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. 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