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HomeMy WebLinkAbout092 (11) , ''�` ;�`' �Il'Y QF DIAMOND BAR �" ppESS �� '�" ' C,��ARTMENT OF BUILDING ANC�SAFETY �� BUILDING PERMIT FIRM�.Y APPUCATION PERMIT � f USE JOBSITE ; �--- � c� � ' � DATE NUMBER �--� CODE ADDRESS f ��'h'` ISSUE ��'�� � '> TYPE >'- APN LOT f TRACT DATE �_1�..� �, ��-�'d CONST. GROUP �' CROS�T REE�'/-�`�GiI� C'�2�si' SETBACK.c'r `n"°"E""E'"5 °��"`OWNER�Z�...-I•�'--c:�t.r�- �ZC}N11VG FFiON7 RW ❑ �:'I ADDRES "u°c��IC�I.G!-�l�- �•� �'r"�- / d� i ^ � ��A�f� ❑ u;; CIT�:2-� ��g-- ZIP .__TEI�.�i��1 StDE;SIDE STREET RW ❑ _���APPLICANT� TEL.� � S!€�E ❑ �:, �:: �;: CONTRACTOR �:� 6., SEWAGE C] PUBLIC PMT� �„ RDDRESS i u'.; CITY ZIP �TEL. �ISPOSA� ❑ pRIVATE SQ.FT./100 GAL �;� STATE o.: LIC.NUMBER�_ GRADlNG ❑ CU. YDS,EXC. CU YDS FILL u' ARCH/ENG/ � �`�'� i�Q i--i' FACTi7R PS AD.1. AFtEANALUATION v:� `-°'• DESIGNER � � � ,_ a:: �' kDDRESS (� 2_�_ G:1 �� CITY ZIP TEL. (rj 3 ' �,. u.� � .� _ _ g�� PROPOSED USE �G`s� G - ic��' ,L-, '�-- '�. 4 a:� — — �' Q GARAGE� �� �; NO.DWEL. NO. NCL � pORCH � ^ V; UNITS STORIES BEDROOMS _ � -�----�— o:: LOT DIMENSION•S VALUATfON____ ADJ.AREA �{ NO OF BLDGS HOW �QUANTITY DESGRl�T'IOTU FEE �:� ON LOT USED E.' i :� o:: U l� �. �� ❑ � � = s'�' �" � P ��{._ �"" LICENSEi CONTqACTORS DECLAFlATIOIJ i herehy allirm�hat I am Loensnd under provimans of ChaMr�9��on:menang V' ^— � � - ��� ��`��1� ��'{• 0: nn�Se:;on!0001 uf pieision 3 0�the Bucmess anA Pmfessions Lode and mry I¢ense is m full Imce and eflxn W ^� `� c:� � _ _ �:: ❑ � w �+:; J6VNF.H�BJ!L7ER O:CLNRF710N I heie6v afhrm tha�I am exempi Irom tCe Comraaa's L�cense L�w lor me foliovring� - '"— �,; renson�,Scc 703�5, 3usiness and Prolessions Cade Any uty ur caunty which reqwres a permA tn conslru[t.� � . i Ca alv:i a�piove tlerionsh.nr reDair ar.V stnKtwe.n�ior to its nsuan[e.also;epmros�he aOP���an1 lar sucM1 q!rmi�` 2 — — H-� Ic;Pr,a sigrr.d staremen�;hal he ix I¢ensed�ursuani�o the p�evisions ul Ihe Conttactar's L¢r.nse Law IChapte�! (b � � � � • � . � � ''� �; 5 lir.mmenur.,�utth Seclion 70",01 cf 7rvis�on 3 nl Ihe Buvness anA Proless�ons f.adel or iha•he rs saempt[herr,fmm{ �S p;, nn�-Ce Guss�ci tl��e alle�etl exemp;:on Ar.y vinlalion of Seclmn 70315 6y any appheant for a permit sub�ecls � �"�� rie ap;ror.art m e u�i�penalty�'•�o�mom than!ivx hur.dred mllars�550U1'• � � --- u.i ��' �JI.as nw^.ei r,'!Ire o«De�4-n�niy empiovees wnr wages as fieu sole cymDensa�ion,wdl Ju me wark.antl I ----�- ~ Ihr.cui:clnr�is�ut�nendr.d a�olfereJ lor sale(Sec 70C-M1 Busness and Pmfessions Code.The Carnracror's License Q �;� Ln�.a does anl aCFly m an ewrer el pmperty who hwids or fmA�oves Ihereon anC whn dces sm�h warM himselL I C� -�---- ----. �;� ar urmigh^rs ewr emploYees,prordeA that suoh imprmemenls are not mtended or clfered fo�sa�c If,however ' Z otei iiu�ii,ulmo::impmvenert rs soid wnhm ane yeai ol cdnpleuon.the owner�6mlde�will have iM1e hwden of provmg j �Q ._—_ �� mat�e A:tl�i2i hmld or inpiove lor;he purpox ol sale.) ': � _i �I,ai nwne�u!�he pmpeny am esdusi�ely cm�tracbny witn Lcensed contnt�ors ro cnnstmct�he pro�eet(Sec I � �—'-'-- ?04a,8us:�ess and Profr.ssions CoAe The Cor.trxmr's i�rortce Law does nal apply lo an ownd o�properq�who � �4 c�� hu:lds cr improves iherean,and whn contracts lai su�h pm�ecis with a:antracmr�si Immsed pursuant ta Ihe Cor[racmr3 !--' — —" �� L¢ersrlaw, � CONSTRUCTiON _ �^''� �! C I::m eaemp;urv]er Sr.� .B fi PC 1Allxh Ceiuf¢alel � }S�/�R�.�/_--��__,_ i;�� �`' °at" °'""" ELECTRIC ____ _�; VrUflNERS'�OMPENSATION OECLARATION I hereby aPoim thac I have.a cendicate u1 crosem to sell-msure,or . a:erUl¢a?e il Worters'Campensalian Insurance,or a certdied royy thaeol(Se�]500,La6 C I � P�.0�8��� __ c� i �•� ❑ce�,n��:a�our rs herehy hxmsheA � MECHANICAL �r. e:i r f.enJied:opy is hled wrth the Ruudmg Inspeceon�e0artmem or Ikpanmem � GRADING .i ��� f.ERTIFI:ATE OF EREMPTION PROM NNBKERS'COMPENSATION INSOflANCE This section neetl not be oampleted ISSUANCE �:� d ihe pe.rmtl is for ane hundred(5100�m less I cerMy that m the perlormance nf�M;wark for whKh iMe {,,,. — - ' permn�s asi�e0.I shall nul employ any persan in anY manner sa as to become sub�ect lo tM NbrYers'Compeivation S`��P �y laws cl CaLMma �... .•. ��.�:..,, � —'- . as -� ., `.: :�, ; W PARK FEE _ Cp Gute �_Ajryl�iani� � u� NOTICE TO APPLICANT H,alxr makmg ehis�Cen�Iicate tif Exemption,you shoaN hecame sub�ect to the NbrMer's SCH�OL FEE� —± Cninoensauan provisims of the Lahoi Cade.pou musl tmtlnv�eomply wnh such pravfswM w Mis permit shall �+- be deeined revokeA ---�--- �'i y.' �rI�'ISION Of INDtISfHIAL SAiET.�P�1�lA4T LE IFM`"„I,,i1qJ:'•^"•�d� _ . �,� LJI heROy.P.tli�y Ihal no exCBvallan irve 151 or more leet in Eepth mla whch a pe�son is reqwrM�o descend � _ er.; wJl he made m cannecuan wnh work autha�+ed by Iha pe'mit.and lhat no huilding struMwe swtMldinp,ldsework, �- w AemoLtmn or dismanI6�-tti2reaf.,wilt Ae mae tAan tAnty�si� �3fil,feeF:h�gh �CMD �.Z.G�p 2.Art 2.Sec _ �'� 341.TitleB.CAf.I .. . � .. ... . . . _ .., _� i_:. ; .,, ���. . . .� . 3:: ❑as owner-6udde�,I will no±einplay 2nybne lo do'work'whKh`would'requirz a permit Imm ihe O�nan al E-- Inrlustnal Salely,as noled ahoue unless such person has a pe�mn to do such work Imm Nm drvimon ---- �: ua ❑Pvisiun of Induatrial SafetY Peimrt No. T T/� n.. 1 D I I'1� FEES `'�( `� COIJSTRUCTI�N LENOING AGENf,V I herehy aflirm Mat tAere is a tonstruciwn kndMg aqnwy Inr the perlo,mante I ;`�'! � Z; ol tlre wod lar whth ihis permit is issued(Sec 3097,Civ.C 1 , . �e.�.�- �� Lende�'s Name COiVIMENTS��-���.'�1�t.�:� �.C--� �{%' ��'� ' lJ`��, pp� Lender's Address � • �� CERTIFICpTE OF COMPLWNCE AND AUTF�IIIZATIW OF EHTHY:I m�ify!h�e read M's application axl atele 1 � y -c-� ! u� th�t Ihe mfor n grven¢auren I agrce to comply wrth atl sta4 laws aiM ciry ordinancn relalinp m 6uitlir�I i� �.'V�"�.Oi�=� t7=-��L_ � �- �,� ,•� f �� consvucba,and hun�e a represen ol ihe De.�enmem ot Bmking and Safety m mter yion the propeny f � ' i• _. lor which have appf d for ��� fn M purpose pl making mspxlions. on I i i H• / —'"�, `�t���`�._ �!7 � RECPT NO. �L. !!` PAIO BY s'z � VAUDATION 1 . at il�pTicant o�hgent �� .-�—''t-- .. WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Applicants Copy B:i106-71/89 '^'' � ` ' . !�' . . .. . .. , . . . . . . ' .. . . . . . �. ,�.�a.... .1::i':.^r e: . ' . . ... , . .. . ...�. �..�..;: :�"F7.��1" . .<tt`^h�;Y:. .. •.�.f1. .... . ,. ...... . . , t� , . .y._:� .. � . . .. �'w.�.�..A�. .. '� � � . . __ _ _ � .. , , . . .. . . . . . . ... ... , , .. . .... .. . . . . ... . . . .. . . .. .... , .. . , ... " . .. . . . ... .. .. .. . : .. . ___ _ _ __ ' _ __ __ _ . _ ... _ __. . _ . . . _ . . . . ... . . . . . .._ ... . , ..., . . . ,. . . ... . . . ... .. . ... ... ....... ....... . . . . .. . . .. .' . ' � c f . - . . �. . . .. . ,., ...... �� � ���� / �� . .. . . . . . . _ __ . _ . _ _