HomeMy WebLinkAbout1083 (8) 9o-I9 �
'"' CITY OF QIAMOND BAR PRESS
�� '�~" " DEPAR'TMENT OF BUILDING AND SAFETY
-� BUILDING PERMIT FIRMLY
JOBSiTE ( APPLJCATION PERMR � ��� USE
ADDRESS l. � I (�C r DATE �- ��4a NUMBER �L,L..�-�-✓CODE I
� APN , LOT.�TRACT 3v� D TEE �-�����CONST. GROUP II
o CROSS STAEET ZONING SETBACKS �"E"B
� m OWNER 5���- £• �2 w N� FRONT RW ❑
o ADDRESS (���' �'��✓%'�y � REAR ❑
� ,;; CITY'Q�M�touA �2 ZIP �765 7�� A�� SIDE/SIDE STREET RW ❑
a APPLICANT TEL. SIDE �
� � CONTRACTOR �(�,.1nt rit--[3�.1 iC I�L SEWAGE
� o ADDRE a ��� ��
DISPOSAL � �N�� � �����
W CITY IP TEL.
� x STATE
W GRADING ❑ CU.YDS.EXC. CU YDS FILL
y LIC.NUMBER TYPE SQ FA A AC�+J. AREAIu UATI N
� y ARCHJE / W 1
� DESIGNER w
� � ADDRESS iL 2
0
j � CITY ZIP TEL. (� 3
z
� � PROPOSED USE �'T-'1' . WA(-L -- z 4
� � GARAGE
o NO.DWEL. NO. NO• � pORCH
y UNITS STORIES BEDROOMS
� LOT DIMENSIQNS m VAIUATlON C;�-�� `��-' AOJ.AREA
o NO.OF BLDGS HOW au�uwTtrY p�5CR1P�(,7isf FE�
W ON LOT USED �
� U
w � Y
� ~ LICENSEO CONTNACTORS OECLAHAT�N.I hereby afhrm thrt i am Yeensed und�provisiais ot Chapter 9�cammercirg i�
¢ wn�Sesnnn 1(��01 Oivision 3 M tAe Busiros:anU PrMessions Loae,and my lemse is n full force eM etfect �
3 � LLI
•+- 04VNER-BUILOEfl DECLA9ATlON:I hereLy afli�m iha�I am eum0�iram�he Contracter'S Lrcense Law Iw tlrc Idlwrifp
reason ISec.7031 5.Busness aM PmFessions Cade�Any cuy or countY w�h r[quirca o permit to canshuct, (y1
oalter improve tlemWrsh,or repair a�ry siructue,priw to its rssmnce,also requues die app�ica�t fw su�M1 prmn 2'
f- ta rile a s�gned statemenl that he is licrosed pwcmnt w the provisions ot the Contrxtar's LkeMe Law IChepte jq
� 9(oommerung with Section 70001 of Orvrsion 3 of�he Business and Pmhssioa Code)a thai he rs eumpt tM1ne�rom �
ef., anA me bass�or the a4egeA eaemptian A�ry vidation ol Saticn 7031 5 ty anY applicanl tor a permit suhR[Is �
x the aDUlrtant to a rnd penalry ot no1 more than five hundrN doliars�5500�.6 a
W
� ❑I.as owier oi�he DropertY.a my emplayees w��h wages as�r sde[omppnwtmn.will do me wor4.mM
1he sirm:ture�s�roi mten�d or oHe�N for uk ISec 70-04,Buvrcss and Pmlessiana Cadt The Contreata's L¢ense Q
WLaw does mt appry ro an mmer ot properry wlro 6uiMs ar improves thneun,aM who does such wark himttlf, (�
a thraagh his awn employees.prmided Mat:uch�mprwemena are not imeMM a ollertd for sak.If,�owever. �
m �Ae hwlA�ng or�imprwement is m�wiMin otrc yeaz d Completion.tk owner��uilder Will h�ve tlie MxEm ol povirry t(
� tAai he ditl not Ouild w improve for the W�Dau ot sak.I �
N
� ❑I.as awrer of the p�opeilY.am eicYarvely contractmy wnh licnned antranon to construct 1k prqect IStt. Ij,l
� 7044.Business ard Professions Code.Tk Conlracto�'s License Law dats not apply to an ovme�ol praperty wiw �
Z� huilds o�improvea ihaean,and wM mntrxu fa:uch propcts wim a�vnbaCtorls)(�msed pursuanl to 7Ne Canvxror's
LCe^SPLBW� CONSTRI,�CTlO t `��` �� �e�
� C�Y'em e�emo��mn sK ,s e ve�nr�xn um,�ehi PLAN FiEV1EW
0 oa���-3-9e� o,� "Ct.`Y�L. �- _L�fdd� ELECTFIIC
� IWRKEA$�CDMPENSATION OECLARATIpN I herehy aHirm Ihat 1 have i cnnf!cate of tunsenl�o uM�inswt,w
a remhate oi Nbrkeri CompensaUon Inswarce,or a rntilied copy lhereM IStt 3BD0.laE.C�. PLUMBING
� ❑Certdied copy rs hereby fvmstKd J MECHANICAL
o ❑CerniKd capy�s i�led w�Me Bmidi�Mspecuan Deaatment a o.o•�+m•�,. Q GRADiNG
Z CERTIFIGATE OF EKFMPTqN FROM1 WOARERS'COMVENSAl10N INSUflAbICE.This ucMn nced not M coripekA ISSUAN � -�''
� d ihe peimrt rs Por one Aundred(SI�O�a kss.1 Certify tAat m Me perfarmao[e ol Ihe work irc whkh this �
» �wimn�s iss�eA.I shap rot m�oy arry{xrmn in my manner so as ro Gxome subpct W�e Nbrkas Ca�ensnion - �f
� Laws ol Cafiforma. � K FEE �f
� W
p Oah �� �
�� W uor�ce m a��a�r n,,�,����a�n E� �ro�m sK����m m�w��� SCHOOL FEES
= Canpensation prwmms ol the LeGor Cotlt,veu` u�.��:f�egly wilh x¢h qwisiam a Mis permA shN
� W he deemeA reuoteA A
�
p� pVl$IOW Of INIX1SiPIAI SAFE7Y PEflWT CENTIFICATKW�
� W
�- ❑I he�eby certdy Mat no ertavaMn IL�r�g � whkA s persm is required m destend.
� wix oe maae m cmnttuan with Murt y�y�rM!�YW� � s�ructve.satldanq laleswark.
F a Oemolmm�m dismantlinq therml.wi�mare ihan thirry-sfx 1381�eei nqh.I�+o�3.2.Gm 2.Art 2.Sec
t W- 3a1.TitkB.CA.C1.
j- x , ..�;:'�:'`...� !=ii,'j
� ❑As owner-buiider.I wip iwt �(yobefr2ditadoif'ahiEh"��4dul�rppir4.1,�han Me Divisian d
F- Industriai SahtY,�s rofed ahow.�su�h yyrion,hae a pennit�d•,dd`'uch.,MoQr_Iqoni tlr Mttan.
� �_�'�::_�[...��'.�3 i.:
� ❑a��5�o���m,a�s��ry��mn� � TOTAL FEES •
� C�JSTRIiCTqN LENONYG AGENCV�I her�y allirm M+t tkn is a�nnstrucum WWg p�ncy hr tlr prkmrre Y -�
i = ot�he xark fu whch tlds pnmit is issueA ISee.3097.Lir.L.1.
i � i�':Na"K COMMENTS
� 4�der's�dress
I Q CEPTIfICATE OF CpAVL1Altf ANO AUf1ONZATKW OF ENTRY:I celily I Nva'nd Mis ippliouan snd shY
tq Mai Me mtamation ryuen u curt�t.1 pree to romply wnh�suv I�ws mE ciry aEiNntes tWtiq to h�etlxp
y constructmn.wM autlw�¢e�reWesentatae ot the Owtm�m d Buid'eip�d Sdsit m wirr wm Ye Papnry
= la whch I hm appled kr Mis pumil tor tlr prpntt of mNinp iny�clions.
H
X � � 5"3�96 RECPT NO.=1_� � PAID BY VAUDA
v siyutue d q�qlicrn or 11�� Ow .. -
WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assesaor Copy,GOIDENROp—File Copy,GREEN—Appficanb Copy
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