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HomeMy WebLinkAbout1495 (19)CITY OF DIAMOND BAR PRESS DEPARTMENT OF BUILDING AND SAFE71 BUILDING PERMIT FIRMLY JOBSITE ! n ., ADDRESS ALJ rZPrE APN LOT 45 TRACT4256 UCATION PERMIT SE NUMBER CODE i —G�/� TYPE OCC. DATE DD �� // CONST GROUP CROSS STREET OWNER—Rr�nalea Calif. Inca ADDRESS Ong Park Plaaa. #1100 ZONING SETBACKS ""0NE*115 FRONT RW ❑ REAR 13 - CITY CITY ZIP TEL*1111.2 SIDE/SIDE 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 N TYPE SO FT FACTOR PSF ADJ. AREANALUATION ARCH/ENG/ DESIGNER ADDRESS W LL 1 2 CITY ZIP TEL. (Y3 3 Z 4 PROPOSED USE 7 np NO. DWEL NO. NO. UNITS STORIES BEDROOMS LOT DIMENSIONS _j GARAGE:D PORCH m VALUATION ADJ. AREA NO. OF BLDGS HOW OV LOT USED OuAwrTY DESCRIPTION FEE UCENSEO CONTRACTORS DECLARATION I hereby mi that 1 am licensed under provisions of Chaptr E Icomimenc with Session 7000) of Division 3 of the Business end Piolessions Code. W my license is in full force and dhc �_U[ r W ❑ W OWNER BUILDER DECLARATION I hereby affirm that 1 am esempr from the CmlfKta'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, a "par any stnactue, prior to As issuenn, also requires the sgalcsnt la such Fermi lofile a signed statement that he is licensed purswnt to the prmisions of the Conams ta's License law (Chapter 9 (commencing with Section 70001 of Divisor 3 of IN, Business and Professions Code) or Out he is eampt Eerehom W the Mus fm the atleped exemption Any vidation of Section 70315 by any applicant la a parol subjects the SPgcant to a evil penalty of int mon than Bre hundred dollen ($500)1 ❑I, as Owner of the property or ON employees with wages as their sole eompenutm. wed do ft work. W IN structure is rot intended or offered for sale ISK 7047, fdusrness W ProletSms Code The Caruacter's License Law does not apply to an ower of property who builds or improves shreon, and who does Such work Iwnsed, a through his own employees. provided that such onprwenents are nut intended Or offered forsok If, however, the building or improvement is sold within one year d compknon. Ile owner -builds writ have the burden of proving that he did not build a improve for the purpose of sale) ❑I, at owner of the property. am exclusively, contranmg with Incensed C.IIKtr7 b t4nrtrun IM proton ISI 7044, Business W Professions Code The ConuKtor's License law does rpt apply to an owner of property who builds or improves thaton, and *no contracts la such protects with a conirKtaOl licensed pursuant b the COM1K10r's L tense Lai l () Z m d (� .Z d _ lV CONSTRUCTION ❑ 1 in tompl under SK . B B P.C. IAKxh Certificate). 1 P VIEW Irate Owners J . r PLUMBING MECHANICAL WORKERS' COMPENSATION DECLARATION I hereby affirm that 1 haw a certificate of consent to saw insure. or a certificate of Veemkiii Compersaton Insurance. or a fouled copy Owed ISI 3800. lab Cl- ❑ Cernf.dcmpyawebyfanshed '3 Carl, ad copy a filed with dna Building Inspect at Departinent in. R I i 1 id l rig Department. Q GRADING CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION R&RAMU. This section Owed not be completed�IlSS�U d to permit is la One hundred IS100) or less I certify that in to performance of Me wait for which dws permit n issued, I Shaw not employ any person in any, mariner b become sublets 10 dr ftlues ration Laws d C �'�' Nate a NOTICENOTICEE TO APPLICANT E, miter arcking this Certificate te ofmpmd E.n, you 4becameald became fiApct b Yk the rtl Conpensanm provisions of ton Labe Code, you must forthwith *6 Lch prowsas or Eves commit thaA be deemed revoked W u- - / • (0d SMTP PARK FEE SCHOOL FEESw DIVISION OF INDUSTRIAL SAFETY PERMIT CIRTIFICATIOF ❑I hereby tariff that no enervation five 15) me me her in depth into which a parson is "wed to thousand. will be merle in connection with work audprvN by was game, and Eel no hINMYg pywctire, U*Wd a falaewmk. Or demobtm a dismarthn; saved, w/ be mese nary sok 13FI MreMpB,i OaF 32. Grp 2, Art 2. SK 341, Tice B. ICA C1 A u L OA. ewrw-budder, I wig now employ ankorm Or do work wW wer\ oru�lda rogwa,a pare`.thew ee Divisor of Industrial Safety, or noted above, tales much pus. Me a pan b N `ipark from the WFsimJ G,.v.�r `Ji' '.' s• . CTS l ❑Or-winef hrdu tnal SaletyPrmt►N � ' .. ,. ^' ..'' �' . TOTAL FEES CO NSTRIICTIM 1EN01NG AGENCY. I Mnby off— that dove is a constKtran Iroa6y agency M 0. pile m ei of IN work to which this permit is issued (1 3087. Cow. C). Larders Nam lander's Address COMMENTS UROflCATE OF COMPLIANCE AND AUDMZATION OF ENTRY. I artily 1 hew sod dais oppkKien W am dui the retornebon Own u Cana. I gin to toeply won N stat laws and dh ardilo , "lasing is bdiay rmstrKtm. inOliorue a npaensinw of Er Dopwtb t d B+:d�q W S"y to sr gen Elle property 1m whch Ism the pant hr the pirgawe rung imsFecMws. x� RECPT NO. 1 �� PAID BY VALIDATKW Signature at Appecam a agent pee WHITE—Department Copy, YELLOW—Finance Copy, PINK—Assessor Copy, GOLDENROD—File Copy, GREEN— Applicants Copy BS106.11189