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HomeMy WebLinkAbout1290 '"� CITY OF DIAMOND BAR DEPARTMENT OF BUILDING AND SAFETY PRESS BUILDING PERMIT FIRMLY JOBSITE � Z ���(� -�-�,� APPUCATION � e^� PERMIT � ' � USE ADDRESS � c 3�.�2 DATE ��t l� � NUMBER � CODE ISSUE � APN LOT TRACT 3 �� DATE �` `�� C� �-� CpNST, G pUp o CROSS STREET SETBACKS .�+o�E��+�s a,o - L�j if ZONING FRONT Ryy ❑ OWNER � ADDRESS �7�-4 v�'fi�Cr-o z-A�� C-�ilv`E REAR ❑ ,�,• CITY Dl�►-�nnl1� 3z��2 Z�p TEL. SIDE/SIDE STREET RW ❑ o APPLICANT ��•�Y ta v TEL.T�L(-�r--f 4- SIDE ❑ z � CONTRACTOR SEWAGE o ADDRESS� DISPOSAL � �BUC PMT#E „� CITY f 1 TEL. O PRIVATE S�.FT./100 GAL z STATE y LIC.NUMBER GRADING ❑ CU.YDS.EXC. CU YDS FILL y ARCH/ENG/ a ,,r� � TYPE SQ FT F R PS �t . EANKLUATI�N : - DESIGNER �� (�• ��C�?�a� c i�v t" W 1 oADDRESS `yv� � . ir�sa�d'c :�' ( o � 2 �'I Z CITY ' ZIP�TEL? �8 ��- � 3 � PROPOSED USE � = % Z 4 o _�,,..f � � GARAGE o NO.DWEL. NO. NO• � pORCH y UNITS STORIES BEDROOMS � LOT DIMENSIONS m VALUATION � � 5 ADJ.AREA o NO.OF BLDGS HOW t�UAN'1`i7Y (���`C IPTYI�N ' �� . : ,� ON LOT USED U � y� . �� oc ❑W � 1 ' ~"' UCENSEO CONTRACTOHS OECLAflATI�N I Miehy aHirm that I am licensod under pmvisions ot Chapter 9 Icommenpnp !�- � �. � with Secnon 7000�of Divismn 3 of the Busineas and Prolessrons Cade,and my Ir.ense is in fuN force and effect. � 3 "� tti � N H�BUIIDER�ECLAflATION�I herehy aliirm that I am eremp�Imm tM Comrxior's LKense Law far Ihe Idlowing Z :easan�Sec ]0315 Busuress aM Prolessrons Code:Any cily or canty whkh repuirrs a permit to cnnstmct, (y o aher improve,demalish,m�epair any structure,D�mr ro rts�ssuance,aiw repwres ihe applinnt lor such pErmil z Qm fde a signed statement thet he u 6censed pursuant lo the provisions of ihe Canttactor"s license Law{Chapler m p� 9�cammencmg with Secuon J000)al Divrsian 3 nf ine Business and Pmfeatiois Code1 a ihat he is e�empl Iheiefmm g Xantl Ihe hass lor the alleged exemDoan Any vwlaiion of Section 70315 bY any appiicant!oi a pe�mil whpcts ' W the ap0luant m a arvd penalty of not more than Irve hundred dollars�S50D)L 4 � ❑I,as mvner oi the property,a my employees wrth wages as tAeir sale CompensaUon,will da the work,aiM t�e stmcture a nm m[ended or olFered foi sale ISec JOd4,Business and Proiesswns Code�The Canrcacwr's Licenee ,q \ ��,,--}.-;,. �� WLaw does no1 apply to an owne�of propertY�6uilds o�improves tAerom,a�wlq dces suth wmk himself, �) �(�(lG�� � � o�;hrough his awn employees,prowded ihel zuch improremenis are not intended m oflered for s�k II,hareirer, � m the hmidma or impraremenl is saN wnhin one year al cmpletiM,Ihe owner�Euilder wili have ihe hmden 01 pfovmg y I�at ne tlid not 6udd or fmD�ove ta�Ihe Dwpose of sale.l '� h ❑I,as owner of the pro0erlV.am ezclusrveM�ontrattiny with Ii�enSM coNraeta�s lo conshuct the pm�ect(Sec � 0 104d,Bus�ness and Prolessions Code The Contrecmr's(.icense law do¢s not apply ro an owner ot property wla �S 6 Gudds or Improves themon,and who contra�ts Por such pro�ecls with a contractoqs)Immsed pursuant m the Cmlracar's ���-� � � Laense Law i N�CTJ�-J � � ❑1 am exe 't undenSa .6 6 P C IAttach Cenifica i LAN REVIE� r� � � o �ate �� ' Ow�er �/ ELEETRIC� J ' � � YWflKERS OIaPFNSA CIARATpN�I hem6y affirm IKat I hm a caMina �mnsent m sNl-�iuure,w a cemh�ate of NbiYeri ompensanon Insurance,m a cerufieE�opy therzof�Sec 3800.Lab.C I PLU MBING ¢ ❑Cerntien capy is nereW�urmsnee. MECHANICAL j _ 1 �,..� o ❑C.enilied copy is fded wi7h the Buiiding InspecLon UeOanment a Deputmem Q GRADING W — � CENTIFICATE OF EI(EMPTION FNOM YWRNERS'COMPENSATIOH INSURANCE.This secuun need not he rnrtpletM `��'�� �"�,� y if Ihe permit is for one hundmd�5100)a less 1 cer10�that in the perfama�xe ol Ihe wak tor whkh this — � �� permii rs�ssu¢d.I shall mt emqoy airy person in airy mamier so as Io 6ecome wbjxt to Ihe N6rkas"Compensation M�� �"" Law:ot Cahfoima W — � PARK FEE o � p Oate ^�v�!-a:�� °'"��^ �1,. SCHOOL FEES � NO710E TO APPLICANT If,ahe�makinp iha Cenilicatg;uN�xp,pptiort Yaifslw�iW hecome s�etl w the Worker's � Campensanan provisionc ot the Lahor Code,ya must�prthwitf"i'iuihpl�wilM1�such povi�qns a thie perme ahall LL be�dedned revoked J � OWISION OF INOUSfflIAL SAFETY PEflMIT CEqTIFICpT1pN� W �t� e� p�� �- ❑I herehy cenify that no eMtavatwn Irve�51 g� leet i�depp�in�o wn�lrc 0 persm e repuired ro deumd, 0 � xnY 6e made in conneclwn with wark authori[Bd`�j dh rmn.6nd'lfiat iq'6u�'dtlinb�surtlum.staNalding.laltewrork. . ..•. 'w demolrtion or dismantMnp tkreof,will he mae ihan m�rry�six�361 lee[hgh �p�ep 32.Gry 1,An 2,Sec W 341,TiAe 6,C A.C.I _ �.,.._.., ....., r.,: . ., .; � ,,•; -;, ;: 3 ❑As owner�bwlder,I wd nol empby�'anZoiVe�o��YLork'which"wwld�requiie.�pinpit kam tlx dvispn al F— Indusuial Satery,as noxd a6ove,unless stjtli'pqr�6n'(ias'a peiinrt Irtdo�suih WorY��irym�Ue;divi�ion � � ❑a�„o�of induslrial Sahry Permit No TOTAL FEES � (� i.� � COWSIRUCTpN LENUING AGENCY I Aerehy alfirm bat thme is a wmtruetion NMinq apency fa tAe perlomwnce t z of tM work Ia whxA this permit a issied ISec.3097.Civ.C I � Leidei s Name � m tender•s nooress COMMENTS hc ^,}-�i(/„�1�' �i/J ���,M ��%.C,�O� � � � � 6 CERTIFIL0.TE OF COMPLIAlCE AIl1 AUTIpR1ZATq0 pF ENIHY I urlify 1 hava read dhs qpli[ation md st„e � v7 tha�the mlamalion giuen K arrect I�g�ee m comply weh all sbu laws and ciry ordinNxet nytiiq to huildinp y crosuxtwn,and aulhariza a rproten xe of the Oeprtoeot ol Buildinp xq Selery 0�e�r iqm tha prupertr = Iw wAich I ha ppled ta 11ris pn 11�tle pupo�e ol makiq in�peclions. � �, i j ��'1�^�(� �` J (�� 5i �e �cenc or ��_a p�h RECPT NO..��_PAID BY �v VAUDATION� WHITE—Departm nt Copy,YEILOW—Finance Copy.PINIhAsaesaor Copy,GOIDENROD—Fite Copy,GREEN—Applieants Copy � BS106-11l89 � , .. ��:y.,.. .✓'. • . 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