HomeMy WebLinkAbout1005 '"� CITY O� DIAMOND �AR PRESS
k �"" ' DEPAI�'TMENT OF BUILDING AND SAFETY
•�^ BUILDING PERMIT FIRMLY
JOBSITE ,� ;% APPL1CAl10N PERMIT �� USE
ADDRESS ';'^ r/r�C"� DATE NUMBER � � CODE
� ISSUE �� q�,� NPE OCC.
i � APN LOT T DATE '�"' CONST.�(3ROUP
� CROSS STRE T :J_5/ ;�l.���i� � _ SETBACKS ��
°= OWNER�,���� .t=%f:�A.?ir9 � � _ ZONING �ONT RW �
o ADDRESS— REAR Q
,,�„ CITL�li� iic���-�'�` /f � Z�p 7��.� SIDE/SIDE STREET ,�RW �
e APPLICRNT _ _TEL.�. SIDE�._ 0
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a CONTRACTOR "'==-- °�'- ' '�'�`�f°'� — SFWAGE
o ADDRESS / __ � ' � • � �'UgL1C PAAT�
.._y DI5P05AL (� pRNA7E SQ.FT./100 GAL
.� CITY .'�'cyi �:> LIP ` �� ? TEL.`���5�
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= STAT ' 1�
y LIC.NUMBER "�`--�-.� 1���! ��:-�/�� GRADWG Q CU.YDS.EKC.�CU YDS FILL
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" DESIGNER W t ' j�
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o ADDRESS__ r�;;,: 2
_, CITY ZIF TEL. '� 3
�; PROPOSED USE '�� 4
'. ____ a�.• GARAGE
o NO.DWEL. NO. NO. `
x '�`. PORCH
�,:, UNlTS STORIES BEDROOMS_ `�,:
�. LOT DIMENSIONS � VALUATION AW.AREA
o NO.OF BLDGS HOW :° AUnrt�fiY C1��'.,+C� .�'=[U �
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W` ON LOT USED_—_.
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~` LIC❑ENSE�COMflACi0fl5 OECLAflATIaN:I Mrehy affirm that I am licensed wder pmvitiont e�CAapter 9 Itommentinp �V�W� .
Y� with Ser.tinn 7000�of Urvision 3 0l�he Business and Prolessions Code,and my license is in full force md eHect e'�`
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,�—'�, (IWNEN�NWLI]EH IIEf.LAflAT10N:I herehy alfirm that I am exempt fram tAe Comracmr's Lsense I.aw for d�e fdbwing •���.
�_�� iensnn ISec.7031.9,Business an�Pwlessians Gode AnV ciry or camp which repuires a pttmit to consVuct,
o ahei,imp�ova,deiwlish,oi repair any structure,prior ta its issuance,alw rtquires the applicant lor smh permit ;;;���
�� ro lile a sgned statemen[Ihat he is hcensed pursuant to ihe prmisians ot me Gonvactor's liceiKe law�Lhep�a 'i:��c
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�� 9lcammenung with Seaion 7000�of Oivision 3 0l the Busineaa and Froleui0�re COde�a Iha�he ia exampt thnefrom �
�d� and the 6esis for the alleged emmption.Any violatian of Seclian 7031.5 6y iny applkan�fof�a permit Su6je[ts y;.�,i�
K� ;he appllcant to a rnil pxralty ol rwt mare th:n!rve hunErzd dollaa�S500L1: �^�� - —
W :n:.
��' ❑I,as owr•er ol tlre property,or mV emPlayees with wages as Neir snle compmsation.wtli Gn ihe v.ro�k.aM ".
- the stmctura is nm mtenGed or offered fa sale ISec 7044,Business and P�afessans Code.The Contracta's Licrose �^.Q�.
e~jj. Law Anes nnt applY ro an owner ot D�oOenY wha buihls ar imp�mes thtreon,ana who dces su[h work himulf.
:'� ar thmuyh his v,vn employees.provided ihat such impmvements are not intended w atfered lor sak It,howeuer, '�����
�m;. the bmMing or improvemem is sold within one year of canpletion,the avner6uilder will have Me�urtlen Ot p�oving ?=�:'q,�,
��" �Lai he d�d not huilA or impro�e far Ihe pwpose aF Sak.l ��1.
H�
�'y� ❑I,as nwner ol ihe properfy,am exclusrvely camractiny with liaensed contrxtors to conauuc�ik projeci ISec. �<:�f,�� --
„o; 7044.Busii�ess and Piafessians Caae�,The Gantretmr's License law 6ces nol ayply m an mmer of propetly wM :'"��
��6y Luildx a�imqoves ihe�ean,and who cantmcts Ia wch projeds with a comrmtor�s�licrnsed pursuanl m the Cmtnctor's •�-:. �----.--.....
'� ; uce�sc taw.� ?�• : CONSTRUCTfON — ��
o". � ,,.-� ,�a
� �.�' ❑I am exempt ur�der Sx. ,B.6 P.C.�Auxh Cenilkme�. � �: P N RE � ._ . '� "_./. C/ _
;p? Date Owner �'�
ELECTR C
,�i NARNERS'COMPENSATION DECLARA710N:I hee6y alfirm ihat I have a certificate of cansmt ro adf�insure,a t;��;,��
.: a cenih�ate nt Woikeis'Compens�tion Insurance,o�a cxtilied copy ihe+eol�See.3800.L�b-C.�. B W G _
'�'` ;:;�MECHANICAL
�x: ❑Ce�lilied oopy is herebY�Wnixhed.
4�
�o� e�tdied copy rs tJed with the Building Inspectinn Department a Deparlmem. ���1 G ING
;W.: '::. . �^7 �
� CEflTIFICATC OF EXEMPTION FflOM WIIRKEflS'COMPENSATION INSUflANCE:This upion need m�he campktd i �
::y�' it the permrt i:for one hundied(5100)or less.1 cerofV Ihat in the perPorm�nce of the wak�a � � ;�,ISSUANCE /K 4 � � �
( permit is issu¢d.1 shall rot employ airy peraon in any mance�so as to beca subKcl a thd Nbrk ' nwT
:�- laws ol Calilomia MI °��
�: ,� � C.�� � EE �
A".
�� �1e��~ �� �"SCHOOL FEES
�W�` NOTICE TO APPLICANT:I�,aher making this Cer�itkare of Exenp'n,you subjett ro Ihe Nbrker's .
���, Campensatian provisions a(the la6or Code,you musl lathwu to ith su[� wisions a th¢perme shaN �
����.' he deemed rtvokcd.
;�p qVISION OF INWSTflIAL SAFETY PERMIT CEBTIFICAiION:
W
��'�' ❑I Aerehy certily that no eMcavatpn five(5�w mwe(ee�in depih nto which a pmsan u required ta descend.
�p�C�,- wdl he made in cannectwn wiM wo�k auMwued by thu R�mil,and that iro huiWpp structurc,scalfoldinp,t�isework
��a'' or demolilion or dismanlNrg Ihereo(will q¢'ilpre�Qn�q,�t�AR�(38�fee�M1ph.(Chap.3.Y,Gry 2,M 2 Set _
�W 361.Title 8.C A C.I- F��I i� :�:� if�
x �i .�'°�a�4,:s� ,
�3�� QAs owner-buiider,I will not empby anyane to da woiY which wald require'a prmil Irpn Ihe Oivbion d 5 :p'
�'.� Industrial SaletV,as noud ahove,unkss such perton Aas a permii to do euch xork iram the dirision. ��F ,
;� a
W ❑Urision o(�ndusirial Salety Pkrm " TOTAL FEES �
� F,.
CONSTflUCTION LENUING AGENCY:I hereby afliim tM1at ihere is a construction knd'aq apeay lar Ne pafomwKe �� '�'
�_. of il�e wnrk far wAich this permit is issued ISec.3087,Gu.C.1.
O ��, "
'�. Lender'sName " CQMMEMS
�'� Lendn's Address `. ..�.' .'`.•.'"" S.:r-� ;� � �
`m `�
a. CEf{�IFICATE OF COMPIIANC�1CN�"A1ffA0Rl A ��E!(iPV:'I���dlti�p'I �ead dws�pp6qlqn and sl�e °�
-�- �hat ihe�nfamatian given is arrec�.I agree w wmply wuh all sute lews and eiry adinmcas rehfinp m huildinp bh�
.y consvuctwn.and au ri[e a represemative ol the Orpmtmmt al&ildinp md Sehty m e�r upon 1k paperty - 'F
�= Iw whKh I have a d for thit per " r I�q�{wse al maYinp in tp„pf,,.... :�.
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*�. _.
. 'nawre of Appkant a Agm� ��� RECPT PIO. � PAID BY ��� VALIDATI
f �- WHITE—DepaAmeM Copy,YELLAW—Finance Copy,PINK—Assessor Copy,GOLDENROO—File Copy,GREEN—Applkants Copy
�BS106-11/89 .
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