HomeMy WebLinkAbout1472 (17) -._ -------.__ ,:_;. __.� _....._.._ __
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'�'` CITY �F DIAMOND BAR PRESS
� � �"� DEPARTf�AE BUoD NGI PE'RMI7ND SAFETY pIRMLY
JOBSITE Q-�� _..., � t APPL1CATlON ����'�PERMIT , f USE
ADDRESS =��2�--� � � G� �._ DATE ��.i L ��-'NUMBER � + .'�=� CODE
IS�UE y� ✓7 /� �r� TYPE OCC.
�, APN _ LOT��TRACT � DATE _�C�?�.�z..�:'_t��CONST. GROUP
`L CFiOSS STRE �� �' "`��.•�-. SETBACKS "'�"�^'�'"E"'g
°��" OWNER C' � r� �LE,rc=�_t r�j 1 . ` � ZONfNG FRONT •� RW ❑
�s ADDRE. S .�2.`i �. L.E�L'��C�--- `REA�2s�A,�; .�-�:. „ •...>t:>.:: n ,
u; CITY �iE1yti'4:;1'+c� �g,:,�..- ZIP�Z��TEL7f�-� z _?tc�� � SIDE/SlC�E STREET �� ' ... . RW ❑
c� APPLICANT �y.,,,_ �Ll a���.�s 36` - 5lDE �]
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« CONTRACTOR — SEWAGE
�; ADDREBS _ � PUBLIC PMT#
— DISPOSAL � PRIVATE SQ.FT./100 GAL
5� CITY ZIP___TEL. ___�_.r
;: STATE GRADING � CU.YDS.EXC. CU YDS FILL
�� LIC.NUMBER 'j`Y�'E SQ FT �ACTC�Fi PS A��l. AREANALUAtION
�� ARCH/ENG/ i � ry w ;
`-' DESIGNER ��?-t-'t'"` � J 1 . G��
�� HDDRESS � �a., 2 j �< L�
���CITY ZIP_ TEL. .� I� 3 �
�" PROPOSED USE_ Q � '�_��L�3']]—��� � 4 _ _
��
� GARAGE
�; NO.t�V�/EL. NO. NO. � pORCH �
�; UNITS S70RIES__BEDROOMS__
c� LOT DIMENSIONS m VALUATlON,._._ � ADJ.AREA
c� NO.OF BLDGS HOW QUA►d71TY �E�{'{�°,�I�f�Q� �E�
�� ON LOT USED_ Q
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�" LICENSE�CUkTRACTOFS OECLAPATION I here6y aHirm that I am licensed mder piomsio�a ol Chapix 9 IcommeKmg y��,,,,�..
eC�rv';if5e�tior 700C�of Division 3 of the 8usmess anA Professmns Code,and my I¢ense�s m full force anE effeu. W �
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� ,�:y� �'
�� ��NN �Bi140ER 7ECLARF710N�I nerebY aHirm�hat I am exemp�from tne Contracmr s Ucense Lax for me fallawing - ' -
_r re.nsur iSe.c 1031 5 Business and Prafessians Cade Anv���Y or caunty whreh repuires a ce�mit ro r.unstru[t. C7
CD m�ei �mDrove :lemoasr, �u repai�any slructure,D��or to its issuance.alsa requires Ihe applxant(ar six:h permit � — -0
�r m fJe a s�9r n xia�em,en7 rt�af he�s hcensed pmsuam�o�he piovisions nf the Convacwr's License Law IChaprer m
e� 9,rommencmg wnh Senian 7000�cf��VISIOtI 3 OI IhP BUSIIIP.SS hclA Pf0�2551016 COAl)Of tlldl IIP.R C%P.fllpl:IIEfQ�f0111 Sz,
�� xnC�he aas�s Im iM alleged e.emyuon 4r.y u:olaLon of Secuon 7D315 6y any applicanl lor a peimrt sub�ects �
"� �Ir.epryhcan;:o a::al penalty al�ot mare than!rve hundred dollars(55001! �
�u
F? ❑I as a.vrer;1^.�e proUerty cr mv employees wiih wages as tneir sole=um0ansaiion wdl no i�e work,and -� --,._ �
the shunme s nat mtenaed ar ofiered fm sale i5ec 70C4,Busmess and Piolesswns Cade.The Cantracror's L�cense Q
�;j Law ines nr.t apply tc an nwner of�mperty who hui�ds ai�mDroves Iheiean,and wha dces such waik himsell, (� ---�
�� nr tlxnugr Irs ow�n en�loyees,pmviaetl ihal such�mprmements are no��nter,ded m olfered toi sak.tl however. �
�
eO the L•uldin9 or inomvement is sU10 wilhin an¢year ot r.Ompleli0n,1he ownir-6wltle�will have Ihr.6urd¢n o!D��'�ng . _
�� that he;hd nm hmid er impmve for the pwpase ot sale I Z
c%�s �
u� ❑� As owner ul:he propeny,am ex[lusrvely comratuny w�lh L[emee contruiors to constmtl the pro;ecl(Sec. �jJ �
�, 774C,Busirsss and Prafessions:ode The Cantraclar's License Law daes not apply to an owner of propeny who 'y^
:Y huilds or�mpraves ihereon�and who conlracts lor such pru�ecls with a contrectorls)licensed pursuanl lo Ihe Canlracior's _�.--��-•-_.
''� I.¢enselawi
�ONSTRUCTIOPJ' ��•. �''��
�� C I ar.e.emo�un r Sec - 8 AC IA C;:nrficatel. PLAI�I REVIEW � �?�f�
:_ .
e:� oaie ` owne� , � , — �ELEC7RiC
:s Yd7RNENS'COMPENSATIIXJ DELLAflAT�W I here6y�fhrm tha�I have a urtit¢aie al mns m io ett-insure.or
°' a cerolvaie�I Workers'Compensauon Insurance.m a cernf�ed cnUv�hereof ISec 3600,La6 C I PLUMBiNG _
e�
%� ❑Certihed coov�s herehv��rshed � MECHANlCAL
e�I❑^ervlied mpy�s hled wdh the Bwidmg Inspecbon Uepartment a o�Pa��mr��. �C GRAbING
�� __._ �'Y"�
CERTIFICATE 0F iXEMPT10N FflOM WOflKERS CDMPENSATIDN INSUflANCE This secllon nred nnt he completed �� il, i�„j
�� iS�UAN�...__._, �
��� d I h e p e r m n i s f o r o n e h u n U r e d�5 1 0�)o r l e s s I r e n d y t 6 a t m M e p e r f a m a n c e a l t h e w o r N f a w h k h I h i s � . �
_ pemut rs icsued I shall noi empby any person in any manner so as to Eetome sub�ect to�he Nbrkers'CompensaLon + �`M`P E'.'�
!� Lnws nf Culilornia � � -�
�__ � PARK F�E
�•� �ate Applicant_ �
�� NOlICE TO APPLICANT II,aher malunq�his CaUfica�r.o(ExempLon,you should beeame sub�ect to fie Worker's 5CNt70L FEES
-•� Compensauon pmwsmns of the Labor Cade you musl lorthwith comply wrth such pmisqns m IMs permn shall
"- be tleemed re.voked '
f�
n'� DIVISION OF INDUSfRIAL SAFETY PEPMIT CERTIFICA�ON '; ,
_ � ', ;;�;. �'� ,—
•JJ �- '`
��- ❑1 hereby cendy that no ezcavatron irve(5)ai more feel m depth mto wA¢h a persm is reqmred to descend
[i� will be made in connecuon wi1�woi!authar¢ed hy tl�is peimit.an0 Iha1 m 6uddinp suunure,tcaf}aldinp,Isluwork,
�°- o� dema6uon or d�smamh�q tMreaf.will her�q!a�n Ih�rly-en 136f.fie(high lChaP 32.Grp 2,An 1,Sec ,_
�� 361 T�tleR.CACI `e,''{¢r� � '�, ,:�
S"...
_s ^s� ,::'':o —
=� �'As owner-hudder I wdl no�empby airyane to do worY wh¢h wauk'ieQw2 a perm�l from du Uivuion�i
F— Industnal Safely,as iroted ahove,unless;uth person hos a permB to do such v.nrk Imm Ilrt diviswn
'C i 'i ; : : . : . �' �' :';. �; '� . �".
e� LGrision ai�ndusrtial Salety Rermit Wo �T. - , � � TOTAL f E ES ���� �� ��}1�
CONSiRUCTION IEN�ING AGENCY:I here6y affirm thal�iliere is'a e6nstruttinn�IeiMvp�pmcy fa tFe perM�mente � � � �_
:� 09 the wo�N lor wh¢h this permit is issced(Sec.3097,Cie C) — .
�� �e�uei•s Name COMMENTS � � ?
i� �endei's Address �
'R CERTIfICATE OF COMPLWNCE ANO QUT410RIZATION OF ENT11Y I mtily I have read Mis�ppl¢Nian aid stat� �
er� ihat�he informanan giwn is curect 1 agrre ro comply wM1h all sLle laws and city ordi�wicn re4lnp ro 6uildiip
i�� rnnsirucnan,and authorize a repreumatrve af the Oepatment ol BuiNinp and Salery m enter�pon Ihe pruperry
- lo�wh¢h I have aDDli¢d for thrs ce�mrt for the o�Wse al nehnp inspxtons.
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X :�r y'„.� � `Y�;y� �.,'�� i 9�• � �•'
siynaiwe of apyKam a nyent p� RECPT NO. r�_PAID BY ��%�-�-> VAUDATION
WHITE—Dapartment Copy,YELLOW—finance Copy,P1NK—ASsessor Copy,GOLDENROD—File Copy,GREEN—Applicants Copy
E3S7 0&11/89 . .�. . .
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