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HomeMy WebLinkAbout1233 '� ''� CITY OF DIAMOND BAR PRESS .�, ,' DEPARTMENT OF BUILDING AND SAFETY �^� BUILDING PERMIT FIRMLY DDR'ESS ���� �N�`�� C�:E�}�- DATE CAl10N...--� �,.� �, �B R 1,�!=� ✓ COS E s�� ISSUE 1 .,C TYPE OCC. 6 APN LOT TRACT DATE ��� 1� �CONST: GROUP � CROSS STREET ���Q1t.�C1_�Z- SETBACKS �wE►Er�rs =-' OWNER �bI![�c��ICW�_C.� ��CC�i-� ZONING FRONT Ryy ❑ � ADDRESS `2'2-��..,;►i.lb t4.t�1 CP���, REAR ❑ „� CITY ZIP�'I��TEL.�� SIDE/SIDE STREET qW ❑ a APPLICANT TEL. ��Ktu.9 SIDE ❑ z Q CONTRACTaR SEWAGE ❑ PUBUC PMT� o ADDRESS DISPOSAL ❑ PRIVATE SQ.FT./100 GAL W CITY ZIP TEL. = STATE GRADING C❑ CU.YDS.EXC. GU YDS FILL y LIC.NUMBER � ARCH/ENG/ �/ � TYI�E ,SQ FT �iCTC3R �S " AL�.1, AREA/VA1.WA't'10N `` = DESIGNER l��`n���� W 1 o ADDRESS 6� � 2 = CITY -�' ZIP�17fns TEL. �r 3 � PROP05ED USE r `' 4 � < < � � GARAGE � . . Z NO.�WEL. � O. �• � PORCH y UNITS STORIES BEDROOMS � LOT DIMENSIONS m VALUATION ADJ.AREA o NO.OF BLDGS HOW (;lUANTrTY p��`����"�Q� '' F.*�� -, W ON LOT USED Q °C � U W � � tICENSE�CONTIiACTORS�ECIARAT10N:I hereby aifirm that I em licensed undei provisions of Chap4r 9(commencinp ; � � with Section 700D)ol Division 3 ot the Business and Prnfessions Code,and my license is in full forre antl eflett. W � � LL QW .�BUILDER DECLARATION�I here0y affirm that I am exempt from tAe Comrazror's Liceise taw for me Idlowing Z reas n ISec. 703L5,0usiness and Prafessions Cade�Any uty or caunty whkh requiies a permit to cunstrucl, � (7 ��- . ����. + r�- . � r� o alter improue,demdlsh,or repair airy struawe,prior ta its issuance,also reQuires the applican�iar such permit .� Qto file a signed statement Ihat he is Fcrosed pursuant ro the prov¢ions of Me Contraclar's license Lew�Chapter y�(j�� pp 9�commencing with Section 70D0)af Oivision 3 af�he Businesc anA Pmfessions Code)or Ihat he is e�empt therelmm , �4. a, and the hasis br the allegetl eiemptbn Arcy violatwn af Section 7031.5 by any applicant for a permh subiecis -- � � the applicanl to a civil penally of not more Ihan live hundred dollart(5500�.�: - -3- W a � ,as avner af the property,or my emplayees with waqes as Iheir sole aompensrtion will da tAe work,and � t «ucmre is not intended or oifered for sale�Sec.7044.8usiness and Piofessions Code:The Cantracmr's litense �cQ_ ,,,,�\ \ � � Law tloes not aDPly to an owner ot DmDerty wha 6uilds or imOrmes thereoa,and who does such wark himuil. �� (J- t'�� ' or throuqh his own employees,provided ihat suth impmvements are no[iMended w olMred for sak.If,howeve�, ; � ' m ihe hui��ding or Impravemem Is sold within one yea�of completian,ihe awner6uildei will hare the burden oi prming -e( = ihae he diJ not budd or impmve 10��he pmpose of sale.) .;�' h h ❑I,zs owner of Ihe property,am ezclusively contractiny wi[h licensed conuactors�o construcl Ihe proj¢ct(Sec. ':��- 0 7044.Business antl Professions Code:The CoNractoi s license Law does not apply ro an owner of Droperty wha � '�. 2 huilds or impmves therem.and wha contractt fm surh projectt with a cantiactarls�licensed pwsuant lo the Contracto/s " �1e"SeLdV"� CONSTRUCTION o ' � ❑t am exemot under Sec B 6 t� PLAN REVfEW 0 oa1e °�""" ELECTRIC � WORREHS'COMPENSATION OECLARATION:I hvetry alfiim Ihat I have a certffic�te al cansent to sNf-i sure,a � a cemllcate of NbrMeri Compensalian Inswance,or a rertified capy�hereM(Sec 3804 lah.G�. NG a ❑Cenitied coov is here6y turnished. ME(.'�-{A(��(i`AL, � p ❑Certified copy Is�iled with Me Buiiding Inspec�im Oepa�tment or Departmenl. W � Z CER7IFICATE OF E%EMPTION FROM WORKERS'COMPENSATION�NSUR4NCE:This section need nm 6e compkted ��� � ` � il ibe permit is for one hundred{5100�or less.I cer�rfy tSat in[he pedormance o�Ihe wak for which-ihis -;�,,,, y permit is issued,I shall not employ any person in any manner so as ro 6¢came subject to�he Nbrkms'Comcensaiion ' SMIP � laws of California. p Oate APp,,�a,�.�� ��' � �`� �`'� �� PARK FEE � NOTICE TO APPLICANT�.N,alter making this Certilicate of L�IemO� V�sMuW�6ecare subje�t tn Me Waker's �-�SCHOOL FEES � Compensauan pmvisims of the Labor Code,you must farthwiM comply with such provispns a this permit shdl , LL he deemed revoked. � J ���� � qVIS10N OF INWSTRIAL SAFETY PEflMIi CERTIFICATIqJ�� W d ❑1�emhy certrfy that no ercavalion five�5�ar more�eet in dept�inta which a persm is iedufred ta Ancend, � will be made in connection with work autlarued by tks permit and ihat na huildinq suucture.satfoldinp,hlxwak. or demolltion a dismantling tlxreo( wdl 6e pe Ma th�ty sir �36�}eet biph.(CheR 32,&ry�2,Art 2,Set m W341.TItleB.C.A.C.I. �..,E..,�-. �:��..:: Sx�it�:,'.,a.i . �.�;��U: 3 ❑As owrier-6uilder,I will not employ anyo�;`tn,.yd'o Vlo�k��whtik wndd t[qluird'a pfrmi4'hom�tlie Di�ision ot 1— Industrel Safety,as roted aEove,unkss such person hes a permit to do such work trom Hrc division. � : W ❑Gvision ol industrial Salery Pertnit Na. ��0��� ���� . d � CONSiRUCfION LENOING AGENGY�I hereby atlirm that there is a wnstruction bnd'pg a0en�y iw IM perlamance x at the worM for which tliis permil ia isaued�Stt.3097,Civ.C.�. � lender's Name COMMENTS m Lender's Address Q CERiIFICATE Of COMPLIANCE ANO AUTNOIqZATIpV OF EMIIY:I cnMy I have road Mia appGc�tian and sute t� ihat ihe inlamatan given is carect.1 e to wmply witA ail slate laws ard eiry o�dinances robtiq to 6uitlinq N construction.and authon:e a repesent ai Me Oeparimen�ot BuiMbnp md$afetY to�nop ipm tlie properry = br whic I e applied for Mis ma o the purpou of kinp inspet5ons. ~ X ��u� "''� t / � �� �� " �� RECPT NO. i�_PAID BY � 117� Signatwe of Applicent ar o.e� VAUDATI WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—Fle Copy,GREEN—Applicants Copy BS10&11/89 ��q.�� ' � �c.�,. �.t�-'�.+� ...n.5. ,._-> r . . . . t . . 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