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HomeMy WebLinkAbout1619 (1106) ` `-'�'� CITY �F DIAMOND BAR DEPAR'TMENT�F BUILDING AND SAFETY PRESS �C� '�'" BUILDING PERMIT FIRMLY , JOBSITE . 1�� �`_1 _ (� . ,2 �E�`�N ��R��CODE ADDRESS �� `��A 1rl �7 ! APN LOT TRACT DATE CONST.�GROUp�. � CR05S STR ET SETBACKS .�a��Ms o ('�- ZONING FRONT qW ❑ OWNER � ADDRESS ��� ��� REAR ❑ W CIT' W��ZIP�.1'2�{ L. � 12 SIDE/SIOE STREET qW ❑ o APPLICANT�{SL�n��.-ib �L��_ SIDE ❑ : e CONTRACTOR SEWAGE o ADDR S � �B� �� DISPOSAL ❑ pRNATE SQ.FT./100 GAL W CITY ZIP TEL.�C�S,�, W LIC NUMBER c1�L�Q� C� GRADING ❑ CU.YpS.EXC. CU YDS FILL y ARCH/ENG/ � TYPE SQ FT FAGTOR F5 AOJ. AREANALUATION `—' DESIGNER W 1 o HDDRESS � 2 z CITY ZIP TEL. � 3 W � PROPOSED USE 4 � � GARAGE o NO.DWEL. NO. NO. � PORCN y UNITS STORIES BEDROOMS � LOT DtMENSIONS m VALUATION .AREA o NO.OF BLDGS HOW �UANTtry DES RIPTION F�E � ON LOT USEO �. � , O�0. o: ❑W I^� � ��cEr�sEo caMeacroas o�c�anarnN i n.«e�.�n�m mn i.m i��a w,da��:�o�:o�cnac�a Iw���u � � � '�a- x wnh Secnon 70001 al pviaion 3 0l iAe&umess ead P�olessm�CoAe.�nL my Icense u in full loree mA eflKt v � r . .S • � �EN&11LOEfl OECLARATION�I herehy etfirm tl�at I rm ermpl Irom�M Conlrxb�'s lKenu lrw lor he Idlow�np = reason(Sec 10.715.B�niness and Prolessions Cade Any uty or[oumy whth reqwrn�pmm�b consUuct, � •�� O il�er mprwe,domdish a rp�a ury qruelura,qpr�o na ssuance.�In rpu�me Ne pplioet kr�uch pMml � ro f�k a spned tutemen�fiet he�s licensed pursuym b�he prwisions of Me CanO�c�or's Liceroe 4w(Gwpta 1{y � ,� O � O � 9 Icammmang with SetLon 7�W1 0l Orv�sim 3 d Ihe Busmess�nA Vrdesaom Cdel a M�t M u��tempt tAnefrom � d and the basis Fo�Me dleged eumptpn Airy rqlanon d Section 7031 5 6y MY BpplKinl}01 a qrmil wGpcts � ,��S � �� x Ow applaant ro a cnd pcnalry of roi mo�e 1Mn Lve M1und�ed daMars(5500�I. � W � ❑I,83 pxne�D�IhB pfOplRy,Of my Rmp10ylCS Wlth WBplS p tllelf 60k COTpinEiA00,W11 AU Mt WOf4,�nd � 4K �— ~ the strunure�s Irot intenGed ar o11erM Im tale(Sec 7044.Business�nd Prefenions Lode ihe Cmtrutor's 4cense ' � Vw�s ro�+OD�v�o��ov:ner ol properly who luilds or impovef tlKreon.��wM Aoes weh work Mmulf, � a thraugh his avn employees,prwrdad ma�mch pnqorements an nof mknded n otlared M uM il,hewever, d�a �M W�IAing a improvemenl ia wld wnhm one yer al compin�m,th ewner•huilder wdl hwe Ihe 6urden ol pminp �� � Ih�l he diG not hyiN rc imprave lo�Ihe purpo�e d fak-) H v� ❑I as awner hf ihe proper�y am euWuvely cmuecnny w��IKen�ed emtrxmrs to ronshutl IM a at ISec ^� 7F144.Bumness.pM},rolesaom Coda.The'Comncwr's Linnse law d&s not applY m m awnei ef p�op rry wlro .'... }'' , 'a ,t,� .; � '��. .. - . � hnlds ar improues ihneon and wha conira[q far wch pm�ec�s will�i COMrM10��f)iqnfl0 pusWnl l�IM LOnU�[t0i 7 License�aw 1 (�i�nl$ TION 0 � ❑I�m aempt unda Sec ,8 b P.0 IM1t��t�CvGlc�nl U4N RE _ .e7C'� -`4' °au a""°` ELE IC � y IAOIiKERS'COMPENSATION DECLARATIdJ I Mreby�Nirm tAet I hrve�urohceu ol canmt m stll�nswe,n o a eruLote ot Nbrkai(Lmpenaalm In�urarce,w�[etified Cnpy Ihalof ISlC 3800,Lab C1. ` o = erufrtd aopy�s hm�Y6y 1wmsAed J MECHANICAL c o ❑f.Knlrtd capy n fikd wnM1 M�Bwldmp Y�specum Dopartm�m w oww���. Q GRAOING W � CERTIFIC0.iE OF E7(EMP7MIN FROM WORKERS'COMPENSATION INSUMNCF.Ihi�t«mn Med mt h eanqletad SUANC � y A IM permil�s for ore hundred(=1001 a bs.I prllfy IMt in tlw pnlorm�nca at Ihe wpk for w�sh Ms parm�.�a rswed.I shitl not�mpby nry parmn in iiry��ner,u Jp ome. h� tlr heri CompnsNmn s laws at CNrtorms ,� '• W �2'�-�U �,'�. ' ; ' � PARK FEE 0 0� �,���� � �or�e T APPLICANT K,athr mekmg tlYs Cnulctte ef Emmption.pu�hwid Mcome ��b u.�w�•. V- SCHOOL FEES .�+ Compensanm pra�s�ms af tk La6ar Lode.yeu mun IaMxnM�xnpty weh�ueA Moxsorn a�hii pmne�h�p � 6e deemed revoYed T � � OIYISION OF INOUSfRULL SAFETY PEIIMR CERT�K li e+Ra d � ❑1 MreDy cendy No�m wcovmoo live 151 or mo��hM n A�h inW vMdi�OW�on q nWiM b NuaM. �e wip he made in eonnenm witl�work rithorind hy Misye'mn.�pid tluf.m huldv9 mucnre,Kdkkinq,Wswwr4. «ee�a�o�a diunontlinp Mnaal.wil 5e mra.thn�tAuq':su t36)tin.+wn.t17�an.s�;6c 2.�n 2.s.� �-' 341.TAe8.C�C1. , . .. . ... , . • � r � ❑As owne�-hwlder.I wiA no��mpky�nyon�o do rork whi[h wouN rpuv��qrM kam Ma 6vqon d � Mduaviel Sekty.�s no4d Wor�.unk�s tuch prEon ha t permt b do 7ieM1 wwM Iran Ihe Mition C � ❑p""��`'°"mr��`""""'°"°. TOTAL FEES � CpJSTRUCTDN 1EN01NG ACENCY:1 I�erehq dfirm Yut tlrrr o�caatruc4m Mdinp yncy b/rc�ertwmnn � sN th warY far whcA fiia pmJt u awed�Sac.]097.Cir.GI. .,.+ LeMer'�Ikme • 'ap'� lender'�pdArcss C� E '� CERfIFIGTE OF COIJPIWCE ANO AIITIbIUZAiQi OF ENTqY.1 prely 1 hwa n�A tliis�intion nd mrc v� ihn fie niam�oon puen i�wrat. qw 10 epnD�Y ni�h�A�YBe Mwt M�tib Nlimnnt nYlnp lo Iiitlinp y tansViet . tAoriee� uliw of Gporhient d Biildiiq d&tletr Y mM�pm h�nperry � lar wMc 1 � IMd M r R ler Ily d mkinp iypecpyp. X �� / �D�G�,"Q yo��� ;� � m p� RECPT NO. , PAIO BY � VAUDA WHITE—Department Copy,YELLO'W—Finance Copy,PINK--A9sessor COpy,QOLDENROD—File Capy,pREEN—App6caMs Copy BS106•11/89 .::Y.r. ..rd.w+rs.ma�s,47+s ,�, s�.". 7,c.✓. ..:y.rr�.:,..�., a,n.w.n.,. �„�„�z. ,.,r.;..,+r.,..� ..�Me�•,rR.�,....9.�"•�qb:`+w>.- m�r�. 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