HomeMy WebLinkAbout1495CITY OF DIAMOND BAR tiri PRESS
DEPARTMENT OF BUILDING AND SAFE71
BUILDING PERMIT FIRMLY
JOBSITE
ADDRESS ALJ r
APN LOT 45 TRACT4256
UCATION PERMIT SE
E NUMBER CODE
i UEQ' -�(� TYPE OCC.
DATE DD �- / CONST GROUP
CROSS STREET
OWNER—Rr�nalea Calif. Ince
ADDRESS Ong Park plass. #11D(1
SETBACKS
ZONING ""0NE�115
FRONT RW ❑
REAR ❑
CITY Tryipatl ZIP TEL. Pv;1 11-11
STREET RW ❑
1:1SIDE
APPLICANT TEL.
❑
CONTRACTOR "T" McGee Electric, Inc.
ADDRESS P.O. Box 1111
CITY Chino, Ca. ZIP 91708 TEL.591-646
SEWAGE ❑ PUBLIC PMT �
DISPOSAL ❑ PRIVATE SO. FT./ 100 GAL
GRADING ❑ CU. YDS. EXC. CU YDS FILL
STATE
LIC. NUMBER 490083
co
TYPE SO FT FACTOR PSF ADJ. AREANALUATION
ARCH/ENG/
DESIGNER
ADDRESS
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1
2
CITY ZIP TEL.
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3
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PROPOSED USE
NO. DWEL NO. NO.
UNITS STORIES BEDROOMS
LOT DIMENSIONS
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GARAGEPORCH
to
VALUATION ADJ. AREA
NO. OF BLDGS HOW
OV LOT USED
ouANTnr DESCRIPTION FEE
UCENSEO CONTRACTORS DECLARATION I hereby affirm that 1 am licensed tender provisions of ChapW E Icornmenc
with Session 7000) of Pvrsion 3 of the Business mind Piolessions Code. and my license is in lull force and effec
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UUW
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OWNER BUILDER DECLARATION I hereby affirm that 1 am esempr from the Cmisacta's License Law for the following
reason (Sec 70315. Business and Professions Code Any city or county which requires a permit to construct.
alter, improve, demolish, or "par any Structin, prior to as ifswaKe, also requires the sppl.ant for such permit
to file a Signed Statement Mat he is kensed purvi to the prwisions of the Contractor's License law (Chapter
9 (commencing with Section 70001 of Divisor 3 of IN, Business and Professions Cade) or out he is eampt Merefioen
and the bees fu the alleged exemepoon Any violation of Section 70315 by any, applicant low a pi Subjects
the Stri to a evil penalty of net mon than Bre hundred dolars ($500)1
❑I, as Owner of the property of ON employees with wages as their sole eompenutw. 160 IN work, and
the structure is rot intended or offered for sale ISK 7047, Buseness and Ptelet"ons Code The Contractor's License
Law does not apply to an ower of property who builds or improves thereon, and who does Such work hunse8,
Or though his own employees. provided that such onprove enss are not intended a offend for sok If, however,
We building or improvement is sold within one year al completion. Ilewn
oer-builder wit haw the burden of proving
that he did not build we iryrove for the purpose of sale)
❑I, at owner of the property. am exclusively, contranrng with Incensed CMIIKtart b t4nrtNn IN proton ISK
7044, Business and Professions Cade The Contractor's License Law does not apply to an owner of properly who
builds ow improves Invasion, and *no contracts la such projects with a eontrKI)i Licensed pursuant b the COM110r's
L tense law )
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CONSTRUCTION
❑ 1 in exempt under SK . B B P.C. IAnxh Certificate).
1
P VIEW
Irate Dwner
J
ELECTRELC r
PLUMBING
MECHANICAL
WORKERS' COMPENSATION DECLARATION I hereby affirm that 1 have a Certificate W consent to tall insure. or
a certificate of Vewkei Compensaton Insurance. or a fouled copy thered (Sec 3800. lab CI-
❑ Cernledcopyaterebyfunrhed
X'3 Caroled copy s filed with de Buddmp Inspecum Department a. R I i l id l n,('7 Department.
Q
GRADING
CERTIFICATE OF EXEMPTION FROM MARKERS' COMPENSATION R&RAMCE. This sections Owedpot be completed�IlSS�U
d the permit is lot one hundred IS100) or less I certify duct in to performance of the wait for which dws
Permitn issued, I Shaw not employ any person in any, manner b becanon We Sublets leo tfunis CrWrialion
Laws ol C
�'1'
Nate ''ca^
NOTICE TO APPLICANT , alter making this Certificate of Eaampm, you should became Srltact b Yk
the r4r1
Compeosenon provisions of ton Labor Code, you must forthwith *6 smith prowsom or yws permit shaA
be deemed revoked
W
u-
/ • (0O
SMTP
PARK FEE
SCHOOL FEES
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION,
❑I hereby critter that no essavatnn five 15) or mora her in depth into which a parson is "wed to descend.
will be mole in connection with work lu hortrN by yell prone, and yet no hINMYtp pywctire, waft dMe Midweek.
or demolition or di"nnMrq th"eol, w/ be mare nary sac lapI beyelapB,i 106P 32. Grp 2, An 2. SK
341, Tile B. ICA C1 p u i
OAS ewew-budder, I wig now employ anyone Or do work wW wvre�dda innow s,a /Knew .thaw Se Divisor of
n
Industrial Safety, noted above, wri such puson haw a Forced to N l er\park Net the WFsioeJ
G,.v.�r `Ji' '.' s• . CTS l
❑Orsion of lndumiat Safety Permit NO
.
TOTAL FEES
CONMLCTI N LENDING AGENCY. I harebs' alarm dei Ul is a construction Ierip agency lar de parMrnarict
W the work to which dus permit is (sand (1 3087. Ci.. C)
lander's Nam
lmd"'s Address
COMMENTS
UROflCATE OF CMKIANCE AND AUTHORIZATION OF ENTRY. 1 cw* 1 how rad pis OppkKien ad atm
Ions the ntormabon on" u correct. I gar to twnply with N am laws and dh erditr , Nkaking Is bid"
tans?audwew a wCprnmurpe W do Do wtt of Bddwp and Sahty to war "an yea property
Ion whth hr la" parse hr the".". auekrp iaraataews.
RECPT NO. —Ji PAID BY VALIDATK]IN
AMSgmatut
at Appecnt we Agent pew
WHITE—Department Copy, YELLOW—Finance Copy, PINK—Assessor Copy, GOLDENROD—File Copy, GREEN— Applicants Copy
BS106.11189