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Home My WebLink About1504CITY OF DIAMOND BAR y DEPARTMENT OF BUILDING AND SAFET a l . n HLIIL[]ING PFRMIT PRESS FIRMLY JOBSITE APPLICATION PERMIT/ SE ADDRESS DATE G� NUMBER TYPE_CODE ISSUAPN LOT TRACT DATEE e262— /D CONST. GROUP CROSS STREET OWNER Bramalea Calif. Inc. ADDRESS OI7 ark El . If I 100 ZONING SETBACKS ''"_MeS FRONT RW ❑ REAR ❑ CITY ZIP TELA SIDE/SIDE STREET RW ❑ APPLICANT r TE SIDE ❑ CONTRACTQR " ADDRESS ' x CITY Chino ZIP TEL -6. SEWAGE DISPOSAL El PUBLIC PMT ❑ PRNATE SQ. FT./ 100 GAL STATE LIC. NUMBER 490083 GRADING 13CU. YDS. EXC. CU YDS FILL (n W LL TYPE SO FT FACTOR PSF ADJ. AREWALUATION ARCH/ENG/ DESIGNER ADDRESS 1 2 CITY ZIP TEL ('3 3 Z 4 PROPOSED USE G GARAGE NO. DWEL. NO. NO. UNITS STORIES BEDROOMS LOT DIMENSIONS m PORCH VALUATION ADJ. AREA ouANTrrY DESCRIPTION FEE NO. OF BLDGS HOW ON LOT USED U ICE l® SED CONTRACTORS DECLARATION I hereby aif.- that I m kensed under pmvisrons of Chapter 9 Icammennnp with Section 7000) of Clumm 3 of usiness the Band Pmlessans Code. and my license is in hull force and effect O� W W ❑ OWNER BUILDER DECLARATION I hereby affirm that I m anent from the Contractor's transit Law M the 1.11"np reason (Sec 70315. Business and Professions Code Any city a county which require a permit to construct, alter, mP,—. demosh, or terpin any structure. pia to its issuance, also requires the e spfar such Perini to file a signed statement that he is licensed pursuant m the provisions of the Contractor's License Law (Chapter 9 lcommmnrg with Section 7000) of Psion 3 of the Busmen and Pnofesaons Coded at that he is exempt therefrom andthe basis lot the alleged tsempuon Any violation of Section 70315 by any applicant for a permit subjects t e applicant to a cwN penalty d not more than Iwe hundred dollars ISSOo) I. ❑ as owner of the property, a M employees with wages as Nair sok compensation, will do ore work, and () Z m J ah, on,structure N not intended or offered I. sale (Sec. 7044. Business and Professions Cade The Centraclor S License Law does no apply to an owner of property who builds or improves Hereon, and who does such work himself. or through his own employeet, pounded that such inproements are not intended a offered lar sale If, however, to budding or irprovemenl is sod within one yew of completion. He owrsn builder will be" the burden of prong that he did not bund ar rmpnoe lot He purpose of sale 1 ❑ I, as owner of the property am esclusmly eunbactny with kensed contractus to conrnuct the project (Sec 1044, Business and Professions Code The Contractor's Lrmse Law does not apply 10 an owner of properly who builds or improves lhereun, and who contracts 1ot such projects with a tonlractor(s) kmsed pursuant In the Cun rKlar s Lrenme taws Q (� Z G , U gag CONSTRUCTION 111 am eremp under Set . B b P C (Attach Certrhute) PLAN REVIEW Dd1e Owner J LEC R I 70 PLUMBING MECHANICAL YORKERS' COMPENSATION DECLARATION I hereby affrm that I have a tortrfrate of content to self insure, a a certificate of Workers' Conpensalm Inwraae.. a certified copy Need (Sec 3800. Lab C1. ❑Cerblyd copy is hereby lumshed Cerbled copy is filed with He Building Inspection Department .R�E3i n CI C*vt enc CERTIFICATE OF EXEMPT10N FROM WORKERS' COMPENSATIONINSURANCE. That whom need rot be completed d to permit is la one hundred (5100) a less I eerbfy that in to Iamunce of the work to which thispermit is issued. I s A roty y emand Pers^^.M and mann wI,, b ore V%rkni Compensation Laws d c O Appkunt Q WDail LL G SSUANCE SMIP PARK FEE SCHOOL FEES NOT OTCf TO APPLICANT. a, cher making this certificate of Exemption. on, clerk be snApct b tle Worker's Campensatron promons Of Ili Lab. Coda. you mutt Forthwith comply with such prowsasn er thus permit shall be deemed evded. _ ,pi, I• ?.•"'^ DWSION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION;', '� ;•�-:' into which a person is red to descad. at an atcavaten Ito IV) a e Ifet m depth nW ❑I Mreby certify Hmor ' Wilbe made in cmnectm with work rnhorted by that perms, and slat na WAdug atrurtue. acaNsdmg. Idsawak, wfor 1A. low 7Z, Gift 2. Ail Z. Sic an dm,ol in a WsmsnM1p thereof, will he more Han ah 381. t Frp 341. Trove 8, C A C 1. ya V(3 L 8 �rJ anyone to do oak which wood return a petawt from am Oivnion d ' DA, owner daldn. I wil not employ anyone Industrial Safety. as toted shove, unless such person hes a punt to do such work tion, IM division. i ❑dmsen d Irdustrrel Salery fhim4 No.' �'•Y = •- 'T'� TOTAL FEES Jo (� 1 r ar ifa ion at se asa corotrucnon lending agency taF CONSTRUCTION LENDING AGENCY, "I he* affair, NHe of it. work fon whch Hit permit h issuid (Sec 3091, W. CL Lenders Nan COMMENTS to wai s Address I CERTIFICATE OF COMPLIANCE AND AUTHMZATIOf OF ENTRY, I catty 1 here lead am appdirMien said aurae i that the nlormabon pion is correct I agree to comply, with as state laws and edy ordraara reinstall d brNrq conaractm, and .me a rapretentaoa of the Dgtrmml of B.dwq and Safety b • K aeon the Inc" ckan la which I bhed for Nm Formal far the purpm d making nepi RECPT NO. �-� PAID BY D VAUDATI I� Ae !�� Q $ynNe d Applicant a Agent Oak WHITE—Department Copy, YELLOW—Finance Copy, PINK—Assessor Copy, GOLDENROD—File Copy, GREEN— Applicants Copy BSit76.11/89 '