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HomeMy WebLinkAbout1180 (5) . _ ...., .. , . . . . �a,,;.:;.� .,.. _r:,s.; :•;r'�. ^ � :.�::6. „ .;�. . .., ..-._.. ._,.:z; ry —_. - _ �: _,..,....�. ,. -vv-. � -...,.._... ,... ..; . t ,.. ..-.',. ;:,... -:' . .. ' `. ��. '"� CITI( OF DIAMOND BAR PRESS �� '," ' DEPARTMENT OF BUILDIiVG AND SAFETY -� BUILDING PERMIT FIRMLY JOBSITE APPIJCATION PERMIT USE ADDRESS ���- `�' � � � � /'�`�r`/lo DATE NUMBER� _ CODE iSSU� f'1,�Z��';�� TYPE OCC. a APN LOT TRAC7 _._ DATE ' � r ,� CONST. GROUP o CROSS STREET SETBACKS �� m OWNER ��m `Ci2r"� ZONING FRONT RW ❑ � ADORESS ��'�'� � "� REAR ❑ W CITY f�' �Q va�- ZIP f'7�tTEL.�✓ ���� SIDE/SIDE STREET RW ❑ o APPLICANT TEL SBDE ❑ e CONTRACTOR � � �''�2� � o . SEWAGE o ADDRESS� 'Z � 't-Ff(` r�r� 1,t7 ^� p ❑ PUBLIC PMT# `"-"�---- DiSPOSAL [] PRIVATE SQ.FT.1100 GAL W CITY� Csr.�*��... ZIP ��4�! TEL. t�� �- s � y LICT UMBER ��� � �`� ` GRADING C) CU.YDS.EXC. CU YDS FILL y ARCH/ENG/ g� TYPE S�' F? FACT�R F�S " J�pJ.AREA�IJA#.UA7"IOM � DESIGNER � � p ADDRESS_ }��„ 2 Z CITY ZIP TEL. (�,'S 3 � � PROPOSED USE a � �' --L-rr�►� "�?�.5 � GARA6E o NO.DWEL. NO. NO. � pORCH y UNITS STORIES BEDROOMS � LOT DIMENSIONS m VALUATION ADJ.AREA o NO.OF B�DGS HOW ctuqN�it�r p�^���1p'1`�Q(� FE� W ON LOT USED ,� °� U w � x ~ LICENSED CONTR4CTORS OECLARATION�.I heieby aRirm ihat I am licensed under pmuisions of Chapter 9(tommencinp 1'- � wnh Secuon 7000�cf Divisian 3 oi the Business and Professians Code,and my license is in lull force and effect � 3 [� u`i1. u- OLVNER�BWLDER D"tCLFRAT10N:I herehV affirm that I am eaempi�mm the�adraam's License Law�o�the lollowing � . a reason(Sec.7037.5,Business antl Professions Code-.Any city or county which requires a permit m consVucL � (a . O aher improve.tlemolish or repalr any strucWre.priar to Its issuante.also requirps the applicant For such permit ,ZTM' F- ro file a signed statement ihat he is licensed pursuant to the pravisians of the Comractor's License Law(Chapter p� � 9 lcommencing wi[h Section lOCD)ol Division 3 al Ihe Business and Pmfessions Cotle)or that he is eKempi Iharzfmm 5,�- p. and the 6asis for the alleged exemDtion Any violation ol Section 7031.5 hy any ap0licant Por a ce�mit su6jecls � � K the applir.ant ro a ciod penalry ot not more ihan flve hundred dollars IS5D01.1. J w � ❑I,as owner ot the properry,ar my employees with wagas as theii sole compensation, will do the work,an - the stmcmre is no�intentlec or offeied for sale�Sec.7044,Bus��,ness antl Professions CoOe:The Coniraclor"5 licen � Rg� � �j ��.�� , r � Law does not aOPly to an owner of o�operty wha Euilds o�imomves thereon.and who dces suoh work hims �(„) � or through hls own employees,pravided that such impm�ements are not imended or oHered for sale.II,howe r, ��� . m ihe building or imp�meme.nt is sold wi�hin one year al:ompletian,the owirer�builder will aare ihe 6u�den o�pro ng [( � that he did noi 6uild or improve fo�the purpose ot sale.� �.� y � h ❑I,as awner of the property,am excluslvely conVac[iny with I¢ensed canttactors lo canstruct ihe pro�¢[t(ec. .p,� 0 7044,Business and Pmlessions Code:The Comra[toi s License law does�not apply to an ownei ai properly ho '�� a builds oi impmves ihereort.and who controcts fa such pmjects wilh a wntrxter�s)licensed pwsuant to Ihe Canlran 's � "= L1e"�`a""' CONSTRUCTION 0 �W ❑�am exemot��ae�se� ,e a Pc�nt�a�n ce��a��a�e� PLAN REVIEW - � o"e °"'"" ELECTRIC � WDRKERS'COMPENSATIfNJ OECLAHATION:i hereby affirm�hat I have a ce�tilicate of consent to seif-insure,or - .--._ .._.. a cenAicate ol Nbrkers�Compensation Insurance,o�a�e�urea�oPr meaor�se�.saoo,�an.e.�. PLUMBING � MECHA�IICAL �t�r'� a ❑Certified copy rs here6y turnished- C � `o �ertifietl mCY��s liled with the Building Inspection OeCartmeat or Depart � � GRAD � JJ � CEFTIFICATE OF EKEMPTICN PROM WORKERS'C�MPENSATIW INSURANCE�.This section need nal e corn e : ISSUAN�i�,.r.' � '��� y if the permt is for one hundred($100)or less,I cetfy tha -n the perfor nce of the wark�f whic is #�;,. permn s�ssued,I shall not employ any pe�son in any manne� as o 6ecam sub t tv the rMe ' ompr. �� �� SMIP �" laws nt iiomia. _ .r� '. � ) _d� eD 4^,>y ,; w R14 FEE o Oak� APP�i�g . . . � NO710E TO APPLICANT�.If,afler making ihis Certdreate o�3EMem�pi�on �ou sliou'�tl��hecane sublett ta the YVorker s �+. SCHOOL FEES � ComOensation pravsians af the lahor Code,you must fmthwilh cnmply with such provisons or this permit sAall - �+- he deemed revoked. a � OIVISIpN OF INOUSTRIAL SAFETY PEHMIT CERTIFICA .�.;�.�i� w ��� � � ���:� o ❑I here�y cenify cha�no excavatinn five(5�or oie feef in epth`'nfo whitA a peuan is required to descend _ � will he made in conneciion with work auMor¢ed 6y this permi�,and that no huilding stri�etwe,ecalfnWinp,falsework. m demaLtion or dlsman9ing thereot will be m re than ihuty �36�leei ngh (ChzD�-3,2-.G 2.Att 2 Sec = 341.T�Ne�.C.A.GI. ' ;i`�, f.::�.�.:�i 3 ❑As owner-huilder,I will nW employ an Qne�do.woTk'-}v[pLh uvWd�wQurcd a�rmYt'Imfn Me Division ot - � � Industrial Safety,as nated abave,unless such�{"erson has a permit to do such work trom the drvision. . g `:. W ❑a�'s'o�o���a�=„'a�sa,e,V�m"No TOTAL FEES �� C�� a � CONSiRUCT10N LENDING AGENCY:I herehy alfirm Mat tAere is a tonskuction lendiig apency far the performance Z of the work fa wAich this peimit is issued(Sec.3097,Ciu.C.I. ' � Lender's Name COMMENTS mLende�'s Address Q CERTIFIC0.TE Of COMVLIANCE AN�AUTHOpiZA F ENT :I erti(y I heve read t6is application and�sbte cis that the intormation given i correct I aryee lo ca p wdh al st laws aiN ciry adins�xes m4[ing[o bii16� ycans7r ion,and authoriz a e resen live the tment iWing and Satety b enter iqOn fhe propetry = tor ich I A aODKed I ffii permit se f maYi i tions. � � '7 ��"" /�Gp �p s�qnature ot npp�ieant or nq�mt pe� RECPT NO. a-�` PAID BY VAUDATION � WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Applicants Copy �, ,,. , ., , �:- �� • , �n ,� � �r t r . _,... . ) 5J F- ... . ..., ..i�� f .:� '.... . . ' . .4 �.�t . '�:�v . � e.:. 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