HomeMy WebLinkAbout1797 (1115)L ER u►shn�u u.�e CITY OF DIAMOND BAR DEPARTMENT OF BUILDING AND SAFETY BUILDING PERMIT P/� go-s�E'f PRESS FIRMLY I ADDRESS. ---V ON ` --PERMIT TAU TYPE _ AE nNUMBER ODE DE APN LOT T CT 1 L - "l CONST GROUP CROSS STREET OWNER ZONING SETBACKS vqKmwMs FRONT RW ❑ ADDRESS 1 REAR ❑ CITY L ZIP TEL SIDE/SIDE STREET RW ❑ SIDE ❑ APPLICANT TEL. CONTRACTOR_. -' �- ted ADDR S I + CITY SEWAGE I OSAL C1 PUBLIC PMT © PRATE SQ. FT/ 100 GAL STATE UC, NUMBER GRADING ❑ CU. YDS. EXC. CU YDS FILL FACTOR PS ADJ. AREA/VALUA ON ARCH/ENG/TYPE DESIGNER s,� n ADDRESS W 1 •E? I ec- -M 12 2 CITY ZIP TEL. _ 0 3 Z 4 PROPOSED USE C .© GARAGE NO. DWEL. NO. NO. UNITS STORIES BEDROOMS LOT DIMENSIONS :) PORCH m VALUATION ADJ. AREA QUANTITY DES IPTION FEE NO. OF BLDGS HOW ON LOT USED r LICENSED CONTRACTORS DECLARATION I hereby affirm that I sm kconsed under provisions of Chapter 9 Icommencing wdh Sechon 70001 at Orvisron 3 of the Bamess and ProfessionsCode. and my Irmae is in full force and effect W f ❑ IAN OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Lav for the following mason (Sec ?0315. Business and Professions Code Any chy or county which requires a perms to construct. alar, Nmpgw,. demolish, r repair any structure, por to its issuance, also requires she applicant for such permit to her a signed statement that he islicensed pwmant m the prim isons of the Contractor's License Lew IChaptw 9 Icommencmg with Section 70001 of Division 3 d Me toand Pmktsrons Cade) or that he is wempt therefrom and she basis tunthe alleged exemption. Any velaon of Section 7031,5 by any applicant for a permit subject the applicant to a civil penalty of not more than fiwo hundred dollars (9500) I (7 2' m d ❑I. as owner of the property. an my employees with wages a Ikrr soft compensation, will do de work. and d fJ the struclure is not mtmded or offered IN safe (Sec 7044, Business and Professions Code The Cantractr's License Law does net poly to an owner of property who builds or improves threon, and who does such work himsell, N through his awn employees, prwalad mat such Nmprwements ars net intended or offered tar isle If, however. the building in mprowment Na old wdN. ore yen of completion. the owner -budder will haw the burden of proving that he did Net build or impow for the purpose of ale.) 01, as owner of the properly, am eslvaNwN conhactarg with licensed cmuacmrs to construct Irk proem ISr 7044. Business and Professions Cork. The Contractor's License Law Moes NMI apply a an owner of property whe Wolds or' -proves thereon, and who contracts to such projects with a comracfor(sl licensed transient to the Conlrecl°r's License law I ❑ I am sump under sec . B. B PC -(Attach Certificate) PLAN REVIEW OM1°r ELECTRIC IAajKERS' COMPENSATION DECLARATION I hereby eflrm than I haw a certificate of consent to sail -wore, ser a certificate of Mhrkes' Compensation Insurance, or a certified copy thereof (Sm MOD, tab C) ❑Certified copy is hereby tanmsled .erdhed copy is filed with the Building Inspection Oepartment or Department J Q PLUMBING MECHANICAL G CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATIO{ INSURANCE This secton Need not be completed d the permit is for am hundred 131001 a less. I y dw ,in She, performance of Ifo wok ler which than permit IN issued, I ship not employ arty person in any anher'W as aLleane Subject In de Mrkrs' Compensation Laws of California -4 4 ..... .. Dat° Appian .2..=K I S �,... FEE SCHOOL FEES �,,e K! .e P (t�, (,MCI n`� •, � -U NOTICE TO APPLICANT: N. afar making tuna C all of ion, �u became subject a the Worker a be dnsabon m arms of the Labor Crile, j¢W glow t Iv f w h wises r this d shill e�emM mmYte ' ` "' °' 4 �•d � p DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION MAY I ❑I h mtiy certify den no arcavanefo fele 151 0 tiros' hNf !q 1prth ipo ajhleh 4 )F? la nqured a deacwtE. wall he made n connection wish work suLhw¢ad by, isle 00 pend Wt so bud dig§ Itr11[tyrs aaNddNng, lalsewrk, or demaktion or ck-sin ling thereof, will. tie. eom' than 1Mty-als yin) feet, high ,JChN .;.l2, Grp 2, Art 2, Sac 341, Title B, C A.0 1 ❑As owner -budder, I will nes employ arNWne to tic irk which would rearm a permit bpm tle Ower of Industrial Safety, a noted above, unless such Demon has a prier to do such nark km as kw rise. ❑ Orwseo of foduwrial Safety Portes No TOTAL FEES a CONS UCrON LENDING AGENCY: I Inrsby dN'- fat them is a erdstrueaon Imdng apathy for ase prfortarsx at this irk m which fins permit in moved (Set. 3097, Cie. Q. Lraler's Nene ` COMMENTS Lander'a Addnem CERTIFICATE OF COMPLUME AND AUTHORIZATION OF 1111111' 1 artily I haw read this mpplicwia and no that the nfamrion given is crrecl I info e is amply wed sop state Mies and city aaSiaeca fOs*4 to Yrldinl emstructon and ranee a wpreeenhiWt d the of Building aid Safety a saw span the I�h tan wbeh I have applied for n h sun Irk at sop -swum. RECPT NO. SL`✓� PAID BY 0O VALIDATION Somata se Agent Dae ES106-11169 WHIT—Depertment Copy, YELLOW—Finance Copy, PINK—Assessor Copy, GOLDENROD—File Copy, GREEN— Applicants Copy EW rVi nET VSK ST 10OF Ry! ockupf WAIN ASIA t MIN 111 A 51 i of VAAL vkp� 0xv NOW �A O'd V L LOW! FIALV& Gf. - TAW KAH vpwxH W7 FTWL ij&: ThOW 1.1v it VIA D.- ..... .... ... ---- ------ SEPT R! TAN K EA Z" SEEP PiTAj WE IIIWII.9%fa�r'�f el " M", ................. M �i li -m IN . . . . . . . . . . . .