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HomeMy WebLinkAbout1445 (29) '�'� . �ITY �F DIAMAND BAF� D �iA+C , � .f...• � . .. 'S �iwVV [9�PAR'TAAENT O�BUtlLDING ANq$AFE$Y F�RMLY '�^ BUILDING PERMI't JOBSITE �y APPLICATION � --' PERMIT USE ADDRESS � / DATE � � NUMBER CODE M, ISSIlE ,�. . � TYPE OCC. ;5 Tr TR/���-�----- DATE �~ �CONST. GROUP 'Y OWNER STREET LO. _ _ ,. , �,.:,� „ `y ZO(ei6NG S�TBAC�K.^^, �"E"� aa � FRONT F1W ❑ u? ADDRESS REAR CJ �; CITY ZBP T SlDE/SIDE STREET RW � �; APPLICANT SiDE ❑ �:: e� CONTRACTOR � �;; ADDRESS �- �y , r,r SEWACaE ❑ PUBLIC PMT� DISPOSRL [) pRIVATE SQ.FT./100 GAL ur GITY ZIP �-TEL. y z�'. STATE � GRADING CI �U.YDS.,EXC. CU YDS FILL �;, LIC.NUMBER_�� -��,� r�Q � ,FA�Ti'JF`� p'� "..,�tb�.F..AFCE/3lVAl.UA7'1Q�1 y ARCH/ENG/ � � `-''L DESIGNER ' �y ADDRESS � 2 cr �; CITY ZIP TE�. ;(,;� 3 �` PR�POSED USE � '� €� oi R,�''.�ic.�i C✓ �_.�: '' ,�J: 6ARAGE c; NO.t�3WEL. �NO. �r/� N . � 40RCH �� UNITS S70RIES�BEDROOMS �q ��: LOT DIMENSIONS h VALUATION ADJ.AREA �� NO.OF BLDGS HOW �i1Ar�TrrY f3�S IF'�'�'101�l `��� : ';. ..: LL� Ov LOT USED � �: �. u.i ;:a x: - ~" IC SE�COMRACiORS�ECLAflATION�.I hereby aftirm�hat I am licensed under pmvisions ot Chapter 9 Icommencinq �^,^� �; wifh Sxtion 7000�of�ivision 3 of the 8usiness and Prohssions Code,and my litense is in tull lorce and etfect _ � �1 � ... �,,�"' LL �OWNER�BUIL�JEfl DECLARATION�I here6y affirm thal I am exemD�imm the Coniracmr's License Law lor�the Idllowing � reason(Sec 70315,BusinCss and Professions Code:Any ci�y or county which requiies e perme�o�consVuc( ���. C� alter,Impmve,tlemolish,m repair any sfrucNre,P��or ta as is5uance,also requires the applican�lar such permit �,'.'.�. 1—� m fde a signed statement ihal he is licensed pursuant�o the pmvisions ot ihe Comraclor's license Law(Chapter ���, Q'� 9(commencinp with Sec6on 7D001 of�ivision 3 of the Buiiness and Pmfessions Codel or Nat he is eMempi mere4om, '�_ G: antl ihe hasis(or[he zlleged ezempeion.AnY violalian of Section 70315 by any epplicant for a permit subjecis '��.�-. k Ihe appLcant to a civil penalty ol nat more than five hundred dollars�5500LF. ',.,�.,4_ W r, d' lJl,as owner af t4e D�oPerry,ar my employees with wages as their sale compensafion,wiN tl�the Hork,and r the stm�ture is not intended or olfered fo�sale�Sec.7044,8usiness-and Prutessons Code�.lhe Contrecror's Licrose WLaw does nol apply to an owner al pmperly who builds or improves thereon,and wba does such work 6imself, :f,y�: or through his awr employees,prwided�Fat such impio�emenis arz not intended ar ofleied fo�sale.If,however, �,, m the huilAin�nr�mpmvemen7 is sold within one year of rompletion.the owner-huilAer will have the bwden at pmvinp ry"��. � thai he did not build or imOrove lar the Ourpose of sale.) �,. h V� ❑I.as uwner ef the propeny,am eKdusrvely cmtractiny wifh licerued cantrectors to constrUct the pmject�Sec. �; � 7b44,Busioess and Professions Code:The Coniractar's License Law daes not apDly to an ovrner ol property who :,�',�j; � huilds or improves thereon,and who contracts lor such pmj¢cls wilh a mMractorlsl�icensed pwsuant ta iM Contractofs d �10e"5e�'"'' ONSTRUCTIQN � W ❑I am exempt under Sec. —.8.B P.G IAtta[h Cwiifica�el. ����F{� [ � F�- p Dete Owner + �L�G+��{G. a WORKERS'COMPENSATION�DECIARATiIXJI I�hereEy�a1}irm thai I have a certificate af consent to self�insure,or a ertihcare of Nbrkers'COmpensation Insmance,ar a ca4fieA copy ther¢oi(Sec.]800,L�.C.i. �-���.��BI�C7 �__ O a ❑ceneiee�apy i:ne�eev i�rrdsnea. � MEGHANICAL p Certified copy Is tiled wilh Ihe Building Inspection Department a Depazimem. ��.GRADING W, � CERi1FICATE OF EKEMPTION FROM V�jRKERS'CDMPENSATION INSUflANCE�,This settion need not be mmpleted SUANCE ` _ � N if the permit it�or orie hundred I3100�ar less.1 cerofy that in�he performance al�he wmk far whkh-this i permit is issued.I shall rrot emqoy any permn in any mann�uyas gAe�t to the 116rkers'Canpensetion �:�. tJ`��P ( � QLaws of Calitornia. �S ���5� ' PARK FEE � �1 �� 4 y� /� C p Date C"�,AtlP17naYif.y�p, 7.• �� f,�.�:�SCifl�/Ol. FEGS � NO710E TO APPLICANT�.If,aFler makmg this Cer�icate�f Ea3"mptidn �you sMuN 6ewme eubject m the Worker's ._+ Compensation prwisians ol tM Lahor Cnde,you must forthwuh romply whh such prmisians or ipis permn shel) - �+- he deeined rewked. ., $�fi" ' JM1 V 4.�t..�..�� "�r' � � `.J. \ qVISION OF INOI1SfNIAL SNFETY PEflMIT��q�� 0� `�`�' 0 1�., � � C'F.2r� °� � ❑I here6y certdy that no ercavatron trvee"(5) �e 1 e�m depih fa which a person is repuirtl to descentl, h� o�e will he made in connectian wilh work authwaed MF•�!�Pe)m�4�and ItIa1 iro tuildi�,strycture���cak(4ldinp.fdsework, ro ��- n demoLtion or dismantling thereof,wdl be��mMe tlYan ehiiry su�•{36J feet Mg6,yChpp 92,'4�b 2,Art 2,Sce � �-- �2� 347.TiHe 8.C.A.C.L ;,,�' �. r.�. _ _ i E. s � `.� `; �;: ..�'.�. t� .._. � ❑As owner�6uilder,I will nM emplpy enyane.to�do wok woiCh woUld ie�ihre a permit irom tlie Oivisipn of �-. Industrial Safery.as irotetl a6ove,unlesS�'su[hqCtson h5s a permit ta�da such work irom tlro drvisqn. � W ❑Urision o1 InAus�rial Sahty Permit No. �QTAL �E�S � �'-�� � � CaJSTAUCT�N LENDING AGENCY:I he�ebY al�irm Ihat there is a mnstruction knding apency lor the pnlarmmro 2 of the work for which Mis permit is issued ISec.3097.Civ.C.). �� � '.�e�der's Name COMMENTS � `'�" �-- = Lender"s Address m Q CERTIFICpTE Oi COMPLIAtiCE AND AUTHOflIZATqN�ENTHY:I certifY I Aaw reed Hris applicuim amf�Ca1e - � VJ thet ihe information given is carect.I agree to comply with all s�at¢laws aiM cily ordronees rel�tinp to 6uitli� yconstruetion,and aNhoriie�rcpresentative of the Dep�tment of iMinp and Safety to 6n4r upon the � � tor which I ap �ed lor this permtt'Jor uryose mekinp" tiors. -. � � �--� � t � ��,,,��� ���o, o a� RECPT NO.��� `�"—PAID BY VAUDATION ` WHITE—Department Copy,YELLOW—Finante Copy,hINK 111'sse�sor�Copy,'GOLDENROD—File Copy,GREEN—Applicants Copy BSi D6-1 t/89 . ... . . . . . . . . . ,�.._.r._.._.-_.,....m...,...,.....�,,,-..,.m.s...,.,...,.-...n..o,,.-x..,.�,Y�,p...... .. � . -��n�•.�� —_. 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