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HomeMy WebLinkAbout1421 _ _- , '�'` CITY f3� DiAMOND BaR PRESS `�� ', ' ' DEPAF�MENT OF BUIIDING AND SAFETV ��RMLY -� BUILDfNG PERMIT JOBSITE �/ -� APPUCATION � (� PERMIT USE ADDRESS �-'�� f���1�.t���3� , DAl'E � �� �,/�r `�NUMBER��CODE tSStJE Q'- l�"�L TYPE OCC. > APN " —�..., LOT "TF3aCT DATE �� �CONST. GROUP � CROSS STREET f '��C�'►'�'��"+�i�� ZONING SETBACKS "'�"'E"'s m OWNER 1 J�d7r�✓-1� f—I�'T2.�-c�G9-t--�`J rti FRONT RW CO o ADDRESS .�.�.�� �.��� t�or3� REAR C� ��yy CITY.��'"r'rrt�o+v.a� _��-,rZ. ZIR. ��� 7 '�``�TEL.� �'� SIDElSIDE STREET RW � C� o APPLICANT TEL. SIDE C� z a CONTRACTOR����+R ��, '� C� SEWAGE , o ADDRESS ����%� �l✓�c�,�t-f, f1 iY�.� DiSPOSAL � �BLIC PMT� I W CITY ' ZIP ����� TEL�`��fge� 0 PRIVATE SQ.FT./100 GAL z STATE � LIC.NUMBER r� �c°o ��'� _ _ _ GRADING � CU.YDS.EXC. CU YDS FIIL I' y ARCH/ENG/ tl3' TYf'�E: SQ FF F,�G7(�fi PS J�E]�1..A �A�/ALU14�lt'�N ` � DESIGNER � �` � o ADDRESS L1, 2 ' '', i CITY ZIF�V TEL. j� 3 I � PROPQSED USE � 4 , I � �' � � GARAGE � o NO.DWEL. IVO. NO. �P �` pORCN �!� y UNITS STORIES BEDROaMS '� � LOT DIMENSIONS � VALUATION ADJ.AREA � o NO.OF BLDGS FiOW GttiAN7ir�r D�S�r IP�F1C� FEE' II� W ON LOT USED � � � � W ❑ � �I ~' LICENSE�CONTFACTORS�ECLAflATION:I herehy af(irm that I am licensed under provisions of Chapter 9(commenung , . , I � with Section 7000;of pivision 3 of the Business and Professians Cade,and my licrose is in lull lorce and effect �. , � I 3 � W. ��i _ GWNER-BUIL�ER�ECLAAATION�,I h:re6y affirm thal 1 am exempt imm ihe Camractor's License Law{ar the fallowmg �.. � � reasen ISec.7031.5.Business and Pratessions Cade:Any city or county which repuires a permit to conrtruct -{!}`� � �y� �I o alter,impmve,demolish,or repeir any stmcture,prior to its issuance,alsa requires ihe applicane for such pe mt ��Z,`� � � , F-- to hle a signzd statement lhat he is Ilcensed pursuant Io Ihe provisions ot ihe Contractor's License Law IChapt r �-1 - I � 5 jcammencing wilh Secliar 7000)of Oivision 3 of Ihe Business and Pmtessions Cod¢)ar�ha[he is exempt Iherefrom ;..'`Sr �~ �j� � � I a. antl ihe hasis lor the�al�eged ezemption Any violatian ol Section 7031.5 6y any applicam tor a permil subjects ?���::�:�. � k the applicant m a civil penalry of no1 more than five hundred dollars(3500�.1�. '��,� W �I a ❑I,as�wner of[he prnperty,or my employees with wages as their sole�rompensa[ion,will do 1he wurk,and the stmcwre is not intended or offered for sale(Sec.7044,Business and Protessions Code:The Contracmr's L¢ense � � II� V� law does rm apply tn an owner ot pmpenV who 6uilds or impmves thereon,and who tices such wark himself, ;.;(,2j ' ar ihrough his awn employees,pmvided that such impmvements are not intended o�offered fo�sale.I(however, �,;,' I � ?he buileing or improvement is sold wi;hin one year ot campletion.the ownerbuiider will haue the Wrden of piavmg e(:: uj ihat he tlid not huild or impmve far the pwpose of sale.) �? � cn ❑I,as owner of the pmperty,am ezclusively conirac[iny wim licensea con[racto�s to cor�siruct the piqttt(Sa LLj.; �', 0 7044,Business and Pmfessians Code�.The Cantratlor's Licenae Law does not apply ro an owne�ot pmperty who _:"'�59.� I Z hinlAs oi improves ihereon,and who contracts inr such pra�ects with a contrador�s�Ilcensed pursuan�m Ihe Contractor's � ' ¢ L1e"Se�'"� CONSTRUCTION a I w ��am exempt under Sec ,8.6 P.0 IAtlach Ceruftahl �;PLQ� REV�EIN I� o od1e °u""�` ELECTRIC I � VvDRKEAS'COMPENSATION DECLARATION:I herehy ailirm that I have a cerofica[e of consem to selt-insure or �, -��� �- a certrficate of Workers'Compensation Insurance,or a certitied cnpy thereot(Sec.3800,La6.G�. -PLUMBIN�'7 � �Z� �� ¢ ❑Certified copy is here6 turnished.� s� MECHANICAL p�a,racv t3iv�. zd3/QQ.3 di'GRA � I� `o ..�Certified copy is flled wi�h the @uY.tlinn losoectio - rtment or Uepartmem i� 2 "^� � '�CERTIFICATE OF EREMP11pN FROM WOAKEPS'GDMPENSATION INSURANCE:This sectian need nm ee�omp�e�ea "ISSUANC �, _ ��] j y il the Oermit is fur one huntl�ed(5100)or less.I rErtify�hat in the pertarmarice of the work ior whkh ths ; .� — 'pe:mit is issueC,I shall not employ any person in any manner so as to 6ecome subject 7a�he Workers'Cmpensauon ��. S`M�P � 'L ws ot California. � � � � � � PARK FEE o � �p Dafe' - - � APpliiant 'i �''� NOTICE TO APPLICANT:If,after making this Ce trticate af Eremptio, au shouW 6ecome subject io!he Nbrkers i�-:�SCHOOL FEES � ,_ Compensatian pmvisions of ihe lahor Cade,you muakJp�ih�co�l���such pwvisians o�tlris Fermrt sha�l '":. 6e deemed revaked. �..� E `'� J " ,._. ��I..OILISIIXJ OF INOIISTHIAL SAFETY PERMI7 CEflTIPICAT�N: ` iay ' .- . . . - ,, . . '. . r, �' Io ❑I nere6y e�dy 16ai no e cavation five(5)or mme teet� depih into which a persm is required to.tlescend � rt tll 6e�made i cafin,ection wnh work author¢ed h ihis rm aaa that aa�N� stmctve,sctifotdin,fal5ework � � or demolitian or dismantling thereaf.will 6e�r�r " thir�s�«�36)�`�'��(Chap.3.2.Gry 2 9An 2 Sec � � w 341,TiNe 8,C.AC�. �*;�� � s 'I � ❑As owner builder i mll no�empbY anyone to do wak wh¢h would regU�fe d.0eunl�,fran Ihe GvBwn ol � � � 1— Industrial Safety,as noted ahove,unless such-pegon�ias a;pe{filiP tt�d'n Such�Wmk„[rum:;llie'divition. , , � � w>; i .�' ,�.� ;'�;, . W� ❑Onision of Indusirel Safety Permit N�%° ° ✓''�- -% " �0��� ���� r� � �...+' �II� �. CONSTR�ION LENDNG AGENCV I he e6y aH m ihat there s a constrwtian lendmg age�y far tlie performance " Z' ut 1he wcrk fo�which Nis permi[s issueA�Sec 3D97,Civ.C.I. � I �� 4enaer's Name � �i m ���ders aaa«s: COMMENTS II '= GEHTIfICATE OF COMPLIAN(�AN�AUT411HIZATRd OF ENTflY:I cxiify 1 have read 6a applintian�nd sW4 �� 'i y that fie Information given is cortecc I agree to comply wuh all stale laws aid ciry ordirences relaling ta buiNiig j y cnnstrumm�,antl authorize a represemativfrBt1the Oepar,ment af Building and Saiety to enter�qon the praperty I F for w� ave applied t��Or ffirs permn�lor lhe Pwp/ose of making inspec[pns. � � � � � �'d����'�/ L�""�-�-�--� �/�4�-9Ea' RECPT NO. 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