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HomeMy WebLinkAbout1271 (11) '!'` �ITY �F DIAMOND BAR PRESS �� '--' ` DEPARTMENT OF BUILDING 11ND SAFETY F�RMLY -� Bi31LDING PERMIT JOBSITE ��s-�,---- � � p' ,,� APPLJCATION PERMIT ` SE ADDRESS ��-'�� <,�% � L:���'I%�°t:��:��.> _ DATE NUMBER �= CODE lSSUE %J _...�j)__G�� TYPE OCC. �'- APN LOT TRACT__ DATE { � � CONST. GROUP " CROSS STREET SETBACKS "�""E""S c� -��� �-� �OI�IN.�a o' QWNER S�`-.V_��_ F3�iONT - - RW ❑ �s ADDRES � J � R�AR_.� ❑ �p CITY � TEL. � ���-� I SlDE/SfDE STREET RW ❑ c��RPPLICANT_ t - �TEL.5q�._;_L ----J SIRE_..� ❑ ae -- -- --- � CONTRACTOR 4 A_ — SEWAGE ❑ PUBLIC PMT# g, ADDRESS__-1� -�'�� 18POSAl ❑ PRIVATE SQ.FT./100 GAL_ w9 CITY C���1�� ZI �C TE �7� _ �� STATE �op,i� � GRADIhlG �t-'� CU-YD�.EXC. CU YDS FILL o_ LIC.NUMBER__ 1=1�� T �- V7 ARCH/ENG/ ,,�C� � �p��A ',Q � �'i p � ��• �REANALtTATION `-'- DESIGNER � . ..�` j � � ' ���=� -�-��� � c� ADDR.F�SS_ �r�.� , `P /M1 � 2 �-` !- �� CITY �_> �V ZIP� E�.�_- - - (� 3 � �.� . � . �. PROPOSED USE_T L'��% 7��_ 2 4 � � � 1 _ ;J 9ARA6E �, NO.Db'UEL. NO. NO. � ppRCH �; UNITS STORIES BEDROOMS_�.._,_._ — �'�� a_ LOT DfMENSIONS m VALLATiON� r''-�• �'��""'"" ADJ.AREA �� NO.OF BLDGS HOW %���, 9J, QUANTtTY I�ESCF�IPTOON ��� G� ON LOT _USED��!Z'��.�✓i r`_� 4 1 �+ "�_ �'-�,�'� ol_ _� U `�.��..-� U� :.-� .+/iYL,:''� �i �'(✓C1y�' 3' � � f'i�(,�.�.��C��._ i���tiC.i :.7-�'> " /C.J� �'� LC; "�CONTRACTOBS CECLABATI04 I here6y allinn Ihat I am Lcensud mder piouisons ol Cha{ner 9�cammen�inp �^ �= •.uim Secnm•7000i o:'Di•ns�on 3 of�he Business and Prdessmns Cadn,and ny license a in tull fmce and elfe�t ��; I 3y ❑ ��— QviNE,BJILOER DECLANATION-I hereby alfirm thal i am exempl trom the Camrxam's license Law for the lollowing u-I rea+on�Sec '037 5,Baarzss and Pmfessians Code Any ory ar cmmy whrth iepwres a permit to cuntlruct, "V' �' '�f�, y,.J�lCi',. %���' '�•��� C�ahe� rnprwe,demohsh �r�epav any stnxNre prior to ns rssiance,also�eqwres I�e agplicant far sikN permil Z �) -']�---{- /� 7 F��,�, tn hie a signe0 statenr.nt ihat he i5 IICCfSEd pU�SJ3�1 10 iF[pravisions af tha Cwlra[�i s Uce��se law�Chapter �p � � i,l. � �/'L��f�r.�'��J! f ��� Q: 3;ca.�n�nonq�,vnh Sect:on'OOOi al Orvrsmn 3 of!he Bumness anA Professions�odei or Mat he�s exempl Iherdmm � �-� r T p„ and the'aasis�or thr.aileged erempbon am wolauan nf Sectior.7031.5 hy any applinn9 M�a permit sub�ects � �, �i��,,,t„� ";,.,�i=f�'(�.%,�"pi •`�jL,J �'� the appncant tr.n cm:l penallv ot ro�^mre ihar.Irve huniretl do:lars 135001 I a -- u.i C� ❑I as ow•ner::I ihe pr�perry oi my cinpinYees vrith wages as iheu sok compensation,will Jo Ihc wo�k,a�i� ~� ihr.snucr.ae¢ntd imendetl or ofleree foi saie iSec.70c4.6usiness ane Pmfessmns Code The Lonuactm's Licv.nse �'�"`-} S {- Q i Ci �'l�iLt�°� � �-t.�G� �j Lav.�coes r•m aD01y m an owner of pmpeny wln huilds a�improves�herem and whn dces su�h wark himul�. O -�� �+r ar tF.�oug��his own emGloyees pmmded�hal such imprnoemmt5 are nat mtended or ofkred lor sale If howevei, �� ee� thr.hwidmg or.nprowment is sold wilhm one yes o1 completinn,the ownei-0mlder wiM have iAe hurden ol pmwng ,Q —___-. v} t6a�he A�d�:nt h:.ud or;inpmve 1u�Ihe purpose ol sale I �� -- V1 ❑i.�s uvmer of;he Fmperro.am exelusnelV cor.tracuny with I¢enseu ronvauors 7o r.onslmct�he qo;ec�(Sec {y Cy 70d4,Busiress and-rofessons CoAe The Contracror's:ce�e Law does no1 apply lo an awner nl pioperly who 54 _ ^! g; hw:As or�mproves thareen,ard whn co�traots lor such pro�ecls wnh a conlraator�sr 6cenmd pursuant to ihe Can�iaclor's � •': ����P$e�a�"� �COfJSTRUG i iON %%J1�'e � �? ❑I am eaemn�anAer Sec B 6 PC IAuazh Cei:ihcateV i PLAN REVIEW �-�� . ��' Ci �aie Owne� �LE�i�.�[��... ��::�'�U o: WORNERS'COMPENSATION OECLARATION I herehy aNrtm thai I hsve a teruhcate of tansem tn selLinswe,or� ��t;r.I ..y /:r � �� i a cend;rate�I Worters Compensat:on Insurance,m a ce�nfied capy ihereot ISec 7800,Lab C� I, ��LV ie�id��,1�,�7� _ �J:�"]C• �'� - � �.CernfieA capy is herehy lurnrshed I �.,/� EIVI Ci{�l���lil�.�� � / G') U� C Certded canV�s hletl wnh Ihe BW'idiny Inspection Oepartment or__. OeDanmeni � � Q��NU w �....-.i�..f ��I L�P7IFICATE CF EXEMPiION iROM WORKERS'COMPENSATION INSURANCE ?his sectmn need not he wmpleted ' S.��AN <_�r'.J�a J!r' �� rf Ihe permd rs im one hundrM ISiD01 or less I certrfy iSat m Ihc performance al Ihe work Im whKh this --���~� V.f -^� �yennil•s�ssued,I shall rot¢mploy anV Oe�sun in any mancer so as lo hecomx sub�ect to tha 1Wrheri Ccmpensauon M�P ���.�j f" taws nf Caldorma. "' ''"''�� '�,�,' �-�--�-�' -c� i".,�,: 't`;' ...":. .;; W PARK FEE LLi Oa�e �:.Ap�(ican�% •'-' �.1. SC}'�OOL FEES NOTICF TO FPPUCANT II,after making ihis Ce�iilicate of E empuon,wu shnuld 6ecome sb�ect m the Wake�'s�� - Compensaunn pravisions of the Lahor Code,you must luthwith comqy with surh pmisans w this perme xhall 1 �+• 6e deerneA revaked s ------ --- �� qVISIIXJ OF INDUSTPIAL SAFETY PEHMIT C�HYI�IIa..41T10P(b���•:Y��~�� �i . L.. B,. ' ---- C� ❑I hereAp aeiuly that no eKcavatwn li�e�5)m more leet in depth into which a persm is reqmrM lo aesce�e, __. pe: wnl tce matle m comctnon wnA worA authrc¢eA bV mis peimn,and tAal no 6uddinq stwpue,scafkldinp,t�lsework, d' ar demuliLon nr dismamiing�Mreof,will be nrore.!han thinr•sit(36�,ieat h���•1Chap�3.2.Grp 2.Art 2,Sec __� �i ;iA1.TitIeB.CAC1 (, , , . . -. . ., � . . � S: .. ' -" ..., �_'. .: � � ___ 3� [;As ownn�Gwlder,I will not empl�Vl�V�"'fo tlo'wurk whi[h wOuM reQuilE a pefmit hom the Div�sbn M F.-• Indusmal SaletY.as r.oted a6ore.unless such person has a Oeimtt ro do sid�work fmm the division -- � � �� ❑�IV1510n of InAusllHl Safery APrm11 No. / d: � TOTAL FEES � ' '� ( �, CONSTRUCf10N 1EN01NG AGENCY:1 Aereby alhrm Mat thert is a cansttuction lsr.di�ry agency for�he pnfarmnce '� e�-�'�� `� = ol mx war4 tor wnu�Mis permi�is iswad�Sx.3097.Ciu.CJ � 1��� -;,�� � te�ne�•s Name — COMMENTS ' � �' m lender's Address Q f.ERTIFICpTE OF COMPIiANCE AND AU7 2AT 0 E Y I cernly I ha;n raad�his apqkatim aml atyu � —� r/� thai the minrmafion�iven is �ect I a te[o wn II;tate I aid c�ry or6nant re4tiip I Iwdding ' ycrosiruclm,aM autha Oreunt ol 1 t ol Bui w�l Sakty b .pa� ptqerty = for which I have a d s permrt 1h i m ns. � ,� � ~ � �� RECPT NO. ��� f'C � PAlO 6Y I � ���--� VAU�ATION_ `I`��, ature oi plcant or n � W ITE—Depanment Copy.YELLOW--Finance Copy.PINK—Assessor Copy,GOLDENFiOD—Fite Copy,GREEN—Applicants Copy BS106-11/89 ;,.. . . ,. . .. �. _ ,. _ � . -. � _.� , -_ ,.,. . :. . . . � . _.�. _.. . xrz:• �.�:-, �..� F,,.,��,. a.t.. ;�,. . ... :�,:. ,., " ' . . • . . . :d;" . .- . . �`;•r.i 4.Pv �'.. . �,�µ'� . , . . ,. . . .. � . ' . . . . ._. . . . ' . . ... . � . . .. ... . ' . . . ... . . .. . ' .. � � . . . a ., . r .. �... . . . .. . � . . . . . __ . . . ._ . . . . .. . ... . . .. . .. ;-.. .. . . .. ._ . . . . . . . . ' . .. . . . . . '.. . � . . . .I. . .. ... - , .. . . . .. . . . . . . ... ... . . . . ., .. . . �. . �. . ... .. .. . � . . . . . ` � .. � r�� �R"13' '� � -�"iT'-�✓yy�.�f�'a'�•.d . .. . .-. ... . . _ . .... ... ... .. . ...... _.. _ , . .. _ _ . _ _ ° . .. ... ... .. _. _ . . _ _