONING SETBACKS "'P"c^�""E"'S `D OWNER-���1^ 4�O5�1 /t�45"�F V►✓1 FRONT RW C❑ o ADDRESS 1�17 �u �'L REAR ❑ ,� CIT�)tA�'�+v^'n �SZZ ZIP f�� TELS9 5�-I JO� SIDE/SIDE STREET RW ❑ o APPLICANT Oc.v�u Lyrz- TEL. SIDE D _ Q CONTRACTOR �.�����-^'' SEWAGE ❑ PUBUC P'MT#� o ADDRESS DISPOSAL ❑ PRIVATE SQ.FT./100 GAL W CITY ZIP TEL. x STATE GRADING C� CU.YDS.EXC. CU YDS FILL y LIC.NUMBER y ARCH/ENG/ t/� T"1t'PE' SQ F'T FA�+CTQR P�. J�1UJ. �kREA�Vf4�[IA'CION ;` , j v' DESIGNER � � o ADDRESS ti„ 2 z CITY ZIP TEI.. (� 3 � PROPOSED USE -� � 4 � � GARAGE o NO.DWEL. NO. NO. ;� pORCH y UNITS STORIES BEDROOMS s LOT DfMENSIONS � VALUA710N ���' ADJ.AREA o NO.OF BLDGS HOW QUAN7ITY Q�„`�`�{��"{Qfi� ��.,�'. W ON LOT USED ,,� � � S � �. i� . F" LICENSE�CO4TRAGTORS DECLARATION:I herehy af�irm that I am licensed ond�Drovisiane of CheD�er 9 Icommenci� � with Sectian 7000�of Oivision 3 ot 2he Business and Professians Code,and my IKenAe is in iull force and eHeal ,.,_� 3 W. - LL ER-BUIlOEA DECLAfl0.TI0N:I M1ereby allirm�hat I am exempt Imm the Conlracror's lieense Law For Me fdlowmg - �reason ISec.7031.5.Business antl Professions Code:Any ciry o�caunry which repuires a permit m connruct �� o alter,improve,demolish,or repair any slructure,Oriar to its issuance,also requires the applicant for such permn �- io file a signed statement that he is licensed pursuant to the prwisians of the Canfraclor's Lkeme Law�Chapter ;'.!�� � 9 Icr,mmencin�with Senion 70�0�of�Ivision 3 0l the Business and Pmfessions Cadel or ehai he is exempt tharetmm ;�.�� y anA the 6asis for Ihe alleged eeemotion.Any riolalion ot Section 7031.5 6y airy applicant Poi�permit subjecis ��;� W ihe applicant m a civil penaAy ol nat more than fire hundred dolla�s(150U�.�. �,_�,;4 i .. � ❑I,as owner of the pmperty,ar my employees w�th wages as their sale campensation,will da Me work,and ���� the structwe is not intended or uHe�ed fw sale�Sec.7044,Bosiness and Piofessions Code�.The Canttactor's Lieense Q � law does not aD01y 10 an owner ol Omperty who huilAs or improves Iheieo�,and who dces suCh work himsetl O � W or[hrough his own employees,prwided Ihat such improvemenis are nat intendM m otlared fir sak.If,however, �:.,��� . m the 6uilding or improvement is sold within one year al campletian,1he ownerbuilder will have the burden fi p�oving :';;c[ � that he did not huil[or improve for the purpose ot sale.) � �. h rn ❑I as awner ot the proDertV.am ezclusively conuactiny with licensed cantracto�s to construct the pmjeot(Sec �� - � 704A,Business and Pmtessians Codc The Comractai s license Law does not apply N an owner al prqierty who ,'R- � ¢ huilds or imprwes thereon.and who comrocts lor such projecls with a wnnactor�s)licensed pursuent W the Cantrclor's , , , � °cen��'"'' CONSTRUCTION i�'z��� �-S � ���. W �I am eaempt under Sec- e.6 P.C.IAttxh Cenificatel � PLAN REVIEW � �� �� 4 °i""ef i ELECTRIC � NARKERS CO ENSATION OECIARATION:I hereM aftirm�hat I have a�erMioate ot cansem to utl-insure.a a certificale of Nbrkers'Compensation Insurance,or a cttiified eopy ihereot ISec.3800,Le6.C.�. -� PLUMBING ¢ ❑ce«�r�ee�oov�:ne�eby t��snee. ;� MECHANICAL o ❑Certified copy is tiled wi[h ihc Building Inspection Department a oanar,me��. �C'GRADING ua Zv„ CERTIFCATE OF E%EMPitON FflOM LNOfiNEflS'COMPENSATlINJ INSURANCE:This sec�bn need nm he romplexd ' ISSUANCE � ��.. S�G� — � It ihe permil is tor one�undred IS100)ar less.I rer�ify Ihat in Ihe pedormance of tAe wak for w�kh thiz �� � � pe It is issued.I:hall:wt emplov any person in anv manner so as to h�cane subject io the Wurkers'Campensation ' S`M�P �i � � = Laws of Calrfornia. W o � PARK FEE o Oa�e APpqW�� L�:�. SCHOOL FEES ��� �...�}��_ � NOTICE TO APP41CAN7:If,aher making this Cenificate o�E�+notiaa vW sMuW 6ecome su6jat Io Ihe WaMer's Canpensation provisions ol the Lehor Coda.you must forthwith comply with such prUvisians w Misµvmil shall - � 6e deemed revoked. . J . p� pVISIIXJ OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: W • � a ❑1 herehy cerldY thal no expvetlon tive 151 a more feet iu Aepth into wM1kh a pefson is tiquved to deacmd. � will he made in connecton uuith work authpixed 6y CMs R�i1.and IArt no Wilding struClae,swNotlinp,fNsework or Eemolamn a dismantNng�hereof,wi�l 6e mrce than ihirty-si��36I leet M1igh.(CM1av�32,Gry 2,An 2,Sec w' 341.Title 9.C ALJ. x 3 ❑qs owner6mlder,I will not empby am�ane ta da wod which wouk requim a permn Imm Ihe pvrspn al � � Industru!Satety,as nated above,unless sucb persan has a permit ta do such wo�k from the divi�ion. � ❑aw=,�,o����n�,a�sa�ery��m��Na. TOTAL FEES �S" �. ` � CONSTRUCTqN LENOING AGENCY:i Mreby afFiim tl�at tline is a tMstruttion IeMiip ApeMy for IM pMformence Z oF the wod for which this ce�mn is isaued�See.3097.Liv.C.1. � Lend"°"a'"` COMMENTS m lenAeYs AEGress '� CEPTIFICATE Of COMPLIAAICE AND AUTFqftl2AT10N OF ENTRY:I ce,tify I M1eve road dNs applicadm md thu 1 y that the�niwmation given�s correct I agree to camply weh all staU hws and cify ardinanca rehtinp to buitlinp . y construc[ian.aM authaiee a rep25entative al the O�pertmeni M BuiNinp mA Salery Oo mar iqon th!praperty = ta which I have applied tor this permit lor 1k ox o1 maldn inspettions. - H � � � � RECPT NO.�,��yZ�L.y4--r.—.—.PAID BY�� `�'' VAUDATION� ' Signetu ol AppiMant or Agem le WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,�OLDENROD—File Copy,C3REEN—Applicants Copy .,. ^r .., ..,�C -.. . . .... ' 3� { . ".�.., -, -<� .,,.r:;., r ;,�..,. .; ...�,....... :. �_.;-a; ..r8-.. ., q.•rer� ;i. ,;4'_na.. . , . . ':[`*- � . ... 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