HomeMy WebLinkAbout141 (14)CITY OF DIAMON BAR PRESS
DEPARTMENT OF BUILDING AND SAFETY FIRMLY
BUILDING PERMIT
JOBSITE
ADDRESS a
AP CATI N PERMIT E
DATE NUMBER CODE
ISSUE � TYPE OCC.
APN LOT- TRACT
f
DATE CONST. GROUP
CROSS ST`BEET
OWNER sic
ADDRESS,,
ZONING SETBACKS MWFADNEICKM
FRONT RW ❑
REAR ❑
CITY I TEI.
SIDE/SIDE STREET RW ❑
SIDE ❑
APPLICANT TEL
CONTRAC 9
SEWAGE Q PUBS PMT A
ADDRES
CITY ZI
DISPOSAL ❑ PRIVATE SO. FT./ 100 GAL
GRADING C� CU. YDS. EXC. CU YDS FILL
STATE j /
LfC. NUMBER
W
W
TYPE
1
SO FT
FACTOR PS
ADJ. AREANALUATION
ARCH/ENG/
DESIGNER C. &ntl 9
ADDRESSZ—
LWEw
2
CITY ZI �� EUL�t-
3
PROPOSED USE
Z
25
4
GARAGE
NO. DWEL. NO. NO.
UNITS STORIES BEDROOMS
LOT DIMENSIONS
PORCH
VALUATION ADJ.
AREA
QIJANTrrYj
DESCRIPTION
FEE
NO. OF BLDGS HOW
ON LOT USED
LICENSED CONTRACTORS DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9lSureneaing
with Section 70001 of Division 3 of the Business end Professions Code, will my Iipnse is in but farce and lftKl.
W
S
NER BUILDER DECLARATION 1 hereby affirm that 1 am enopt from the Contractual a License Lew M the Idlowinp
mason ISec 70315, Business and Prafesswns Code Any my or county which sequins a perms as mnsbutt,
alar ueprove, demolish. a repair any structure, pier to ill issuance, also requires the applicant For inch permit,'
to fide a signed statement that he is licensed pwsuent to Me prwnnn$ of the Connector's License low (Chapter
9 (commencing with Section 70001 of Division 3 of the Business and Pmlasswns Codel a that he is remain therefrom
and the basis for the alleged exemption. Any vrdation of Section 70315 by arty stokers for a permit subjects
the apphcare to a cod penalty of not more show We hundred dollars 135001 ):
❑I, as owner of the property, or mry employees with wages as most ads campensahnn will do the work, sM
the structure is not intended or offered la site Iliac 7044. Business and Piolossmns Cade The Conhncta'a lrcanse
uch work himself.
Law does owl apply to m owner of property who builds or improves thereon, and who does tor
or thrmigh his own employees provided that such smprovements are not smendM a offered for sate R, however,
o tbuilding ion
9 or D rovemest a sold within on year ofw completion, the oner-bsilda w: the will have burden of Priming
he did not build or improve tot the purpose of sale.)
01. as owner of the property. m exclus valy sontrectmy with licensed cmuactors to construct the project (Soc.
i7044. Business and Professors Code The Contractor's License Law does nor apply to an owner of properly who
builds a improves poison, and who contracts ter Such protects with / cantrahris) licensed pursusnl to do Cmtraceor's
License Law'
t9
(p
S
','
0.
W
CONSTRUCTION
i
❑ 1 eon mampt order Sec ! B P.C.IArssch Certdoerel
PLAN REVIEW Ve
i Dote Owner
a.� q
ELECTRIC 3 R t Dy
PLUMBING �y� •� - 5- 0
MECHANICAL
MRKERS COMPENSATION DECLARATION. I hereby, aNum that 1 Novo a urnficate of consent to calf-mre, of
' a cerhhcate of YWrkere' Coupensatmn Insurance, er a eeMied copy thereof (Sect. 3800. Loss C.).
Certdned copy is hereby furnished
Certified copy a filed with the Building Inspection Deferments a Depertn ent
i CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE. This section need ml be completed
if Thepermit is for one handrail 131001 a less I cerMy that in the performance of the work for whkN this
patron is issued. I shall not employ any palm in soy mmnn an as to become subject to Ili Nhrkws Cooperation
Laws of CaliforniaWW
' ate Apidat'
� NOTICE TO APPLICANT N. after making this CerMiple r ofd Exemption. you should Msmr entities ct the Workai a
LL
GRADING `
ISSUANCE 3 • (� d
PARK FEE
SCHOOL FEES
f Cooperation provisions of the Labor Code, you must forthwith sorrpN with such provisam or this permit NN
• be deemed revoked
Ai f I U
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION.
i
� 1:11 Mreby, ceniy that no enavaon fire (5) or more feel m dash into which a person Msquired to Getad,
a v• � t r'r r v..r s,
�...,
wry he medic in mnnecon wnh work Sutborited by this parmd, and Ws no pudding snucsuse. scdtolding, lalanmrk,
or demolition or drummtyng thereof, will be We than derty-six 1361 lees high. ICop 3.2. Grp 2, Art 2. See
j' 361. Tile 8.CA.C1
.r..r... +'•`S..: n.,
❑As owuar-bulda, 1 will not employ asyero to do work which would require a permit ham the Divisor at
.
Industrial Safety, as mod above, unless Such person has a sum to do inch work tress de division.
❑awaim of Industrial Safety Arcot No
TOTAL FEES d
CONSTRUCTION LENOING AGENCY: I Iwreby oHirm des pan is a crostrartni leading agency for M palertrwree
e of Ili work fa which dill paint M rued ft. 3097. C v. C.I.
Lender's Nacre
COMMENTS
Lender's Add ... a
I CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENLRY: I costly 1 have Ined Vas appecnciost NA spin
s Ma to mfenni gum oma. I ayes to —*with am Mies and dry a(dean to cess (deaguiding
cmavncoan. and Su a ppreaentamo of die Dapamowt el ddkknp and wiry • eon No else pepefry
s to wtech I have for the per IS, m of makes; kapecasmar n
x
RECPT NO. ...!�& PgID BY1pWDATION
rot d t a Agms —T�-- oar
WHITE —Department Copy, YELLOW —Finance Copy, PINK—Anantseor Copy, GOLDENROD —File Copy, GREEN— Applicants Copy
Jx
1 -LO?' R J(DiSTS
i L
n IA REC)tlTS. . .
UNDER Hf)OR 1.
1NDER R-00H (,C)N[,,'t)IT
r1REN-AcE FOUNEDATIO-11
VIREPLACE F.30ND RFAM
R T BC)ND BFAM
N
Flj',;AL BOND r" AMC
I LJ�q:
HEHCHNG'
7
P001 '-:iNAL
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orF S.l I E INWS,
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DED:CMIONS
FINAL ENG,
LAUS�-APE; 1 R R IC,
NSITE
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C.',tkl IMPS.
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I FINAL ZCMINC
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-PT, FNAL P lFiE D E
HE-,'�L TH DEPT. FINAL
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-V, FEES PAID OF
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ENERGY
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