The URL can be used to link to this page

Home My WebLink About130e ti ice' Y CITY MJF DIAMOND BAR DEPARTMENT OF BUILDING AND SAFETY BUILDING PERMIT PRESS FIRMLY JOBSITE a L ADDRESS T t Y �44�# Ai APPLICATION PERMIT USE DATE NUMBER TYPE_CODE ISSUAPN DATEE CONST GROUP 2 4 3 02 v 3 LOT .�" TRACT 3�` CROSS STREET ADDRESS—L? 2- V 56 otel A.'l/ PG _ ___ ____ - OWNER Sg•ae(r dr- x[:] ZONING SETBACKS "�1AE1m FRONT RW ❑ REAR ❑ CITY �" f%9 awe wiI 17-h- ZIP 11761 f TELL /- O SIDE/SIDE STREET RW ❑ APPLICANT TEL}4r9_aGo SIDE ❑ CONTRACTOR ADDRESS CITY ZIP TEL. SEWAGE ❑ PUBLIC PMT # DISPOSAL ❑ PRIVATE SQ. FT-/ 100 GAL STATE LIC. NUMBER GRADING ❑ Cu. YDS. EXC. CU YDS FILL N TYPE: SQ FT FACTOR PSF ADJ. AREA/VALUATION ARCH/ENG/ DESIGNER ADDRESS_ UI 1 {Uj' ,I, 2 CITY ZIP TEL. (rj 3 PROPOSED USE e Z S a'q- 4 GARAGE NO. DWEL. NO. F NO. UNITS STORIES BEDROOMS LOT DIMENSIONS PORCH VALUATION ADJ. AREA OUANTITY1 DESCRIPTION FEE NO. OF BLDGS HOW ON LOT USED LICENSED CONTRACTORS DECLARATION I lsereby affirm that I am lisermad order potentiators of Chapter 9 (ctenneminD with Season 7000) of Ownun 3 of the Business and Proksmons Code, end.y license is in full force and offs". ❑ L11 OWNERSOLDERDECLARATION I hereby affirm that I am mempt from the Common's Leena Law for the fidkwmg racnn ISec 70315 Business and Professions Cade Any pity or county worth requires a permit to construct alter enprow. demolssh, m repair any structure, prion to its issuance. also mauves the applicant tar such permit to file a signed statement that he is Icetrsed pursuant to the provisions of the Conuam's Lexae Law CNPIa 9 (cammercmg with Section 7000) of IWsmm 3 of fire Business and Professions Cade) or that Ae n aampt tMrelrom and the basis for the alleged enmption Any violation of Section 70319 by any opplecont for a permit subpcis I. aPpbcant tt a crvd penalty of net mon than hue hundred dollars IS500)1: ❑L as wiener of the property, a ray employees with wages as titer soft compenahon, will do the work, and thestructure 4"aintended or offered to ale (Sac 7044, Bapmss and Professions Code The Contractor's License Law does not apply to an owner of properly who builds or mote"& thereon, and who does such work himself, ; ' 3 a. ie( m through his own employees. prowdd Msuch improvements simprovements sr rot intended m offend for tick 11. hew f, the budding m improvement a aid within one year of spmpkmn. the ewner-buildn will haw shot burden of proving that he did not build or improve for ton purpose of sale.) El I, as owner of the Property. am escamwly contractmy with licensed conuaetos to conmnetdo prgact (Ser 7044, Business and Professions Code The Contractor's License Law does wns not apply to an a, of property wit y builds o improves thereon. and who can,—. for such projects with a contractor(s) knnsd pursuant to the Cont otm's License Law) : CONSTRUCTION ❑ 1 sin exempt under Sac . B. h P.0 (Attach Cetilcate). PLAN REVIEW Dat` owner ELECTRIC WORKERS' COMPENSATION DECLARATION I herby aNu. that 1 have a certificate of percent to aK-ensue, in a creditors of Vkrkers' Compensation Inatome, a a certified copy theaaf (See 3800, Lab C). ❑ Cerotied copy is hereby furnished ❑ Certified copy is tiled with the Building Inspection Osparbnant ar Olparlmtnt CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE TMs section two not be completed it theperms a for cm hundred (51001 ahiss I certify that m the performance of M wwk for which this .j < y 0 PLUMBING MECHANICAL GRADING ISSUANCE r -- perm, is issued. I shay net employ arty paran in my manor a oto a become abject to the ftleers' Compematra Laws of California in nt 0 [:- SMIP e PARK FEE SCHOOL FEES NOTICE TO APPLICANT m rbject ue ker's ANT , after afthis Coufcate ate of of Exemption, you should hcac oto drior Compensation Inertia,", at the Labor Code. you most ferthwoh cor.ply with such praieiors a thia permit shag • be deenad revoked DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION /^ --�C—U� f, 01 Mraby corldy debt nut acervation live (5) or more kat is depth into which a person is 1purrd so deseca d, vitt be rode in connection wah wok admired by the permit and dal to building structure, scoffofdug, bawverk, a demofrtion or damendng thereof, well be mere than Ihety-six 136) tat high 034p. 3.2. Gg 2. Art 2, Sec 341. Tide B. CA C) ❑As awms-budder, I mil net employ anyone to do work which would require a parent from M Disease of Industrial Safety, as noted above, onless such person has a Meant to do such work from do diAion. ❑ Dwsuto of Industrial safety Penin tip. TOTAL FEES CONSfRWTON LENDING AGENY AI Mail offlm debt then is a construction Imdkg posy be elle Mal.nhaca at the wink for which tho point u hoed (Ser. 3097, Civ. Cl. Lender's Name COMMENTS trader's Address CERTIFICATE OF COMPLIANCE AND ZATION OF ENTRY: 1 car* I baa tad ft application add ase that the .formgtsii own u mr 1 ap)n a amply tomb i state Wrs ad city odnous reading Y bustling construction, ad taea rap amain} af the Department of Building and Salary b emm riga the Property for which 1 Hve a lad len this mit hid the a of .eking mspmbons. Il RECPT NO. PAID BY VALIDATION t ,- / Sgna e d mints f Dem WHITE—Department Cody, YELLOW—Finance Copy, PINK—Assessor Copy, GOLDENROD—FBo Copy, GREEN— Applicants Copy I N'S", p E C T i 14 rj, E C) R 0