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HomeMy WebLinkAbout1189 - -- .,--._ _..... .._ �.._- .-._, _ ...__ . . .....,. _._.. 4 J � �, � � � '- '"`� CITY OF DIAMOND BAR PRESS '•��' � DEPARTMENT�F SUII.DING AND SAFE7Y `, BUILDING PERMIT FIRMLY JOBSiTE APPIJCATION 6 � PERMR USE ADDRESS���� ���"�� C��l� J�R. DATE �"�� ��--NUMBER��CODE ISSUE � TYPE OCC, 4 APN I�OT TRACT DATE �``�'�a=CONST. GROUP " CROSS STREET SETBACKS ��� �- '�"°"'E''E'"5 ° OWNER ICt�2�C hlv�1)i-.� ZONING �O�__ � ❑ o ADDRESS��g�S C-��{7^I� C.tL,�„F�� REAR________.�....=., 0 w CITY�1�tO�nt� �.�2_ZIP�C�.�TEL� '�5 SIDE/SIDE Sl'REET� RW 0 g APPLICANT �1�[D �C�F��[Gi TEL. 1-Z" �- SIDE 0 � CONTRACTOR ��+R.T�—A nt D a�1�nl�r �°'���- SEWAGE ❑ PUBLIC PMT�► o ADDRESS ���• �o"� S10"1 DISPOSAL � pI�NATE SQ.FT./1l�GAL W CITY �����^1� �'� ZIP '�q� bS TE! �'� 2S z STATE 5�Ol"I� G'3R GRADING � CU.YDS.EXC. CU YDS FILIL� y LIC.NUMBER y ARCH/E � "i'YPE SQ FT �A�A:PS � .°74i3,1::�t�EAN�KL[IAlr�ryN ' " DESIGNER w: � a ADDRESS ;�j,, 2 ^ = CITY ZIP TEL. (� 3 � PROPOSED USE � z � � �P�C1�—S cvk'¢ � l � GARAGE o NO.DWEL-t�+2�' NO. N . ' y " I b � PORCH y UNITS STORIES ��R,����� VALUATION D . DO ADJ.AREA s LOT DIMENSIONS '�`'`�� � o NO.OF BLDGS HOW �UAI�Tmr DESGRiPT N ''. �� W ON LOT USED �: � U � � � LJ ENSEO LOMfiACroftS OELLAfiAT1�N�I Mrehy affum Ihat I am licensed under D�ov�sions of LAapid 9 Itommencing � � wnh Secimn 7000)al Orvisron 3 a�fie&ismess and Proieaions Cade.and my Ixense is in tuB fwce and eflect � 3 � � �+- OWNER�BUIIDER DECIARAT10N:I M1ereM alfirm tl�at�am eaampt frum Me Contrutar's Lcenu Law tor the Fdlowiiy � reasan fSec.7031.5.Busmess and Pmfettians Code�Ony nly or county which reqwra a pe�m¢to canfhuct, {� o alter imFrove,demWish,a repar arcy s7rucmre,Orioi to iis awance,alao repuires�he applican[(or w[h permii Z Q ro f�le a signed s[atement that he is licensed pwauant to tk gwisions of Me CmtracWr's licenae tdw(Chapter ffj s 9 Icammencmg with Sectian 7000)al Guision 3 of the Business and Professia�x Codel a�a�he is eKempt tlurekam �. y and the basis for the alleged exempuan Airy vwl�tmn d Settwn 7031.5 hy any applipnt la a pe�mit w6jects � � ihe appl¢an[lo a civil penaltV of�wi mo�e Uan f'nre Aundred dalWrs ISSOOId: a' W - � ❑I,as owmr ol the properry,or my employees wiU wages as tleu mk eompensaeon,will dp!he wmk,aiM ~ ehe sVuccure�s na�intended ar ofierM lar sale ISec.709M1.Business and P�ofesenns Cade:The Cmttxtar's license Q �j Law does�at apply to m awner a(property w!ro 6wids or inprmrcs therem.�nd who does such wmk h�mulf, �U ' or througn his own em0�oyees.pmwded Ihat such�mprovnmems a�e nat mlentled a offered ia�saA.If,however, Z� m tlie hmltlmg or�mprovement rs mid wrtNn one year of mmpletion.tM owrcr�Cmider wdl haue Ihe Gwden al pwnip Q _ �hal he did not huiN or imD�ove to�Ihe Ouryose of sak.l = N V� ❑I,as cwirer af Ihe property,am exclusrvdy conlractiny wnM1 licensed coniractars M construct 1M pro�ttt(Stt. yU,( p1044.Busir.ess and Pmfrssions Code:The Convxmr's license Law does no�apply m m amer at ptoqrry wha �� Z hbilds or improve:thaeon,and wha contracu for su[�prajeeh wrth a rontracmrlsl iicmud pusuanl In tM Contrxla's �^� 4 L1Ce"�'�'"' ONSTRUCTION � 7) . a� W � ❑I am exempt under Sm ,8 fi?.C.1AttxA Cen�ficatel P�N RE��EW � °a1e °ixnef ELECTRIC � W➢RKERS'COMPENSATION DELLAflATIdV I he�ehy a(firtn tAa�I have a cerefitau of tonsent to sNf-insure.a pLUMBING a wndicate ul Nbrkers'Campensation�nsu2rce.ar a aertAied capy IMeof 4��.3&70,Lah C� _ � �cnofied copv�s hercbv�u�nishee � MECHANICAL _ o �f.a[ilied caoY is filed with�he 8uilding Inspeation Oeparlment ar o�oY���t. d GRADING W \ �+-� � CEflTIFICATE OF E%EMPTIQN fROM WORKEP5 CINAPENSATION INSUflANCE This section n�ed not Oe campkted ' ISSUAN _ 1�.O` J y if the De�mn a for ane huntlred;SI00)a Mss.I renify tha �n Me perfmmance ol the wor4 tar whkh'Mis F. permrt is rssued.�shall mt empby aM Ge�sa^�^any manrer so s to ome ai 1�o I rkers�impensaum s`M JS q o �aws o� a�dania. / � PARK FEE ' p Oa�e� �-- � ���ADdi�am ..� � �wncE APPIICA iF.�����k��m�:c�m�ef�,a�o�.�n�w na�:�q�,m,ne w��•= � SCHOOL FEES � Compensahon prouisons of 1he Wbor Code,you ma'l�C.�.F6'rt16Fi cqg�(�w�such pravums et This pem�il shal 'i 6e tleemed revoked. i;1 s�"�=�•� a s pViS10N OF INOIISTHIAL SAFETY PEflMIT CERi61CAilON: _ W �I herehy certdy�hat no eyravaton five('� r�p e t �m�Qepth�p A�persm n rzQuirod ro tleumd. � will he made n cmne�tion wiM woit autlwrve�l�ifiic De�u.�Inp Euilii n9 svuctue.uafkidng,iWsework. - a denoktmn ar diamantYng tMeal.wil he�mdrd�Iran t�rty-�d�w1'�C�gn.�chay.sz.cry z.an z.s.c . W' 341.Title�,C A C;. S 3 [Jps�wner-huide�.l vnA nat emolap;AqdaE t¢"d"o-wprk'vMidi;royW+49ure;3;pm�i1 irom the dvnion of H. Indusmal SaFety,as noad abo�e,wks3''suc�penan fia's a,permi�io Ap�such�+k-htm;9r�^^gaa �:;s �, , . , . .... � � . . W ❑Uvisim ot Indum�al Safery Pkrmrt�No4r.���• + •�•�'f V'�+ ~ ' TOTAL FEES l d � CONSfRUCfION 1EN01NG AGENCY:1 here8y alfirm Mat tlwre is a wnsemtian Iadinp aqency Iw tlr pnk�menee � = nf the wart for wnrh Mis{rrmt is issuad IStt.3097,f�u.GI. � LeMer's Name COMMENTS � Lender's Addres ' m f���- �.c 1 nn o.h� •v B� 6L � CENTIfICqTE OF CpAAPLIAl�CE ANO AUfIiIi2pT[N DF ENIRY:I cvlily 1 Aave nM tM�ppintv�ad�ab t/� mat tM�nformadan goen is corrat.1 ayee to[omply wnh all su¢laws aM ciry ordinrxa reYtvq m 4nJdiip � � � y construc .and autM1oritt a rcp�emntatire of tmmt oi Beiiduq and Sa ty m ennr Me qaparty 7� 1� � /� � tar w�K hax ied 1w Nis Pm far the al maki ��x l.\ . � �,�1� �y�'L � t� RECPT NO. 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