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HomeMy WebLinkAbout1693 (44) _....,,. _..__..._. ,,, . __ '"� � ClT�( �� DIAMOND ���` ��~��� �A� PRESS < ^ • D���� BUI�LDING E'RM TND 5llFETY FiRMLY ;� JfJBSITE ' J/�-rYlp.,y,r� ,�J,�}T:� APPUCATION „� PERM{T (�J� USE � ADDRESS � � -� � SSUE '��� TYPE ER �-��-�C�ODE 4 APN �O�TRACT DA7E ��S CONST. 1 GROUP o CROSS ST ET��n. SETBACKS �►E�+*s � OWNER T�s�'�+-[� ZONING FRONT Ryy 0 o ADDRESS � � REAR � ,� CI7Y ZIP�TEL.�S"G77f� SIDE/Sl E STREI:T ' qW [] iii o APPLICANT �'���'�-j � �.�.* �EL. SIDE_ [] z a CON7R,4CTOR '�s SEWAGE o A�DRESS�/'S'-�'" � i .�'*° y'a'"�� D{SPOSAL � F'UBLIC PMT# „� CITY�. Cc�tG�-�.� ZIP �'L7�� TEL.g`�s "� . � PRIVATE SO.FT/100 GAL rr z STAT y LIC.NUMBER G- �'��� �%LI`���� GRADING O CU.YDS.EXC. CU YDS FlLL y ARCH/ENG/ �: �'E; S� �T �A�C11C)�(PSI. `.� �A 4 A�EiA�irl� [,�kT1�O1V ' � DESIGNER '""' � 1 ( o ADDRESS � 2 � z GITY ZIP TFL_. 3 '-- �: � Z 4 � PROPOSED USE . � _ � �i'�_� l c✓�.f%J �'. Ats+�nc 5 � GARAGE ! o NO.uWEL. N�.�T NO.' — y UNITS STORIES BEDROOMS m. �CH � LOT DIMENSIONS VALUATION ADJ.AREA o NO.OF BLDGS HOW QUA�urrr�::.DESGRIPTIC?N:; .:' ` � E : : W N LOT USED Q. ' �� � � W :U: � � MAACTORS OECLAflATION:I he�ehy aHiim Iha�i am licensed untle�p�av�sions ot Chapler 9 laammencinp .'�b+� � with SecLon 7000�of�Jivfaion 3 of Ihe Business and Prafessions Code.and my license�s in full force and elhct . W: � ❑ .::�j' __ LL QVJNEP.�6UILDEF OECIaqATION:I heieby aHirm thal I am e�emD���om ihe Contraz�or's L¢ense Law Por the ldbwing reasen�Sac.7�31.5, Business and Pro�essians Code:Any cdy or caunty which r¢quires a permil ro c struct. :�.��}.' O alt¢r.nnpmve,Jemolish,ur repair any stmcWre,prio�to its issuairce,also repuires Ihe appli[an uch permil -? 1-- ic file a signed slatenen�Ihat he is licensed Dursuant lo ihe O�ovistons af the Con " ¢•nse law(Chapter ,':py� � 9 Irommencm9 wrth Seqion 7000i of Division 3 0�Ihe Business and Pm}es� e)or that he is e�emp[therefmm ''� — d and:he 6asis far the alleged:xemp�ion.Airy violatwn ol Sec' .5 hy any applitant(or a permn w6je[u �.;a; x !he applicam:n a c:vil penalTy rf nut more than frve hu a ars 13500)I ��J: — W a. � �..�I.as owr.er af�he proU�rty.m my empl s wnh wages as theii sole compensavon,wdl tla the warY,antl Ihe simcwre is net imended or Mfeietl I ale ISec J044.Business and Prokssians Cale:The Conlro[tar's Liente �.��. �,~j Law tloes no!apply io an owner roperty wM builds or'improves fhneon,a�tl who tices su[h worY himse�f. �•.�� ' or tl�roug"6is av;n employees, a�i0ed ihat such imprnvements are not nrtenUed or olfered lar sale.If,however, � � � � , ' i.Z'. m the toildir.g or imp�wemer.. - sold�vrthin�one year ol campletian,the owner-builder will A3ve 1he bwdeN a1 p�ming� y Ii-h-a��ne did not nmld or�-mve tor the puryose ot sale.l `� � � �� � � � �- � . �- y LJI,as owner e D�openy.am'ettlusiuely contracimy with licensed coniraclars Io canstrucl the prajeo[(Sec. ',t��j ' 0 1i144.Busine nd Profedsions Code:The Camracmr's License Law does not apply ro an owner nt propeny who :i`,�' Q Cuilds or ii� wes iherear.,anA whn conmzcts foi such pmjecls with a tontractoqs)licensed purtuant to�he Cmtractor's ' �'^j� Licens w; �"CONSTRUCTION r��fG�V � �', � Qc'� C W I am exempt under Sec � ,B.&P.C.IAt[ah Cenifcatel. ��..PLAN �EW ��L�[��1� J Date -� A+�ner ) � �� LECTRIC y VuDRKEFS"CDMPENSAiION OECLAPlIiIqV:I he�e6y affvm tha��have a certiFicafi ol consent m sell-inswe,a �,��,'..� ggrtificate of Nbrkers'Compensation Ir.surmce,or a certiiied copy thereol(Sec.3800.Lah.C.I� ��� '. PL� _ area oov�5 ne,�nY r�„�.5nea. � MECHANICR�L o S 'red copy�s filed wrth Ihe Bm�dmg Inspecaon Oeparunent or oepanmen�. :'Q;GRADINCi W y� � "„ERTIFICAiE OF E%EMPTION fROM WIXiKERS�COMPENSATION INSUPANCE:This sec�Lq,p.�eed�ol he eompleted � UAN pVQ y il the permit @ for one hundred i3100)or less.I certitp Mal�n t ernrL�l the wwk lor whKN thi5 ���•�� }� Q�— permrt is issued,I shall not employ any person m airy s eo hmane su6i�����rkns'Campensatron ����' � Lews nl California. � �,. �! '—' , o , ;:� w �a�"EE o��e / i W NOTICE TO 0.P IPr�lf,after makng this Ce'ofma�te orf E emplion.You shauW hecome wh�ect to the WorMer's �-�:�SCHOOL FEES � Comp¢ns provisions o1�he Lahor Cade,you must fonhwith camO�Y wiM such prov�sions w this permit shall 'i I med�evaked. J .�. . t p� pUIS10N OF INWSfRIAI SAFE7Y PE�I. E�TIFIC4710,1�1,j �`�""x'' W _ !cl`..,;r",) d eahy rertity ihat no ewcavation five 15j m more leet in depth_�'W-�vM i a persan�deuend. � wdl he e in can�re[lian with worM autlnrued by Ihis ',t�z1lCiTa�m hwldi�g slruclure,sralidding,falseworY, or demol2ion or tlismanling lhereof;wiq.he�� n thiny�su(36)fee[piph:�Chap 32.Gry 2,Art 2,Stt W- 341.Title 8,GA.GI t._.:� .. .. . .... .... ... ... .. _ . ::.. _'... .... :. ....... . .....: :"• 3 ❑0.s ownerhuiWn. not`EinqbY'iAynrie'lo tlo`wor4��whiiti�wouMliquire a permit Imm Me 6risbn of ' . . �-. Industnal Snfet oted above.unless such pefaon has a 0«mtl m do such wark hom the division � W sion af Indusrcial Safety Pormu Na. � CONSTHULTbN LENDING AGENCY:I herehy affirm tl�at�here is a construction Imding apercY�����o�.� TOTAL FEES • D C� Z ot thz wark fw whuh tM1is pe�mit is issued(Sec.3097,Gv_C�. � �eneer's Name C M6 EN S_ .�.�r,' / p=p Lender'S Addrzsa � � 'Q CEFffIFICATE OF COMPLIANCE ANU Al1TIqPoZA71pJ OF ENTRV:I certify 1 haw read IM1is applsotion aid stik va that the�nformaiion giuen is carecl.i agree ta rnmply with all stale laws md[i9y ordiiw¢es relotiqp to huiNiip yconsiruction,anA aulhor¢e a reD�K��e ol Ihe Uepa'unent d BuiNinp md Saaety m mm upon the plqe�ty = for whi I have aOVI¢d far � permil urMe rpase nf maYie�pp��ppp���ppp�&&FIons. . � H , � ry ` ��s�'� T�` REGPT NO.--�--f--„_ __PAID BY U C)� VALIDATION � $gnii a� mt or Aypi� '�bh WHITE—DepartmeM Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOl.DENROD—File Copy.GREEN—Applicants Copy BS106-11/B9 .. �.... .�....�., ..::�. ,�-:v.n.w.< ...:.........::. ... . . • ...i . ..�...... .. . .. .... . i � � - , � . ..r,.� . �.. .. ._,.: .�`. .. . . . .. ..,.�.:. ..r... , . . -. \" - . .. � . 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