HomeMy WebLinkAbout180 (10) �'` t��-. CITY OF DIAMOND BAR � PRESS
` ���•" ' DEPARTMENT OF BUILDING AND SAF�_ !
� �� BUILDlNC PERMIT FIRMLY
JOBSITE APPIJCATION j� "� 4 � PERMIT �� USE
ADDRESS �43 S. Leyland Drive 2( DATE _L "� '� NUMBER / CODE
ISSUE TYPE OCG.
>'' APN LOT 23 TRACT 42564 DATE CONST GROUP
�c GROSS STREET Grand & Diamond Bar SETBACKS '""'�""E""�
C� ZONING
°'�• 04NNER Rramal Pa T.imi tac� FFiONT_ RW ❑
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�� ADDRESS C1nP Park P1 a�a ��1 l Q2 _ REAR ❑
��� CITY Irv�E ZIP A�711� TE�.��l�.�� � � SIDE/SIDESTREET RW ❑ _
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�; APPLICANT�ew Plumbing TEL9�7-"�972 � ' SIQE ❑
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;;: CONTRACTOR Ne�a Plumb�n� GontrartorG, Tnr_ SEWAGE � PUBLIC PMT#
�; ADDRESS � 00 R, ar A,g�Qnd AvP_ . DISPOSAL ❑ pR�VATE SQ.Ff./100 GAL.
°; CITY AnahPim ZIP_92$_Q.6.TEL._ ��7-�q
:;e STATE [�26109
��� GRADING ❑ CU.YDS.EXC. CU YDS FILL
�;� LC.NUMBE — "�PE SG� FT FACTOR PS AD.I. AREANALUATIUN
�' ARGH/ENG/ W 1
��' DESIGNER W
°�' ADDRESS iL 2
6:�
t:� CITY ZIP TEL. (� 3
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�� Z
�� PROPOSED USE `�
�.� d GARAGE
�� Na.DWEL. � NO. NO. � pORCH
;°; UNITS STORIES BEDROOMS
�:� LOT DIMENSIONS � VALUATION ADJ.AREA__
�� NO.OF BLDGS HOW RUANTITY pESCRIPTIf3N FEE
� ON LOT _USED �
�
r.c (.1 "
�C U'o 'Sf[1 CONTR.�CTORS DECLARATION I here6y affirm ihat I am I,censed under provisions o1 Ciiapier 9 icommencing � � � �
,= wnh Secuar 700�j o�^urvisian 3 of the Bus!nr.ss and Professions CoAe.and my htense is m!�II b¢e and¢tkct � SHOWER `�
'•; ❑ � � LAVATORY �. J
';+= 71NNEB-3UILDER CECI�RATION I hr.reby aflirm iP�at I am eeempt fmm the Cnntracror's L�cense�a.v 1ur ihe following ,-� - �
,-� •eascn�Sec- 7C315.6usness and Pm(essions Code�Anv crtY m countY whrth requires a peima lo construct, C} �,�„_> S�i�� ��„�,�
eo :dier,inprove tlemolish,or repav any stmcture,prio�m its issuance,alsn requrtes lhe applicant for such parmit Z ,r7 '
i�= ro fiie a signeJ stateinem that he is ur.er.sed pursuant�o the pmvismns at the Canvactor's Lmense law(Chapter m � DISHWAS�IER %
;;= 9;commenuny witL Szcuan 7700I ut Divisicn 3 of the Busmess antl Pmfessinrs Codel or tha�hr.is exempt theiehom � �^--,�.,y
i;L and�h?hasis�ui Ihe alle9ed exemption Any violalian u�SecUon 7D31 5 iry arV apOLcant!or a perr.nt suh�ecrs � CLOTHES WASH.ER y,,,/
'`L I,ne ag{',Ireznt tc a cimi penahy ot rot more Ihan five hunJred 6ollnrs 155001.1 —� � �
'�� ❑I.as cwne�o�c'ie pmoerty.or riy e�nplayees nrth wages as thefr sale�o:npensa!ioc, wtll 1c the w�crk,antl i1
°- GAS SYSTEM OUTL�TS _,
Il;e aim::ure is nm intended m offr.red inr sale�Sec.7044,Business ar.J Rotessions Cale The Conlracmr's L¢ense ¢ HO SE BIB S �� I
r;� :an coes nnt aFD�Y�,ar owner ot proprrq•who hwids o��mpraves thereun,antl who dces such work himseN, �
�++ .r unucrl�I�is ewn en0��yees,pravitletl ihat such inprovanents are nm i�cenden or offerr.0 far sa�e ��.nowever. � / W[�TER H�ATER �
m wP n�,ae�-n���-�nm•,omP���s som witl•!n une year of r.omplenor..the n,xner6wlder will ha�e Ihr.Curder•.ol U�own9 d � �"" -�
� �hal ho d:d rot"mld ar imp�ove for the purpnse af sale,� U
rn
�n ❑I.as uwner ot;+c pmperv,air.exclusrvery coruecucy with licensed cnnnactars to canstrucl the pro�ect jSec {,�J
'04:,Bus�ness a�tl Prnfessions Lude The Convacta•'s Licerse Law daes not a�ply to an owne�of D�ope.rly wha �
��hudds er impmves therean,and whn r.on[racts fur such prolects wrth a contractm(s�6censed pwsuant to ihe Canlractm's
'a ��P°Se���� CONSTR:JCTION
_ _ _
'� ❑ �an cxemp�iinnei Sec �5 PC 1Altach Cer.ilcatel PLAN REVIE�N _ _ ___
i� �aie_ ow�e� ELECTRIC
� 6'JORKEFS'COMPENSATqN�ECLARATION:I hereby affinn that I have a certificate af consent tu self-insure,or
a cxrnl�r.x:e ef Wmkers'Cnmpensanon Inso�ance,or a renified copy Ihereat(Sec 3800.La6 C I PLU MBING �__
� C C>iufie.r.mpy�s herthy fmrished � MECHANICAL _
o Cerufied cuU4•s fileo wrth:he Bmidmg InsOectfnn Departmenl or Oepanment *�S GRADING —��-
ia.� / .�
Z CcHTIF:CIdF OF EXEMPTION PflOM WOflKEAS'COMPENSATION INSURAN;;E This sectioc r•eetl not he campleteA � iSSUANCE / �
� il th?ye.rru:is lor une hundred�,c100j ar less I cenify thal in Ihe pedarmance o� Ihe work fa�which Ihis ���
y �
� pernn is issued,:al'all not employ a��.y person m any manner sc ns l0 6ecorte suh�r.ct m the NMrkeis'Compe.nsaLon SMIP _ __.____
L'JWS Uf CaLfornia
o � PARK FEE �
p Date AVD��cant �
W NlITICE TO l+PPLICANT.If alter makfng ihis Cerirficate of Exempuon,you should hecnme sub�ett ta Ihe Nbrker's SCHOOL FEES ii
� �ampensatior provisions of ihe La6or CoJe,ynu must torihwith comply with such prmismns or this permit shall
�+- he deeneA revokeA
J
� OI41510N OF INOUSTR!Ai S0.FETY PEHMIT CERTIFILAlION� —
W �!��
a ❑I IieieM1y r.erufv ihat no ercavation irve 15j or more teet m de0�h fnto which a penon is repwreA ro descene, an
swi11 he made m canneaian vnth work authonzed Iry this permit,and that na 6uilding structure,scaffoldirg,lalsewark, �
� or dena6nan m dumantliny thereof,will he more than thiny-ss 136)�eet high (Chap 3?,Grp 2 Art 2,Sec
W ��.T�;iee.car,� -�'r�'rr,,��lp`MC�t~�!D f3AR
_ C
� CAs ewrierbuildei,I will not emplay anYone to do wark which would reqwre a permit from Ihe avisian of F f�� �tl�l/� Ari� j��ATY
1— Industria!Safety,as noteU ahove,unlrss such persmi has a permit to do surh work from the drvisian —��,�cr �'��
^� _
W ❑O�o�ision M Intlustrial Safety Perini�Na TOTAL FEES `7
�'CONSfRUCTION LENOING AGENCY I herehy aNirm that there is a wnsrtuctlon lendmg apency tor the perM`mance �.
Z;ol ihe wurk fnr wh¢h this permrt is issued ISec 3091.Cn C I.
�f Lender's Name COMMENTS —
m Lender's Address �
Q�CEHTIFICATE OF COMPLtANCE ANO AUiHOR12ATI0N OF ENTPW I cerufV���e read this aDVucatian and state
e� thal the mlormahon given is correct I agree lo comply with all stata laws and ary wdmaxes relatinq to 6uiHmp
yconsvuc[mn and aNlqn a reD�esematne ot the�epanment af Bmldmg and$afety m enter upon the properry
= fai wh¢h I h g applie rc Ma permit tor the puryou of making inspecuons.
� � � �C ,�/� :� � C�`�G�`,�z����
X Signan�f Applicant or Agem � ' o.,�e� RECPT N� ._��LL/_s�PAID BY VALIDATION
WHITE—Department Copy,YEILOW—Finance Copy, PINK—Assessor Copy, GOLOENROD—File Copy,GREEN—Applicants Copy
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