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Home My WebLink About1254 (13) - -..__ _._, ,..�. ____,... _. .,.__ _._._ _ _ _�_,.,...n_.._. __. --�._._ �` '�'� CITY OF DIAMOND BAR PRESS DEPARTMENT OF BUILDING AND SAFETY �.�`� . y BUILDING PERMIT FIRMLY JOBSITE APPUCATION PERMIT U3E ADDRESS �1'�� DATE NUMBER CODE ISSUE „_� TYPE OCC. 4 APN LOT TRACT DATE �' CONST. GROUP o CR05S ST ET SETBACKS �� °-' OWNER � �- ! ZONING FRONT' Rlly ❑ o ADDRESS �b �- ' REAR ❑ W CITY �l�Y� ZIP��TEL.� �'`'�7I7 � SIDE/SIDE STREET RW ❑ o APPLI�ANT � � U �.. r TEL�'f � J - SIDE ❑ Z � CONTRACTOR � � fJ SEWAGE a ADDRE S 1��J1 D _ DISPOSAL CI PUBLIC PMT� ,� CITY � -C� ZIP� ��' TEL. Z�'i.'- ❑ PRIVATE SQ.FT./100 GAL L�J x STATE � ,,�,� y LIC NUMBER ��;�:�,�,� GRADING ❑ CU.YDS.EXC. CU YDS FILL y ARCH/ENG/ (n T�� Q � �� p� " �a�f. ARER�IJ/�[.UATIOhf `—' DESIGNER r �l' 7 �l1 ��4'- �W 1 , �j� 1 � X ��. � p ADDRE `"�-� -�C. D � � 2 c�i� Z-f' '� C$� t-1' = CITY d831.. C d�t�f: ZIP � TEL. (� 3 C� � , f.7 � , �,�.� �Z f l9� � PROPOSED USE �` 4 � � GARAGE z NO.DWEL. NO. NO. � pORCH �, UNITS STORIES BEDROOMS � LOT DIMEN510NS - m VALUATION � � ADJ.AREA o NO.OF BLOGS HOW QUANtITY p�SCRIPT#ON �� W ONLOT USED Q °C � U W � S ~ !�CENSEO CONTPACTORS�ECLARAi�DN I Fere6y affirm that I am licensed under provisions ol Chapte�9 Icommencing � Y wrth Sectmn 1000)ol Oivision 3 of the Business and Pmfessions Code,and my iicense rs in lull torce and elfecL � O I�I 3 L�J tj . � TNNEfl�BUILDER DECIARATiON:�here6y attlrm ihat i am eaemDi fmm ihe Comracior's Lianse Law Im me iWlmving Z ieason�Sec 7031.5,Busineu a�Pmfessions Gotle Any citp or counry which cequires a permit to construct, (} O alter impmve,tlr.muLsh,or repau any s[ruc;ure,Orior to ils issuance,also requires�he applicant loi mch permrt Z �-- �o file a signed statement that he is licensed pursuam to ihe provisfons of the ConVactor's License Law(Chapter ��p � 9 Icommencing with Section 700D)of Division 3 of ihe Business and Professions Codel or Ihat he is exempt iheretmm T`. � antl��e 6asis Im ihe atleged e�emplion Any violation of Section 1037 5 6y any applicanl Por a permu suqens � "� +he aDU�uant to a civil penaAy of roi more than five hundred dollars IS5001.1. � W � ❑I,as owne�ol 1M property,or rtry employees with wages as Iheir sole compensation will da the work,and the stmcture�s nat mte.nded or olhred loi sale ISec.7044,Business and Professpns Code.The Contrac�ar's License s[ � Law Does nut apply to an�wner of pmpenY wAo huilds or imprrnes 7hereon,antl who tices sucA work himself, U ' or through his own emDlovees,D��ded thal such�mprmemems are not mtended or olfered for sale If.hawever, � � m me 6uAdmg or Impmvemem is sola wnhin one year of compleLon,the owner�buildn wid have ihe burden ol pruving Q � thai hc dfd noi hui1C or�mprove for Ihe purpase of sale.) � ti ❑I.as owne�ol the pmperty.am exclusrvely aomiactlny with imensed wmracrors m mnstmct Ihe projea ISec � 0 7044.Bu�mess anJ Pmfessians Code�.The Comranor's License law tloes no[appty to an owner ot pmperry who � ¢ mdtls or impmves ihereon,and whe controcts fm such Droiecls with a comranarlsl licensed pursuant M the Contracla's License Law.� . L•�NS•TRUL•T�Q ��Q � �..�� 0 /� � ❑I am exempt under Sec ,B.&PG.IAuach CenAicahl. ,_�E �:1��.��p '� , �� p 9ate Owner EIECTRIC { � WOfiNERS'COMPENSATION DECLARATION I herehy aflirm thai I have a certilicate of cansem�o selbinsure,w a cernficate ol Nbrkers�Compensation Insurance,ar a certitied copy thereot(Sec JB00,lab-C.I. PLUMB�NG Q ❑Certitiea copy is hereby turnished J MECHANICAL o ❑Certified mpy is hled with fie Bwlding InspecLon Department or pepartment. �. CjRA��N(�j � ' W � �ERTIFIf.ATE OF EXFMPTION FROM WORKEAS'COMPENSATION INSURANCE�.This settion need not 6e compleied ISSUA�. � �� 1 ihe permit Is lor orre huntlred�5700)o�less.I certify ihat in the perloimance of the work lor which ihis �i,,,. �� pennrt is rssueC,I shall irot employ any person in any manner so as to hecome sub�ect ta Ihe N4rkers'Compen5ainn _ = Laws nf Calitorma. �� , � E,"'? , a ;,� ;1 W PARK FEE p Oa�e pqpl.c,�nt�,...z�. �`_� � NOTICE TO APPLICANT�.It,ef�er making�his Cei cate"81 E.�amptiafi'yw shouN became subjat to the Nbrker's �- SCHOOL FEES —+ Compensation provuions al I�e La6or Cotle,you must tanhwnh comply with such O�a�a�ons w this permit shall � he deemed ievoked. a W �IVISION OF INDUSTRIAL SAFETV PEFMIi C�f��,I$��TIONr! � ��"� 0 ❑I herehy certify�hat no excavation tive�5ror more�eei�Pn�dept� nW which a person is requiied to descend, 0o wdi 6e made m comiecnon wllh work authar¢ed by this permi(and�hat no buildinp stru[tur0.scaffilding,I�luwark, � or demohtion or dismantling therea(will he more[han thirlY-sfx�361 feet hfgp.�fhap,3.1,6ry 1,Art 2,Sec W� 341.Tltle B.C.A.Gi. �.�,."('..,1� ( ... . ..<., � . .i'i m ,:.c. .�.,., .. 3 ❑As uwnerbuilder,I will noi e�bjLapirone in do,wort.wNch�woulA�le�urre i pimit hom ihe Uvuion M �— Industrial Safety,as noted above,unless suah permn has a Dermil ro da such work from the drvision. � � W ❑Oirision of Indusnial Sahty Peimit No. TOTAL FEES � �� CONSTRUCTION LENOING AGENCY:I herehy aHirm mat lhere is a construction lendi�agency fa Ne perfarmmce � Z of the vrork foi w6ch mis permit is issued(Sec.3097,Civ.C.I� � Lentler s Name +—+� C�MMENTS mLender's Address , 'Q CEHTIFICATE Of COMPUANCE AND AUTFIORIZATION OF EMflY�1 cmtify I have road this applicrtion and sn4 �n ma�rhe�nformation given is caact.I agree to amply wiq�all state Hws and ciry ordinairces relaunp M GudCinq y canstruciion,and authorire a repreuntative of the Oepartment of Buildinq aiM SaFety ro entn�qon Me prape�ry = for which hare a 91ied permit lar 1M purpose of makinp inspectiom. � ~ X 't [ b � � p� s�j�� — siqnamre m npo�ican� 'nqem De� — RECPT NO. � PAID BY[d�t" /�L>��UDATION r WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOIDENROD—File Copy,OREEN—Applicants Copy BS106-11l89 � „- �: - , .,. ,. ,. e , — — ,. _-- _.s - . n .. � <:; � s�1.: . � ...: , k. . . . .�r . . �,. ,�� ``be�i� k£�ii�(g",,� �i `�33��:�.��°�� a,��`** �� 'E r' . l„s�''�a � ii .�6b k sa�`�.£�A b< .4�s�.�.,. . ,. , w �ivfb s��: 3ffiE � rs�, �Y. } $..� 2�¢ � $��”'x , i��:� 7 i x."�:},r 1 n�.s.��A s k� n S'''.d.. .�� €A.s� .�„::si# � � �: � S�;�;iptar� ` �` 1�,�..:r.is�� t� r�,-j�'.� :s ,�s?s' ��ss€.��;��j.s E„��Y24�'�'��h`�'�3?,�'��:,��e'�.��a ��?;Ysi �.. ,�"s�?"��"`�""�`"�.`��a��:�',�k`�,:�'��,. �4i�� S.<��f��t�€r:', ��t� �'ta�s �}��`��u€ ��r:� y��t=�� y „ 3 ��. �� .�'� ��s ;�.. � �s ��z�s�� E � i s, � ��a � �-3` �,� �,�" .�,�.e m � s��i s��:n��3ssn - � �':�.'�',��'��so-��€�y 3,� .��s.F,�.� 7 �'..�,t�i�i ; � a I i� ��Asa��zw.��I�.: � � :> � � :<'� rr,� ��R��'t��. � ��s,;,�,:.; � �`:.i, s,, ��, �•�.�i� .:.k �� a'.'� �i .,�.i �a5 .3�. 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