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CITY OF DIAMOND BAH PRESS DEPAR7MENT OF BUILDING AND SAFETY F�RMLY BUILDINCa P�RMPf Jd9SITE APPUCA110N C`C PE 11' `�� U$E ADDRE9S �L�� S �� Dc�AS7UE NTY�R��,d�v��CODE �' APN LO TRACT DATE � y C�—��� CONST. GROUP o CflOS5 STREET SE76ACK5 '.�"E"'S �° dWNER �1 ZONtNG F�Nt RW ❑ � ADDRESS REAR ❑ ,�; C17Y _ ZtP 9l7 TEL l SIDE/SIDE STREET FiW ❑ q APPLIGAN TEL. ��� SiDE � Y ` � CON7RACTOR SEWAGE o ADpRESS � � DISPOSAL � �BUC PMT+M W CITY ZIP TEL.�_ � �NATE SQ.FT./100 GAL z STATE y UC.NUMBER�-����� GRADiNG ❑CU.YDS.EXC. CU YOS F{LL y ARCH/ENGI��..,�,� /y,, U3 ��� � ' ���` � ¢ DESIGNER��,�` � " � � � S .: � ADDRESS U. 2 = CITY���/i:� ZIP T '-� (,�r 3 � PROPOSED USE � � 4 co � GARAGE Q NO.DWEL. NO. NO. � P�� � UNITS STORIES BEDROOMS s LOT DIMENSIONS VALUATION ADJ.AREA a NO.OF BLDGS FtOW oumu�rrrv p Q � � ON USED � W v GJ�.( I°C' . � � S C, IICEAiSED COMflACTplS�ECLAHATION:1 here6Y alfirm tlw1 I am ksnud uda prmuions ot Chpw 9lcommmnnp 1� � ` �y� wnh Secuon 7000)ul Oiviaon 3 of Me 8usiness and Profeuwns Coda,aM my Icenu u in fuil iwce xb eftect � � 3 � � u- OWNER�BUILOEfl OECLAflAiION:I herebv atlirm Mat I am exertpi from dw Coniracwr's Lrcxrue Law for the laibw�nA . reason�Sec.7031.5,Business antl Pro�ess+ans CoOe�.Any city or caunty whc�reqairos�permu fo tonsu�c�, (% Calu�,imp�wz,demotish,a repai.any muc�we,prer ta iis usuvoce,isa r¢�ures Re appkwit fa sch pnmd 2 �-- to fAe d Slglild SIB�PRM111�IIB�I1G 19 MCC�SCd a/SUi�t�0 MC pf0V1f10�5 0�tMt GOf�UK1M S LKC115C UW(ChiPIC� m � 9(commencing with Senion 7000)ol Diuision 3 of�he Busir�ess�nd Prufessiaa Cade�u Ihat M�s enrtpt�ehom� '� a md the basis for the atle9ed e.remptim Am vdmon o(Section 1031.5 6y aM applumt fa o psrmit aupeca � W the applaant to a cnJ penally of not more man tiue huMreU dolktt(5500�.�: � � ❑I.as owier of tne Praperty.a my empbyeez wnh waqes as tAeir wk can�risauon.will tlo the woM1,ab � tAe s�ructure�s not inttMed or oNerM iw aak I��.7644.Businwss md Protessims LoCe.Tlae Gmvector'S�fsme d � us V Law dces not apply io an owner o�properlV Who W��S a�mproves Merem,and wM does wcfi wwY henzll. () •.• oi thouyh his own employees.prw�dcd Mrt eu[d improvemcnts are not inRrdeA a ofle2E fa sde,��.Awnvn. -� � the Wilaiag or improvemml is sold within mu yex of cwnpetwn.t!k owner�Wiltler wiU hme Ne huden ot pmup � y Ihal h¢did naI hmN m imyrove tw tht ryrpox oi sak.) va ❑I.as owner ul�ne p�opertY.�e:�4anely mnlrazixiy with licensed conUactara W construct Ihe pq�t ISx. jJ 0 7pA4.Business Ind Profnswn�Cade.Tte Contrxta s lrcanse Law Ews iw1 oppY N m�avrier o�praprry urlro � 4 hwMs or improues thtteon.�M wM con�rac¢1«sucM1 propcts wim a�ontrx�nr�al licrosd pusum to Jr Cmtraclar's licenu taw I NSTRUCTfON � W � ❑��e.�m�m&s«. ,a e vc w�w�c«nra,�i PLAAI REVfEW � °a1e °u""" LECT i L,J, �O ' WORKEHS'CWNPENSATtlM OECLARAII(lY:I here6y alfvm w�i o-.,�a arorrax or��,m�n-n.,�.�,a PLUMBifJG a ceruficate of Vbrkns'Compensa�m Msamce,a e eerofied copy ihereof ISa.3BW.1a0.C.I. 0 e ❑,�,�c�vrKa���+:��nr�u���a � 71AECHAiVICAL � . C�1 o tF1 Cruhad�a�is h�ed wi�h the Bu�dirp�mpectro�Dwanmem a p� o�m.m. d GRADING � CEfii1FICATE OF EXEMPYION FROM WORKfRS'COMPENSATION WSIiFlANGE:TAia sectwn�ed not 6e co�kad � y �i the pamrt is Im ax hWdred Ii1001 a kss.I ce�Liy 6Ut in IM prl0rrarK�af IM work 1or wl�cA Ilis yermit is issued.I sh�not enqby any person in prv�uanre�so a to hecwe mhp[t tAe MlCrkps'Cupensrtm SMtP �� �"' Laws ol Caldornq. ' p Oah ���1�� row�� � ��� i� SCHOOL FEES '�" NOT�E TO A CAM:M.after m�king tlm Cauitne ol E�xnytion.1w � euhat m Ik VArtu"t � Compensat'ion provisqns ol the LaUx Ca9e,yw must hNtAlrim yeo��.�w+�:ekch prwaom u tlis pamn�a1 . LL 6e drei�d matm � [x �_..� � pVI5Yt1V�INWSTRUU$AFETY PEflR4I GERIIFICl171tlNf�! � ❑1 hoetry cendy�ha�m 61�mmn fxa(5I or moN(eel in d[plh mb wkeh�prsan n raaurW ta dacentl. C wdl he mMe�n cwmechdi wM NMk a1MG�iiW M�De�.�1 dM ro p�n tufb�q I�eMeh. �— u dnnnlmm a dmnai �krrol.wiY 6e ime� t� !MdP�;IPn��31.Gry 2.Art 2.Soe, n� i� aet.r�e�B.c.aCi. � a���r�� E,.�,sa x 3 ❑As oMner-WtlJn.I wiu rot emqoy nryw�e w do waM wl�h waY npwe a Pmm�imm tlr Orom d � Induatri�l SafelY,as roted�he�e.unMss such,penon�s�,➢eun4b da sud�wNk IN�Uie dnr1R�� ,. � o0ni�'°""�s"�' � '� TOTAL FEES L s,hn re,��w�. - � CONSTIi(1CTIIIN IfNOM�I'AGENCY:I hneW�Hiim tlut tlsre o�tomvaoon Mndin�aprcY for IM/Klma+nn m fhe waM tn wlxtA Mie ORme u iswed ISe�.3097.fw�.C.�. � ��'''� COMMENTS �% "�" LenAn's Atlaess � CEfl7tFCAiE OF COM�IIMCE Rfq AIR�URR7AlU1 Of ENTAY:I cwefY 1 have rm!tlu;pla�Nm d s�Mr r� tlut the iniumatm P�n is w�eet I pa ro�mplY wM�II at+1e hws wd cib adin�as nYaq ta 4i1iM � omstruction.�d mtlwrin�r�4e+e d tlr D�prm�m d BuW+9 mA S+MY e���e P�M fa wrlrch I Iwe appled ior tla mi1 br ih prpa`e d mNuiq uupciau. T ` r Sqm e d mt a npm� /�I�'`v RECPT MO. �� PA1D BY �v` VAUDAT WHITE—Department Copy.YELLOW—Finance Copy.PINIhAsses�or Copy,GOLDENHOD—file Copy,OREEN—ApWicanb Co{ry $St06-1 tl89 . :, , . � ��r.�_ ..� <. 9 `�r:��"�„�� ���.��� x��� �µM ���� ��s h _ ��,��'����a � Y��. � �� re$ . w�<�� p ..,n i�*1�+�'."�`. ,� �r , m-; �r a�— �� .�"£ y��,*.+Yw� �. ._.,.,a"M � � ,�.�. :, {� "� ,` £� i �� �z., � s � a s�� �y ,.. s� a..�� "�'"�� . . .. �� '"�. ........� _,� . . . ._ ��e:�.s ��111«7= £� ���`� i'���i� � �, � � � � . � ��6 �. ; k . „ , � .... - + �� t ,: ?L .. 4 - L-, - : ' �. ..� � ; .'. .... .. ._� .... . . . € ..... ... ... _ ._ �sl�/� _�. -� .___ _ ; - - _ , W� _ ;� ; { - . _ _. #. , : � g � �fz��;� _ � � �� _ _ - i .__. _ £ , . . ., � � �#�� � � ,, � _. _ __ _...... ___.��._._ . ....._. _ _. _ _ _.__ - ' �;' : . , _ ,_ _� _ �� _.. _ '�� � _ D9 �t-4b� � _ ; ._ < _ � � OlC za � �.4 =� .i V'� � ' _... ,_.. ... y.3 i ._ ._ . .,__ ., � " ' __ ...__. �.... ........... .._........._.._ _. ... _,,,... ...,....._._,_. _...._ ._. ......... , _.._ , _... _._ . , � �. f _ � l .� .__. �. .. ..._.., ..... ...._.. ._... ._._.. __� . � .`. ... : .... ..... - . ......... ....�. _..,._ _...._..._. .. _.. ._ ... ....._.. .___....__. . 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