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HomeMy WebLinkAbout1345 (17) \�. 1`:.� �` '`� ��T�' OF D�AnflOND �AR ���� '•�"� �EPARTMENT OF BUILDINC AND SAFETY P�ESS ��^ BUILDING PERMIT FIRMLY JOBSITE '`- APPLJCATION i7 PERMIT r� • USE ADDRESS �r+�'� � ��'`��•�'� �� � DATE �`�a' /'��UNUMBER J CODE ISSUE C TYPE OCC. Y APN . LOT 7RACT DATE ���"'� � ��ONST. GROUP � CROSS STREET '-R���?-�5 SETBACKS �� °C OWNER ��+��'�� ��t3�� F� - ZONING FRONT RW ❑ o ADDRESS Z'-F 7�'L'7 `%��' E R`1 �- � REAR ❑ QC'—, W CITY_ �� ZIP TEL. ' -s 7 �� SIDE/SIDE STREET RW � g APPLICANT C��� �`�!-�'�•��' TEL. SIDE_ ❑ z 4 CONTRACTOR `�=' e1�"4'" ��'' ` �`''� SEWAGE o ADDRESS - DISPOSAL � PUBLIG PMT� _ � CITY ZIP TEL. _, � PRIVATE SQ.FT./100 GAL `'��2 STATE a LIC.NUMBER GRADING � CU.YDS.EXC. CU YDS FILL - � y ARCH/ENG/ ;�T:TYP.� a�Ct:.F1` �AG;R'�R::f�.';:... .AOJ; AREANI�LUATION ; .: `=' DESIGNER "' ' ;LL,1 1 /)'[a f �/, c. �� "[l:i; o ADURESS _ .(,�,. 2 z CITY ZIP TEL. 3 ---- :C'�:. � PROPOSED USE DP-L�� < «-G= ��+r��i `Z` 4 -�2.-- � _ �:. GARAGE o NO.DWEL. N0. N0. � ppRCH y UNITS _STORIES BEDROOMS �Y � LOT DIMENSIONS � VALUATION ,� ADJ.RREA — --- r � o NO.OF BLDGS HOW ounNTrTv� .DES..RIPTiON:. ��E W OU LOT USED " � —_ ,�:c`3: --- - W O :ff: �Z ~ I16F.NtiEI];ONl HACTURS�ECLAflAiION�I herehy affirm Ihat I am licensetl untlei piavisions of Chapter 9 I�ammenaing — � witl; ion 70001 nf�iwsion 3 nf�hr.Rnsmess and Pmiessions Cade,antl my li�ense is in lull loice and effect. �;��,��� 'Q3 W:--_ — �+ CfWNEH ISWLII6R OECLAHATION-I L•eieby allimi ihat I am exempt imm the Comractor's License law lor Oie Idlowir,g � ir.nsnn�Sec.7031.5.Busine=s and Pmlessions Code:Any city m mumy whlch requiies a peimit to cunstruct. -'>(}' oaltei.impim�e,demniith,nr repau any slmctwe.piior to ns issuence.also rzquves fhe apphcam foi such pe�mil �r�Z� —'-- � m hle a si9netl si��ement that he is licensed Oursuant ro ihe pmvisions of the Canvacmr's license taw(Chapter �;;�p: .. � 9!cmninenuny with Scction 70001 nf fAvision 3 nt ihe Business and Prolessiais Code�or ihat he is e�e.mpt iherefron� .,.•�- a antl thr husrs for Ihr,allegeA exemption.Any violntion of Section 7031.5 6y any aDD���aut tor a pe�mit subjects ;.;�. w !Iw ayplicane ro e civd yenalty u(not more than irve hundred Aalla¢(S50U�) �"J� --- "— a. � ❑I,as nwne!ul ihe Oroperry,nr my employees with wagex as iheir sole compensalion,wiH da the unrk,and —�- --- ~ the stn¢ture is nm mtenAeJ ur uHeeed lur sale(Sec.71W4.Business antl Pmiest�ons Cade�The Cunvacmr"s License � � Law An2s nni apply to an owner ol pmOertV who huiltls nr imDroves�hereon,and whn dces such work himselL �;:C�,�'—. ----- W or ILiuuyh his own e.npinVPes,pmvided IAat such imp�wemenis a�e no1 intended or ol(ered for sale.If,however. m thc umlCing nr imprnveme.nt is snld wit6in one year al cwnpletiun.the owner-huilder will have the 6nr�an of pmvmg ��-'Q" — _— � ihnt he Aid nut GuiIJ ur impmve far the pnrpose nf sale.) ��2'.. I�i h ❑I,as uwne;at the prnpe�tY.am extluslvely tonfiaCtmy Wiili li[PnSed conVeCt0i3 to[anstru[I Ihe p�a•,ect�Su ���' ��"—� i o 10a4,Business and Pmlessions f,oCe:The Cunlraclui's License Law does not applV to an awnei oi U�operry who ��•�` _� ¢ CudAs a�hnyioves ILereun,and who oantracls kr such prajecls vriih a contractar�s)LcenSeA pursuam to Ihe Centraclor's �� LicenseLaw.l •��,�� CONS�RUGTIC7N ___ .� � � � � U I ain exemp!u A-e�rf se�. B, P.C.lana.e Cernt¢atel. �� :���PLAN F�EVIEVJ _ ��S�y_ t%' �% p �ate_ ` fhrnei ��(.:. EL�Cr��.�i � WORKfNS'"OMV NSATIOM OECLABATION.I hereby allirm ihal ave a r.erllfiwtd al tonsenl to sell�inswe,or �.^.��� � � a cerlificate of Nqrkers'Compensation Ins�ronte,o�ace�tifietl cupy Iheieot(Sec.3804 La6.C.�. ♦^��'P�-U���NC] __ __. � ❑Cerutied cupy Is here6V lurnishetl. '�j,� MEri�"�AN��a/�L __ _ ___.__ o �.��I:e.niheA cnpy is�i�eu wnn u�e Oui�dny�nx�eci�oii Oepa��mem o� _oepa�urcem '�:;GRADIPVG -- W Z CERTIFICATE OF E%FMPTON FflOM WOPKENS'COMPENSIlTION INSUHANCE This sec�ion need not be mmpkted 0�.:�S'�`VANL`E �•� � ,� �'� � if the permit is fnr une Imndre�l IS1001 or less.I cenify�hat in Ihe pedormance ol Ihe work loi whkh�this y pernnt rs issued,I shall ru�emplay any peison in any mannei sa as tn hecame suhiect W tM NOrMeis'Compensalion �-y����; S`M�P — � j �1 o Laws al Cal�forma. . PARK��E __ W' p Oate AOOliwnt _ ��:�.. � NOTICE 70 APPLICANT�It.after making ihis Cenifica�e ol f.mnD�bn,yau s1wuW hecome subject m ihe Wwker's '� .S�if"��QL FFECJ _ —+ Cnnipensaunn prrnisions al the labw Cvde,you must knhwith co�ply v�11L��y�h provieions or this pe�mit ahali LL 6e Jeenred revaked. .�%:, ' �'.i ----- — � qVI51LYJ OF INDUSfHIAL SAFE7Y PEBMIT CEflTIFIC0.ilOW: `i ,�`!c�`:. � �* — d � ❑I Ircre6y�ertAy ihat no e�cauatmn Irve(5)ar mme leet m depih inro which a pe�son is iepuired lo descend, x will be made in cannectiai wnh xrork aulhor¢ed Iry IAu peimit,and thal no building simcture,scalfdEing,fdsewruh, � or deinnlition ur dismantlinq the�ea�,will he mae t�a�ftlqrry�sin�(36hieet�•�EY�ap.3.1.Gry t.An 2.Set � __— Z 341.TitleB.f..A.f..1. .Fr..� F� S .a;�'.;�. . �y .. ._ . '!e. !�i a ... � ��As nwnerbud0er,1 will nol empby airyane Po do wmk whith wouM�equire e pttmit fmm Ihe Uvision of H Industiixl Se�ety,as noted abore,unless such peYsan_M1as a pFrmit�p,da Spch Aw�k fram.the�division. � .; : . ;, .e� . ,�', •_ �—� � ❑arisimi uf Indusirial Safet PormR No � � ' ' �� - ' �yf r�� � " TOTAL �E�S •' � CONSTRIICTKIN LENI]ING AGENCf�I herehy aff rm Mat tMie is a conshunwn lendnp agmcY for Hce pe�fo1mance _ _ ��� ,� „ x nf thx wmk lor which ihls peimil is issceA ISec.31197,Liv.G.). � �ender's Name -- — .COMMENTS m Lendr.r's Address '� CERiIfICATE OF f.OMPLIANCE AN�Ai17HOW2ATIU1 OF EN7HY�I cerlify I have read Ihis appleition anG state �— tI� ihat ihe inta �� i iven is care �ee to wmply wrth all slaR laws a�city ardi�wr¢es rela6np to huitli� y cnnslruclion, d au mize a r unta e o Oepanmem of BuiWinp end Sofny m enter upon tlx properry = lur which I ve e0 a�for Mi permu f r p se o}makiig insyxtions, • _ F— • � � ��✓ �7 G�� ! � � sqnawre of APplkent oi Apent e RECP7 NO._ PAID BY �' VALIDATIO W T Department Copy,YELLOW—Finance Copy.PINK--AssesSor Copy,GOLDENROD—File Copy,GREEN—Applicants Capy 6510R-71l89 _ ����� , . � i ; � ' � , ��� , ���a� ' �;. � '� � ��i�i�. , � ��' I � �� iti��iy� - ' ,. ��.. - �' � '�. , , ,. �� �flda� y � : i . , :._.. _. ....! . � . �. , ,.,:... . ..� . ,..., � : : , 'NE��?� , . , . , ' . �KRFy: � ' . 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