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HomeMy WebLinkAbout1044 (11) ,�. �: .�. �'�c_ ��-c��� CITY 4� DIAIIAfJND BAR ppESS DEIPARTMENT QF BtJI�.DIIVG.AND SA�ETY ��ti, �i111.DING b���iMIT ° , FI�M Y °' JO�SiTE APPLICATION PERMIT USE ISS�E ; z,,�� /^� 7YPE ER � , �CODE ,�.. - ,.�. � ..�wr..�» � ,��� L _�JC,�""- LJ 'a`. ADD E � APN ' ""LbT '° a TF1AC'i� `�i a',;s � DAYE .�`,:; ;' �:ONST.�GROUP ,,,� �9 �M o CROSS 5TR T SETBACKS �'�"� °-= OWNER ZONING FRONT i�W � o AD�RESS �' �! � ��E' ` RE/5Fi � W CIT`l��� ZIP ���'EL. 'Z'S SIDE/SIDE STRE�T RW I� a APPLlCANT TEL. �t � SIDE � z Q CONTRACTOR SEWAGE o ADI7RESS a DISPOSAL � �BLIG PMT# _ ,� CITY I TEL. C� PRNATE SQ.FT.01�0 GAL ��� x STATE � GRADING 0 CU.YDS.EXC.�CU YDS FILL y LIC.NUMBER � ARCH/ENG1 +� TY�'� a"`i�Q F�" Fi�G'T�S� �.�� .i� �. A ` �1L` '�"� N`. `—' DESIGNER �' 1 o ADDRESS �' 2 = CITY ZIP�TEL. j�; 3 � PROPOSED USE � 4 � v `� �` GARAGE � NO.DWEL NO. NO.� �: ppRCH '� Z UNI7S STORIES BEDROOMS � LOT DIMENSIONS �. VALUATIOPF f � ADJ.AREA o NO.OF BLDGS HOW '' �DAN'��tY [��� �t�PT �1 � ;� '.. �; " W ON LOT USED ,,�,. - � � ' � W _ ~ LICENSE�GONTBACTORS OECLAflATIDN�,I here6y atfirm ihat I am laenud under pmvisions of CAapiM 8 Itommenemq �::, � weh Section 7000�oi�ivision 3 of the Busi�ss a�d Prafessions Code.a�my liceme ia n full krce and eflat �, 3 � ""d�. iJi< � OWNEN�BUILDER DECLANATION�I hereby allirm that I am exempt Irom the CoMrazmr's�icense Law im�e 1dbw�� �� Z reason�Sec.1031.5,Business and Pmfessions Code:Any cNy or canly whkh requires'�a-p8�m1 k"'tonsW�t }',�"! o aher,improve,demalish,ar reparc any slrucNre,prior to iu issuan�e,also requues the applicant tae-sich pmrtul .::��]. 1=- m file a signed statement that he is licensed Dursuam to the Omvisians af the Conaactar's l�ceme L8w ICh�ptei ,����.. � 9(eammencing with Section 1000�of Olvision 3 of the Busirtess and Proleubns Cade)or that he is eyempY therehom y znd the hasis Inr ihe alleged ewemp�ion.Anp violatian ot Section 70�7.5 hy arry appliWnt 1ar e peYlna'sub�ecis -�^'„j�. � fie applicam ro a civil penalry of not more than five hundred dollars(55001.1: , �" W . . .. , . :_,.V� I � ❑I,as owner ot the omDerty,a mv emD��Y�s wrth waqes as their sde com0eneatqn'wdl do thq wurk ard ��. the structure Is nat inre�ed or aflered lar sale�Sec.)0A4.Busi�ss and Ihotesswns Cade:Yhe Contraclar i License r�'�, - � �,~j Law daes nol apply ta an owner of pmperty who 6ailds or Impmves thereon,and who dces iuth woik�hunseH �.. � •.• ar tMough his own empiayees,provitled ihat such improvamenis are nm'imendM or olfered fo(sak.�It,however '�,.. �m ihe 6wlding or impmvement is sold within ane yeer of com0�e�ion.the owner�builder wid have the 6urden ol provi� �;`. � Ihat hi�did nat buiid ar improve for Ihe purpose o�sale.) � � h �• V� ❑I,as owner ot the prap�ny,am exclusively cantraMing wM1h licensed contracW�s to cornMrutt ik pmjxt�Sec. '�.,_iy;�!+. � ?044.Busi�cess and Professnns Code:The Contracmr's License Law does irot eppw ro an owner of properry who �!, � �uiids ur impraves ihereon,and who comra[is lor such pmjects with a tontracta�s)licrosetlpvrauam�to tlMConuuWr s Q Licensc�aw.J :....:� .�i�NST��CiT��N O � ❑i am erempt unner Sec ,B.e P.G.�Anxn ceniticate�. i,", PLAN REVIEW '�7 3 �D `'J��J.�i � o Date Owner ��.;:��. EL�L•TROL• � 1� f�,.;.., r � rY9flKEflS'COMPENSATION DEELAFATION:I heretry alli�m thal I have a certifiwu of�onsent ro self-inaure a = / a cern�icare at Wurkers'compensa�ion msmarce,ar a cermied copy thereof Isec.3800,lau.C.1. PLUMBI{VG ��••^'" ~ a av v ,,�,,,j�p:, MECHANICAL "� G O ❑Certified co is hereh �wni5hed. W ❑Cenified copy is filed with the 8uildinq Inspecdon Oepariment a Llepartment '*4'�(j�A��N(jj � CEFTIFICATE OF EXEMPTION FflOM WOHKEH5 COMPENSATION INSUfiAACE:This se�tian need not 6e cortpkted ; �SS`UA�(,�iE y it Ihe permit is for one hundred�5700)a less.I cenify tAat in the pertormance o}lhe worq fa wAich tMs _ permit is issued,I shall nai employ"am/-perstin in any menne(so'As�i6 6eiome w6jflct-to the 4Wrkeis"Lnmpensetan �� ,C�`M�P o Laws ut Calitomia. {, �y,':-� �'�� PAR� FEE � k� t t':� � � NOTICE N APPL�pNT�.It,ake�makiig Ihis Ce�tificate�e�"a'nn�fi���we e��s�ei�,m m�waw.�5 .��.SCHOOL FEES —� Campensation pro�isions of the lzhar Code,you must tathwiffi comply wiM sueh prwisims M this permil sh� � u- he deemed revaked. a W �IVISION OF INDUSTRIAI SAFETY PERMIT CEAiIF :� � � � ; �� d ❑I Irereby cendy ihat no eKcavatnn frve��5)ur mqe leet in deplh into whieA a pe�sm ia required to dastwid � will M made in cannection with worY au�urued hy this pe�mit,a�that ao huilding suucture,xcalfa0dinp,faL�wiark � � or demnlition or dismantling iherroF,will Ee mor1e,thanylUrtry s�x(38,�f@e,t,lry�1CARp.,�,2,�..�rp 2.An P See W' 341.TitIeB.C.A,C.�. �'�.I i� l�i� �� �.f•Jt�,�}� ,...o i.1.�.n,; t ; _ �".,�� +.,,�.-. q i t;� �;7,n,,�a:"�/ '�. . . ... . 3 ❑As awner-builder,I will nut employ aLLyow 1�1 8o%iYOrk��F'hiNI:FhM1M�req�Alb�A�rtnil ltom E�e D�nisian af � � r IiMustrial Safety,ss nmed a6ove,unless such person hes a perm8 to do suth work lrem 9ie divbpn. . g . . .. , . '•ir W ❑a�,5������,,,u�s�e�Y��,�,Na. TOTAL FEES d � CONSLPUCTbN LENDING AGENCY:I hereby�f6rm Mot there is a coirctructien hnding pmoy fa tlr perlwmance - x of ihe work 1or which Mis permit is issuad(Sac 3097,Civ.C.�.� � � - � tender's Name COMMENTS �� ��� � mLendei's Address - . �, '¢ CERTIFICATE OF COMVLIANCf ANO AUTIqR12ATIpJ OF ENiRY:I certi(y 1 Mve teiM tlq opplkNim wl�h9e , �✓a Ma[Me iniormetion giv¢n is car agree to comply witb all stam laws md eiry or�a rd�6p ro diil7inp � cansiru ' and authorim a�af Ihe Oepatment ol Buidiiq md Sobly b eiitr upm the praperty . . . = fw � 1 ha apDlied far M per tor al mekinp inspections. �. � ;� t � � �� �� 7 �`'�y RECPT NO. � PAI�BY /� �--••'" VAUbA710N twe of Applicant�ur qqent Ofine - - ,q�tl::i a�� ;�;�,�a � WHITE—Departmen9 Copy,YELLOW—Finaace Copy,PINK—Assessor Copy,QOIDEMROD—File Copy,GREEN—Applicants Copy '"" "` ' ° �" ast os-y iisa ,�4. _ ,� . . .s, �... r &'�,}x'*`r:e,�.�"y,�'.,:".�t v af..:;,. 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