HomeMy WebLinkAbout1493 (17)' CITY OF DIAMOND BAR PRESS
DEPARTMENT OF BUILDING AND SAFETY
BUILDING PERMIT FIRMLY
JOBSITE
ADDRESS
APPLICATION PERMIT tj SE
DATE NUMBER TYPE_CODE
ISSUAPN
D TEE Q� ?+ 9 C? 40 CONST. GROUP
LOT TRACT
CROSS STREET w/k- lZurl b?2 •
OWNER v
ZONING SETBACKS w.,toy WNW
FRONT RW ❑
ADDRESS ✓
REAR ❑
CIT ZIP O/ TE9,1 x
SIDE/SIDE STREET RW El—
APPLICANT TEL?
APPLICANT
SIDE ❑
CONTRACTOR r
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ADDR�S ! �' �
CITY] A'iU o47' B ZIP ,TEL -
STAE
LICT UMBER '— I 2 JQS
SEWAGE ❑ PUBLIC PMT f
DISPOSAL ❑ PRIVATE SO. FT./ 100 GAL.
+ `.
GRADING ❑ CU. YDS. EXC. y CU YDS FILL
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TYPE I SQ FT FACTOR PSF. ADJ. A EANALUATION '
1 y5'1 • -30 3 K.
ARCH/ENG/
DESIGNER ����
ADDRESS /g/8� a+N.9C 6'422 :le. 18 �
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CITY�rd�V/M Zl�r� TEV
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PROPOSED USE ' "
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GARAGE
NO. DWEL. NO. NO.
UNITS STORIESJ— BEDROOMS N
LOT DIMENSIONS
PORCH .
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VALUATION ADJ. AREA
OUANTITY DESCRIPTION FEE
NO. OF BLDGS HOW
ON LOT USEDD�N%'PlK?1-
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LICENSED CONTRACTORS DECLARATION. I hereby Blum that I am licensed under pravisions of Chapter 9 (co mnencing
with Sarson 7000) at Division 3 of the Business and Professions Cade, and my licanse is is lull force and dfact.
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OIVNER BUILDER DECLARATION I hereby affirm that 1 am 9—al from the Contractor's License lav for fine following
reason (Sec 7031 S. Business and Praltssions Code AM City a county which Militias A permit soeanspucl
3coliv m erguthe applKm. far h parol
alter ..prove, demolish, a ", any stroc"ne, p-, to its e . Mars aW
to file a signed statement that he is licensed pusuant ID the provisions of Me Contractor's license Law [Chapter
at he is empt therefrom
9 fcommenctng with Section 70001 at Division 3 of the Business and Profession Code) a M.e
and the bass far Me alleged erzmpbon. Arty vidation of Section 70315 by any applicant fa a pefuut subects
she applicant to a evil penalty M
penalty at nol man five bandied dollars IS50011.
1:11, as owner d the property, w my employees with wages as Nen sole compensation. III do Me work, and
the sbuclae a not intended ar offecd Ia sale (Sec 7044. Susrnass and Pmlesswns Code The Contractor's License
Law does rot apply to an owner of property who fluids a emproves Merton, and who does such work himself,
at thiauyh his own employees. provided that such exprovements we not intended a offered for tate it. however,
the burdmg a improvement is sold within are Yea of completion, the owner bulda wit have the burden at proving
Mat he did not bull Or .prove for The purpose at sak)_
Ell. l. is owner of the prOam taClusiveM eonira(legWig)w�licensed contractors to canitiuct the oculist (Ser
t 7044. Business and Professions Code The Convector's License taw does not apply to an owner of property who
builds or improves thereon, and who contracts Ian such proleets with a tontracta(s) licensed pursuant to the Cmvaetol
Leense taw)
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CONSTRUCTION 1
n ❑ I am exempt uoda See . B b P.C. [Attach Cerbleakf
PLAN REVIEW
°ereOwnerELECTRIC
J
PLUMBING
MECHANICAL
f MRKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of const.. ea sal .sae. a
a cerbbure of V*,ki Compenaten Ins Ancef, a a certded copy thereof (Sat 3800, Lab. C.).
i
❑ carniled copy is hereby furnished
i❑ Certified copy Is hid with the Building I spation Department or Depatman..
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GRA NG
i CERTIFICATE Of FyfMPTI]N FROM IyAHKERS' COMPENSATION INSURANCE. This section need rot De completedN`^
I the permit is la one hundred (SIDE) or loss 1 certify slut in the performance of to work fair which this
- perm .s issued, I Nag rol employ arty permit in arty manner so as to baore sublet to the Mhrkeri Compensalm
Laws of Callame
> y->�
> Care i' ppplcant
'
� N(ITCF TO APPLICANT. M, after inamp Md CerofKate lit faemDvan, you should become a6Kct m dere N'oker's
Compensation provisions of the Labor Code. you must fwth-Ah comply with such provisions or this permit $half
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PARK FEE
SCHOOL FEES
be dremed revoked
' DIVISION OF INOU57R1AL SA91 MITRT FCAIIDN n
Of hereby [entity Mat kvatnn INA (SI ac moa Teel an depth into which a perste is required to descend,
will be made An contrail with wok aulhaitd tv thd permit, and Mat no building structure, suf)oldug, fatsework,
a de.oktKn a dsmamkrg thereof, wet be more than thirty six,(36).leel high. (Chap 3.2, Grp 2, Art 2, Sac
341.T-nell.CACI CITY G.
.
= OAS owner-bwlde l�`wil moi, t!nVlay.pirmos> Lo a work Lv1iKh�veeakl rpuire a permit hoer aka Division of
- industrial Safety. as noted abort, unless such persons has a perms to do such week Isom the division.
❑Di.n_ d Indoori.1 Safety permit No.
TOTAL FEES It
CONSTRLVON LENOMIG AGENCY. I hereby affirm duct tie t is A tonsbnemn Won aWKy by the perfrrsnarKaOWL
of the work fa which this perml i; issued [Sec. 3091, Civ C.).
Lender's Now
lender's Address
COMMENTS
d CERTIFICATE OF COMPLIANCE AND AUTHAZATION OF ENTRY. I cwbfy I have mad this apgk~ and mar
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Mat the nla,me .on given b eared I ayee to ply with a1 state laws and city Ordinats. raleag ro build"
contructuo, nd authorire a:;m.nlahet Oapalmeut d Builday and Safety ser per span the prapxry
era which app.' a this p la cit d anak•g iltpabmi.
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RECPT NO. PAID BY VALIDATION BS
12125�
Signature of Applifielh t a Apert Dap
WHITE—Department Copy' YELLOW—Finance Copy, PINK—Assessor Copy, GOLDENROD—File Copy, GREEN— Applicants Copy
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