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HomeMy WebLinkAbout096 (11) ''�` �` �I�'Y OF DIAMOND BAR "��'' pRESS � x-�"/' Cr��ARTMENT OF BUILDING AND SAFETY � F�RMLY -� BUILDING PERMlT JOBSITE -� ,� � APPLICATION PERMIT � USE� ADDRESS ,�� .��.k ; C.�� DATE ,,,.,� NUMBER �'' '' CODE ISSilE ` � '��} TYPE OCC. ?� APN LOT � TRACT DATE r��_..1�CONST. GROUP �� CROS REET �`- "'� SETBACKS ��"15 Z�NIN� � OWNER —i �RONT RW ❑ �'..�` ADDRES '�' `� c3�, � � REAR�� ❑ ;� CIT�+ZJ +��_ZIP TEL. �-3/3� I I SIDEfSIDE 5T'REET _RW ❑ �� APPLICANT TEL. �--� 8lDE ❑ :z — K CONTRACTOR SFWAGE ❑ PUBUC PMT� ;� ADDRESS DISPOSAL ❑ PRIVATE S�.FT./100 GAL �u CITY ZIP TEL. 'r STATE �:� LIC.NUMBER_ GRADING ❑ CU.YDS.EXC. CU YDS FILL n ARCH/ENG/ � N�'E �� � FACTUR F'S ADJ. AREANALUATION •"' DESIGNER ' W 1— .! '� ADORESS LL 2 �� � CITY ZIP _TEL. (� 3 _ � PROPOSED USE � ��� � -k� ''.�- Z a � � ' � 1=F� _ �` � GARRGE ;� NO GWEL. NO. Np� � PORGH � UNITS STORIES BEDROOINS �:� LOT DIMENSIONS m VAL'JATfOfV�. ADJ.AREA 1� NO.OF BLDGS HOW c�UAPlttTY p�$(,',RIPT1ONi FEE �y ON LOT USED Q � � �� � �;� i � _ x,�`Si:�A- Si ��i(!� :/�.`"C(�_.1^ ,. !ICENSED 30NTflACTORS OECI.AflAT;ON I hereW alhrm ihat I am Lcr,nsed under pmv�sions of Chap;er 9 kammennng �� �;_ �9 SecLun i000;�!Oiwson 3 ut the Business aM Pruless�ons Code,and nry hcense is in 1u11}orre and eHect W i'' '� � W _��_ �_ fhVNER L+JILUER CE0.APFTIOk I herehy aflirm ihat I am exempt hom ihe CoMracior's Lrtense Law lor Me followmg � � asur:Sec 7031 5 6usines5 antl°rofe55ians Cade Any uty m mumY whrch reqwres a permt m wr.strxt O� b �rmr npiove,:Ir.mclish,or repau anY slmctwe,pnor lo rts rssuance,also repwres Ihe uppLcant(or such pe�md I .2` —� t- to fde a siynr.J s�.r.ement that he:s I¢ensed pmsuan�to the prnuisions e�the Cantractor's L¢ensc Law IChaptc� [(y ��?¢mm�encing Hr.h Sectron;p001��Onision 3 ot the 8usiness anA Pmfesvans Codel or IhM hr.�s eeempl�hemirom� '� i:t�un][�e 6asis�or ihe a�le,etl ewempuan Any violatmn of Section 70315 6y anv app6ca�u foi a permil su6jects� � �� '�ie ap;�n,-.ant-r.a cnil penahy ol nm mare Ihan five hundred dollars�S5D0)I -�`# - ��� �II rs o�.vre�nl�se prnpertv m mv employees wnh wages as thert sole compensa6on,will da ihe work and�� ��-i--- �� Ih¢svuc�wo�s nnt mtendetl ar nHnmd far sa�e�Sec 7044,Business and Prolesswns Cade The Contraclo�'s Lcense i eZ tt I j;j Law does rai apo�V�o ar owrei nf property who 6wlds or impmves tAxreon,and Wha Ace<5uch work himself �� C.)}-�-- !;�+ a�:YrnutA�lis cwr rmpinYr.es,U�o�+ided[hat sucF�mD�nvemems are not mlended or ofhred fcr sal2 II however � �� � ��,�o�ire Cmir.inc cr imprerenem is sold��vrthm one year ol complenon.the owner-6uilder wdl have fie 6urden a1 pmring �Q�. --� �?�tl�n1^,e A:d nm hmid nr impmva for Ihe purpose af sale 1 �� �, Y� r�7 i�.�1 a�owner�it iEe propeny am euluvvely coNracnn�wrth�icensed ecnvacNrs�o consnuci 7ne pml�:�ISec �� I:ISG,Bnsiness antl Prntessions;ude The Conlracmr's Lmense law does not apply to an owner ol paper:y who S� �= bwlJs ar�mprovev therean,and who contracts for such pro�ecfs wrth a comractorlsl�i.ensed pwsua�t to the Cantreetai's . i 1itzf5e�^�� � ;CONSTRUCTld�1� ;��C��a���,�mp���oe�Sec 8 E P.G IAttach Ceruf¢etel ���,I.PLAN REVIEIN � "�),�� gp�I:atc Owner j �r �L�C�I V...__-..��- :i� 'MIRKERS'COMPENSATION OECLpflATION I here6y a11i�m thai I haue a cerUf¢�te al tonsen� �o sell-msue,m # �0 a cerdficale nl Nqrkeis�ComDensation Insuran[e,or a certihea copY�hereof(Sec.3800.La6.C.I � PLUAABING _._ e:� I s � ❑f.end�ea copy is herehy IWnrshed. I � MECi�"�p1N�Ci/4L .'L a7 I❑f.eruhen capV is hleA.vnh tnz Bwl�mg Inspecuon Departmem or Oepanmem � d GRADING _ ,.0� �2 CEHTIFICATE Oi E%EMP710N FPGM WORNEflS'COMPENSATION IRSUflANCE ihis se[non need not he:ampkttd Q��SSUANCE �a if;he permrt rs lor one hund�ed(EI00)a iess I wruly f6a1 in Ihe pedormanee of Ihe wo�k M�whah tMs — t.o permit a¢sued.I shall nat employ any person in anV mannr so as m 6v.come suh�ecl la thz NbrFers"Compensaton gM�p F� Laws M CaliMmia � W �� �. : .. �.:.. ��PRRK FEE c� Dam Applxant' • '. • : ...� �� NUTICE TO APPLICANT II.after making ihis Wnifiwie'.,qf�EMemptwn,you��s6ou�1 hecame sub�Ec!m ihe Worker's �"'t.S�i�"���.L FEES -.J_+ Compensae�m provisions of the LaCor CaGe.you musl(6rthwith coinDN�vJrt��such Rdyisions er ihis permn shall ��-I he deemed revokal ------ a'�� i'y- pViS10N OF INDUSfBIAL SAFETY PEAMIT CERTIfICA71IMl.,, � ��;,.;,,. ---- — �� C.I�ereby�e��dy thal no excavatmn Irve(Sj diwR•�(�el m deptf�mto�wAmh'�a'person is mpmred to descrnd, �� will be mede m con�ctpn wnh wo�k aulhor¢ed by iliis permrt,and Ihal no huddng euuaure,scilfddinp,(a�sework, � ��- w Aemoitlion rn dismanthrg thereoF,will he more than thirty-sir(3fi�leef high (pnp 3.2.Grp 2.Art 2.Se� ___ :ie 3C1.T�neB.CAL1 �� _c :.' ' � i� �.. .�.' . - - � '� _, ?iG ❑As owner�bwlde�,I will ro1 emplay arryV�e�to do work which waM rEqhun'a pernlii'hom Ihe P��sion of �•- InGrsi�ial Salety.as nohd a6ave,unlesa sucli-person h6s a pamii Io dG such'work'Iruin Nie�7i+awn — •.F _; ❑pnsim of Indusvial Sakry Rermrt Na TOTAL FEES ��_ �.-�. CONSTRUCfION LENUMG AGENLY�I heehy aHirm that theie is a cansrtucWn IeMmp apox.y iw th pe�fermence �r ul the woiM tor whrth mu permit ie�saued�Sec.3097.Crv C.) . °� I.ender's Name COMMENTS =�� �-�� r - 4� ���_ � Lender's Add�ess ' ' d] - . �� CEflTIFICA7E OF COMPLIANCE ANO AUi{qRIZATIW OF ENTRY�I cerrily I have read Mis applitation and sLu � ^} � u� thal�he inlormahan�pven is�areq I agree tn camply wtlM1 all stao?Iaws anA nty aidimnees rel�liiq to huitlinp �/� �;,•' ..�k-(� ~v..r�. �{� �-•.=� "��'r �-.�� � � �,� can a rue a rePresenWtive al the Deprtmenl ai Buildinp md$a}�r 7o p�q���e p�r1Y �-' �,J . _�_ lo which I have applie ihrs permn r iryose o�makmg inspeawns, � -::��� �.� .: �J yg��'�e a'�o�� ��� 3 �rc� � RECPT NO.---.�-����PAIO BY ��.�J �� �'VRE_IbATiOM _� WHtTE—Department Copy,YELLOW—Finance Copy,?INK—ASsessor Copy,GOLDENROD—File Copy,GREEN—Applicants Copy 85106-11/89 -`r_\.! . . . . . �i'-.� �. .. . .. . . . . .. ,. . .. .. . .. .. � __ . . .. . , .: : �„ � . � .: . .� ..... . . . 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