HomeMy WebLinkAbout102 � � _
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-�� � CITY OF DIAMOND BAR � PRESS
�„� •�•�� DEPARTMENT OF BUILDIPIG AND SAF�TY FlRMLY
:.� �UILDING PERMIT _
JOBSITE DATE CATION� , S , �,,.i� NUMBIER � �Z' aSDE
AODRESS �r� �' ��' � "r� fSSUE ` �`°+�—TYPE � �` � OCC.
� qp� LOT . , TF3AC DATE ��.� CONST.—'�_GROUF��
4 y}5
� CROSS 8 EET — SETBACKS
� zONiNG FRONT � �'-A�j i ❑
OWNER " �
o ADDRES _!��-- G �� ?.f � ` � REAR .
w CIYY�r � '� ZI_1�- l TELr�TL�'/`' SI STR ET R1N O
g APPLICANT � ,.� TEL:���'.X�'_ — SIDE._
m CON?RACTORr'�- H t" � _ -��,�L_
.,= SEWAGE ❑ PUBLIC PNlT �
o ADDRE ' �� '� � DISP05AL ❑ PRIVATE SQ.FT./100 GAL_
� CITY � !�� ZiP � _�' TEI.E.� �� ��� �`
x STATE
y LIC.NUP�IBER ���� GRADING � CU.YDS.EXG. CU YDS FILL
y ARCH/ENGi � ��� �d � �A�� PS kC)J. AREANALUA7't�N
`=' DESIGNER W � -- �=^-6`f
� ADDRESS �- 2 . �
� CITY ZIP .� TFL. (� 3 "
z �
� PROPOSED USE ��2- '-F=��-•-- 4 ��
g � GARAGE
o NO.DWEL. NO. NO. � P0 '
x UNITS STORIES BEDROOMS — - ADJ.AREA
s LOI DIMENSIONS m VALUATION�_
o NO.OF BLDGS HOW � QVANTRY DESCRIPTI N F�E
¢ ON LOT USED � ' t t. C j � ` (J , 7 U
.,, �
~ �ENSEU CO!�TRAL?ORS OECLARATION,i herehy aifirm�hat I am litensr,d under provitions of Chap�e�9 fcommencing �
Y rh Sec�ur 1UJ01'��Cn�xion 3 af the Busmess and ProMssmns CcOe,and my I¢eine u n fWl torce anA eflect w
Q �
3 � � �
� !RNNFR E�JRDEF 7E�LAFATION i�erzhV atf,rm Ihat I am eMenu�Imm the Contracmfs License Law lor me toliewinp � �
�easor ;Sec '0315 5�rsiness ar.d Professoes Cade Anp ury ar counry which reqwres a permit ta construtt. O '
�
Oa��ei �m;,rove,ikmol�sh o�•e0a���ny structn�e,p���ar to its�sm�ce,a�so�eGurtes�A�e ap�l�cant la�s�¢n pe�mrt �
¢ m 1de n oi9ned s�atenzr[Ihdl h.Q i5 IiC¢OSnd PLf5118N to Ihe prmi�ons�.d the Convacmr s L¢ense Law(Chapter {,�1
s :f�cmnmera¢r,•x•tl�Se-6nn 70001 uf Orvisin�3 cl�he 8usmess and Prnfessrons Code�m ihat he rs n.empt therclrom '�S,
y a^e�uN 6n�is fci�"e a0e9ed e+emnuo� Ary wolaimn ol Secnon)031 5 Lry any appLcart'ar a pnmit sub�ens �
x �hc ap;hcar.t�o a anil penalq�nl not ma:e t6an`rve hundred dollars!5500I; "'�
,�+ n-
� ❑i ��x�w^.er'd t�e pruperty or my eriP�uYees wtlh wa9es zs then sale comCen:a•�or..vnll du Ihe work.and —
tlw atni[inre�s aat in!enAr.A or alfere�for salt ISec 7044,3usirzss acd�rotess�ans Gde Th.Con[nrtur s I.ir.enze �
',~j�Lem :loes rr.t a�ply tr.nn owne�of�roperlY w'hn Gwltls a improves thc:wn,and w�o ders such wmk`imsell (�
•.• i ibrnn9r Lis oan r.mylcyres.�ro�^Ced Ihat such imprmemems aie not interdetl nr nifered foi sale !1 ha�Heue�, �
m I iLe 6i;iidinn r�rip•c.er�!r.l i>s��A�vithin one yeo�nt compixt+on the�wner-bciider wd�h2ve+.he DWden nf provmp �
� thai he 4id ret h.ir^or�mprevv br Ine puqose of sale I
y U
y ❑, a;myr=r �•�ire;�ope!!y,a-r�erdusively coFttacun�w�i�h:ensed commctors m construct tlie pro�¢tt�Sec �J,�
'04�,"ouxiness and�iofessioss Cade The Contractor's lmense l�w Gues nat epply ro an or:ne ai pmperiY x�ho �
Z I:o�Ns ai nnpmves mer?er xntl�hhc can�razu tar suc�pm�ecis vri!D a comracmrls�hcensed purwant?o thz CnatractoYs
¢��i��rs��aH i CONSTRUCTION __ --I
W ❑I am:xeiap;wde•$ec _ B 5 PG IAttM�Cerlihplel PLAN REViEW
N
o pa�N Owner ELECTRiC
� NANKERS COMPENSATION OECLAR0.TIOhl I here6y a16rm that I have a cernhcate of cansem to self�insve, or ����8l�G, I
a:cv!•ca!e o''Ne�kers��„cm�ensatioa Insurance.or a re�td�ed copy theceol(Sec 38W,Lah C 1 � I
z!.��,/c�:�����e.o�r is here6y fmmshed � MECHANICAL _
p i'.1`�G;ndien:opy is fiied wtth the&uldrog Inspecnon Oepartment oi ,Ocpanmenl � GRADING
�i�EPTIFICaTF OF EdENPT19T1 FROR1`A9RKfRS'COMPENSATIUN 1NSUNANCE Thls ser.e�m nmd not he compkten (� ISSUANCE ��3' ��
y'�f the pen�nt� for one hundied j5100j m less I cernly Ihat n Ihe Imman[e of die wmk fa� wnich tNt
p?:m:t�s issueA,I II rot mplay arry Owsan in any manner so as ta re su6�ec1 to lCe iF,ers mnpensatmn� s��P
� = laws�I Clit m /'' ���� /r' � '
o n�n ����� va. � . ! � L'�4�L��` I W PARK FEE
A lira �` �
4J NO71f,E TU APPLICANT If ahr.r makmg ihc Qrelicate ol Erempuon,yau sM�N be me subject to ihe 1M1Mker's+ SCHOO L F E ES
� �ompensanon pmyisior.s a1 tne la6or Cade,you mnsl lathw�lh comply�nflF sucfi w�aons a th�s permrt shall�
�+– hr.^eemed revokeA � –`--'�—
� �
¢ pVISICN OF INOUSTflIAI SAfETY PEHMiT CERTIFiCA716N
W
o ❑I herebY cerldy Ihat nn excauaUan Irve 15'�or mare 1¢et m deDth inlc wheh a person is repmred to descend.�
� wdl hv.made�n co�nechon wnh waik authnved hy thrs perma,and that no 6uildinp stwcture,scafkldmp,fdsewarl,� —
or deinolmnr ur d:smantlug ihe�e.nf w�ill be more than thiny-siy 1981 feet high (CAaD 32,Gtp 2,Art 2,See� __
Z 761.T,�Ic 9 f.A C:
Y ,
3 ❑As awnertwddeo.I wdf na�emplay anyax la du work wh¢h wuuld rzqwre a per¢+it fmm m�u�,��,�� CSTY OF D1A",I1GND BAR
f— imlusvia:Saleiy,as nateE a6ove unless such person has a Deimit�o Ga su[h wo�k Iram tAe divisian. �U I LG I��IG AN Q SAF ETY
� '
� ❑U•isinr•of Ivdustnai Safety Permn No ` TOTAL FEES '�O ��
� C(1NSTRUR�ON 6ENOING A5ENGY�1 he�e6y aifirm th�tlkre is a construction leadiq ag�afM��1he RrMrtnna �
6'7
zIal�he work tar wm[h tMs perm�t rs issued(Stt 3097,Civ.C,I.
�1 lenAeYs Name COMMENTS_
m t.r�ders aed�ess
Q CER�OFICATE OF COMPLIANCE AND AUTNORIZATqN OF ENTRY.I ee��ily I have re�d Mis applintan�nd shle �•
vy tAat Ine in!armafian grven correG I agee lo camDN wrth all sta�e iaws and ciry artinmces reLahng Io Cuildinp _.
� cunsvucuon and aulho a representatrve o1 the Uepanment d&:iknnp and�/W en� �the NOR�N
= to�wh¢h I havr app' M�thrs permrt lor 1he p a km9 inspee6ons. �
� , A ��
X—� - r � �"' RECPT NO. _PAID BY VALJDATION
Siynawr ApdK t or pqent �"te
WHITE—Department Copy,YELLOW—Fi�ance Copy.FINK—Assessor Copy,GOLDENROO—File Copy,GREEN—Applicants Copy
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