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HomeMy WebLinkAbout1530 (32) __. ___..._._._ __. . .. -- •. ____.....____W.. _........_....._............. _ ��-- ---- - '"` � CITY OF DIAMOND BAR PRESS DEPARTMENT OF BUILDING AND SAFETY F�RMLY BUlLDING PERMIT JOBSITE APPLICATION � PERMIT �2T SE . ADDRESS � < DATE -� NUMBER��CODE ' ISSUE TYPE OGC. ` APN _ OT�C_T CT� DATE `��' CONST. GROUP o CROSS ST ET 1 � �.���x'� '�` ZONING SETBACKS `�''PO'�"E'"s °= OWNER l EAR � � � ADDRESS W CITY ua a_...ZIP � TEL '�� SIDE/SIDE STREET RW ❑ o APPLICANT • �L.����'�' TEL S�� SIDE O z � CONTRACTOR SEWqGE ❑ PUBUC PMT� o ADDRESS Z F - • DISPOSAL Q pRryqTE �.FT./100 GAL W CITY n'._�p�nr� �t'� ZIP g� � TEI.. Q /� Z STATE GRADING �CU.YDS.EXC. CU YDS FILL y LIC.NUMBER ";'�(pE SQ FT FACTOR PS A�.J, aREANALUATION y ARCH/ENG/ �/� W 1 (� `—' DE5IGNER � � ADDRESS LWL 2 x CITY ZtP TEL. (�j 3 � PROPOSED USE �,eE�l— L.90 t�oI d 4 $ � GARAGE o NO.DWEL. NO. NO. � ppqCH y UNITS STORIES BEDROOMS oc LOT DIMENSIONS m VALUATION ADJ.AREA o NO.OF BLDGS HOW � � 4uANTmr DES RIPT�JN ,: : �. : FEE ' . , , W ON LOT j USED Q grd r�►�� � W ❑ H � LICENSEO CUMRACIORS�CLA0.4TqN�.1 MnEy dfirm N�t I rn licenpd mdv provitian+o�CAaptu 9�WmmaKinp Y wnh Section 10001 e1 Uivision 3 d�he 8us�ness md Rolessona Cade.and my Irmu it in full Porn eM eNect. w 3 � � ONNER�BUILDEfl OECIAHATqN I M1erehy�flam dut I un wmpi hum the Cuatt�etd't Leenfe Uw la tlm klbwinq . reuon�Stt )0315,Busfness end Professiona Cadr Any ci�Y a county whieh rpuirp a permrt ro cautruot, � Oaher.improve.demofsh.a Rpa�r�m�structure,prior m iu auwice,also rpur�s Ne�pplicml lor wch permil G ro hle a sqnM ctaurrcm M�t Ae is licennd purswnt ro Me prwiwns of the Contrxn��ti�me Uw IIT�D� p7 �� 9 Icommencing with Scc�ian 7000�ol Oivision 3 0�Me Busineu mA Prolessqro Codd a tlut he s�+umpi tlwelram � d u�6 the Easn im th ctleged eMemDUon.Am wolaRon d Srtia+70315 by my�pplium lor�p�Mn wbjens � K the epplkant�o+crvil penaNy o1 nol more tAsn liv�hundred ddbrs 1f50011�� � W � ❑I.�a owirer o1 thc propertY.m nry�mployees witM1 wepea u iheir tak rompenwum,w111 Eo roe wark,nd . r the snu�mre ia not inteMed ai MhrM 1or sle(Sec.70Y1,Busirou uW Prolessione Cad�.ihe Comncta'�(i�mse �.� V La.+�does mt aOC�Y to m avner o1 qoperty wha builds a mqevef thartm.md who das sueA wmY AimwH. � o.�hrough Ho own employess.prw�ded that wch improvemems are ro�inroided a olbred im f�k 11.M1awswr. = the 6wld�nq a�mpwemmi ia�old within one y�n ef canpktion,tle awne-6uiber will M�e tlw hurA�n ol pwiep � y IINI 11!OiE IIOI Wlld Of IIIIpfOV!�Or Ih!�111p09E OI Sik.� _ � ❑I �s awner at tAe qape�tv.+m ercluuvelv convactMy wrth lice�ud oonu�emr:m wimae�Ir y�q«t ISr. W 7f144,Busiross�IN Pf0It531d15 COdE Th!CO�i�N10!'6 LXlnS!Iw�das�mt�ppiy m an wxia d poperly who `� S6uks or�mprwan theraan.and who cantncq la auh pmjects with a conhactw��l��M�W��umt 1e Nr Gmincta'a ` L¢ense liw.l � W ❑4�m ewempl undx Sx 6 6 P 1�it�:n tainie+m. P � � � wu °iwn" ELECTRIC � 4YORKERS'COMPENSAT�J DECIARATI0IJ:I hw�by dfirm Mst I hew�arefiute a��:M��r���,�.�.« � pLUMBING o nrulicaie ol Wor4erd Compeivatim Inwonce,or e cnrilied oapy ihertof($a.9800.L�O.41. � D c��mKa�wv�:n.,eM t���.n�a. � MECHANICAL p ❑f.mitied copy n tiktl wnh tAe BulOuiq hspeeum DeprmNm a o�,.�.M. d GRADING W � CEIITIFICATE OF EllEMPTION FRpd NNHKEflS'Ca11PEN5Ail01d MISURANfE.This ycuan nud rol 1�compNud u v y il th permn n for one hundred(5100)a Ysa.I prpfy Nut in Crc pnWmrrt�st IM wark lor wM1icM M'a - Q � . paimrt is issued.I ah�ll mt empby My qnan in�nY��r SO p b blcame wh�lct p q11 NWiM3'�,Ol�pinY11011 ' SM� 1 L� � �aws ai Ca16omH. o � PARK FEE �, o.« ►w��� W NpTICE TO APPLICANT:N.�Itei m.k+,�a,��Grtifke[e ot E�emption,ya�Mdd Mcmie w6lect b tlr Nbrtx'� �- SCHOOL FEES � Conryienatwn pwisim�ol IM L�6or CoAe.pu nust faMwi�h�m�plY wiM wch Orowons a Ni�oemiit�h�ll � k dcemed revWM � � qVISION Oi WOUSIRIAL SIIFETY PERHYT CENTIFY'AIiW: ❑I henbY cerMy 1M1 no acrvalon Rvs(51 a���d�h��h�,i persOn if rpWnd b IYted. ey_- wdt he mWc in canneam wiE�worY wG�arved by lAs pf1iP1G i�d��l4 MFldin�qruclin.lollolAinp,6hawink. a CmmNim a dismantling 1Mreof.will he ewe Mun��rry��t"�7@I d8e1,.1dph"I�P!2.Gry Y.M 2.See z� �i r�,re.cec� _ � s mmerpwltler.1 wip rot rrybY„W��b worY whrF weuW rpuin�permt hom h��oian N � IIA�SUYI S�My.K IqMA�EDN.MNle WLA p!!!0(A¢'f�mi�b�uch��o�tlr lirition. � . . ❑ansim d Mdua�i�l SehN lMme Mo. 1 C. �'J� � TOTAL FEES oZ � � � casrnucrqw lFNotac AGEucr:�n.nnv w�rm w,�sn.q.fqsauc+iw+rdwro!a«KX��N�0^^� � at i�e xnr4 fu whsh Mia pterm,il q u�ued�.��.�iv;�:I,I_,,;i ... ... i.. ,.. � 4nder'�11ame (.�(Q�'�' . ...-- - .' �MMEI�r � Lede�'e Addiess . .-._._ '� CENfIFrATF Of COAAPIJAACE ANtI AUTMYIRIITM R ENTN'f:I e�ely 1 Wve tid firc;piratm rd�hh N Mat 1M wlolm�tian pwn is wrre[t.I pree b mmply with�II sYt Iwr�Md uq�NiWICC 1141Yp b Widinp . y cau7ructan,wd�uNprue�npMntaW�e d dR D�prleeni d Buitlinp aAd 6rtdy�o�1r�pan Me F��h � lor wAcn I �p Ird or nis p il b Ik p�pme d mkinp iupecmn. 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