HomeMy WebLinkAboutNo Permit Number (20)CITY OF DIAMOND BAR "� PRESS
j DEPARTMENT OF BUILDING AND SAFETY FIRMLY
QUILDING PERMIT
WHITE—Department
JOBSITE inAPPLICATION
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PERMIT use
DATES NUMBER CODE
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ISSUE �3� �' �" TYPE -(SGC.
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APN LOT TRACT
DATE CONST. GROUP
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ZONING SETBACKS tk�rtaaiEens
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OWNER Bramalea Calif. Inc.
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ADDRESS One Parc P1. #1100
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CITY Irvin ZIP�972714_ TEL.
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SIDE/SIDE STREET RW ❑
APPLICANT _ ' _�,l7— 6!11-1 TEL.
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CONTRACTOT" M�-C',ee_ R1 Prt-ri r. Tnr. _
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SEWAGE ❑ PUBLIC PMT #
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ADDRESS
DISPOSAL ❑ PRIVATE SO. FT./ 100 GAL.
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CITY rhino ZIP TEL. _
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STATE 490083
GRADING❑ "U. YDS. EXC. CU YDS FILL
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PROPOSED USE �- i � J
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GARAGE
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NO. DWEL. NO. NO.
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UNITS STORIES BEDROOMS
VALUATION_._ ADJ. AREA
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LOT DIMENSIONS
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QUANTITY DESCRIPTION FEE
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NO. OF BLDGS HOW
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ON LOT— USED —
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LICENSED CONTRACTORS DECI ARATION I hereby afthin that I am licensed under provisions of Chapter 9 (commencing
wen Secbun 7000; of 3uwsron 3 of the Business and Professions Code. and my license is n fdf farce and effect
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7,UNFR BUILDER DECLARATION 1 homey alfirm that I am exempt ,ram the Contractor's License Law for the following
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-easen nS^.c 70315 Business are P•olessums Code Any city or county which requires a Perrin to construct,
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alar "prove nemulsh or repair, any structure, prior to its issuance also requires the applicant lot such perms
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to file a signed statement that he us uicersed pursuant to the provisions of the Canuaclor's License Law !Chapter
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9 Iramrrenc.ng with Suction 70W of Division 3 of the Business and Professions Call or that he is exempt therefrom
•he ;m Any Section 70315 by !or
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and cues the alleged exemi tmr violation of any appla:airl a permit subjects
hp appm:ani la a twit penalty of rot more than live hundred dollars (5500)1
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I I as nwne• of the aroprny. or my employees wnh wages as their sole rompensahon. will do the work. and
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the sractun; is net intended or offered for Sale (Sec 7044, Business and Professions Code The Contractor's License
Law rands not appuy :a an owner of property who builds or improves thereon, and who does such work himself
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or ;!ireugh ms awr employees provided that such improvements are not intended or offered for sale If, however,
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rim -uhIr. u� improsemert is soil venhrn one year of completion, the owner bnilder will have the burden o! proving
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o'an rc did ^.ct Nude or improve her the purpose of sale.i
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❑I, as w,e- of the property am d.dus-ly contracting with acensed contractors to construct the pre;ecn (Sec
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MA4 Business and Piofessiars Cade The Contractors License Law does not apply to an owner of property who
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audds or nnpmves thereon. and who contacts for such projects with a contractorlsl licensed pursuant to the Contractor's
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(: law,
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CONSTRUCTION
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❑ I am exempt dndet Sec B. fi PC (Attach Cerlificanl
PLAN REVIEW —
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'Date owner
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WORKERS COMPENSATION DECLARATION I hereby affirm that I have a Ceftlume of consent to Selfmsure. or
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� nhra'e of U7orxers Compensator, Insurance. or a cc,t.hed copy thereof (Sec 3800 Lab C I
PLUMBINGY
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LM1Cernhed copy is hereby Iumrshee
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MECHANICAL
Certified copy s filed with the Building Inspection Department or BT-lildinCl _Oepartment
GRADING
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:LRTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE This section need not he completedOtt
�f the acrinol us for nn hundred ISIOD) or less I certify that in the performance of the work for which (his
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UANCE
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r. is issueA.h,,fff���fffl i employ ay person rn airy manner so as one suhlecl to Ibe Workers' Compensation
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Laws of Calif,
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PARK FEE
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SCHOOL FEES —_
NOTICE TO APPLICANT II, after making this Certificate of Exemplion, you should become sulryect ta the Worker's
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Compensahnn provisions of the Labor Code, you must forthwith comply with such proursmns or this permit shall
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he deemed revoked
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71VISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION
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❑I hereby certify thatno excavalen five I51 or more feet in'depth into wfi¢h a person is ranted to descend.
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will be made in connection with work authorized by this permit, and that no Wilding slmcUae, scaffolding, falsewoM,
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m demobbe, or dismantling thereof will be more than thirty six (36) feet high )Chap 32. Grp 2. Art 2. Sec
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341. Tide 8. CACI
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OAS nwneo-6wlder. I will not employ anyone to do +k'-yIrlct would fequire permit from die Division of
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Industrial Safety, as noted above. unless such person has a perms to do such work from the division.
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C�Division of Industrial Safety Permit No. - 'r
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CONSTRUCTION LENDING AGENCY I hereby affirm Iliac there is a construction lending a0ky, for the performance
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the work for which this permit is .,sued (Sec 31197. Civ. C 1:
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Lenders Name
COMMENTS
Lender's Address
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CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify I have rid this appficatfon and state
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that the information given is correct I agree to comply wrlh all state laws and city ordinances rdating to building
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construction, and authorize a representative of the Depnlmenl of Building and Safety to s0aa the property
Mr which I h pplued for Mrs permit for the purpose oJf/mak' inspections.
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RECPT NO; "' y'� VALIDATION_
PAID BY r ' I` i' 41VALIDATION-
Signature of Appl ant or Agent Date
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WHITE—Department Copy, YELLOW—Finance Copy, PINK—Assessor Copy, GOLDENROD—File Copy, GREEN— Applicants Copy
LS106-11/89 `