HomeMy WebLinkAbout1497 (17).-�^.•7 t.., 4w.�—^^.v ^"•. r,F- err..—.,:,c"'"'7-'p :'<+�i✓•': l-!r0:'-»Tw+. ,y.�. .. + : y �> 'e7�FT'.^+ �•^3„ ^s is +,�.•�+.r-�. .: ?. ser ^_
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CITY OF DIAMONDBAR
�- PRESS
DEPARTMENT OF BUILDING AND SAFETY
L BUILDING PERMIT FIRMLY
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DATE CATION . PERM IT I • ��/ Cus 15
ODE
ISSUE r "" ti TYPE OCC.
DATE I=' ) CONST. GROUP
APN LOT 6 TRACT4�
CROSS SPE EET _� -
OWNER �•SY' ,
ADDRESS JL
CITY Iz 126 �ZIP� TEL f
APPLICANTS / 77 P �-��� ✓ TELr:_ � IF
SETBACKS ae+toaEhEaars
ZONING FRONT RW ❑
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REAR El_JiJI
SIDE/SIDE STREET RW ❑
SIDE ❑
CONTRACTOR ~T" MoOemee Electric, Inc.
ADDRESS P•0• BOX 1111
CITY CtlfnO, CIO- ZIP 9110F3 TEL X91—Ca46
SEWAGE ❑ PUBLIC PMT A
DISPOSAL ❑ PRIVATE SO. FT./ 100 GAL
STATE
LIC. NUMBER 490083 Exp. 4/92
GRADING ❑ CU. YDS. EXC. CU YDS FILL
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TYPE SO FT FACTOR PSF ADJ. AAEWALUATION
ARCH/ENG/
DESIGNER
ADDRESS
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2
CITY ZIP TEL.
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NO. DWEL. NO. NO.
UNITS STORIES BEDROOMS
LOT DIMENSIONS
GARAGEmPORCH
VALUATION ADJ. AREA
NO. OF BLDGS HOW
ON LOT USED
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ANTrTY DESCRIPTION FEE
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LICENSED CONTRACTORS DECLARATION I hereby affirm that I am licensed tinder provisions of Chapter 9 Iconoencirg'
with Saxon 7000) of Division 3 of ted Business and Professions Code, and my license is in full force and eftectV
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❑
OWNER BOLDER DECLARATION I hereby affirm that I am asanpt from the Contraclw's License Law for the hallowing
reason (Sec. 7031.5. Business and Professions Code Any city or county which requires a permit to construct.
alter. impfove. demolish. or repair any atructwe. prior to its issuance. also requires the applicant Ia each permit
to file a signed statement that he is kcensed pursuant to the prnisons of the Contrector's License Law (Choptar
9 fcrsnmencing with Saxon 7000) of Omskn 3 of the Business and Prolossiorc Coda) of that be is traps therefrom
and the basis for the abeged exemption AM va4lion of Section 70315 by any applicant for a permit subjects
the applicant o a tied penalty of not mare than five hundred dollars ($5001).
❑I, as owner of the property. a my employees with wages as Mer sok conpensaoen. will do the work, aha
the atis notintended or offered la sale ISec. 70:4. business and Piokssnns Code The Contracts s tkorise
Law does not apply to an owner of property who builds or improves tWean, and who dos such work himself,
or Ihrough his own employees, prwrded that soh mprwerneats we not inerded or offered for sale If, however,
the building of improvement is sold within one year of Conpklnet, the owner-boler will have the burden of provng
that he did not Auld a improve for the purpose of sale I
❑ . as owner of the property, am eeclusrvely contracting with Insisted contractors to construct the protect ISec.
7044, Busi'as and Professions Code: The Contratai s License Law dos not apply o owner an oer of property who
builds on improves thereon, and who contracts lar Unit protects with a rontrecter(M) Irtenrd pwsttarn to Me Contractor's
License Law I
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CONSTRUCTION
❑ I am exempt under Ser. , B. b P.C. Witch Certifica el.
_REyIEW _ J / �•
Date Oyer
.PLAN
ELECTRIC~
WORKERS' COMPENSATION DECLARATION I hereh affirm that I hwe a Carhnsent o no insure, or
fcate of co
a certdcate of Wmkai Compensation Insurance, a a eaofied Copy thereof (Ser. 3800. Lab C.).
❑Certified rrrp9ii hirsM fannshed. — --- .. ' . , •: _ :... _ ; - >: _... . -._.
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PLUMBING '
MECHANICAL-- . .... ..... . ..... ... __,..•....._�_,_._.: ..:._--- _
p�
Iskl Cenbhed copy is filed with the Budding kiwaseen Department or DepatmML
Q
GRADING
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section trod not be C -i -Nd
d the permit is for one hulled IS IOD) a lass. I randy that in the ponformeno of M work M whick this
patent is issued, I shall rot employ any person in any manes so !s'p aaMwe Mutters to the Mbrkeri Compeneawan
Laws of C.14or < J s
Gate. �Anka�,�ey.•� .L�a�.r
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ISSUANCE �'.'� '�•' ''
—
SMIP
PARK FEE
SCHOOL FEES
NOTICE TO APPLICANT. N; after mekirg this Ceref cae of (smaon, Year shaded taamrr atApn anOn ywka's
Compensation provisions of.the labs Code, you must londmrnh comply with such pnaigons or this permit sAall
be deemed revoked. T! )i
OMSION OF INOUSFRIAL SAFETY PERMIT CERTIFICATION- �f
01 hereby certify that mi excavation five (5) a mere fol ept/h' ns wh ch a
will he meds in con lion with wink aohaaell by tele pawn. anddhan m �N xructve, tulkeNrep, Ilial w reword , dtl lalawata
ar k
a it-.*.. a des ri thaeef, will be mere Men Mirry-al. (381 loot high, JQty,1�y2. Crap t. An 2. sec,
341. Turk 8, C A I. (IUJLJu
❑As owner6wlder, I will rot employ anyorre to do AR waid again a power hem IM Divprr of
Industrial Sally, as noted stove. unless such person has a pawn to de such work hew it* dwin 7 hI�
. rL i 7 ur
❑Owls of 104.31141 Safety permit No.
.
..
:TOTAL FEES tt i
�r'i✓ •ri `"ie
CONSI`RMIDI1 LENDING AGENCY. I hash affirm Ilyk,llrr,isR 8ogaattat Werdrirp agency IN em Allman
of the work for which this paint is issued ISac.-
lenda's Name
leader's Address
.COMMENTS .
CERTIFICATE OF COMPLACE AND AUTHONZATION OF ENTRY. I Citify 1 two rod Mit Applicable and stay
that the information pirven is catect. I atpo to two* with aE am laws and rdry adisrrn raA as is Yiding
[asttruetan, ad'eudrorne a Ipresaelabn of tlr Dspartarent of Baiiq ant Sally b aeeer rep dale preperp
la wlrnh LaaGe ajpked Ia this pontis la tlr pmpse d nlrekiq inpckan. (•_
.
.
Its -
RECPT NO. `J PAID BY _= { VALIDATION
sgnaar. d Applleewt or Apeni Dar
WHITE—Department Copy, YELLOW—Finance Copy, PINK—Asseaaor Copy, GOLDENROD—Feb Copy, GREEN— Applicartb Copy