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HomeMy WebLinkAbout1506 (19)CITY OF DIAMOND BAR PRESS DEPARTMENT OF BUILDING AND SAFETY �.. RUILDING PERMIT FIRMLY WHITE—Depei"Ir 4ent Copy. YELLOW—Finance Copy. PINK—Assessor Copy, GOLDENROD—Fab Copy. GREEN— Applicants Copy JOBSITE �/ tiG /',� ton APPLICATION PERMIT USE E 9 �9r �y NUMBER /� D ADDRESS J e�8 C�� _CODE DATE - �-9 - 90 CONST. GROUP APN LOT TRACT CROSS STREET ZONING SETBACKS 'wff7E1'L'[m ;V^OWNER or.,a Clive. FRONT RW ❑ ADDFj_ESS I REAR ❑ 21 CITY I, - a 2 ZIP j IZf� S TEL SIDE/SIDE STREET RW ❑ ` am APPLICANT TEL. SIDE El am CONTRACTOR SEWAGE El PUBLIC PMT A ADDRESS DISPOSAL -❑ PRIVATE. SO. FT./ 100 GAL 2 CITY ZIP TEL. ` STATE GRADING ❑ CU. YDS. EXC. CU YDS FILL z >` LIG. NUMBER co TYPE SQ FT FACTOR PSF ADJ. AREA/VALUATION ARCH/ENG/ 1 DESIGNER W LL 2 ADDRESS 3 0 CITY ZIP TEL. PROPOSED USE z 4 GARAGE o NO. UvVEL. NO. NO. PORCH p H UNITS STORIES BEDROOMS m e LOT DIMENSIONS VALUATION ADJ. AREA QUANTITY DESCRIPTION FEE o NO. OF BLDGS HOW W c ON LOT USED U r L ' / / / O ~ LO SID MTRACTCBS DE:LARATCN 1 he•e.y all.,thK I Sm bnrs.d undo pwi ., of US;:. 9 Icomre•rmp [[W.a� Y mi-+. SKhan IOOC; of D,d.on 3 el Y'e Ls ness and P:C'essdns Cade. and IN hent@ is in full large and t11Kt 3 ❑ W LL C::.tifR BI::tDER C[CIAP.ATCS 1 hereto dhrm that I am ewwt from the Conuatlar's License Law Ir de tof,wrrp Pm'essioa Lode Any rad+�'es a to eorYrul. l,7 �, W teaser ISec 74115 Cas nrss and city r county which prima lar 2 O a::r• arpa.te demolish, or repeat ary .1 L"ve prior to itsass.ance also fail ,% Ne aprkam such p.ma H N We a srC+w! s'renerl CaI he n kersrd pcsaant b tet pwadns o! Re Canaxfar"3 lrnae law IChapfn m I s w O s 70:0; of D. w O at she Baa.ess and Pralessiort Codel a the be a a•empu doll". 9lianrenc�nl Klt^ Sint .& 70315 fp � / $ las.. d 2% W tall ehr Cass lo, Ce Sre;ed e.es^D'wn Ary h•a:aeon of $.often M try SOPlcant 1 pees suClrta the al:'kart to a tn.1 p+ally of net mo'e Char. tare huodred.dolarS 135041 I _j CL H ❑I. as moi at the poperty w my e'nrlaeees w m %wes, as Ilru Sde tor'.per.Lbn w.8 can the work and ` (J _ r ,4 sy •Z_ U• =� ""''• it. sr'ucm'e a MI rrtrnlyd r olle'ed to sae ISec 71144. Business a,d Pmfess,ors Code TM Coatracgu's Lente Law des not a;;'y to ar, ware, of pini y ba bydas r, anp~-"eon. and Kho dies such wmk bmu'l. Z q ilk W W it a..;, td own emW-Yee S. pwdM �tb� Isarl' snpnowt,t7 for. 't0I Rttrdvd a of!e'e7 Ir sale 1!, hawser, de tc.c.rg o rmD'w I a uld w Nm ane yew oUcti pte:mr, The dv+,e' build. w 11 hire, 0. Ivin of pw.q res cn that he di.1 Pit h.,ld r rmp'ow for the pu'Pose of sale) ❑t. as awrer of the pggelly M tGMLrr�.y MMISIC.hrk Filth homed [r.a SCtaq to CDnS:Fun Irl pgK1 ISK V W c 7O•H Bas,ress and Ptrtetwrs Caw .The Cov:yattcr's license law dant act appy -to an owner of p'op'ty aha Z rywts w.th a ce^t•sl licensed put -art 10 Me Cantund's b'.df a ,mpwes Ca'ecn rd who COM'xts lx weh pxdg �aQ s Lice-wLawl - ....._ CONSTRUCTION o aaa H ❑I era e,emp! urdw Sec B 6 P L IAlirh Ln ulrael PLAN REVIEW '17•DI Ilo.glo_ `= a'• °"^" ELECTRIC 2 57e o 0 CDMPfNSATIIN DECLARATION 1 hnehy a!'.m Nat 1 tire a [nblcate of [-runt In sarl 01 a aW,IReERS• PLUMBING I grrht.a•e of vw.sai Co Aeration Insua". a a car uled Cray thwK1 (Sec OBOC• lab C 1 e❑ Cau'eE gxr is he'ety Irrmded J MECHANICAL j 2.00 o❑ rrf.he! Copy a bred or III the 6r4 M InsaKu-n Dedwtmeal r pgatrent Q GRADING W = •�Fj CERT:ICATE Cr ExfMoTOle iROA! IATR%EAS' LOMPfNSATRIN WSU9ANC[ This -[ten fwd of be trrolelad ISSUANCE1S.00 Y S 2_ o O d the pert+t rt lar en hiMled (S ICCI a less I undo Cut �n [4 pwlwmr¢e al M work b hch this v' ^s is ,shed. I that not em a- son. n muni.• so as to biome wbpcf m de 111 atm pe. a employ ry pe' Srry Lm,pen SMIP Sf0 Laws of Cal:rn,a• , l _ ' ' I' = :' I -, ; J LU PARK FEE �.e ..'Apdiui c U— SCHOOL FEES WITICE TO API;CANT M. after-makcq IIS Cerokre M Exemption, you should bKfine tubla[I Ia the VMker•t Con ensaf.nr pennims of the Lahr Code. you mmt forthwith comphill with such pwnens r an parmd shad be. domed reraked n n, -I 1' % C i I I %a 7► s 01h4,l;h Of WOIATRIAI SAFETY PEfib/T L'MIFIC+kTtON C& []I hereto tKldy Nat m acRnm Ire 151 or we feet n depth ease which a person a required to dntrd o C we be modern torrKlion Wlth wdk N4wu4d by Me Perna• Said Owl an heldrep sirmliae, staflaldoll. lYeawpl. rel_ r d—. '.I.. o dismr:s"p thereof, wd be sac Pa. Ow7-sw.1781 Mt Mph IChp 22. Grp 2, An 2. Sac 21c K1•Tire 8. CACI I i OAS orae braider 1 w4 not employ anter to do —k Aith weA rause a permit ho. to Draw ad f— Inst :rut Safety, as noted Mewl, unless such prrlin NS a permit So do such wak born IN 0-ron f WZ. 4:1.cm ❑Dwf.n of Inds sau1 Safety Pmm� No TOTAL FCo O S EES AUKY I eq' dhrm that lairs q a construction le^%'•AI tlw'[y la M pwl.m.ce CneSTRUCTDN LENDS[, hat DI Ili walk la which tha pnr.t a issued (SK 7097. Car C I of PTC qQ Z<=;' I",, s N,re COMMENTS mlt,&'s Address t CFRT;FCAr.E Of COMPLIANCE AND ALIT1DIb1ATUf OF ENTRY 1 crely I MN read M oppkosi will rats H that M .'".afro poen a carries apes to toaeyby An ad sloe laws am city rdnown ealeaep Po badlry y [.,srrKlro, Sill wlhrue a lgresr,tanM of tla Dowimant of Borrope od Salary 'A MY cyan the property SIN wt-Kh I 111re 511 IN MIS permit Ir Ra prPose, at rraYq an petaa ` ' RECPT NO.PAID BY f0 Z VALIDATION Sgnatuc at at I Meals I Dar WHITE—Depei"Ir 4ent Copy. YELLOW—Finance Copy. PINK—Assessor Copy, GOLDENROD—Fab Copy. GREEN— Applicants Copy