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HomeMy WebLinkAbout1295 (17) '�'� CiTY �F DtAMOND �AR PRESS � ' `"� DEPARTMENT OF BUILDIN(;AND SAFETY �^ BUILDIN�PERMIT FIRMLY JOBSITE f APPUCATION ' -> f'ERMIT C U�E C C, ADDRESS � ��'.��a��'� ��'��- ��' DATE �— � ��J NUMBER � �-/ CQDE � APN LOT TRACT DAT E � ��CONST. GROCUP �',� �� �+ o CROSS STREET SETBACKS �� °-' OWNER � � ZONING FRUNT qyy [] o�ADDRESS `� '� � ' �--' � REAR_ Q W GITY� Z.ZiP i2 TEL.�.��L SIDE/SIDE:STREET RW ❑ o APPLICANT_ '�L. SIDE ❑ z a CONTRACTOR _- �' �1i.�'" a ADDRESS•�G���, . � %� QE POSAL C� PUBLIC PMT� „� CITY��'f�+ � ZIP '� ��TEL �' � � PFiNATE SQ.FT./100 GAL = STATE y LIC.NUMBER �-��=�� GRADWG ❑ GU YDS.EXG CU YDS FILL y ARCH/ENG/ � TYPE: SC� FT :Fd�4CT�?W.PS. :. ADJ:,_,,,AF��;A�JALUATiON � DESIGNER W: 1 p ADDRESS + 'l,Wj'., 2 � CITY ZIP TEL. � 3 g PROPOSED USE V 'ti'�� � — � 4 C] v ;�, GARAGE �;. o` NO.l7WEL. NO. NO. �: pORCH y UNITS _STORIES BEDROOMS m; � LOT DIMENSIONS <: . VALUATION ADJ.AREA ,.�._ ,. o No OF BLDGS HOW ,auAtuxirY �;.,�ES�RIRT1f�N: ��;': ' ; FEE, ' ; W ON LOT USED a. --"" � � W ❑ y' = 4- ~ UCENSED CONTRACTORS OECLARATION:I Ae�e6y affiim�hat I am licensetl unAa D�ovisions ol Chapre�9 Iwmmencinp � �vnh Secian 70001 of Oivrsian 3 of�he Business and Pmhssions Code,and my license is in full imce and efiea. ��W: O J:. 3 ❑ ":W]: � f!WNEH-BUIL�EH DE;,LAflATION:herehy atfirm that I am exemp�irom ihe ConiracWi's�cense Law loi Ihe lollowing ��._._.�,,,/ Z �eason i5ec 703!5.9usiness anA Prafessions Cade:Any :iry ar county whieh requirzs a permt w cunstmct, ;{} � - �J�'�u��{:. ��� '�,� � O I alizi.improae,Jemulish,or repau any stmcturt.Crior m ns issuance.also aquires the applicam far such permil ` Zr': ' � �'�.+ ¢ to lil?a syned s!atemenl ihat he:s!icensed omsuanl m ihe prwisions of ihe Coniraclor's License law(ChaDter �j�({J. ��.�,�I:,��awp s 9 Iconmenc:ng a�ilh Settian 7�001 of�ivision 3 al ihe Business and P�otessions Codel ar Mat he s ezanpt thereham ,�. u,and Ihe hasis�or;he alleged exempdor..Any viai�tion ot Sectio�70315 by arry appiicant ki a permil subjects `.��� W he apOhtant m a c:vil penalry ol no1 more Ihar fi�e hundred dollars IS50011. �� J ❑ �. � i as uwrer rl the properry,or my employees wdh wages as their sole compensauon will do the worM,and � tl�e stmr.iwe�s nat imended ar alfereE fm sale ISec.7044.Busness and Pmtessions Code:The Cantracmr's License ;'�; V Law does rol aCUly;a an owr.er ol Vraperly who builds or improves Ihereon,and who dce5 such work himsdl, �'(�� ' or ILrouyh his cwr xmplayees,pro��0ed that such impruvements are nal intended or ofhred for sale.If,howeva, ��..:Z' m tl�e huiicmu or improrenem rs sold wRhm one year al completion,Ihe owner�6uilder will have the 6urden of pioving ';�.. � Ihat re Ai�net hmld cr iin0�ove tor Ihe pur0ose of sale.l �;�� y � y CI,a:owner of Ihe G�oDe��Y.am exclusrvely contractiny wi[h Gcensed comracmrs�n cons�ruq tlx proR[t ISec. '.pJ` � ;04A,Business and Prolessians Code�,The Cantractor's license Law dan nol apply ro an owner af praperty who ;;Si.' � Ludds m imprnves Ihereon,and wha roniracls Ier such projeets with a[ontratlaqsl licrosed pursuant 10 Ihe Canirxloi s tice�s��aw•i CONSTRUCTiON _ O W ❑I am exenpi wmer Sec .B.fi P.C.IAuxh Cenificatel� �` PLAN REV�Ew H p Ilate av�e� �'�. ELECTRIC 4 WORKERS'C9MPENSA710N OECLARATION:1 herehy affirm Iha�I h�ve a cerlilicale ol consent m self-insure,a �^'� � a rer6ficate of Nbrkers'Compensa0on InsuraMe.or a certifiea copy t�erzof ISec.3800,laE.C.�. ��- PLUMB�_� ^ /r� t�� e Q ❑C ied caDY is hereby�urnished. .�.' MECHANICAL _ o enifieA ccoy�s filed wiih the Building Inspection Oepanmenl ar oeoanmem. ,'�� �RADING W "— ` x LERTIFICATE Of EXEMPTION FflGM WDRKEflS'COMPENSATION INSIIAANfF�.This sec�ion nred nat he campletetl ; ISSUANC�__-� 1 .00 / � :I ihe Dermit s lor one hundred IS1001 m�ess.I tily thal�n the pedarman[e o�the wak 1ar whkh�this h r permit is issued.1 shall mt employ airy Person m any man xo as to Cttome subject W ihe Ylb�kers'Compenulion :..;;. SM IP Lavrs ol Calif rma. o L — �r-'� / "" RK'FEE p Oate � AOYIi� .:W: � NOTICE TO APPLICANT:II,aNe�maWng�his Cenitic of ExempGan,you s x s�n,���o me w«�•5 �,��-� SCHOOL FEES _ � CamOensalmn prwrsions of the Lehor Code,ya sl Iartl�wlM camply with suo rovis ns or Mis QC�I�III SFBII � Ue deemed revoked. J � DIVISIW OF INOUSTRIAL SAFETY PENMIT CEFtTIFICATI �. , W ..:� ').;i ..:', !i :''.. o ❑i hereby rer�ily that na e�cavation flve�5�ar morr'ieet�F"depiii�iMo'vuhEh a peison is reQuired ta descend, � will be maAe in comecnan with wort aulhor¢etl 6y Mis permi�,aM thai no huAdinp struclwe,srafblEnp,fysewoik, � or Annalitnn nr dismamling thereol.will 6e mare Nan�hirry�sia 13fi)feet high.(ChaD�3.2,Gry 2.Art 2,Sec � a 341.TiNe 8.C.A.0 I. ... ,s� n ^s �;.,>+f.;"y� x ��g 3 ❑As ownei�builder,I will not empby anyone`fi 1do�YhY whicF'�'woul��FOqGifPa permil Irom the Divuion ol : � Intlus7rial Safety,as notetl ahore,unless such person 6a5 a peimit m do wrL work from Ihe drvision. � ')S'. W ❑a��5�o�of����,���sa�e�Y�,m�,�:��;-:.•,�; :: ;_ : ..:.::.::. . . :... 5 TOTAL FEES � � . C � CONSTRUCTqN 1EN01NG AGENCY�.I herebp:YI(irm;tha(�hete��i;a.�constr'uc4aii�lendiP�`8ge�iy:lor tice perla�mmcx Z ol the worY lor which iM1is permit is issued'f5it'.3097;�CN.'C.r.. : .._..' '. • ' � �e�dcr's Name COMMENTS mlende�'s Address Q CfRTIFICATE OF COMPLIANCE ANO AUTIIUIIZATIa1 ff EMiRY:I mrryly I have read Mis applintion and staa y Ihat ihe infama�ian given is cprecl.I agree ro mmpiy wrth aIl stam laws ard ciN ordinancM rehting ta Muldi� ycanstru �n.mA aulhorize a�epresenlatiue of the Oeperiment o(BuilGmp a,M Safely m!nM ypn tl!prqferry � = far which plied tar thi permu for the OuWse o�making inspeelims. H � ��,��,� �o��,�� ��V`�� �� RECPT NO._' ^ � 1__PAID BY ���VALIDATION ' WHITE—�ep�ctlnent ,YELLOW—Finance Copy,PINK—Assessar Copy,C,OLDENROD—File Copy,GREEN--Applicants Coov BS106-11/89 —.�� , �,. _ — , , .� : ...... , :.. .. . . . ,. ,. . ,,. •--,. ._; . . ., , ... . ,. �.,,,,;,.,:. . , .'.� ' . . . .... '- "5' � .... ' ..... -.�� -... 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