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HomeMy WebLinkAbout1362 (1077) ......... .... . . , ,�._y.-.__ _.. � �' C'ot�'�vt c'�(��cJ '"� �'� -� CITY OF DiAMOND BAR PRESS ��"' � � DEPAi�'TMENT OF BUILDING AND SAFETY BUILDING PERMIT FIRMLY JOBSITE 13 `O t D�A110N �nj_ , ��� NUMBER � �� CODE ADDRESS Z�' ISSUE TYPE OCC. ` APN LOT TRACT DATE ��"~�� CON3T. QROUP e CROSS STREET ZpNING ��C� � Q'"s °= OWNER Q��• IAmor+D A� UF..f'i"K(L� � ADDRESS 3 O SI-t L.l � S'1� (O O REAR ❑ W CITY_�NTA��io ,Cf� Z�p �(p 1'EL.�L�� SIDE/SIOE STREET qy�1 ❑ o APPLICANT � r' TEL. SIDE ❑ z 4 CONTRACTOR �'L-�- CoNST¢-ucT/a SEWAGE e ADDRESS '�l� W � �`'�'' S� S't� �'"�a ISPOSAL � �BUC PMT� .� CITY��y�-��-S.�ZIP '�Cpl TEL� �+ '�"� , D PRNATE SQ.Fl:/100 GAI. = STATE —T y LIC.NUMBER ���� �'S � GRADING � O CU.YDS.EXC. CU YDS FILL y ARCH/ENG/ � TYPE SQ FT �hhCiOR PS - `ADJ. AREANALUA7'ION `-' DESIGNER�dS�FCOWSIGI � Un�Ab�y A"r.a$'Z1C W 1• . �'f D. �(! o ADDRESS ���s- �yW„ 2 = CITY p��^� � ZIP lOfO TE ,� Z'�Il �r 3 � PROPOSED USE z 4 o Q '-' � GARAGE z NO.DWEL. 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NO. � PORCH y UNITS STORIES � BEDROOMS m � LOT DIMENS�ONS VALCJATION ADJ.AREA. o NO.OF BLDGS HOW ouarotrrv 'DESCRIPTlON ' �EE ' W ONLOT USED � � ❑W � � IICEN5E0 CONTHACfOflS�ECIMATION:I herehy�Ilum Ihat I�m hcenwd undrr Pronoiona ef Ch,p¢9 Itnmomonp � �Q wnh Seccnn 70001 ot pvision 7 of the'Busineas en0 YrMeswons God�,onA my Is�me x w lull Mrce�nd df�t 3 w � CN�BUILOEB DECLAqATDN�I hereEy dhrm Mat I Pm e:emot Imm tlie Contrxm(a lcense L+w for 8�e Idlowinp = rzasnn ISec 7031 5 Business�id irofesvons CoAe Any uty o�cwnty whKh rpuire��permn ro conrtrue�, (a O ahe� improue,demohsh,or repar am siruclure,y�w lo rts iaswnce,Nw�ryu�es Mt�pphunt lor�uch permn � M-- W lik a agned slaument Mal he is Ycensed puiswnt q tlie qwisim�of tM Lmncwr'c Lkeme Uw(Ch+p1a Q� � 9 Itanmennng wiM Salwn 7D00)ol pvision 3 ot Me Bus�ness nd ProkssioM Codel Or 7M1�i k ie wem01�hx�han ',� d and the hcsis lor Me�Ilepetl exemptnn Any u�datmn d Secuon 7U375 by anY appluant Mi�pe�mn wEpcn � K the applu�m Io a civd penahy o1 not mnre Ih�n Ine hundred dpllaq(55001 I ..� �u 4 � ❑I,as owner al�he propeny,or my empbYees vnth w�ges n iheu sde[ompematqn wnl do 1M woh,and ilie svuciuie�s no��ntenEeC or olhreE fa eale ISe[ T014.Bus�ne�s and Protessans Code The Comucta's uceme .( v Law dces no1�DdV 1n m m+ner ol praperty wM hmld�or xnOrows Merem,,nl wAo Eoes ueh wnk hmulf, (� ' a�Ihraugh hrs own employees provided that eucA mprovemenv ae not mtenEed w d6rrd ki sak II,havever, z Co ihe bwMmg or imp�ovement is wld wiMm one yex a�mnplelwn.tlr pwner0uA0ei wdl h�re tAe OurEm u�povmq �[ y Ihdl hE OiC OOI bullA 01 ilnpfOV!FDf fhE D�f003!Df S�k.� � U • � ti� ❑F.'ls�xn�r�at tde p�oPerty.iAn�cNsrnfy contnclxy wM Ircenyed sontruta3Ya unsvuct tk prqKt'ISec. � . , 0 709A Business and Professions Cade Tk Convumr's Leenu lwv does na�opp�y ro�n ewner M p�eprty who `� � , ." � Wdds ar improves therean.�nd who cantncls Ip such pro�K7e with�mnV�ctoi(s)M��aed purswm tri ihe Cmtncta'a � licenu Law I � .. � . .... � , , 'r . 4 ❑� PLAN REVIEW I am e.empi uMer Sec ,B 6 P.L.{Attxh Grohnrt) � DB1e °ixn" ELECTRIC � WONKERS COMPENSATIOAI OECLARATION I herehy allrm thai 1 M1m�ceiuhttlt al canum m sNbmswe.a s unAica�e ot Wu�Mpo'Compensalwn kaw�nce,ar�cmt�fud copy tM�eo1�Sac 3800,lab C.) PLUMBING 0 ` ❑CendinA capy n 1em6y Iwmehed � MECNANICAL o �Camied wvv u 61etl wnh Ne BuAAmg Irnpcnan Depanment p Uepxmum Q GRADING W t � CEHTIFICATE OF E%EMPTIOAI FROM WOtiKER5 COMPENSATION INSUNANLE This tetlwn nred noi 6e compkpd �S'S`VA 1 � y A IM Dermit rs 1ai une hund�ed Ii700)a less I eerHly tAat n�M prMrm�na ot Me Wwk lor wh�ch IMs ^�',� permit n�ssueA,1 shall rot�mpley nry perwn in�ny manrcr so ae ro Mcome wb�ec�m fhe Nbrt��i Cpnpenwtron y� � l�ws ol Celdomia 0 0�� �'�i�.�""� W PARK FEE � NOTICE TO APMCANT M,she�mslmp M�s CanF�f E�ni�tiiqik. ���sh,pAd 6seome HL�ut m Ihe Ww1w's LL- SCHOOL FEES � Compensanon povnims ol the L�bor Code.rou mual IortMnih iomply wnM1�iuch poNsm�a aia permil tANI � Ge Otemed�evo4M Y � OMSION Of INWSTRIAL SAFETY PERMR CE�I �'�'yy ''�� � ;�r o ❑I hereEy cerldy Mal no e¢awlpn Irve�5� rTdNeet o de�fh nt��V p��tm n rpuind to Asund, � wtll 6e m�de u�conM�im wiM work autlqrved py p�rs ppimil.and tlnt no 6uddnp�Uuclu�.It�itoldinp,I�Isework. a demalinon a d�smmtlinq tl�eeot,wAI ht more�h�n ihrtty��n,��8�hei�ph.�qyp.,,�2.G'p Y,Ah 2,Ss _ ]61.TitleB.CACI l:F;i�T•A,'.K,�_nu.�r.:.''..�-. ..'� F'" .. Jy �,,_ • �''�_ •r,..-� j;; 3 ❑As awMrhuitlei.I wdl nm mqluYSsiyahe:.tb�N9�N'+RTwhich.riotYd,�IqY�n*i'9�TMIhom ihe Divsw M f— Indusui�l Sdety,u mted�6ove,unks�fpfh'pehon'lus Y�pe}Awf'lo'do'�ah JrMM h6�rhA pwnian. � �� ❑Omsim d YM�rrq15dery Permn ND TOTAL FEES �j CONSfHUC1qN LENOrW AGENCY 1 MrWy dlirm Mt tlen o�oonfCucGan I�riAmp pencY tor Ilr prfumimt� Z M th work For wheh Mis qrmit u i�wed ISec 3097.Cn.CJ. /� ^� � 1en°":"'� COMMENTS � —lD—�1� p=p lender's Address � CERfIFICATE OF lU1NCE ANO AUTFqR12Al�i OF EIliRY I eatily I luve nW Lis�pplcnia+rM thta i%) 71181 tlIE i1110fINi pven n ta�ect I�pree 10 h w�M MI s4te Wvs�nd tiry erliiwica r�htnp m�Nlmp y constructron. n Iho�ue� r'senuuve ol arm�enl d&xlAinp md S�hry b�ler qon b�raprq � W w�ch 1 r Ird For s prmn lar 71r e�Ymk� hms ,� ���/—--�L y� Sipn�tire d Applcnt m/pent yd — RECPT NO. R410 BY�'�,�„- - YALIDATION WHITE—Department Copy,YELLOW—Finance Copy,PINIG—Assossa Copy,(30LDENROD—FNe Copy,(3REEN—Applicar�ts Copy BS106-11/B9 � . 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