HomeMy WebLinkAbout161 (1113) CITY OF DIAMOND BAR pRESS
DEPARTMENT OF BUILDING AND SAFETY
BUILDING PERMIT FIRMLY
JOBSITE APPLJCATIOt�! PERMIT SE
ADDRESS ffi� 1 1300 S. Valley Vista Dr. DATE NUMBER CODE
� APN �OT TRACT DATE ��.���.)� CONST. � GROUPg�
� CROSS STREET V� Vista Dr. G�t�w' Ctr. Dr. SETBACKS � ���++�
OD OWNER P.K. D�.a[[nnd Bex'�Tenttu'e �vu• � L.�- ZONING FRONT
� ADDRESS 818 W. 7th St. State 700 REAR ❑
W CITY � ��� ZIP�17 ��2.'13 6?3-1 SID STREET RW �
o APPLJCANT TEL. DE �
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6 CONTRACTOR �v� P11nbi.t� CO. SEWAGE
o ADDRESS 1�� ��' S�• p�$��L � PUBUC PMT+IF
„� CITY Inclu.sttY'v ZIP 91746 7��18 3G4�4401 ' � PRNATE; , 5C1FT./100GAL
z STATE � GRADING O CU.YDS.EXC. CU YDS FlLL
y UC.NUMBER �
y ARCH/ENG/ � TYPE SQ FT �ACTDR PS A[)J. AREANALUATIQN .
`=' DESIGNER W 1
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o ADDRESS (,E, 2
= CITY ZIP TEL. � 3
� PROPOSED USE Z '�
� _ p GARAGE
o NO.DWEL. N . • � PORCH
y UNITS STORIES BEOROOMS
� LOT DIMENSIONS � VALUATION ADJ.AREA
o NO.OF BLDGS HOW QtlANTITY pESCRIPTION FEE
W ON LOT USED �
�
W �
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C SED COMNACfORS OECLAqATUk�I kiehy Alirm that 1 am Ikensed undu proviams oF Ch�pter 9{commp�cirp �
x wiih Section 7000)oi Divi�on 3 0l the Buainese md Piotessiona Cade.�nd my license i�in hN foru�nd slfict �
3 ❑ lU
� RJJNER-9UILOER DECLARATqN 1 heiahy affiim Mat I am eumq iram the Contrattar s lcenu l�w lar me tollawirg
= reason�Sec. 70.'i15.Busines�and Prolessians Cade:Any city or caunry whieh nquires�permd m eonstrun, (} S�T 09PtS � ,
o elter,�mprme,demaliah,p repau arry�ructure,pior to as iasuence,Wta ropuKes tl�a pplicam hr wch permrt � cn M
� m file a agned�tetement Ma[he is Gcensed pursuant ro the prwisqns of the Contracmr's Lkense law(Chspter m 8 �ya�I1P5 � 7�JV - �W
oe 9 leommena�with Secum]000)af Oivision 3 oF ihe Bucinesa and Yroleaaiont Codel a that he is e�t Mneham �.� � TL__y � �•� _ ��.�
a and Me haas for the alleged awemptian Airy vidatun al Sectim 7031.5 by�iry eppLuni kr o rmit whetb U1J.{iCtl
X Me applicent to a eml penalty af mt mme Ihan IM hundmd dollaa�f500�.) a
`" 1 Pemri.t Is.sue Fee
� ❑I,�s owrer of tlx property,a my employeea wnh wegrs�s Meii tde wrtpens�6on,will do tAe work.md
tlie structurz is not intended m aflered fm asle�Sec.7044,Bumness end Prolesaions Code The Contrxtar'e�aen�e :..q
� Law does not epply to en owner al propenr wha builds a improvas theroaq md who dces 7uch xro�k Mmxlf, �(3
W a fiiougA his own employees,pmvi0ed thaf wch imprwienen[s de nm intended m offerctl Poi sak.If,Aowever, �
= the 6uildinq a improvement is wld within one yeer al completwn,the avner-6uilder wdl hem Ihe hu�den al pravinp
y Mat�e did not budd a improv�br Me purpose of sde) Y
� ❑I,as owner vf the properly,am�ulwiveH tontrxnny wilh M[ens[d ContntloR 10 wnsiruct tFe p�olect�Se[ •µUj
0 7044,Business aid ProFesaons Wde TM Canvaclar's lic��e law doe�irot�pply m�n pwner 01 praperty wM �
6 bitlda or�moraves tlereon,end wM contracta fm wch prolects wiM�contrctor(s)FcensM pursumt to 1he Cenn�cror's
c
u`°"'�v""' CONSTRUCTION
4 ❑I�m exempt wder Sa ,8 6 v.C.lAnech Grufnta� . PLAN REVIEW
0 oaa ��ef ELECTRIC
� YARRERS'COMPENSATIOAI OECLARATION:I hereEy effkm thet I hae a eerL(icate ol cansem to nlf.inaure,m p
a een�ficate ot Nbrkers'Compenaatian Insmance,or a eendied mpy thneol(Sec.3800,Le6 C 1 � PLUMBING 1 �
� MECHANICAL
� ❑Certrfied capy ia M1eieby furmshed � '
C
`o �ernheE copy is liled witA tAe Buddmp Inspxtion�eparlmenl w ao.�mKm. 4 GRADING
.�
� CERTIFICATE OF EXEMPTqN FROM WqHRERS'COMPENSA710N INSUBANCE This seclron need not 6e campeled ISSUQNCE
y d Me permit u lor one hundred(5100�a less.I ter6ly Ma�in tlw performenee af�h�wak lor whKh this
permit is issued.I:Aall mt employ any person in eny menner so�a�o hecome aubject W ihe Nb�kns'Compens�[ian SMIP �
= laws af Cahfornia W m �r,,�,�T;
� �i.J PARK FEE
� �1e �d�Ce�� , �+- SCHOOL FEES ��
� NOTICE TD APPLICAM.M,oNer mekinp Mis Certitiute ol Exdnption,yw ihauld 6ecome�ubxl to Ihe 4Wrker'f
—+ fmpensatien provnims of the L�6or Code.you must fanhweh eemply wMi weh pwisbna a Ihis prmn rhd
� he deemed revaMed.
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¢ VIS OFINOUSiRIAI SAFETY PERMIT CERTIFIGAiION
� �_..Ti�T9if y
o re6y ceitAY tt�al rro excrvaton live(51 a mae het m Npth em whieh e penm ia nquind m dettend. �� �p
� II M made m cmne�tpn wiM vprk M�thuved by Mns permit.wd tlut m h�ildinp�t�uctura.ewlfokmp.Itlsewak. a �7T'1
M ��y
«demalit�an a d�smanNing thereof,will M mae Nen ffiirry�ea�361 het hiyh.ICh�D.9.2.�rp 2.An 2,Sec �3�1a������/
.,x• 911,TitleB,CAG1�
S
3 ❑As owner6wldm,I will rot�mpby nyane w do wark which rmuld rpuin�pnmrt hom tlie pivaqn d
1-- IiMusvisl Sale�y,�s muE�Eove,inNss su�h perwn Ms�perrtul 10 do�u�h work hom M�f Aivispn.
�
W ❑a�s����,���a�s.�.���m���. TOTAL FEES ( �� �
a
� LOHSTAlICT10N LENOING AGENCY.1 Mre6y dfirm Mat tlien h�em�trucmn kndiiq percy fa�M1e pertammcs
Z al IM work lar wh¢h liis permn is usied�Sx.3097,G+.41.
� lander's N�me COMMENTS
m lender's Address
` CERrIFICATE OF COA�WLIANCF AN�AUIF�RiZAT11�1 OF ENTIIY:I eaMy 1 Mw rpd Ihis rpplenian md s4tr
�%J fAal iM v�inmatwn pven n eprect.1 qee m cmmply whh aN rtam Mws�nd eily u6nnw nlatnp to huiNinp
y mnstrunron,md ritAonn�iepresemaw�of the nent ol Buildi nd SUety 1p�nter iqw tlN poperry
� ta wti¢ a e�ppl�fa U�i� rt for tM pupo m�pnp na n
'na�we oi ApplKnt or Apent � !/ � b� RECPT NO.�'..�Q�PAID BY_���(�VALIDATIONYZ`�
WHITE—Departmenl Copy,YELIOW—Finance Copy,PINK—Assessor Copy,GOLOENROO—Flle Copy,GFEEN—AppliCants Copy
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