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HomeMy WebLinkAbout1240 (6) � . w � �'''` CITY OF DlAMOND BAR PRESS � DEPARTMENT OF BUILDING AND SAFETY F�RMLY BUILDING PERMIT JOBSITE APPUCATiON PERMIT U�E ADDRESS �3 S � � � e DATE NUMBER CODE � APN OT Z TRACT� p TEE �� �� `v C�ON�ST G�P � CROSS STRE T� $��K$ � a� °-' OWNER � ZONING o ADDRESS_�?Z-.� Q!]��Yt�+�T�2-po- �'�� REAR ❑ W CITY,�.%•�ptt� � ZIP 9l7�5 TEL SIDE/SIDE STREET RW ❑ a APPWCANT ' TEL. SIDE ❑ ` CONTRACTOR " �- s �", SEWAGE � pUg�.IC pMT# p AODRESS ��y S iA��FITE.CL J FF '�2 DISPOSAL ❑ pR�VATE SQ.FT./100 GAL w CITY�AMON D �ZIP��TEL. W SC.NUMBER '�I S��S Si GRADING ❑CU.YDS.EXC. CU YDS FILL y ARCH/ENG/ � "�PE SQ FT FACTOR PS AOJ. AREANALUATION �' DESIGNER� W � p ADDRESS ,�� �+t1� ��Tlt '$,T. � f.J � 2 Q z CITY�La M Pn�r- ZIP�TEL.`�?-J U 3 � PROPOSED USE Z 4 � � GAflAGE Q NO.DWEL. NO. N�• � P�RCH y UNITS STORIES BEDROOMS � LOT DiMENSIONS � VALUATION ADJ.AREA o NO.OF BLDGS HOW QUA E.S'C�RIPTION �EE W ON LOT USED � ae U ~ ❑ C7 110ENSEO COMNACTOHS OECURATbN I AereOy Nlvm��at I am IcmaA wtln 0�'isian ol GpeD�x 9(commnKinp Y wnh Sauon 10001 of Dhrspn 3 ai the Buamess ud Pmhssiona Gode,md mY Icmee i�m hll lace rd dhct W cg 3 � W � �1JJNEH�BUIIOEA DECIARATqN I herehy MLrm the�I�m eumpt Irom 1he Convsior't LKenp law la Me lotlowinq � reason�Sec.7031 5.Businasa md Prolesuons Code Any cay w tounry w�Kh npwru a pmm�M epnalru[I, ('� $� O al[er �mprove demdish,a repair em n�ucwro.pinr m ns iacuence.Nao requres d�e�p01x�M lar s�eh 7ermn � • 1=- to hk�sgnM mremem�h�t�e rs Iccnsed ourw�m ro the prwrsbns al roe Cmnx�or's lkanse L�w ICh�pur p] e�e g icmmmmcmp w�N Secnan 7000)of Orvison 3 al tne Busirieu and Prohss�ona Codel�that he is ewemp�thuehom � � enE�he 6as�s hi tha slkged uemp4on Airy v�Wanon ol Sxlron 70315 by Iny�ppLnnl Mr a Omm�w6Kcts � W tM�pphc�N to a crvd penally aF not moro thsn frve hunGrcA Aallais If5001) Q � ❑I.as owmi nl Ihe properry a mY employees wnh w�Bes�s Ih�v mk comqnwoen.w�l tlo Me woiY.n� ih cvuc�urt�s noi imeneed or dfered fa s+le(Sec.T044.Busineas mtl WMessans CaOe TM Lm[ncmr's luense f,~„� Law Eces rot aDo�Y to�n owner o�oroperiy vrho bwNn p impmues lhereon,trd wM Aoti suoh wo�k himeelf, (�y' W or lhmugh Ms wrn emD�o'I�es,O�d+�dad tMi auah imprOr�mmts are nol mtended or Mtered Po�N�M,hv,wwr, Z = ik Gmltlinq a unpravemeM u sald wnM1in o��yai ot�omp4Uan,the owner�huilder w�n nw�we e��em m Mo���o q N iAa�he d�d nat 6wld w xnDrme lor Ihe purpose ol s�e) _ i.) V) ❑L�s aNrei ol Ihe P�openY.�emWsrvely canln[uny wn�IK�nsN cmiwcmrs N canstruct Ilx pra�ecl(Sa IL 7046.Bus�ss�and Prolessian�Cade Tht Lomrxtor's Litena lauu loes nol+pply to an ovmer pl proqrly wFa � Z uudds oi imprwes Mneon,and whe ronv�cu for wch O�Iecis with�mntraroqsl 6em�M W�sum�b Me C��iKtor's � ���•^�<<■w� CONSTRUCTION 0 r ❑I am etem0�under Se .8 b P.0 IApxh Cernfc�a� {�� �/�ENf � °are °i""" LECTRIC ' - s WONKEXS'CaAPENSATqN OECLARAl1UJ I IrreEy+w�m m,�i n:�.nrnn�am a�em�i�o:r��nsw..a pLUMBING �" a cemhwre a1 Ykrleii Comxnsanon Insurmce,m�caiihed copy iheeal ISa�800,tih.C.) 6 ❑Cernfied capy is herz6y lurmslmd � MECHANICAL W ❑Cennua copy n�ree w��h M�Bui�dinp Inspecem Opximem n Oev�an�m Q (,'� a CEATIfICATE OF E%EMPTION FRdN YARKERS'COMPENSATION INSUIIANCE 's pn eed not mmpkted � v � d the Deimrc is lar one hundred(SI001 a k�a I uruly tlut m e qd ne N w w n v' mn n issued,I shdl ro�am iry (P . OH vbY MY armn in, mannei ao. o a n t ro er m � �.,,,,si c,ino�na, PARK FEE p Oate �pp�iunt � W W NOTICE TO A LCANT ,d4r mek�nq Ilx�Cn61Kne d �on,pu shaJd lecome waeq ro Me N1xku's �- SCHOOL FEES ! Compensanm O��swns ol Hr la6or Code.you muzt eomply wiM t�h paienm a Mrs oemif aMI �+- 6e deeired rEuoYed n...� � � pVISIUI pf INGISTNIAI SAiETY PERMIT CERTIfCp "�,,.1� "'�D 1 W $ � �� a- ❑I hereep cendy ihet na�ttrva�an hve 151 a mwe I�in d6CtM1�iKto whieh�persm n npwred lo b+cab. o�G wiN he mede in connecnon whh xak i111wr¢ad by d41 R�mk.md Nal m 6Yildinp ia�[flre.fLYIMEin1.hl�ewar4. �- a demolmon ar drsmanthnp thereal.xnll he more Nun�hrtry-Nx I�)�et hph{Chh�p 31.Gq 1.Rtt 2.&c z 341.TMe B.C A C 1 ���i� �Y�r� A o) 3 ❑As owirr�MilE�r.1 witl rot mqhY nyone la hie Nquld rpm�e�print hwn de arrism d � Indusmal S�IetY.+s naud Wave.mkss mch penon M��pemy�m�o�ucM1 wor4 hem Me H+nion. � ❑Dms�mofbdusbalSakh��tNo. '- ',���.! ' �`:� .. E�'�";} TOTAL FEES CWSTflUCfqN1ENDIN6AGENCY:IhiMy+ 'm t6ve'sy�tensbueow.NndiapNent/'krYr'nbnnrin � a d�lie work la whKh this pemiit u rstued ISec{�,7G.9,I��C�• � s �''"'"" COMMENTS m lenki'e Address ` CERTKICATE OF COA'PIIAlrE AND AUfF�UZATIQI OF ENTNY I drMy I MYe md rus ppliution rd fLh sn ma ea nfurtuean Qu.n r arRn 1 pree o comply wnn�p sun Mws Nd dry a6�wr�s rttnp m hrNiip yconstnKoon.and w��M1oriu�nVieunutiw d Or Dquunent d&+ddinp rM SoMY 10 w�Yr�pon qr�np�ry � M whch I haye�pphed lu Ihia oannn 1a IM pupou d nrkmY w�pettnru. X Sqnatue d Apqrnt a Apent p�y RECPT NO._.!l.Lti�PA1D BY � �_VAIJDATION WHITE—Department Copy,YELLOW—Finanoe Copy.PINK—Pssessor Copy,GOLDENROD—FAe Copy.OREEN—ApplicanUa Copy �Qf66-11lB9 ,Z� -• . . -.. . .. .. , . . -' e� .. , , e ,�.. • ,_. _. ... . . � � . _ ;�::: .s.:;;•'..,.,� ,nr•..o..... . . . �-.�m .n- , ....:. � - �,; �:<-..(����� '� ���..Y �������;�.; .�������� � :.. � ::�� ��=;.� , , ��Y�` . . 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