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CITY OF DIAMOND BAR
' DEPARTMENT OF BUILDING AND SAFETY
BUILDING PERMIT
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FIRMLY
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ADDRESS J�-���-' �Lt li!
APPLICATION PERMIT
D_l4TE NUMBER / •� CODE '
ISSUE > yr ie1' '} TYPE OCC.
DATE 1 0 , CONST. GROUP
APN LOT 45 TRAC142564
CROSS STREET
OWNER BraETlalPa sial if - Tru-
ADDRESS a P= Tal a • 11144
ZONING SETBACKS •viaaEkcmm
FRONT RW ❑
REAR ❑
CITY " Tit ADIC-1 ZIP9271,4_ TEL. R51-113
SIDE/SIDE STREET RW ❑
APPLICANT "22 Lk -2 --di TEL.
SIDE
CONTRACTOR "'T" McGt . E ®C•I:E3C, Inc.
' P.U. BOX 1111 _
ADDRESS
CITY L'�liriyJd Ca. ZIP 91708 'TEL. 591-546
SEWAGE ❑PUBLIC PMT
DISPOSAL ❑ PRIVATE SO. FT,/100 GAL -
STATE
LIC. NUMBER 490083
GRADING ❑ CU. YDS. EXC. CU YDS FILL
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TYPE SO FT FACTOR PS ADJ. AREANALUATION
ARCH/ENG/ '
DESIGNER
ADDRESS
ILU
LLL
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CITY ZIP TEL.
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PROPOSED USE r i" ��:I �:.._
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GARAGE
NO. DWEL NO. NO.
UNITS STORIES BEDROOMS
LOT DIMENSIONS
F)
PORCH
VALUATION ADJ. AREA
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QUANTITY DESCRIPTION FEE
NO, OF BLDGS HOW
ON LOT USED
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LICENSED CONTRACTORS OELLARATON. I heraty affirm that 1 am fcuasd Ada previsions of CMpw 9 (conneai
with Swoon 7000) of Oivisuln 3 of The e Business and Professions Code, and my Imes is IAN face gd
WNER BUILDER DECLARATION I hereby affirm that I am tempt from de Conoac sir's Leeman Law for the Mai
reason (Sec 7031.5. Business and Prole«ens Code Any city or county whichrequired a permit to construct.
alter" improve, demolish, on repair any structure, prim to as issuance, also requires the applicant for such parred
to file a, stined statement that he is licensed pursuant to Ile provision of the Contracter'd Licari Law IChdpa
at he is eorpt therefrom
9 (commencing with Sector, 7000) of Drin ion 3 of the Business and Professions Coi or Mr
and the basis for the alleged stamption. Arry violation of Section 7031.5 by wry applisans for a print subjects
the applicant h a clod penally of not more Man fine hundred dealers ISSDO) ):
0 1, a: owner of the property"any, employees with Napes a Mir sok targensatian, with do Ile work, rd
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Ile struwr9 is not intended or offered for sale ISec. 7014. Business and Professions Code The Conortar i License
Law does not apply to an owner of property who builds a improves thereon. and who dors such work himself.
or through his own employees, provided that such mprmemmts we not intended a offered lot sas. N, however,
the building or improvement is told within one yur of completion, the aurwr•hMder erg haw the burden of pnaieg
that he did not Wild or improve lur the purpose of sale I
01, as owner of the property, am exclusively eontraclry with licensed contractors to coottruct the product (Sec
7044, Business and Professors Code. The Contractor's Lo:awe Law, does not apply to an awns of property who
Wilds m improves thereon, and who contracts la such praNcts with a eonttana(s) kcensd puaiwl h the Conoocmi s
License Law
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CONSTRUCTION
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❑ I am e—pi order Set. . B 8 P.C. uMth Cera11ae1.
Date ane
PLAN•REVIEW
ELECTRIG->
WORKERS' COMNSATIdd DECLARATION I Mreby, glom that I haw a traleaw of tonsmi to sold-ksswe, a
a «rebate of vwikers' Cmnpeaeaten Nsuorce, or a certified copy thereof (Set 3800, Lab. C.1.
Q.eerm•d spy is feeeey fumshed,�-.
Certified copy n filed with Ile Bu4np Inspettbn Department a Building - Deprtrrsm.
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PLUMBING
MECHANICAL
GRADING
CERTIFICATE OF EXEMPTION FROM WORKERS' COMNSATMN INSURANCE. Thin where need' be ear�he
�pn
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d the permit is fur one hundred (SI00) a Ins. I certify that n she Performance of On wok whch°hM
', permit is issugd, I that not employ, any pawn in wry monnrtle lei h becti Offset h the Mbkrs' metes
Laws of Calilorn a I/ ?
Dae :a% 7a::' </ V Applicant �
NOTICE tri APPLICANT- 1, after making this Caulrak. d�peor, you slwdd Intone sublect to lee Waka'e
CWIWS ion provisms of the labor yotPlVrtt} tdmply " tach prwssm or this porrait YsaN
he deed revoked
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PARK FEE
SCHOOL FEES
DVLSl01t OF Nd011STR1Al SAFETY PEAdalleafflyrachl
-
i CI hereby «riny that no eaawwn five 151 or man lent in ire owe a pass n ragwrad m rhseetd,
. vA be mole n tomaoan with work authavd pJ�y MetA`�}IW ne hnddap structl/e. atalloldep, Iattaemh.
• a demohien or drsmandr, char krN; mid ifriilyri ) het high. (Cho, 32. Gig 2. An 2. Sec
341. Tole 8, CA.C.1. L,L,1 s-
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1 QAs onsime-buiWr. I wig nor employ tnypm to do va i;wlsl l-siail nigra a pawn ham b D" of
Industrial Salary. as nmol a C,lunksgtuvfeasen tPr J md-t vmlde tenon tln dwistow.
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❑Owisine d In6rthiee Prmn�iNd-` - �
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OTAL FEES
r CONSTRUCTION LENDING Aii : I Loyalty, thembut Mrs is a tnmtadon Indnp avecy fair to
: of Me work la which On permit s sound ISee 3087. Civ. Q.
' toda•sNares
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COMMENTS
' Lmi Address
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CERTlfCATE OF Cf W-UAFCE Alm AUTNOWATOd OF ENTRY. I ounaly, I haw added ft apploati ve d am
r three the nformetirr own a cares[. 1 Van to woolly with of stale taws mal city adouoca nhay to bed0iq
' cmfauctron, and andronse a npnwrtuove of the Decorousness of Bddirp and sorry or am pen to pop
for which.I have aopind for this emit for On punaose mstsp.Wacsem. f
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RECPT NO. -' "�' PND BY `''� ! VALIDATION
Sgrnwit of Appaeart or Ape Bra .
VW ITE—Department Copy, YELLOW—Firianee Copy, PINK—Asmatior Copy, GOLDENROD -File Copy, GREEN— Applieame Copy
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