HomeMy WebLinkAbout1495 (17)40
CITY OF DIAMOND BAR
DEPARTMENT OF BUILDING AND SAFETY
1W ! 1 BUILDING PERMIT
a—
i
PRESS
FIRMLY
JOBSITEAPPLICATION
ADDRESS NLt
PERMIT
NUMBER
ISSUE
Dff > yr ie�/;r7 TYPE OCC.
DATE 12 0 CONST.— GROUP
APN LOT 4!5 TRAcrdl.7564
CROSS STREET
OWNER Ermnal Pa rAl if - Tru-
ADDRESSe-P=L-Tal a=.11100
ZONING SETBACKS kvixmkcmm
FRONT, RW— 0
REAR 0
CITY " Tit VADIC-1 zip 92714 TEL. R51-113
SIDE/SIDE STREET --RW—0
APPLICANT "22 TEL.
SIDE 0
CONTRACTOR T" McGtw. Elqc9:��, Inc.
ADDRESS P-()- BOX 1111
CITY Chinof Can. Zip 91708 'TEL. 591-646
SEWAGE Q PUBLIC PMT #
DISPOSAL ❑ PRIVATE so.FulooGAL
STATE
LIC. NUMBER_ 490083
GRADING 0 CU. YDS. EXC. — CU YDS FILL
(1)
TYPE SO FT FACTOR PS F ADJ. AREA/VALUIATION
ARCH/ENG/'
DESIGNER
ADDRESS
W
I
ILU
LL
2
CITY ZIP— TEL.
3
PROPOSED USE7
- —4—
GARAGEJ
NO. DWEL NO. NO.
UNITS STORIES— BEDROOMS
LOT DIMENSIONS —
:D
PORCH
VALUATION ADJ. AREA
QUANTrrY DESCRIPTION- FEE
NO, OF BLDGS HOW
ON LOT USED
LICENSED CONTRACTORS DEUM71ON I he,* affirm that I am licensed sardia limisions of Cho" 9(l
with Section 7000) of Dinsian 3 of The Business and Professions Code, and my Intense is in full fortili
WNER BUILDER DECLARATION I hereby affirm the I am exempt from the Conhatear's Lcerese Law for she following
reason (Set. 7031.5. Business and Pral,coam Code Any city or trinity which required a Permit to construct.
after, impfuni demolish. On topi any structure, prion to as issuance, also requires the applicant loi such permit
to file a, sqned statement that he is licensed pursuourrill W Ow provisions of Ik Contractor's Licriest Law lChs"
9 (commencing with Section 7000) of Drinsion 3 of the Business ined Professions Clidal Or that he is 1-0 therefrom
and the basis for the alleged dismission Any vwolaoon of Session 7031.5 by any appicarif for & permit subjects
the applicant to a civil penally of not win than finne hundred dopers JSSDO))
E31 . as mrier of the property, or my employees with wages as over a* *111 do the work, and
Ihe strawre is not intended or offered for sale ISee 7014. Bworniss and Professions Carlo The Cooliattors Lrow
Law don not my to an owner of property who builds Or improwis thertion. and who dos such work himself.
or through his own employees, trovidind that such impraimmumts we not intended Wofforrod lot sale". houirwor,
the building ainipmriernaint is UM within one yew of tampletion. the Onnewir-builder .11 have the burden of plouing
that he did not build or improve for the purpose of sale I
01 properly. = exclusively corritractirill with licensed contractors to construct the Protect (SK
7iiii.asuo"'Or Of the
4 Business and hPirotessions Code. The Corstraclear's Lictirree tai does not APOY to an Verde of property who
Wilds ii improves dierton. and who contracts he such projects with a camtracuu(s) kersond pursuant to the Contractor'sLicenseLml
CONSTRUCTION
El I am entionfil eider Sec B 6 P.C. (Anath Conti
Date G.W
PLAN REVIEW
ELECTRICS
WORKERS' COMNSATION DECLARATION I hardly Olson that I haw a cortkaw of consmi to md-ir4we. Of
a certificate of lNorkes' Compensation kisiname. Or a certified copy thereof (Sac 3800, Lob. C I.
0 -Carolled copy is hatillay furmsw.
(3 Combed copy.3 filed with did Building Inspection Department a Building
PLUMBING
MECHANICAL
GRADING
CERTIFICATE OF EXENIFTION FROMFROMWWORKERS' COMNSAIRCIN INSURANCE Thin saran read
jSSU--' -1 / -
6s—LANCE - 5
4 the permit is for one hundred (SIOD) or Ins I comfy that er On poloretionce of the
permit is issued, I that 001 trildi any parallel in Shey flulliffill(All 1i to bKORW tb*t 10 the Makers' meson
C.14.
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Laws I I/ 'I
..
Dam ;771A - V Applicaril - 1�
NOTICE t APPLICANT 0, after making this Cinfi.ficalk of fing"nor, you shoodd I suilinest to lint WMw*s
I CWIWSDM INNISMS Of the Labor 000V " Inch prevented; do this porom Yeai
be deemed revoked
Uj
IUL
SMTP
PARK FEE
SCHOOL FEES
EIVM OF INCUISTRIAIL SAFETY PERM dleLER lyCATION
CI I he* certify that no tinevortion five 151 oe mors Im ha is rinalival to denoted,
Lowell pow
will he mooft so connection wide vent Now Li suractione. scallowuni lobsonoods.
dernin ion or drumeandw; lhv�. firl, C1. Zv0nh;.' led high. (Ch" 32. Gil; 2. An 2. SK
1, T.* 8, CA C 1.
E)As inemou-buillidet. I wig nor employ &win so do warri t. '" tVivii r� 121 a ponvert here ft D" of
linduarrial Safety, as noted atem. 1. 0011111 alkpww 9W it a di -such waste she derition.
a
C,
-4
Jr)
OTAL FEES )
CONSTRUCTION LENDING AGE I bw*v affirmout froom is a crativerecoon loavency fair to Perfain"i
of 0a wank for which Inis permit is leaned ISon, 3007. Civ. Q.
tonde"s N—
2t
COMMENTS
Leader's Address
agTlfCATE OF COW.UAN2 AM AUTNOWATION! OF [111M. I ratifyI he read ft appincradde and am
that the inflarriation few a clumust. I Van to conaddly with all state Lewis and city cadvionsca toldraing to bWbq
construction, and mithOrrlit & NPNSWUbW Of OW OWIaent Of Boddaing and SIMY to MW WM 10 PIP IV
M which I haw atattlard fair this wait for On frappe reatae.Wader•.
f
RECPT PAID BY VALIDATION
Supialwo of Applicant or AgipNO.
VITE—Department Copy, YELLOW—Firiance'Copy. PINK—Adswallor Copy, GOLDENROD—File- Copy, GREEN— Applicwtts; Copy
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