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I _ ___ -- __ '':�. �Il'1( Q.F DIeAi1�OND ��lF� PRESS '�' ' D��ARTMENT OF�UtLd71P1G Al+iD�AF�TY .,� ��'��i������s-� FIRIOALY J08SITE .,;�°'`� ' ��ry �� 1�/'�y}� "`r �4F�LICATIOtd ' `` PERMIT : USE A�DRESS o` � �,GaL.s�UvC:a.:�:+ � DA�TE �° .�.IS ���NUIvISER,�, > _CODE ISSUE � .��"'_��g TYPE OCC. ` APN LOT �FG4C°T DA7`E � �-%' COl�T.' GROUP e CR�5S ST � � S���IG�S .�+a�.E�rrs m OWNER:� " Z04V�P�(a F`R()hf�` RW ❑� � aoo�Ess iG �i,etoc,c:�� R�� ❑ i ,� CITYY,'41�'Yt.,t''?�"lG� IP � T�L S6DElSl��S'iRE�T RW ❑ �., i 'i o APPLICANT - TEL� uID� ❑ z „ I ,m CONTRACTO' SEWAG�''. ,:i. o ADDRE ' DISPC)SRL C�. PU�LlG F'�AT#_ _ w CiTY ' '+� ZIP � �L� " � � Q f�RiV/�TE SQ.�1 i0Q GAL I i STATE �` � GRADIP�('s n ��3.`1��.�3CC.�CU YDS FILL� I � L{C.4VUNIBER � ��"°�`"�- �I y ARCMJENG/ �'T��� '� AQ�6. ���PVi4LUATiE39�1 �' DESIGNER ��I Q ADDRESS ' . �: 2 i = GiTY Zll' T (�{ 3 I�I � PROPOSED U8E "�raT�,�L'.�-i �/L�d,h�.a-�'' � 4 j � � GARAGE � I � NO.OWEL. NO. NO. � PORC�i I � UNITS STORIES B�DROCIMS � L07 DIMEN510NS' _ 'VALU�i'!C3ld - ADJ.AREA �, o fVO.OF'BLDGS — FiC3Vl� - __ � l2UAt�€fiY ���$�'I� F�� W ON�OT iJSED � � � �i = , � ~ �UCENSEO CONPRACIORS OECLARA[qN�I he�eby afhrm thae I un kmsW u7da p�ovitims of CFuptce 9 Iconameneaatg };. � �' wnM1�Sxnan 7Ct101 of Uvivon 3 af fhe&uiness aM fRe9estane�Ca&.and my laease is in 9u11aee���M elfect W. � . � � C] � r ��i !+- 6tNNEfl�BiJILDEA DECtA1WT10N:I M�ehy aifirm Mat 1 am esem,yv,lmm vAe Cortq icroe's�ieer�se tsun fw�e fdb�arg ,,.— ,a � x reamn ISec.1031.5.8usiness a�ProFeuans Cade A�ry tny ar countY���ra�uuira a pnma re crostr�si, i�� �"e a �i o alkr:impiwe,demdish,u rmpar,am rructve.pna m iti�swqsce.alsa,r¢gaires du appi�n4��,for suh prrnt . y-- Ii- ro fik a signed sntemen9 Mat he is licensed pursueM ro Nie praisions oP the Corttrxlw'r Lcame Law ICh+Na qr��.��, - �(� �� , � � �9(mmmen�m9 wrth Se�tion 70001.af Divisian 3 A M¢&wnets aM.Probssioap Codel'ff�af he is eiertgt dbrelram � g., . . _ I � ��.antl.�e Wus-fo�rne alkged emnv�n.Aiy vidanon of$�Cai�n 7a3tS iry arry apWisafsi M a�..pmnit whpe�s ��. . W !he a001ua�t iq a�ivd D�alttl ot mt mmt than fiw hundrsd dMlars.IS50a1.1:, . -��i�. .. . . � .❑I.as owner.at�he pruprty.n my emDloyees wim prfges as their soY�ampariaatio/o�;.,w�N Ao.Uie wnrk.mtl ����� � fhe stru�twa�s"noi mtenaM or NIe��iw uN ISoc.TOM,�uuioe�s a�Prohsswrs Code:TAo Cdoyrxmr i lipnse � � ',rj,. law does nat applY to an owner�.;of prepeny wM hmMz or�improves 7hereon.and who AeEc aieh waeq him�li. �;; II a thraugh Ms awn employees.Prw�ded Mat such impaamee&�aie nm inan�A or',ofPerpd Fa'S71e.�It,Mwevte � � = the 6uiWing or imdravem¢m is sold wlthin nne Yex nl complet��ik mKx-huNw wNl hm que Mrdan o!prav� �?, y ihai he Did no�Miiltl a imDrove forMeµrposr o}sak.1 . . ��� .. � ❑f.as owre�,oF^Vre propenv.am eao4undy eont�aetiny,wiah''lieereed canuxmrs m we�cMue�.rhe p�qect 15ec. 'g�gg'; Q 7044,..8usin¢s5';rd Proiessans Code:Ths Conuxmi s tkenir law dom not appfy to en��wnrr'�.of gioOMY who �,.. I � hudds or imprwes ihaem.�and who�.coniraNs for sueh pmpen wiA�a euntroctdl�l liednpd qewant ta!he COntrxPor s . li�enu Ww.l . . . . . �.Ci�������.+���� W� ❑I am e.em6t under Sdt. .B.6?.C.IAntxh CxrRlitah). �-:- :�PL.e4� ���f��� .p,: Wte - Owner �,.EE.��sY��t.` _ � YYURKERS'COPAPENSATION OECIAMTIdY I ireraAY aHimi Ihe1��l km�cer�ifiwp�of canqnt ta sdf�insme a '�^"" • 1 Ph a cer i�are ot!Mvkrs'Compeoweion Inswuse.w a teetilied�c�V thea�(S�e 38Qd.Lah.C:I. �L.u����c �"�...s,�, c I � Lntrfiee copy is heretiq fumisliad. � C � �: �O� ❑Certifi6 cmqy is filad wrth Nk&olding Ins�btkon Oegrtmmt ar Dqptment. ..�.� �(`j a CEFITIfItATE�7f�EXEMPTIRV FROM YdDAKfNS'CpNPEN50.T�9�SUq4Ntff:Tlis sendori ero�!rmt 6e��� �;�g��q�� '"` - m yit d�e permi�is foe aroe huMrM IE1001�kss.I eertifp th.a�in ihe pmlamasce oi tla werY Pan whiah�Hus � ... � - . . I� permn is isxuetl:�.l shaY ro[empNy aiq penno in a�ry rtunmv so aS m Eem�me w@pc2 m tl�U4�rrkrs'f.arnpem� �-�-'',��0� ,_� Laws of CalPdam,(u. {/� [�` �; p Date 1 d'�"��� �� �m �.!��(,R',,rk�Z�i ��piR�F�� � NOTICE TO AP%.ICANC:M.after mah�^,9.tlris cM,nr��,ea��,+o�.w�+:na��� `� m n.w�s � SCF900L F��S �+, Campensanai Oeeuisims ol the lamor��ow musi 6ptqrivi9�emp{y wiUr seeA prmffiidu ar tlAs permil sPo� ��+- Ae JeemeG rz�aked.� T, ��.,...qWSlp9 OF INO!JSfRIAt SAFETY P¢AMIT CERT�ICATIdI�ry� . aW. Q.,,,nl heeBy cn�Ny tl�at no ertavarmn Iwe(51 a�emre hec i�AepM inm p%eh a pRaw is eaf�tiratl io dacmd ��, wiu he made o omnec�m wnp,wak�ori�e nrrrn p�.r,�n�st m m,i�a:y swecue. � sffisacarC � ar demolrtian w'eismamliry it1�1[df"w(iial 6e�mc�erthui�'iA�r�F� tl3b1 9m�I�.{LNp.3.2.Gip P.An 2.S0t m� W';�%i.Titk 8.C.0.C.�. , I_ 3 .:,[]As owna dnlder.I wiN�not ertpbli,w!yon!lo do wak whu��warA.;s�um a qnM han Eir 6raian ol � . .. 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