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HomeMy WebLinkAbout1171 _ _ . � _ . . ., - P c���t�"- � � � r �� , ClTY OF DIAMOND BAR PRESS DEPARTMENT OF BUILDINC,AND SAFETY FIRMLY @UILDING PERMIT JOBSITE APPLJCATION �„ PERMIT U� ADDRESS a��VE NTU�ER,�..,�CODE ,► APN LOT TRACT� DATE ���[�""� CONS1: GROUP o CROSS STR SET6ACKS �� °-' OWNER ZONING �� � � � ADORESS REAR � „� CITY ZIP �TEL ��" SIDE/SIQE STREET RW C� o APPLICANT TELy � SIDE ❑ x .= CONTRACTOR �� -- -L�' � SEWAGE 0 pUg� p�# o ADDRESS �'' � � ' DISPOSAL ,� GTY ZIP TEL. � PRNATE SQ.FT./100 GAL � STATE GRADING ❑CU.YDS.EXC. CU YD5 FILL � LIC.NUMBER y ARCH/ENG/ , � TY�"'E Q FT FACi'�R P5 AD.1. AREANALUATt �' DESIGNER � s�� 1 W y I • O ' o ADDRESS � � W LL 2 �J`� = CITY ZIP E�, {� 3 i f • � � PROPOSED USE � 4 � '�,�' GARAGE P NO.DWEL. NO. NO. � �R� y UNITS STORIES BEDROOMS m � L07 DIMENSIONS VALUATION AW.AREA o NO.OF BLDGS HOW QUANTITY p�SCRIPTI(3N FEE W ON LOT � USED � W H �, IItENSEO fAMRACTOH9 OECLANATIpN:I leiehY dfirm that I�m kanaed undar pmvoions ul Chepyr 8 IiommmKnq � Yp w"vh Saua �01 0�Oivrsion 3 of the Bucmesi end Prp�essiona Code,md my licmae u w fui loice Nid AhcL � 3 W � OWNEN BUILOEP DECIAflATpN�I�eieW dfi�m tl�a�I wn�cnnpt trom tM Con6actar'�LKenu 4�w lo�Me IWv.rmp = ie�son ISac 7031 5.Businesa md Prolass�ons Cade�Any uly e�eounty whch rpurrp�oermrt ep eonsuucl, (7 o alter �mpo+e,d.maush,or repair enY����uro,prror m nc��euaMe,Nw rpunn Ma�ppliunt la auch osrmn �,2 � ` io fAe�sqned atattment tha�lie is licenaed pwsuent ro tM1e pais�ona of Me Cenvxmi t Liuirce Uw(Chprlm tp pC 9(canmencing w�th Saoon 7000)d dwaan 3 al Me Businen and Prdessions Codel a tlwi M u enmpt thxelrem .�'� � and Me bess ta�M�alkged eeemp�an Airy vielalion cl Seclion 70315 by ary applium ta�perml au6R�U �� W t0e�pphcanl to a crvd penellY ol ml more Nan fve hurdnd doAen IS50011: � FO„ ❑I,as owrer of ihe prtqeny,n my xnpoyees rnm wpe�u ihelr mk tampen�anon.wAI tlo the rro�Y.�tl ilie atruclure n not intended oi offered fn ule 13e[.iD04,Buainess�M iroiessmns Cade The Lantru�v's Litenae q r,~j Lsw does rot apoly tu m awnar ol property wln 6mlds a improves therean.aM Mho does auch rarM h�mull. � 'V . ' a�hragn his own employees_prwiAed that such improvemems an rot i�nndeE Q ofhmtl lar sek II,howeuer. � � the huiMmg or irtqrm/emem n�oM Nvehin one y�n d comDknon.dr u�'ner�6uilder vnll I�eve Me hurdm al ryorNp :q. y [hN he dd not huild a improre lor Ihe W�W��sak.l �� � ❑I.�s owner of i�e O�opery,rn evoiuuusry mnnecnny wM IaenseG eonvacmn m mmruct tlr pqect�Sx 7014,Buvress mA Vrofessiont fqtla Tlt Comncni�License ew bn nm�pply m M axnr el puperry who � . ` 6mMe ar improues tl�ereoq m op f«weh is conlrKmqsl Y sM uam ro e Cmu�cmr'i , �"""'�'°'"' e� CONSTRUCTION I � ❑I am�umpt uder Sec _, 6 P.��a,Krk��o�,roi. . pLAN REVIEW _ • . � O7e °' ELECTRIC � WURKfRS'COMPENSATqN OF0.ARATION I herehy�Ihrm Ihn I A e�eerOfcm o!tanemt Io aW-naun,�r o a aeru�ma�e o�µb�wers'CompensBtwn Inwnrce,or a enWied mpy ed fSu�eoo,��e.ci. N PLUMBING 4 ❑CernUed capy n MrcDy fwmshed J MECHANICAL o ❑CarulNd capy rs liled wrth me BmMinp Iropxuon D�Oartment w O�pr�mwi. � QRA�ING W � CERTIFiChTE OF E%EMPiHq�l fROM VVDHKERS'COINPENSA7IOH INSURAHCE Thi�ucuon med nm 6�romukted ISSUANCE /� y rf�he permil is Por one hundred IZ1O0)p Mss.I pr0(y M�1 h the prkrmr¢e M�he wM la wAcA�ha pNmn u ssuM.I shdl rot empky�M Ontan in�M Mnror eo n ro 6aCome wbl�tl tlr Nhikeri fanpmwtion gMIP � / o �,,.:m c.i�m��.. � PARK FEE 0 o.re n,ci�nm � h0T10E TO APPLCANI M.�fter mekmg tlns CslAiule d Ewmpuon.yao should becane�u6iecr b ihe HbrMn'� SCHOOL FEES —� CmiDensaum oroti�ions ef Me L/bor Code.wu mmt fortlnvih mAAy wiM MM1�OYRqM r tl���Y�o�h�A � . � be deern�d rauoked J � W�SIUY OF INWS�HIAL SAFF7Y PER � ❑I here6Y�1AY tlu�nu atsvroo ( •, et deDth iim w1.c6�lersan s npmrod Eu ducmd. � wil h T�de in cmnecuon wilh�vork a' by '�nd IMt m b�ildnp�ru�lun.�ctNolZnp.Naework. _ a demo6uan a disaentlinp IMieol.wdl 6e mae tlrn MKh'u�1361 Mt hipli.(Clwp 7.2.6ry Y.Art 2.&c �_+� 761.Title 8.C A L.1 . i ❑Ae ermn�hwWc.I wiA na[�la�na t �pyy11+h waWE n9au�pumn Im�Me anem• � I�sUul Sekty,n mted Wm�� a h �qhnildeo oa�h wert ham tlie Nwam. . � o°'""�,�"�,°'.�5�,""'m""° TOTAL FEES � C�NSIHUCTqN LEAb1 E :I �i�f'Ya't'MkMv � NM:q+pen�r ler M rerkm�ce ! 3C al Ar wnrk la whch Yiy'� `i}� �gi p� S Lmder'aName D��LV��I^�1'.U�r.T'�eY f+ m LMNi S AdA6i9 v �� � t CERTIFICATE OF COMVIWICE AND AUTltlPoIAT�I Oi ENTRY:1 uMy 1 M�wad IMia tipknim�d m� aia thet ihe nlamanan prwn a wmct.1�pne oompy ' N�uY Yws Md iity a�inwrca ql�tiq 4 i�il7inp � y canarucum.m R� ' he 1 d BuiIWi9 ad&hcr 10�m ion W Maomry � lor vYh hr Ux�permt br np iqtD�cUons� Sqn�lua d AppFnnl oi AqM, p�q RECPT NO. � H41D BY��,.��YA[JDATI WHITE—OapanmeM Copy.YELL —Finenee Copy,PINK—Assessor Copy.GOLDENROD--FAe Copy.CiREEN—ApplicaMs Copy � • ~~'�•f..�_ ••Ir+. .tV:{'�V . .(•_eA:e .�1r�q�.�('�L�j'. �♦ � i • ., � �.:-�rl�:�p�. . t, . . .� � '.M.e. 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