HomeMy WebLinkAbout1641 (39) --=� , '"� CI�Y �F DiAMOND BAR PRESS
`�.�. �T�' �' DEPAF�MENT OF BUILDING AND SAFET'1t ��pMLY
BUILDiNG PERMIT
JOBSITE ic ', � APPLJCATION i s'ti ��+ (� PERMIT USE
ADDRESS ja�� D D�arn�n.d i�ar �I��(�r DATE ����.(`_NUMBER CODE
ISSUE � TYPE OCC.
� APN . LOT TRA�T DATE � �� '�.r.CONST. GROUP
o CRO�S STREET SETBACKS �E��
ZONING
�° CWNER l.�IQ� FRONT RW ❑
o ADDR SS ��`n� REAR ❑
W CITY ���Y��;1�, � I� ZIP ����J TEL. • SIDE/SIDE STREET RW ❑
o APPLICANT TEL. � ' SIDE� �
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� CCNTRACTOR i +� � a r SEWAGE
o ADDRES � " DISPOSAL � �BUC PMT+�
„� CITY ZIP_l��_TEL. ❑ PRIVATE SO.FT1100 GAL
z STATE �;�,�r�� GRADING � CU.YDS.E;KC. CU YDS FILL
y LIC.NUMBER „�t�"1 �3�
y ARCH/ENG/ � �:TYPE.. SQ FT' FAGT�IR::PS. .:: ADJ: ARE�WACUATION°` '::::
�' DESIGNER_ ��'`---�_ W �
o I ADURESS ��-.."".—�--- . I,WL. 2 -
Z CITY IP TEL. (� 3
� PROPOSED USE - I � Z 4
� d GARAGE
o Na.DWEL. NO. NO. � pORCH
y UNITS STORIES BEDROOMS
� LOT DIMENSIONS m VALUATION ADJ.AREA
o NO.OF BLDGS HOW ouaruriTv pESCRIPTl01� FEE_„_,
W ON LOT USED ¢ ,; �t . '—'"'
_ ❑ � ]L_ �
~�LI,.ENSEU CON?flACTOflS CECLARATION�.I neiehy afUrm thal I am lirensed under prowsious al Lhaprer 9 fcommencinp -h
¢ �.vnh Secuon 7�OCI of 7i�isian 3 ot the Besiness ar.tl Pmlessions Code,anC my Lcense is in full imce and eflect W
o J.
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LL�fbVNER-F,W�OER D"eCLARATIDN:I here6Y altirm t�a��am eaempt Irom�he Contrecmr's Ucense Law�lur the following .
_'masai ISec '0375.Business anA Pro�essions CMe�Any ciry or county which requnes a permit m crostmeC �C,J� �
o aL•e� m0�o'+e.tlemoush,ar reoair any siracture.prior tp ns issuance.also reQuhee the applicanl far such permn ?
4 to I:Ix a siyced sta:emert Ihz!he is IicerseE pursuam m the provisions of Ihe Conttacmrs License taw(ChaDle� �-p]�
p� 9�;mmmencme mith Ser,ion 70DOj o!�ivisior 3 0�Ihe Business and 7rofessbns Code�oi Iha�he is enempt therefmm .'�� -•
d I antl Ihe]asis Icr ihe alle�eil esemptior.Any violation ol Secnen 1031.5 hy anV applicanl!rc a Oermit su6jects -''
x ?hc a;F��i:���',m a civ:l penally ol nm more Ihar.Irve hundred 7ollars(55001.1 a.
� ❑i.zs a�.vr.ai o�Ihe a!��erty.o!my emplayees with v.�ages as iheu sole compensanon.w�ll do the work.ana
� the stmctu:e is nm imer:oet or oHered lar sale iSec 70C4,6usiness and Protessona Code The Conira�mr's License ���Q `f ( � Y r"'• �
V.Law does�'cl appp tc ac owner af pmpeny who huilEs ar improves Iheieon,and who does such wark himsalf. .�(�
W r.i t�:rcuch�iis owc enployees,pra'+idetl Ihat such improvemer.s are not intended o:oflered for sale.If.however. � �' I ..J
m th.e huilCinr_.cr Impmvemem is sold w;hin une year o�comdenon,Ihe ownerbuilder wtli have Ihe 6wden ol pmvng 4�
-� tha!he ilii:nm L•u��d ci improve ter Ihe OurOose ol sale.� ��
� �I,as ewi�er ol;ne pmpert4.an xxcluswely co�tractmy with Lceraed eomrocrors Io co�siruct Ihe prqect�Sec. ��W:
� ?p<4.Business and Rofessinr.s Code The Comracror"s License Law daes not apply te an ownn of ora0erry wAo ��.g
Z Cwlds ar improves ihereon,and who conlracls lar such pmiecis wiih a wrttronor�s)licensed pursuant ta the Coniractor's
< ::cE�'"�s"•.� CONSTRUCTION
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� ❑!em.exemp�under s� ,s,a Pc.;a,�a�n ce���a�are�. PLAN REVIEW
p De!? Dwner ELE�CiTR��,..- ��
Q �.40RKENS �OMPENSATION OECLARATION I hereW atlirm thai I hme a ce:tificale of consem m seil-Insure,or �
� a:en�i¢ai?rf Vmrkers Campensation Insurance,or a certified copy thereM ISec.3600,Lah C.1. P L U M B I N G
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Z G tenmec�oov is nerecy�urnisheo. ECHANICA � .�...�
¢ �____...,_� —
G eroi:e9 coFV•s liled wilh t�e BwldinG Inspectmn Oeparimen�or llepartmem. Q��GRADIN.(�7
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Z f,F71FN;F7E OF EXEh1PT10N FflOM'vVORKERS COMPENS0.TION IILLSURANCE:TMs secuon r.eeu not 6e comP�etzd ;o� SUANCE ' � /r �+\�
�I i? ine perme is fcr ore hundretl(S100!oi less.�ceriify that m the performance of�he wak lai whch Ihis �"` � �C�" —
y I�ermi�is issued,I shall rot employ any persor.in any manner so as�o be[ome sub�ect Io Ihz Vkrkers'ComOensalion ~ S^M�P
=I LaNs of�alifnrma �:W
o I n,�o I(;�sl�Qi`� apPr�a�� uJ PARK FEE
� NDTICE?0 APPLICANT-II,aHei meMing this Certificate nf Eyemptio, u should becamc e«m�ee wo,�rs ���'SCHOOL FEES
_-+ �ompe�isa9en provisions of the Lahor Code,yau must luthwnh c nith such prov'ians oi this permit shall
� ce oeemed ievrked.
�
p� �IVISION OF INOUSTRIAI SAFETY PERMIT CEfli1FC1Ri0N� ' ,,,„x....
� *; ;_�. ., . .,:,.:;
d �!neieey cerldy+hat nn excavauan Uue 151 or mae leet m depth imo wAioh a persan is reqmred�a desren0. ;
¢ -n-ill Se matle�n connecuor.wiln work aulhw¢etl by this permil,arid that no hmlding s�mcture,s�a�falding,falsewarY,
�- or uertiolicnr oi dismantling�hereof,will he more than thiJ..ty-six 136�.deet high,,lChip.32.Gry 2,Att 2,Sec �
z aci r�nca.caci ""i x,: "'" � ?�'ws<,"
_ �? .
3 �As ownerCulder I will nm employ anyone io do N•mN which wauld reQuire a permit imm Ihe 6vision d -
�— InJusuial Sakry,as r.o;ed above,unless such person has a pemet Io do such wwk fmm.the d'rvision..
s ❑a�,=�a�a��„d�s���a�S�e,Y�,m��Na. ", � .- :: :..:.:',",; : ;;.: ':: ::..; TOTAL FEES , C�
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� CONSTRUCTION LENOING 4GENCY�I hereb/�nn.�Mat•ihere is a�iatlshtittion�len�inB apeMy lar fhe perfortnance
Z ol�he wwk�oi which this permil is issued(Sec.J097,Civ.C.6 ! , �
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tenae�s Nxre COMMEN � ��_�f4� �` � �. �
m Lentle�'s Atld�ess , j
¢ CERTIFICATE OF COMPLIANCE ANO AUTHOHI2ATIai OF fNTflY:I ceridy I h�ue read tl�is appicatim and snh � � �,_,
w iha�vhe nlormalion given is correct.I agiee m comply wuh all stah laws a��iN ordnances relatinp m 6uiMi�q
y qnstmalion,anA authrcim a iepresemaMe of the Deparimenl of Builling mA Salety to ennr upm IM property
= for which I have applied Mis permit for the.D�Wu d mak�ng inspcetians.
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�na we af Applicant nt �i7ote RECPT NO.�._.�.�_—PAID BY .''�s7 I. � VALIDATION
.
WHITE—Department Copy,YEL�OVJ—Firiance Copy,PINK—Atsessor Copy,GOLDENROD—Fite Copy.GRE'EN—Applicants Copy
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