HomeMy WebLinkAbout1499 (19)I
CITY OF DIAMOND BAR (-1
DEPARTMENT OF BUILDING AND SAFE) ,t
A t BUILDING PERMIT
PRESS
FIRMLY
JOBSITE n
ADDRESS `rgE
APPUCA11ON PERMITSE
NUMBERZY'CICI CODE
TYPE CC.
CONST GROUP
APN LOT 50 TRACT 42 64
CROSS STREETETBACKS
OWNER Bramalea Calif. Inc.
ADDRESS One Park P1. 4f1100
ZONING affix Ekcwm
FRONT RW ❑
REAR ❑
CITY Z P TEL 891-31
SIDE/SIDE STREET RW ❑
APPLICANT TEL.'j&A3 I
SIDE ❑
McGee ec ric,Inc,
CONTRACTOR
ADDRESS P.O. X
CITY Chino ZIP 91708 TEL.991-6461
SEWAGE DISPOSAL ❑ PRIVATE PUBLIC PMT
SQ. FT./ 100 GAL
STATE
LIC. NUMBER 49.0118.3
GRADING ❑ CU. YDS. EXC. CU YDS FILL
CO
TYPE SO FT FACTOR PSF ADJ. AREAIVALUATION
ARCH/ENG/
W
1
DESIGNER
ADDRESS
LL
2
CITY ZIP TEL.
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3
Z
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PROPOSED USE
GARAGE
NO. DWEL. NO. NO.
UNITS STORIES BEDROOMS
LOT DIMENSIONS
PORCH
m
VALUATION ADJ. AREA
OLIANTITY1 DESCRIPTION FEE
NO. OF BLDGS HOW
ON LOT USED
fJ
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LICENSED CONTRACTORS DECLARATION I hereby offum that I am Licensed alder previsions of Chapter 9 Icommencing
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with Section 70001 of Davison 3 of the Business and Professors Code. and my, license is in hl force and effect
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MYNER WILDER DECLARATION I hereby affirm that 1 am stamps from the Conuacta's License law for the following
reason (Sec 70315. Business and Professions Cade Any city at county which requires a permit to construct.
alter, improve, derr6sh, or repay any structure. Prior to its issuance. also requas de appbcant for such permit
to file a signed statement that he is licensed pursuant to the prwisons of she Conaattor'a license Law (Chapter
9 lcomrrenciN with Section 70001 of Division 3 of the Business and Protestant Code1 or that he is stamps therefrom
and the basis for the staged exemption AM iodation of Section 70315 W arty applicant fa a permit subtects
the applicant to a crud penalty of not me than Eiw hundred dollars (=50011
❑I, as owner of the property. a my employees with wages n Men sok compensation, win do the work, and
the structure Is nal intended or offered fa sale ISec 1044, Business and Piolessms Code The Contractor's License
Lav does rot apply to an owner, of property who bull= or improves Mason, and who does such work herself.
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a through his own employees. provided Mat such rmprenements are not intended a offered far ask If, however,
the building or onprmnarri is sold within one yea of canpinwn, the owner -builder will hive the burden of proving
that he did not build or improve for the purpose of sale I
❑I, as owner of the property. am exclusively contracting with licensed contractors to construct rite project (Sec
7044. Business and Professions Code The Cmtracta's license Law does not apply to an owner of property who
builds or improves Vernon, and who contacts la such protects with a cnlractor(s) ktensed pursuant to the Conuattor's
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CONSTRUCTION
License Law 1
❑ I am ecempr wrier Sec , 8 Is P C (Anzh CerofKatel
PLAN REVIEW
Dal, N"`e`
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CTRIC i
.�-.-.r.���
�'��J��j1�J (j
MECHANICAL
WORKERS' COMPENSATION DECLARATION I hereby affirm that 1 Nave a eerafKah tic eonsms m atlfnsure, a
a certificate of Ybrked Compensation Insurance, a a entified croy thereof (Sec.3800, Lab C L
❑Certrbedcopy, ishereby irashed
Caroled copy a tied with the Building hspectn Department a RT1 i 18 i ng Divestment
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE. This when need not be completed
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GRADING_
UANCE
V Me permit is la ere hundred 13100) a less. I terrify that n pnformnce of rile wort for which this
perms is issued. hall rot play arty person in any manner so some aubiecl le th Nbrkeri rgensatKe,
Laws tfi� -
Nate v Apps
ttampae
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PARK FEE
SCHOOL FEES
NOTICE T APPLICANT. lf, aur making thio Cerklcof oon, yea shouldbecome subhat to tlw Nbrker's
Canpensanon provmns of the labor Code :'yee meet forthwith _cooply with such provisons or this permit shag
be deemed revoked
DMSION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION u i
❑I hereby certdy that m eaaialion Ire (5) a mere feet in depth into which a person is raµnamd.
d to des
2 be made in connrecton with wwo�kk tbgad by thus perms. and that no building structure. scaffolding, hisswork,
a demdhhn a dismantling Ikial,rii�e imlre �lurt tlirtyaa 361 feet high Chad 32. Grp 7. An i. Sod
341. Tide B. CACI
❑As owner bwber. 1 pg. attic empty any. to da wart which would requua a farnrl from M Division of
Industrial Salary. as noted elohie. �rkss skb parson has a forms to do such wort from the division
I'�I fFN eel:; ,,� "•'�.••: :•:.✓ f ry
❑Diwsrn d Idustrul lehrf4rmt Na ... / ° • ,,.
$La
TOTAL FEES
CONSTRUCTION LENOIG AGENCY. 1 hereby ofhrrn Val dire is s dansVucbon lenp ndagency for der perlaer
aKe
ofthe work fa whKh dvs permt k issud ISee. 3007, Cru. C 1.
Lender's Name
COMMENTS
Lender's Addess
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY. I candy I hate tad dais 20486n and stew
that the information Irven is Coned. i agree to comply, with ag shat lows and city ordinances; rawsig to buadng
construction. v u impressionism of the awhinent of Ideddatp and sally so our apron the prgaty,
hr w sae Diked b this prone for ted
I�f^T �if7K
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M;77
RECPT NO. l51v U PAID BYO/2 / VALIDATION
e a Appkent a AderM gale
WHITE—Department Copy, YELLOW—Finance Copy, PINK—Assessor COPY. GOLDENROD—File Copy. GREEN— Applicants Copy
SS106.11/89
MSPECTION RECORD
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