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HomeMy WebLinkAbout127 (11) __� �� _ .,__,,_ .� , .. ,. _.____--_ _..�,_,: . _, t�. . _... . .__ ,....__,n._ .M�--,-�_�..�..,,�,,,�.;-, , �-.,�.. ,. � � '� CI�Y �F DtArVtOND B�4R ;� �-'T" DEPARTMENT OF BUIL151NG AND SAFETY PRESS -�^ BUILDING PERAAIT FIRMLY JOB5ITE '` APPUCATIGN Q PERMIT U5E ADDRESS 2. O� i�1 S, (,�r" DATE _,.��-�`$^t NUMBER y C�4GODE ISSUE ' TlPE OCC. ` APN ` LOT TRACT DATE .�. CONST. GROl1P o CROSS STREET COVE I��a?Q- �^ zON1NG SETBAG6C5 �"'�"'� °-' OWNER V�'�'"12-t-��LS FRLIPIT RW C❑ o ADfaRESS �'� �' REAR �"? ❑ W CITY�p�.L�n,pa S.LL�_ IP_ ��ro�TE[�.`�(r.L:.$��7 SIDEISIbIE STREET� --�.� RW ❑ a APPLICAfVT C�I�c-J., AOQ�/1A� TEL.`�LtL-..G.4�,�. SIDE � CD z 4 CONTRACTOR�',,�li�,�P�''�� I��— SEWAGE o ADDRESS Cj�� �Ct�!a �. g'`�� DISP()SAL ❑ pUBLiC PMT� ,� ClTY 'T)tM�o�� � ZiP `��-k S TE�..B�.I.`f?4� � PRIVATE SQ.FT./100 GAL z STATE �q�r � GRADING ❑CU.YDS.EXC. CU YDS FILL y LIC.NUMBER � �OZ` �� y ARCH/ENG/ Cb�' '�Yf''E SG1 �'T.�k1 I� PS kC3' RH�IkNI1L'A"�' y QESIGNER �,' � S�O d D&Cr ' o ADDRESS (�,,;, 2 z CITY ZIP TEL. (rf' 3 � PROPOSED USE Sw t ru nn i�1 Pesp +4 S � 4 � � � GARAGE o NO.DWEL NO. NQ. �, pORCH y UNI fS STORIES BEDROOMS � L07 DIMENSIONS �'' VALUA710N ADJ.AREA o NO.OF BLDGS HOW QUdN7175' C��S�i�`I ��I ,, '� ��E' " w ON LOT D�� USED �S�'R-- ,,� ' �'� : � �,y W � �; IC NSE�CONTHACTOflS OECIAAATION:I here6v aftirm thal I am licensed under Wovisinns ot Chapter 9(commennnp �. - � with Se:tion 1000J of Oirision 3 of tne Business and Protessions Code,and my license is in Full tarce dnd eftect. �,; � � - 3 � ❑ �: � � OWNEA�BUILOER�ECLABATIDN:I here6y affirm ihat I am exempt Irom the Contractor's License 4aw for ihe fdlmving ieason;Sec 70215,Busness anC Praiessions Code�.Any city ar county which requires a permit ro consiruct �-,. �� o aiter,Improve,demohsh,or repair any simctua,prior to�ts issuance,also reQuiies the apDlinnt br soch permit 1-- lo file a sgneA statement ihat he is Ilcensed pursuam ro the prwisions of the Cunhactoi�s Litense Law�Chapter ,�:: � � 3 Immmencing with Section 10001 of Uivisbn 3 ai the Business and Professions Cadel or th8t he is eMempt iheielmm �', �� � d and[he basis for Ihe alleyetl esemption.Any vidation ot$ec[ion 7031.5 hy any appl�icant toi a permit sublecR ';�,��.�: . x the app!¢ant to a civil penalty oi nm more ihan five hu�rzd dollars(5500�.): � "- ,.�15 W �:: � � CI I as owner ol the pwperry,or my employees wii�wages as their sote compensauon.will do�he work and . . the a[ru:wre s not intended o�offered fm sale�Sec.7044,Business and Prulessions Code:�The Canuanor's License 'x[; . V Law co:s not apdY«an owne�ol piaperry who huilds or improves thereon,and who Eces suoh woik himself '(`J.�:. � �+-� or through his own emplovees,prov�ded Iha�such improvements are nm��ntended or olfe(eC for sale,I('however, • �", �� � the 6uilding or Impm�emenf is so�d wi[hin one year of complaion,the ownea6uilder will ha�e the burden�(il p%wing <(. y that he did nm huiltl or im0�ove for ihe puryase ol-sale.� ,�'. h ❑I,aa owner ot�he Droper�y,am e�clusively contractiny with 7icemed contractors ro construc�the pmje[t ISe[ �y' .„: � O 7044,Business and Pmlessions Code:The ConUaclpr's Licanse Law daes nol apply m an�owner o�p�apertY who '{;,'�,.;: - , .Z huilds or improves ihereon,and who wntrac;s for such pmjects with a contractor�s)licensed puis�anl ta the Comractor's - '¢ `"`"�'""� CONSTRiJCTION I.,� o ' � ❑I am exempt under Sec. .B.&P.C.�Attxh Cenifica�e' ��. P�N REV�EW • G fk!e� Owner 'E�..��iTR��i � « „u�,S�rL--.. � WOftNERS COMPENSATION OECLAFATION:I heiehy aNirm that I have a r.ertitic6te of consent tn self-insure or �� ' ' + � . a cenrficate o�Vbrkers CompensaLon Insurance,or a cenrfied copY Ihemof($ec.3800.Lah.C.) 'PI,.UMBING 1 O �/r A � ❑Ce�hfied coDY is fle�ehy turnished. .����y�G�HryN�CjAL " r�� C �Certified copy is fiied wi�h the Auilding Inspeclion Oepartment or Lleparhnent .�S(,a��Q��N�' , w Z CERTIFlCq7E OF E%EMPTION FROM lNORKERS'COMPENSAT�ON MSUNANCE:This sectian need not 6e tanpleted (�,' ISSUANCE yi�the permit is lor one hunGred(5100)or less.I certify that in�Me per�ormwnce oi�he worN far whkh fiis � pennil is issueG.I shall no[emDloy any person in any manner so as Io ome Sublect N ihe Workers'Compeasatm ��:� S"'�yP � � Laws oi Calltomia. � � . o PARK FEE p �ate_1���`� Avc��=a�� �',SCHOOL FEES � ��� � � NO710E TO APPLICANT:R,after making this Ceriificate of FMemptian,you shauld 6ecome suDject to the Waker s � Compensation pmvisions of ihe t�r Code,you musl tanhwith mmply with suah pra�isp�s a this permit ih�ll -� � be deemetl revaked. �%�'��� '��' '� '���� � Q qVISIOW OF IN�USf AIAL SAFETY PENMIT(�qTIFiCAl70N: � � - d ❑I hereby certfy;hat no eiecavatmn live(51 or more ket in deprh inta which a person is required to deseend � win be made in cannecnan with wark aumor¢ed hy this permit,and ih�t na buildmg suuttwe,scafMidinp,hlsewurk. �a��� � � A m nemolition nr Aismantling iheienf,will he more�an thirty�six f36�feet high.(Chap.3.2.Gry 2.Art 2,Sx b Y"4 W� 347.Titic8.Gp.C.I ��I��p � - x � � ❑As owner6uilder,I will nIX employ arryone to do work which wauld�equire a permi7 hom tAe Divqqn of � �.— Indumial Sahty,as noted aGwe,unkss such persan hAs a permii lo do such wwk irom 1he drvision. — � U � 1 '�� V W Orvision ot Industrial Safery Permh Na . T47A� ���� d � CaNSfRUCTION LENUING hGENCV:I herehy aHirtn that there i�a conshucGan bndi�age�rcy lor Me perfom�ana i OS of�he work for whic�this ptrmn is issued�Sec.3097,Crv.C). . ,. ,. � . , n �e�der'sName COMMENTS�T�'1�� �^��� �L'pT �(�'� m lender's Address � -� � p � s L' T a CERTIF�A7E OF COM A�E AN�AU 12ATION OF ENTfiY:I certlh��read iM1is appliu�ian end slek ` N thal ihe iniormation ven is correct. a e to compty with a�l stale laws a�M eiry ordirtaMss reWtinp to 6uAdinp .:.:.,, � . y construcvun,and oris a rep nt of the Oeputment ol BuiWinp and S�fety ro yqn Me praperry � fot which I ied for this m' pi�ose oi marnp inspectbns. F�- � h � T �,/'''� E=—_-^� ` RECPT NO. 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