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HomeMy WebLinkAbout1159 �' '"� CITY OF DIAMOND BAR PRESS � DEPARTMENT OF BUILDING AND SAFETY BUILDING PERMIT F'IRMLY JOBSITE 7� v/�L✓ �E ISSUE ATION � TM�ER-��CODE ADDRESS � `'� � APN LOT.�TRACT DATE � .��"�l�CONSI: GROUP � CROSS STR ,��T.�B SETBACKS �� °•° OWNER �/>�//1�5r3'b� L�fLi;Q ZONING FRONT RW ❑ o ADDRESS 7��U F�l LA/V LG REAR ❑ W CITY .,�,��ZIP�L,7��TELC�i�� S�DElSIDE STREET RW ❑ o APPUCANT TEL�Q3 SiDE ❑ z a CONTRACTOR SEWAGE o ADDRESS DISPOSAL ❑ �B� �T+� W CITY ZI TEL. ❑ PRIVATE S(].Fl:/100(3AL z STATE GRADING ❑ CU.YDS.EXC. CU YDS FILL y LIC.NUMBER h ARCH/ENG/ � 7YPE SQ FT FACTOR PS ADJ. AREANALUATION = DESIGNER W 1 o ADDRESS � 2 Z CITY ZIP TEL. � 3 � PROPOSEDUSE�,T�n �'0!/E,�_ Q 4 � ,,,� GARAGE = NO.DWEL. NO. NO. � pORCH �, UNITS STORIES BEDROOMS � LOT DIMENSIONS----�d� � �3'� m VALUATION ADJ.AREA o NO.OF BLDGS HO QUAN7ITY DESCRIPTION ��E W ONLOT USED � � � ❑W � H IICENSEO CONTflACTONS DECIANATqN I Mre6Y�����m Ihat I�m licenwd wder prowiona el Clxpyr 9 Iwimrnn � QY with SKtlon 7IX10)o�Gais�on 3 Df Ihe Busmpss enA ROfeSMons Cude,in0 my Islns!4 m tull hrce�nd elfect. ' 3 {y ' � NEP BUILOEH�ECLAHAT�N I herehv dfirm Tet I em ezempl Imm ihe Conlrectw'a lrenu l�w toi 1he Idlowmp = reasan ISet 7031 5.Businezs aM Piofess�ons Code Any nty or county wMch nqui�et a pnml tp wnatruct, (ry b aller imprwe,demdish,m repnu aM mrucwre,0��m iu nsuaMe.dm npu�es Me epplcam 1oi iuch qrmn 2 Qta hk a signeU r��emem��a he is kenseE pxsu�m ta Me pwisons ol Me CmxocU�'s Litense Uw�Gh�pter �p c 9(canmenung With SeChar.700010l 6vis�on 3 of IM Butineas ind Pralasaons Lodd ar 1M1�1 M n�yempt Merefmm "� d and the basu tor d�e allegetl�cdnpGon Airy vnlatian of Sectqn J031 5 6y�ny�pphc�m br�permrt wb�ts ^, � ihe aDV���-anl lo a cnJ penalty W not more thm 6ve hundred Aollaq�5500)(. Q W F ❑I,as owner ot Ihe properry a my emplopes wilh wapts q IAor aale Compensadon,w�N l0 1�!work,�nC the avuctwe is nm mtenAed or Mlered im sale ISec.7044.Busmeu md Roleasmns Lade TM Cmtncror's L¢eme a v liw dces mt�pply lo m owner ol praperty who Du�tls a imprwe�1Amon,�nd who does�uch worM h�ms�M � W a thraugh h�s own emplayees,pronded that iuc�m�piavemen[s re nol wlended a Miered loi aak 11,howerer, � m ihe Wilamg a imprwemem is aoW wiNin one Yesr ol tamplenan,th wvner�Cuilder wdl hwe tM1e Eptlm ol pannp y iha�he d�tl not Owld or morove lor�he purpose ol s�k 1 2 v1 ❑I.�s owner of ihe poDenv.rn e�cluarvely conlrocnny vx1A hcrosed[onVatars m mnslruot the pro�e[t(Sec �y 0 7pE4.Busniess oM Pralessians Code The Contr¢tor's linnse L�w Eas nat�pply ro�n ewnn ol praperty who `� ` hmlee o�impmvee therem,and wha[omncts lor such propcis with�aomrxlorls)Lcamed yursuml M the Contnclds Ucense law 1 CONSTRUCTIO / c � ❑1 m eae ,under .B C.IA onl E� �r o O��e a+�« ELECTRIC � NqNKERS'COMPENSATIOIV OECLpqATION I huehy�Nnm tMt I nrqlnate d oonsent m ull' urc p a cemhcare al WorFers Compensaum Insurelct,or a cnbl¢d wpy thneot ISec saoo.�w e�. PLUMBING � ❑Ceruhed cooY�s hmeEy furnished J MECHANICAL C ❑Leruhe�coDY is�Aed vnth me BuAdinp Inspxnm U�pulm�m or Denxmimt 4 GRADING W � CEHTIFICATE OF EKEMPTqN fROM VARHERS'CUMPENSATpN INSURAIxE This uthon need m�6e tompk�ed y A t�e permit is lor one huMred 1l1001 ar kss 1 cerhly that in Ne yerlormariee of d�e wo�k For whch tlxe � parm�t is issued,1 shall nol empby my pernn n my menne�to�s ro Eecomt ab�at[o Ihe Nbrkai Wnpensaam CJM = laws r�Caldorma � Ra ,��. + � oaie ��";'- +� � W PARK FEE � � , �- SCHOOL FEES � NOTICE iU APPLICAM N.Iher mek�ng tlw Cx�hut f E ' p��on.�ou'';ito�id hecane cuba�ro Me Mbrk�i� � Cmmpensauon prwuians of tlm UGor LoOe,you muet Ipp�wrth camply wih nch pauam p dn�oe�mn NM � 6e dcemed revoYed .�.� W ONISIp�lOf INWSTRIAL SAFETY VERMIT CERiIF�Ilal fl '�.., � A y �� 0 ❑I herMy cerldy[M1at no ncrvatwn liw(5)a�e leet m depth Mm whKh�persm q rpuieA 1p dacmd. � wiq be made m cm�ctron wNi wor4 autlwued by Ein permn.and M�i no 6oiqinp pru�lv0.u�INWinp.INsw+�ak. u Cemohuon m d�smenlhnp iMreof,wdl Ee myre Ilien mxry-si�I�BL.het h�.�Gupr7�,Gry 2.An 2.Su W 341.Ltle B.C A C I C�'� '�r ,, t.. . . . . ... , . _ . .S,� ...... . . .. 4.,f 3 ❑as m�x�a�daer.i w�t no��mploY�M�1'�W.do wo�L wl�ch wouW lpwn i RmMFfian IM Oiwion d f.. hMustr�al Sale�Y.+s noud�6ove.unNsa wch person Ms a pe�mn e do ruch work hom the divi�nn � �� ❑p�isim oi Induartia15alery Rrmrt Na TOTAL FEES CONSTRUGTpN LENOING AGENCY I Irre6y Nfirm Met tl�e it�romtr�Yndi�q penry br Ihe prlormma • Z d�k worl Iw whch�hn permn s uved�See.3097,fiu G) � Lin°"`�'"" COMMENTS m inMn's MA�ess s CER?IFCA7F OF COMPLIANCE M10 WTIqIYIATpJ pF EHTIIY 1 urMy 1 hw�md 1��ppfeKim md Me tn tlut me nlam�non pren is rorrcct I a�ee m mmpy wtth W suee Iwr�md eity erti�ca nl�uq m luii�q y consuucuan.�nd wtMive�nMan�aew d IM Dqr1mm1 d Buildmp rd S+MY`mM yan IM poperry � la whKh I have� IKd Im fAis peimn Ip oupo�e d m�ki sKcwiu. . r � ��=�y --��G� RECPT NO. � �_ PAID BY �. 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