HomeMy WebLinkAbout102 (5) � � _
.�-��",_
�,,, r'"`w+
-�� � CITY OF DIAMOND BAR � PRESS
`„� •-�•� DEPARTMENT OF BUILDIPIG AND SAF�TY
�UILDING PERMIT FlRMLY
,� APPUCATION ��,� PERMIT U5E
JOBSITE DATE -�t-�-�--{-�--=-TYPE ER ` ��OCCGaDE
AODRESS �r� �' ��' � "r� fSSUE ` /` '
� qp� LOT . , THAC DATE ��.� CONST.._._..�GROUF��
4 y}5
� CROSS 8 EET — SETBACKS
� zONiNG FRONT .� �'-A�j i ❑
OWNER �
o ADDRES �� � �- �, ?* - � � REAR .
w CI7Y�r � �� ZI_,�- l TELf�TL��'/`-'� S� STR ET R1N O
g APPLICANT � ,.,� TEL:���'.�'_ -- SIDE._
m CON?RACTOR °�- H �" - _ -R�.-d'C._
.,= SEWAGE ❑ PUBLIC PNlT �
o ADDRE ' ��1 '� � DISP05AL ❑ PRIVATE SQ.FT./100 GAL_
� CITY � ;�� ZiP � _�' TEI.E.���� �`
x STATE �c�.��
y LIC.NUP�IBER IV v �_, GRADING � CU.YDS.EXC. CU YDS FILL
y ARCH/ENGi � ��� �d � �A�� P� ��• AREANALUA7't�N
`=' DESIGNER W � -- ��^-6`f
� ADURESS �- 2 . �
� CITY ZIP .� TFL. (� 3 "
z �
� PROPOSED USE ��2- '-F=��-•-- 4 ��
g � GARAGE
o NO.DWEL. NO. NO. � pp '
x UNITS STORIES BEDROOMS -
s LOT DIMENSIONS m VALUATION�_ ADJ.AREA
o NO.OF BLDGS HOW � QUAN7iTv DESCRIPTI N F�E
¢ ON LOT USED � ' t�. t j � ` (� , 7 U
.,, �
~ �ENSEU CO!�TRAL?ORS OECLARATION,i herehy aifirm�hat I am licensr,d under provitions of Chap�e�9 fcommencing �
Y rh Sec�ur 1UJ01'��Cn�sion 3 af the Busmess and ProMssmns CcOe,and my I¢eine u n full torce anA eflect w
Q �
3 � � �
� !RYNFR E�JRDEF 7E�LAFATIDN i�erzhV atf,rm Ihat I am eMenu�Imm[he Contracmr�s License Law tor Ihe lollowinp � �
_. �easor ;Sec '0315 5�isiness ar.d Professocs Cade Anp ury ar counry wh¢h reqwres a permit ta construtt. Y) '
�
O a��ei �m;,io�:e.ikmohsh o��e0a�r anY sUuctn�e."v���ar to ils issu�ce.also�eGurtes�A�e a�f�cant la�sach permrt �
¢ m 1de n oi9nrd s�aienzrt iha;r.e is licensnd pursuam to Ihe prmi�ons�.d the Convacmr s L¢ense Law(Chapter {+p
s :f�cmnmera¢r.•x•ri Seabnn 7p001 uf Orvisio�3 cl�he 8usiness and Prnfessrons Code�m ihat he rs n.empt therclrom '�q,
y a^e�uN 6n�is fci�"e a0e9ed e+emnuo� Ary wolaimn ol Secnon 7031 5 Lry eny appLcart'ar a pnmi[sub�ens �
X �hc ap;lmam�o a anil penalq�rl not na:e t6an`rve hundred dollars!55001; "'�
,�+ n-
� ��i ��n�w^.er�d:�e pruperty or ny emP�oY¢es wnP weqes zs then sie comCen:ai•�or..:•nll du Ihe work,and � - -
tlw titni[inre�s aat in!enAr.A or alfere�for salt ISec 7044,3usvess acd�rotess�ans Cnde 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 tl:rnn9r Lis own r.mylcyres.Fro�^Ced Ihat such imprmemems aie not interdetl nr nifered foi sale !1 ha�Heue�, �
m I itie h�aldmn n rip•c�ei-,er.l i,s�lA�r7hir.one year nt complxtion the�wner-bciider wd�h2ve the DWden n)provsnq �
� thai he 4id ret h.ir^or�mprevv br Ine puqose of sale I
y U
V) ❑, a;mrr=r p�he;�opo�.y,ar�erdusively coFttacun�wit�h:ensed conlmctors m construct tlie pro�¢tt�Sec �J,�
'04�,"ouxiness and�iofessioss Cade The Cantractar's lmense lflw Gues nat epply ro an or:ne ai pmpe��Y n�ho �
Z I;u�lds a�nnpmves�ne�?er xntl�hhc canerazu tor suc0 pra�ects wi!D a comracmrls�Imen<ed oursuant!o thz CaatracbYs
¢��i��rs��a�i CONSTRUCTION __ --
W ❑I am:xeiap;wde•$ec _ B 5 PG IAnM�Cerlihplel PLAN REViEW
N '
o pa�r Owner ELECTRIC
� NAHKERS COMPENSATION OECLAR0.TIOhl I here6y a16rm that I have a cernhcate of cansem to self�insve, or ����8l�G,
a:enrt•caze.o''+ve�kers�Gcm�ensatia�Insurance.or a ce�tdud copy theceol lSec 38W,Lah C 1 �
��',J r,o;�i�,ed coay is nerebv hxnrshed � MECHANICAL _
p i'.1`�G;ndien:opy is fiied wtth the&uldrog Inspecnon Oepartment ai ,Ocpanmenl � GRADING
�i�EPTIFICaTF OF E.rEkPT19N FROM`A9RKfRS'WMPE45ATIUN 1NSUNANCE Thls ser.e�m nmd not M:compkten (� ISSUANCE ���
y'�f the pen�nt� for one hundied j5100j m less I cernly Ihat n Ihe �mman[e of die wmk�a� wl+ich thit
p?:mA�s issuetl,I all rot mplay arry Owsan in any manner so as ta re su6�ec1 to ICe iF,ers mnpensatmn� s��P
- � laws�IClit m�J`'� ���� /;' � '
o �/�,/�j� � �� �'�4.�t..��' I W PARK FEE
C ry�n Applir,a '` �
4J NO71f,E TU APPLICANT If afler makmg ihis Cerelicate ol Erempuon,yau sM�N be me subject to ihe 1M1Mker's+ SCHOO L F E ES
� �ompensatmn Vioyisions o1 tne La6m Cade,you musl imthwOh comply�nnF sucfi wu�ons a th�s permrt sFall�
�+- hr.^eemed revokeA � -`--'�—
� ��
¢ pViSICN OF INOUSTAIAL SAfETY PENMIT CERTIFICA710N
W
o ❑I hereGvi cenrfr that no excauauan Irve 15'�or more leet m deDth inlc wheh a person is repmred to descend.!
eC wdl hv.m�de�n co�nechon wnh waik authnved hy thrs perma,and that no 6uildinp stwcture,scafkldmp,fdsewarl,i
d 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:
� ,
3 ❑As awnerhmldeo.I wdl nat empby aayax Io du work wh¢h wuuld rzqwre a permit fmm m�u���,�� CITY OF DiA",�GND BAR
f.- imlusvia:Saleiy,as nateE a6ove unless such person has a Deimit�o Ga su[h wo�k Imm tAe dNisian. �U I LG I��IG AN Q SAF ETY
� '
W ❑U•isinr.of IrJustnai Safety Permn No ` TOTAL FEES (ZO Z-�
� C(1NSTRUR��N 6ENOING M^iENGY�1 he�e6y aifirm th�tlkre is�construcuon kadiq ag�afY ta��VK�� ,
6'7
zIal!he work tar wm[h tMs perm�t rs issued(Stt 3097,Civ.C,I.
�1�e�ner�Name COMMENTS_
m i.r�ders aed�ess
Q CER7IFICATE OF COMPLIANCE AND AUTNORIZATqN OF ENTRY.I ee��ily I have re�d Mis applic�tan�nd shle �•
vy tAat Ine in!armatian grven correG I agee lo camDN wrth all sta�e iaws and ciry artinmces reLahng Io Cuildinp _.
! �unsvun�on and autho a representatrve o1 the 6epanmem d BuiW�np and�/W en� ��he WOR�W
= to�wh¢h I havr app' M�this permrt lor 1he p a km9 inspee6ons. �
� i A ��
X—� � r � �"' RECPT NO. _PAID BY VALJDATION
Siynatur. Apdic t o�Agent Oere
WHITE—Department Copy,YELLOW—Fi�ance Copy.FINK—Assessor Copy,GOLDENROO—File Copy,GREEN—Applicants Copy
. .. _ . _.. _ , . . . , i
. .--�
. . . .. . . ... . . .... .. . . . . . .
_ . .. . _ _ .. . . . _ _ ... ... . - -- - - .. . ..
. . . . ... . . . . . . ..... .......... ... . . . . �
�. a
��
7� . .. ....... .
. .. ; . . . . � :... . .,.... .
. . . . . � , �r/ . h � ... . . .. , _ . _
.. .`� ' ' . . . . . . . . .. .. . .
. . . . . . . .. . .. . ...
r
,. ..... ... .
.
, .... . . ..
. .... ... .
.,. . .. ::..
„ ,: ;, ;;..
,.
..� . :: ...: �. . ... ... ... . ... .
� , ,
''�,a<��..
. .. ,
. � ... .,:.
.;,.;�;;. ::. � -•"
_� ,, � ,
,.Y„ .
.. ....
F:� , .. , . , . . .. ,