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HomeMy WebLinkAbout129 (11) � AR PRESS '`''` CITY OF DIAMOND B '�'� DEPARTMENT OF BUILDING AND SAF�TY �UILDING'ERMIT FIR�LY JOBSITE APPUCATI4N PERMIT �j U8E ADDRESS 2-'� �3 8 � ��G��ST Dr� DATE ��"�1'�� NUMBER��-^ CODE _ �� ISSUE TYPE OCC. 6 APN �LdT� R��AC7� a DATE ..� CONST. GROUP o CROSS STREET_�� w NG: SETBACKS ;. ���rrs `-° OWNER f�. M�2-S � ✓ti -__ ZONI pRQNT RW � � ADDRESS Z C� � 4�� C�Re$T �r REAR"' � ❑ �d,,, CITY.�i t��.tc�_�Y ZIP g176 S 1'� 7 Sba- S g' SIDEISIDE STREET �-'� RW O o APPLICANT r.�1-� +�, �ad L5 T��('v �'rb -a S' SIC1E," �---� � a n.,'' �,,�," � CONTRACTOfd C �h.f��s2-y�a- [ �a��1^^-��-'�-- SEWAGE � FUBLIC PMT#E o ADDRESS 19_��LS'� G�;���+ �.�'s DISPOSA� ❑ pRIVATE SG�.Fl:/100 GAL �; CITY �, suo r ZIP qLZ�TELL7�D84S � STA�E y LIC.NUMBER l85 �n�- C-53 GRADING �I GU. YpS.EXC. CU YDS FILL y ARCH/ENG/ �'' TYPE' Q �1' �l�kC.l'S'�R P� ` AC?J,./�k�I�A4t1JA�.UAT�I N : ,.. ; � DE5IGNER � � ''�.70 S•In� JkAt.t� t�_ � ADGRESS CG: 2 � CITY ZIP TEL. `� 3 � PROPOSED USE Sw�vv�vw:w+.� P�� � Sp� ` 4 � .. • :�µ �c d GARAGE Q NO.DWEL. NO. NO. �. PORCH � UNITS STORIES BEDROOMS � LOT DIMENS10P1S m VALUATION g ADJ.AREA o NO.(�F BLDGS HOW QUAM�1'I71' C���3(iF�F[�"14 - ' �� � oN LOT o�e. USED Rcs�c�t.�e. � Fn�2 ;;cv��i 3 :;;�Q : � � � � � IICFNSf-0 C�MRACIDRS OECLANATION�I herehy aflirm thal I am liceoud under provisions y Chapter 3(commencmg � with Sr,qion 7000i�t Division 3�ihe 8usiness and Pmfessions Code,and my license is in�lull force and effect � 3 ❑ ;:� _ � �- OWNEF�BWLOER DECLAflA710N:I hereby aftirm that I am exem0l irom the Cantractor's l'reeme law tor Me lalluwmg /� /� /� reason(Ser..70315.Business ane Pmhssions Cade-Any city or caunry which reqUires a permil to COnstmct (�-� 4'.a/"j�� �/"' ! .�� Oaher -npm�ee,tlemolish,or repa r any simcture prior to i�s issuance.also requims the app�icam far such permit �; � . I 1-- to f le a signeA statement ihat he is licensed pursuaM m ihe prwlsians of Ihe ConhaClor's Gtense Law IChepter (y��� 5 � 9 I� nencing with Sectian 70001 of Division 3 ai the Business and Professions Code�or that he is eMempt therelram '�,4- � and the Easis for the alleped e�emption.Any violation of Section)031.5�y any applicant for a permit subjects i'�.^a._ W Ihe applicant lo a civil penally ol not more ihan fire hundred dollars 1550�1�1: "'-�:: "Q:... � � ❑I,as owner of the proGerty,or my employees with wages as their sole compensatian,wiN do tAe wark,and : the stmcture is not intentletl or ofleretl for sale(Sec.7044,Business er.tl Professians Ccile:The Contractor's Ucense ,a�, Vlaw dues�ol apply to an owner of propeny who huilds or improves thereon,and who daea such work fiimself {� � W or Ihrough his a✓�n emploYees.pmvided that such impmvements are aot inlandeA m oHeretl Ioi sale.If.however,� ;�.�; m the 6uil0ino or imprmemem is sold within on¢year o(completion,the mvner6uilder wili have�the burden nt p�ovmg �I � [hat he did no1 hodd oi improve far the Dufpase oi sale.l �_ ti v� ❑I,as owner ot the propmty,am ezclusively coniracting with licensed conttactors to canstmct the pwject�Sec. !�(yp a7044,Business antl Pmfessians Gode:The Con[racror's License law does fwt aDO�Y�o an owner at D�aPerty who �!_^�S„�. � , � 6uilds or improves thereon,and who comracu tor such projects with a con�raciw(5)licensed pursuanl to the Cmm�ctor's � - LicenSeLaW.1 ;. (,'`�NST�U�",T'��(� W ❑�am erempt uneer Sec. ,e.6 P.0�Anxh Cenificaie� i p�N REVI�W , � � � o��_ °"'"ef ELECTRIC • �� ' WOFKERS COMPENSATION DECLAAA710N:1 herehy atfirm that I haae a certificate of corsent ro se�f�insure,or : ��—�yr+.� . a certif��cate of VJorkers'Compensation Insurance,or a certitied copy thereallSec.3600,La6.C.�. -: PLUM BING � A..� 0 Q ❑cerlifiec covv is nereby�urnishee. ��?. MECiHAN�Ci/�il p �Cerufied coDY�s liled with[he Buildin8�nspection Depar�ment o� OeQarimem �C�GRADING W t � CEP7IFICATF OF EXEMPTION FPOM WORKEflS'COMPENSA710N INSUNANCE This section neeA nm 6e comple[eA : ISSUANCE __ �L � y ii ihe permit is loi one hundred�5700)o�less.I certily that in Ihe perlormance ot the work for whicA ths pe mit Is issued,I shall not emplay any permn in any manner sa as to 6e,come suhjec�lo ihe Wurkers'Compensation � SMIP � � r La s ol Califomia. � o �,e lti-8-9�i Applicant C'e�l�. �-u-er�S�. �JJ;PARK FEE W NOTICE TO APPLICAWT�.li,aher making this Certifeate al Exemption,you u become subject ro the Worker s �-�:SGidOQL FEES -�_-+ CanDensaYian pmvisions af the Labor Cade,you must IatbwiM tomply with smh O�ovisions or this perm8 shaA �� � � � ���� �+- he deemed revoked. - � . ._ � OIVISION OF INOUSTRIAL SAfETY PERMIT CERTIFICATION� W n- �I hereby certify Ihat no ercavalion�rve�5�or more ieet in deplh into which a person is rryuired to desaend J""1'+�F � will 6e made in connec0on with work auMwued 6y fhis permit,and that no huiiding struclwe.s[iHolding,falsewnrY j� �� . or deniolition or dismantli�g tFcereot,will be morc tha�thirry-siz(36)feet high(ChaD�32,Gry 7,Arf 2,Sa W' 341.TiNe 6.C.A.C.). � S - � ❑As owncr huilder,i will not omploy anyone N do work whith wouM rBquire a pxmit from i6e Uivi�ion of �... Ind�stnal Safe�y,as nmed ahove,unlrss surli person has a Oermit to da such wod fmm 10e AivisiDn. - � - � Wa�;s,�o���d�,�„e�se,ery��m,�No �Or TOTAL FEES �. � CONSTRI1CfI0N LENOING AGENCY:I hereby affirm Ihat[here is a coosiruclian lendi�opemy lor the perfoimmce x a�tM wnrk Por which this permit is issued ISec.3097,Civ.C.�. l t . . � lender'sName ('.�MME�ITS ✓��'�EX�^�" ��?Dla`I� \ � Lender's Address � Q CEflTIFICATE OF COMPUANCE AND AUTiqHIZATIpV OF ENTflY:I certi(y I haue-�ead tl�is application aid atale 1 cn fhat ehe�nfo aaon giuen is carect.I agae N wmply wilh a0 state laws md ciry ord�ronca telatmg[o dnldirg yconslruMiun, nd authara¢a,repiesentatNe ol the Oepaftment of Buiding a�d Salely N e�M�on Ihe praperty m^J � � for whi�h I ve lor 's permit for[he purpose of maMing inspeciroas. �"' r (� s�pn ot App�cant m n9eirc ! ��te — RECPT NO. PAID�Y �� `� VAUDATION HITE—Department Copy,YELLOW—Pinance Copy,PINK—Assessor Copy,GOLDENAOD—File Copy,GREEN—Appflcants Copy .::�,.».._..�`�._�____—___.__....__.._M,.�-�,��n,A��,,�.��..............�,........H..�,�...�....o.,�.�.__w_�__�r.__�____,_�,..._.,__._...,�..�.,,�-..��.,. � �;,;. ��: .- ,� � t ..--.. _ � :... '-.+,,. � .�,,,{. ...,-':, t'�. .� ', v+.�: �.,Y.�. :_.. t.� � . h � ... ,;.,c �r_:.'..�.. „��:..�T 4 -� � F . ;.;.:._ i r ?.), ,s?; �::.a � • . .. ^ . � ��rca,�� i< ��� s a� �e€' �« a .x�im t � � �in?� '�r � ��f�� ��'�������*�Z ��'��a�� ��fi k,������ � � � ' �6.�'�. 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