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HomeMy WebLinkAbout1053 (8) � �.. CITY OF DIAM4ND BAR PRESS ��►� '�' " DEPARTMENT OF BUILDING AND SAFETY � BUtLDING PERMIT FIRMLY JOBSITE APPUCATION �.-- ADDRESS dt.I!� �'►vh t� cl�-c�C'� DATE _.� "�-� �� �� S3 � NUMB R COS E 185UE �-TYPE OCC. f APN L T�TRAC,ST DATE � � �"— � L CONSI" GROUP o CROSS STREET�y `n`� "� ���a •�P e�-.F-' ZONING SETBACKS ��rns `� QWNER '�'�- ` — �1-r r�w FRON7 RW ❑ � ADDRESS a L�S ��� l �(Z.l"�-u REAR ❑ W CITY 1�� N� �_ZIP ��.1�TEL�a�i-n'7�L SiDE/SIDE STREET RW ❑ o APPLICANT�nr��-=7i�, Si-r.r�-�., TEL$b1-D-L� SIDE � x a CONTRACTOR_ �� ..._._ — SEWAGE O PUBLIC PMT� o ADDRESS � � DISPOSAL W CITY ZIP TEL. � PRIVATE SQ.FT./100 GAL � STATE y UC.NUMBER GRADtNG ❑ CU.YDS.EXC. CU YDS FILL y ARCH/ENG/ � 7YPE SQ FT �AGTC�R'F�S A�f: 14R�li�L' ON: ,> ,= � DESIGNER � 1 � ADDRESS CL 2 0 a CITY ^ZIP TEL. (+� 3 � PROPOSED USE�Fp � � `a' �'��n�'�r�"' `� 4 � c����t�c�.Nt1,��ti� (�'l..c.�'1.� � GARAGE o NO.DWEL. O. N0. � PORCH y UNITS STORIES BEDROOMS s LOT DIMENSIONS � VALUATION ADJ.AREA o NO.OF BLDGS HOW Q��►r+�� 'DESCRIPTl�3N ' ' �EE W ON LOT USED „� ; � � � � �. W ~ LICENSED CONTqACfOflS OECLARATION:1 hereby atiirm�hat I am ticensad unda D��gu�a�Chapta 9lmmmeneinq � L�,� 1 C C'`~ � w�th Sxnon 70�0)of Di�iaon 7 at the 8usiness and Professions Coda.aad my lieense B in tull tace and eHect . �. 3 � lJll. � Efl�BUIIDER DEq.AflATqN:I herehy atfirm that I am exempt from tAe Connaaor's ticenme Law fw the fopowing � reasan�Sea 703L5,8usiness and Professions Cotle Any tiry or counry which requirts a pOrmil to construt � �} t L.r ,� ~� o alter �mp�ave,tlemolish,a repai,r arty slrucWre.O�q�M tli rssuanee.ilm requiai the applieam Im sueh permit Z r � Qio fJe a signed statement that he is licensed pursuam ro 1he prwisians at the Contactar's Liceixe Law IChapter �� � � s 9 Icommencing with$ection 1000)of Wvis�on 3 0l ihe Business anC Pmfessions Code)ar tdai he is a�empt�here(rom ^��. a, and the basis;or Me alkged e�em0���Afry violation of Section 7031.5 hV any appliwM tor a permil wbjats --� W the aDO�i�ant to a cwd O��N of not more than five huMred daNarc�5500�.1: �- � � ❑I,as ownei of the pmperty,or my empioYees witA wages as tlieir sok canpensation,will do the wa�k,and - � tlie etmctwe is not intentled or offereG 1m sale ISec.1044,Business antl Proieuions Cade:The Cantracta's licEnce � Ww does not ap014 m an owner ot propertY who huiltls ar improves Mereon,and wha does such watk himuH. �.C�. W or thraugh his own emD�ayees,provided t6at wch�mDmvements�re not iniended a alhred kr sab.If,howevee. �.Z� m rhe bwWing or irt�rovement is sald wnbin one Year al canple�im,the ownerhuildm will Aave the burden of proving :�.�[ � Tat he OIG not�wid a impwve for tAe purpase of sale,i �-� y V v� ❑I.as awner of ine praperry,am euluslvely conha[tiny whA Iicense0 contncmrs ro construct tAe pro�ect�Sec. �.{�) 0 10+l4.Business aml Pmfession:Code:The Comrocmi s License Law does not apply to�+mme�of praprry wha ��S�� 6 6mIAs or improvas thereon,and who controcts For sceh pra�etts wiM a contrattoilsl liemsad pursuant to the CDntraela's . License Law.l C�NS"rRU(jT��N 0 � ❑I am exempt wMer Sec. ,B.&PL.fAtixh Certilicatel. � P�(1� R�V�Ew o Oate Owner i 1 �"1 Q WORKENS'COMPENSATION OECLARA�I��� �y f m` I have a certiticau of eanaont ta sN4insme,�a ' �� A oa cerolicare af YWrke�s'Compenaation4��i5�a�a�' k`op��herea�(Sec.7800,lah.C.I. '���y�" LUMBI � � .~i l..' 4 ❑Cerufied capy is hereby furnished. � MECF{AN�Ij/�L C ❑Cenified capy is filed with ihe Building Inspection Deparimen�ar 6ro�nmem. `���GRADING � �ERTIFIC0.TE OF EXEMPTiON R P�°p1��.A7�{yj INSURANCE:This sectbn need mt 6a�a����a -Q�: �SSUANCE � ��_� ����C i y �f the permit is for o're hun ed' ��es�urGF/WIlVin the performance of Ihe work lor Wnrn�m�9 �. permit is issueo.I s�all nat employ atry person in any menner so as m 6ecane su0kct ro tAt N4rlurs'c�,ce�� � - SMIP = Laws of Califomia (L� p Oate C':F`•? �"`� �;�=;"�,;,i��.. �; �.:; LL; PARK FEE � � NOTICE TO APRICANT"If'OUSr91qAi �hf�CArilNdd�E�oKltlmq"Gu�"�bl,hhould becamc subjett to Me Worker's SCHOQL FEES _,+ Compenation prmnsimi^'n�'C�1fo{�od9;'y�u'�+u`sl'9a�Wntl�camply wrth sueh provisions a Mii pa�mit sha4 � be deemed revaked. J pC qVISIl1N OF INOl1SfRIAI SAFETY PEqMIT CERTIRCA710N: d o ❑I nere0y cenrty that no ezcavalron frve(51 ar more teet In depth into whicA a person is required to descmE, s wdl be made�n cmnenwn with work authoritM�9r this permrt,a�Mat ia 6udd'eg s�ruc[ure,sraifoldinq tYuwwk, d n Oemolinon ar dismxKng tMrrol,will be mae Man tAirry�si�I361 fw1 high.(tluP 32,Gry 2,An 2.Sec W� 341.TiMe 8,C.A.C.I. Z 3 ❑As owner�builder,i will not empby airyone to do wvrk wAich wauld«quire�qrmil from lAe O�ivuion of - � Industrial Salety,as roted above,mless such per�m Aax a permit to do such work imm the divisun. E W ❑Oivrnw of Industrial Safery Permit Na. '- ���,,,���No,�,�,,,�,,:,h� TOTAL FEES ;�j"'}.��' � rdry affi�m�hal there is a mnstrunion Iending�pency la tM patornwKe Z of tAe work fm wAich tAis pernit is issued�Sec.309T,Crv.C.). � leMe�'s Name COMMEN7S mL¢�der's Address �'� CERTIfICATF OF COMPUANCE ANO AUTNqpZATlaI OF EN7(lY:!certily I Mve raed fhi�application and stab us �twt ihe infamalion given is cmact.1 agree to comply w�l+aA sm�e I�wa aM city dtlturce�r�Iing ro 6uitlinq y constructwn,antl authmue a tepnuMalrve W Me Oepatment M Buildi�q and S7Fety t0 eM�Won 11N pr00enY - = la which I haox a lied far Mis pelmn(or the pirpose o}maluip intpttiors F�— � �3 � ������� ,��b� RECPT NO. � � � PAIp BY^-� i �}� VAUDAl10N WHITE—Department Copy.YEL�QW—Finance Copy.PINK—Assessor Copy,GqLDENROD—Fle Copy,GREEN—Applicants Copy „�M� . � � �' ������������ . ����� ^; �p:,� �', ��E �.� �.4'� �' ���y�,a. k €: a...g:, a�.i �� §� �. �. . .a. ... . . ... °� �`��-�.> '�,.��' . �� . � . 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