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HomeMy WebLinkAbout1138 (5) '('� CITY OF DIAMOND BAR pRESS � DEPARTMENT OF BUILDING AND SAFETY . tJILDING PERMIT �IRMLY ODFi'ESS l y�v • J. II G� � �CA710N r __ '.��.f n ��E f ��CO E �p �L � APN LOT TRACT DATE �l���"!�lCONST. GROUP " CR05S S EET SETBACKS ��� �-° OWNER ZONING �OM � ❑ g ADDRESS �- REAR ❑ W CITY � ZIP � TEL. SIdE/SIDE STREET RW ❑ o APPLIC TEL. SI�E ❑ z c o ADDRESS � SEWAGE ❑ PUBUC PMT# o CITY � ZIP E�2��_ pISPOSAL � pqIVATE SC�.FL/100 GAL x STATE �y �� y LIC.NUMBER 3 ! GRADtNG ❑CU.YDS.EXC. CU YDS FILL y ARCH/ENG/ � TVPE SQ FT FACTOR PS ADJ. AAEANALUATION " DESIGNER W � o ADDRESS � 2 z CITY ZIP EL. (�j 3 � PROPOSED USE 'u Z 4 � � GARAGE o NO.DWEL. NO. N � pORCH y UNITS STORIES BEDROOMS s �OT DIMENSIONS � VALUATIDN ADJ.AREA o NO.OF BLDGS HOW OUANTITY pESCRIPTIDN FEE W ON LOT USED ,Q � W ❑ � � IICENSEO CONTflACfORS DECIARpTpN�I harehv e16im�Aat I�m licenaed undei pravuwna af CFapur 9lcammemnp �� � wnh Secpon 70�101 0(Urmon 3 ot lhe Busmesa md Vmhsnans Cads.�nd my 4mse q�n lull Ip[t md Nlat W J�e � W � pWNEq BUIL�ER DECIAflATpN I hrehy dhrm Mat I em uemp�from Ihr Conlracwr'�lKenae Lm la�tlm Idlawnp . = reasan f5ec 7071 5.8uamess md Proleeaons Catle Any uty or eanty whch reqm�a�q�mn to contttuc�. (� O dler improve,tlemd�sh,p rpan�ny�1�ucMe.pior ro ds nuunce,dw rpwres tha�pplcml to�luoh yrmd Z /= ta hle a sig�ed statemem 1�a1 he n Yce�sM pursuam to Me pwisions W Me Cmtrub�'�lkwne 4w�Ch�ptp p] � 9 Icommenunq wnh Secnan 100010l avis�an 3 M ihe&umess mE Prolessane Codel a tlm M a�»mpt Mmfrom � � md the hams lor Ihe allegetl eaempinn Arry vmla�pn d Smnon 1031.5 6y any ipphpm ki�Rrmn w6�tf � � Me�ppl¢am to�cnd Omalty of no��wre th�n Irve hundred dollan(i5001 I Q W � ❑I,as uxnei of the Oroperty q my empbyms w�w�ges n 7M1eu�ok[ampensavon.wdl do tMe wori.ud � �he s��kmre is not miended or oflerM la wls(Sea 7004.Busmsss and Pwiess�ons Cade The Conlnctw"s Lee�ae q �'Q O� V lew Eces�ot apyy la�n owner ol Propmry wAo bmHa a impioves thereon,aM who dme e�M vrarM h�mteif. U ' a M�rouyh his rtw�n emo�W�es,pw�ded th�t fuch.np�ovemems+rc�M mtended a oNarcd bi s�k I�,hov.ever, Z _ �he budA�np a improvemem if sUd wiMm one year pl tmpletwn.Ihe owner�huildn will h�ue IM hurden o1 pavn0 .Q y iha�he did not Ewla or impmve to���e purpose of ak 1 2 h ❑1.as vxrre�o��he properry am exclusneN��pBCiilly WIIII ICEIISld fdlYi[IOfS 9A fdllSlfu[I ill!p10JBt1�SG[- w o lOd4 Busmese uN Ro�aaons Code Tk Cantnna's 4cense L�w Aws mt�pply to m o�nv d propertY wM � = hudOs or improres[hereon.�nd who comncla kr sYch prcpct�wnh�contracmr�sl hcmeed punuml ro d�e Conul¢tu'� ` �"`"�`�""'' CONSTRUCTlON e � ❑I�m exempt unEe�Sec ,B,6 VC IAnxh Cerafcau� PLAN REVIEW � o"° °"""" ELECTRIC � WOflKERS�LOMPENSATIW�ECLARATION I here6y�Nirm Mat I�ove a rern/kate of�msent ro eeM�mave.u a atl�hwte at VNor4era'Compensatmn Inairanoe.or o cnDlied copy tMied ISec 380D.l+G L 1 � PLUMBING 0 _ ❑Lntdred caOY�s he�e�y Iwmshed � CHANICA Q s C ❑Cernled capy rs h1eG wnh thc 9uddmg Mspecum Oeprtmem a Oepxlm�nt d C„qADING W Z CEO7tFICA7E OF E7IEMVTUN fROM WURKERS'COIMPENSA7ICN NJSUIiAN(:E Tlus fettnn nNd MI be compklM ISSUANC ` � d iM perm�t rs}oi one huMreO If 1001 a kfs 1[erol nat m the y Y px�nmance of Ne wnk M whrL IM� permit rs rssued.I sh�ll m��mD�ov�'Geiton in my mmnu w rs w Ecwne w6Kct W IM Wurkas'Canpenunon S`M�P L�we oi Caldornr 0 oa� � �'� �,�•. 7s W PARK FEE � �q � ����m�'r'a wq« � SCHOOL FEES NOTICE TO APPLICAHf H,�Mer m�ki this CxufKale"61 hem shouW became t b 1M Nhrtar'a � Compensonon provnims ef Me laEor CoEe pu must/arMwnA tomqy wrth meA pow�pns x IMf permrt thall LL 6e dee�red revaMed J p� OIVISIRJ OF MOIISTRIAL SAFETY PERMIT LfqTIFIGAS1p�l��i o., w . o ❑I heretry[ert�ly thei no e�uw0on live(5�a nae leet�n dqtA nro whrth a ppem u rpmnd b Aracend, � will he m�Ee in�onnec�qn wiM work euil�n�ud Ey mrs pe'miL M+d MM no WYNnp structure.tufPoldinp,IWewar4, a demoNum a d�smmtlirq tleieol.wiB he more Man dxr,ry-ea 1381 het�ph ftluD 3 2.Grp 2.An 2.Sec = 341,Ltle8,CAC1 ;- ' " ' W . S � ❑Aa oMnerhulder,I wdl noi empby�nyane to do wo�M wh¢A wouM rpuin�permit kon IM Orvicio�d � Indusuul Safny,�s roud�bove,unlesa�uch yenan Ma a prmil m do w�h wwk kom IM dNi�pn. � �� ❑pr�a�m d LMustrul SsfeN��t Na TOTAL FEES "`r . pC� CUNS1HUCftlN IENOttIC AGENCY.I herehy dlirm fFar Ikie it�pontbYcoon IpM�np peney ly pr ppymrica Sd�M wark td wlxch tAia permn s uwed(Sec 3097.Cn.C.1. "' 1ni0e'°1ane COMMEM"S m lende�'�1lddress '� Cf1iTIFGLTE OF COMPIIANCE ANU AIRIqitlZATU'l OF EN1AY:I arMy I Mw md pe�pp6cNpn aM Mtr � d�at Me niormat urnn I qpee ro rmqly wi�M1 all�ur Mxs wd eM��n nqtinp h Yuidinp y cons�rucv w rort mroue M Me O�pr�men�N Bmldinp r�d S�kty b�er yon Ihe pa0erry .—�C for I heve sA a mn lor�Ae prptae d m�kiap nqxctn�u � � 1 ,� �,�i p,��� � RECPT NO.�PAID BY J� I I YALIDATION TE—Department Copy,YELLOW—Finance Capy.PINK—Agsessor Copy,GOIDENR00�—File Copy,(iREEN—Applicanis Copy B 106-17/89 —'-- .�w+..r.w++avrw...ww _.,---� _... . .. �. .., i.. . . 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