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Home My WebLink About114 (5)CITY OF DIAMOND BAR PRESS DEPARTMENT OF BUILDING AND SAFETY BUILDING PERMIT FIRMLY WHITE—Departm6-riTtopy, YELLOW—Finance Copy. PINK—Assessor Copy, GOLDENROD—File Copy, GREEN— Applicants Copy JOBSITE — / ADDRESS LL-' �& . APPLICATION PERMIT � �USE DATE —_Ii `�_. NUMBER _CODE ISSUE TYPEOCC J1 �� APN LOT _ TRACT _ . DATE CONST_ GROUP_ CROSS STBEE OWNER ZONING SETBACKS FRONT— -----RW- ❑ i ADDRESS °- ✓� %(�-�� REAR ❑ SIDE/SI EET RW—_ El— CITY -^. ' V/ ZIP _off % TEL _ APPLICAN... _ TEL 4 � ❑ a o CONTRACTOR ADDRE_ (-%' ,' SEWAGE ❑ PUBLIC PMT — DISPOSAL [] o �J /� "•7 4 c PRIVATE SO. FT./ 100 GAL W v /& TEL. CIT . J' ZIP GRADING ❑ CU. YDS. EXC. CU YDS FILL z STATE L.. y LIC. NUMBER — TYPE SQ FT FACTOR PS ADJ. AREANALUATION raRCH; ENG% W 1 S2 I DESIGNER — ADDRESS— _ LL 2 _ n CITY TEL. 3 U --ZIP PROPOSED U a 4 M GARAGE c NO. DWEL. NO. NO. POR UNITS- STORIES BEDROOMS — VALUATION ADJ. AREA I ' LOT CIMENSIUNIS (iUANTITY DESCRIPTIO FEE o NO. OF BLDGS HOW W ON LOT____ USED ¢ �� _ W = I! Q - H BECLAflAiIOFJ I I•ereby alfinr thatam licensed under provisions of Chapter 9 (commencingY 'Xill W rz —1i S.. A CLI "no 3 of the Business and P,elessmns Code, and my license is ,, full force and effect o i J Lpg uv_ :bVNFR [I fit DER 7FCI ARATI0N I hereby affirm Chet I am exempt hum the Contractor's License Law for the folkiwmg 2 rerrnr SJO?' 5 Rnsnuss oral nrolessiors Canco Cane Any city or county which requires a permit to construct, o r mpn,er: a J,n3r;ish air repwr any structure prior to its Issuance also requires the applicant In, such permit Ca ;y!ncd stater^ert ma: Fie is licensrd pursuant to the provrsmns .it the Canuaetw's License Law !Chapter rye P nrrmri ri: ,r. ru rr &:rt:cr 100C; of Oivis:an 3 of the Busmess and Profeesirm Cade) or that he rs en rcpt therefrom :3x J ii aur• ex S;vss I:• IF, ajeged rxnmolmn Any xmlalmn of Sri 703 15 by anv appbcam 'or a permit sublecls 'Li, applic3r r •r. a I ivil penalty cf not more than See hundred dollars 1S50011 A W aw•rr of •he property or my employees with wages as thea sale compensation -11 it the work, and r( U F •lu; su x',rr, s -ut werxbad or afle•ed Ina sale ISac 7044, Brsinesis and Pmfess,cns Crile Th,Conmartor's Urense. vLay. !;:es int apply to an —,a, of property he builds or improves thereon and who does such work Frmsell u tjuuirgt his rwn •,mPIcVees, prov.ded that such improvements are not intended or olrerea to! sale V however, .S on I :hu building Fir imr.•acemrrt rs saki are year o1 completion the owner-hudder will have the harden nl pr C[ h ?-he p. at :r•; .:nl nn' '•, i:r. .rr :m^,rr.ve far the purpos, of sales u? �I is owner of •he prnomty an, exclusively contracting w:th licensed contractors to construct the project (Sec W 7044 B•nes ns ;:nit ror croesss Cade The Contractor's Lcensr Law dues mol apply to an awne:to of property who 2Sa.. c wi 'ilds :u improves ver Rim who contracts for such pm!ects with a contractorls) licensed pursuant the Ca-r—ror's - CONSTRUCTION -cense Law I I tm exempt order Sec B Fa PC iAtfach Certifrcatel PLAN REVIEW owner ELECTRIC s yV9RKFP,S COytPE NSATgiN DECLARATION i hereby affirm that ! have a certificate ('Iconsent to sell ensure, m "- r, i « rnc�se of yJnrkers Compersation Insurance, a a certified copy thereof (Sec 3800. Lab C 1 PLUMBING _ z I— Cardia cagy rs Farah; furmshad MECHANICAL o u, t _ •Cor Abed ca;y :s ailed with the Building Inspeecor Department m _. Department. < GRADING eZ^. ::ERTI GATE OF [*MPTION FROM vyURKERS COMPENSATION INSURANCE This section. oared not be compkted ® ISSUANCE � y it the permit is for ane hr,nried (SION at less I certify that is the perlarmance of the work for which this Fermi'. is issued I s'Iall Fiat employ any person in any manner so as eeome srblect to the Y16 Dampensabm .f I Fill !— laws of Caldor n/J6-yy� SMTP — ,.v _ W PARK FEE NOTICE TO APPLICANT Iiafter making this Carldicate, of Exemption, you should beme suhleU to the Worker's W I= SCHOOL FEES Gunpensabon prowsmns I, the Labor Cade, you must forthwith comply with such —nuts car this permit shall 06 ri F.e deemrav ed ed oc yo 1� pC _ FNVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION a- o ❑I be•ehv cemly that In excavation five (b1 or more [eel Fir depth into which a person is required to descend. (`ITV h —DIAlto d 1 will be made m cnnnechcr .,In work authonred by this permit. and that ne building structure. scaffolding, falsewnrk. demnlaror dismantling feet ' ONE) BAR m ur o' thereal, will be more then thirty-six (361 high (Chap 32, Grp 2. Art 2, Sec :kll Tali8 CAC, e_N .—_ BUILDING D SAFETY -FZl' It 0A, owner hudder I vxll not employ anyone to do work which would require a permit from the Oviswn of I-- Indus,.! Safety as rioted above, unless such pemen has a permit to du such work from the divuran ,¢• , ❑ O:visror: of Industrial Safety Permit No TOTAL. FEES F e7 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a crostrucann lending agency for the pmformarxe am of the work lot which Ibis perms rs issued Sec. 3097, Civ C ) Lenders Name COMMENTS . larder s Address_ m CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY. I certrly I have reed this epplicatrm and state _ va Wfor 'hat the i ifamalion quer rs correct 1 agree tp comply wdb alt state laws and uty oNrrencis relabng to building mrstnrniur., and Guth xe a representative of the Department of Building and Salify to ler upas the property which I have aFP Inr the permit !or the perp . a i sprnons. ��s� _ _ f — s natwe M h� I 9 App ea r Agent Cate RECPT NO. PAID BY VALIDATION — WHITE—Departm6-riTtopy, YELLOW—Finance Copy. PINK—Assessor Copy, GOLDENROD—File Copy, GREEN— Applicants Copy