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HomeMy WebLinkAbout111 (5) ,�.,. .��--•. '`� CITY OF DIAMO'ND BAR ' ` `,�.,� `•'�� DEPARTMENT OF BUILDIPIG AND SAF�TY PRESS -� BUILDING PERMt7 FIRMLY JOBSITE /� t,..-� � -L� L��� ��. APPLICAl10N � PERMIT � � � CO E ----� ADDRESS / �`� � � SSUE r�_ TYPE ER,�.L'�C � APN __ LOT � ' TRACT � DATE ��..�!_.�.��.__GONST.�--�_GROl3Pu�! `� CROSS ST ET__ SETBACKS J"'p�"T� = ZONING =—° OWNER FRONT_ . ,��q17 � ACDRESS . = � � ' __� ��_ REAR � ❑ � CITY.�y 1f ��— Z � T�� -' S1DE/SIDE��7 RW ❑ Q APPLICANT TEL,,. ���� �-- SID�� ❑ � GO�ITRACTO �� �� �� �= �� SEWAGE O l�DDR �" n ?� ❑ PUBLIC PMT� �'''��',— �-�-- ISPOSAL ❑ pRIVATE 5Q.FT./100 GAL_ � CITYS�./_t._'`_°!' ZIP�TEl��J/�``�' = STATE ���- .� GRADING � CU.YDS.EXC. CU YDS FILL � LIC.NUMS�R._.Y_ �'' �� — y ARCH/ENG/ � NRE SC� FT Fl1CTOp F�S ADJ. AREANAi.UAT10N `—' DE5IGNER � � _ o AGC)RESS__ 1J„ 2 � CITY ZIP _TEL. (�j 3 I a � PROPOSED USE� h-"- '�Z_--� Z q _^_—_� � . � GARAGE � i Q NO.DWEL. NO. NG. � y UNI?S STORIES SE�ROOti1S� — � L_OT DIMENSIONS � VALUATION ADJ.AREA o NO.OF BLDGS HOW I Q�����' OES'CRiPT� M FEE ."' w ON LnT USED U • ��� , ��.—� � — _ � ~' LI f4S".C:1!JTRACT9RS^ECL�(7AilON I here�y aNum fiat I am IrtenseA under pmvisions ol Chapter 3 I�ommennng 1- � .v•L Scr.io� ;7f�]�if O.vis�on 3 n'Ihe Business anC Pm�ess,oi5 LcGe.and my Icense is m full for[e and ellect I � =I�E�6L9.]ER OFG wHFT�N�I he�by alfi�m d�at I am eremp�Irom rtie f,umracter's L¢ense Law for�he iollowmq w — —� :�ti::: %,^.31 5 Ous�ness anU Pmfesaons C�e �ny nry ar ceunty wMch requires a permil !o consVun, (7 o nli��imp•oee •i�r�cl�s^� n repar a�iy siructure.pnor m ds iswance.alsn�eQei�es ihe ap(licant(ar such permn Z s I 9,';:Pin�sc ryJ d�`ISe:�I o•�I7f.0�cl C vP in�d3Polslhe 3 isineh s xnA Pmkss ons C Ae{mcthat he�snr,en pi�he efr�m '� — �I�rA�I.+:asis tur:hr allege:l rxempnon Any'dipldLD%�01 SMtiol'7G31 5 Iry any applicant lai a permn SObI2[IS � w�"'e�pPhcrnt:n a r,.�il pena,t/n'rot ma�e thar�`:ve hur.�red tle4ars{35001!� � i � �._ .u�er il•�z piuperv a:riy empirryees wn�wares as Ihert s�ile^_em0e�sal:on v.��!I Au Ihe wmY and ~ •ne s'ris•„r[s i,�t nrenUcJ:r aHeretl Inr sale ISe[ 70d4,Busmexa end P:ofesamns CaJe Thc Cpmecloi's L¢ense Q[ � Lan:I:�rs r.o�n�;��ly ic an o.wr.r o'P�openy wlm 6�nlds ar imprmes Iherenn and who dces such Mnrk himsell (� _ W oi thr��.iqh his;:wn emplcyee� CmviEetl th�i su�h�mprovemen+.s+:e�m��ntended ur olfereG!a sale I:,howe�rr, � m I�'ie LmlA�nn rr i�,��r.eer,erf is solA x^thin o�e yea:cf comFle.;mn.tAe awnrr�utlder will have:hz hurden nf provmg Q y�"�nt he i�tl��r::..��:o:im:ravr+er ine P��rpose al snle.i v V)�C�' �5 rs�e�o�rtir prope�ty xn exclusnely:�::[racun�wrth hcr.nseJ r.antroc�a�s!m m�str�ct;he pia;ect!Sec pj �"— o "M1M1,3u<rie;s a��d Prnlesoons;:od� The Co��ractor i Lrtense!aw Aoes�01 applV 7o an axner ot pra0erlV who � ^J___ x I C�.fiis nr;n;von:.:here.on an�who r,onnans lm sucn pralecrs wtth a�oniracorls)licensed Dursuam m the Contrac�w's, ¢�����°°��'aw CONSTRUCTION _� i — �j�.._. I i��e+em;e i.nder Sec ,B b�C(Attach Cerblicale) PLAN REVIEIN Q '�°:`— °i""" 3 ELECTRIC � R9RKFRi �QM14'ENSATION OECIARATION I herehy a��vm thal I have a urnicate ol cansenl to sell-insure.or�� �crrnh�a!e�d§'mrknr,",umpensatmr Iesurance,nr a certifred copy ihareaf�Sec 3800,La6.CI I PLUMBiNG _ _ 0 Q ]r,,:;a����i,00y�tnrren�•+���,�:ned `I� MECHANICAL _ o �ciuhed cooy s iilM wnh;hr.Bwldmq InsOenimi Onpar�mem ar_ Depa.imeni.' � GRADING __ Z Ch2TI��CaIF CF,YEVPTIOAI FflOM 14T1RKERS COMPEYSA710N INSONANCE TNs seaian neeA not he tdnpleleA � ISSUANCE /��J �= f ;he mrnn•s Icr one hnrdred' 1001 oi�ess I[emlV ihal — y � S Gedormance of Ihe ork hx whkh this ;� �:t is�ssur.C,'shall t emplay ar.y persar.in any manne;so�o ame wb�at ro the Nbr s'Campensation SM I P _ �.aH���a����. �� � �-- W pARK FEE � �d �� W a �ate K A7Plieants u.. � Nf,P.f.F TO�1FPLICANT II,aher makmg th�s Ceruhcaie of EMempvor.,you should me su6�tt1 to Ihe Nbrke(5 SCHOOL FEES Conoereann+prnvinons of the.abw Code,you must forMwnh oamply with such 5wviswns ar Ih�s pe�mn shall --r—�- LL j he deenied reuoYnJ J �� �I 0161510N OF INOUSTRIAI SPFFTY PERMIT CEHiIFICATIOAI �}(� a�[II hre�y rertily Iha;ne eycaaauon five 151 or mne leet m deF�h mte wh�c�a person is requirv�to descentl � � �QJfM �i will Ge madr.in r.ornecuur wrth work aut�o��zed try th�s permiL and that no building sVucPurz,sca�foldinA.«sework, �'�` �— m Jem;:6eo;i•ir d�smantlinq thereal,will 6e mme Men thuty�s�x 136)fevl high (Chag 32.Gry 2,Ar1 2,Sec ____�_ _ W 'iA! T�9eC ;:GC! ; x � i.�,ls iwne��llundei.I wAI no�emolov anyone to do wark whkh wqild�equire a pmmit tmm me Ovuian of Q��C� p— Imh�svm:Salety,as no�ed aMve unless such person has a permit ta do such work hom the d'wision � �-- � � � L!rnw�s����f Industnal Sale!y Pe�mrt No. TOTAL FEES �4 CLWSfqU�ION�ENUING AGENCY I herehy ai6rm that there is a mnshm�im Ieid�nD epency�or the perfam+ante ' = nt ihr.wo�k fnr whidi fcis permn�s issued�Sec 3097,Cir C) �����drr Y va�re_ GOFAMrhfTS p=p,lemler�FAdress 4 CERYIFCATE OF COMPt1ANCE ANO AUTFpflIZAT10N pF fNTflY i cctify!Aare read Mis appliratwn and suh I � �s �hu�hc���formana�given is wrrect I agree ta�omply wnh all shte laws aiM r.ity a�dinamae reletinp to 6uiMi�g � y mnelnKhun,antl authume a 2pasenlaWe af ihe oeyr�mem ol Bmldug xnA Safny ta mvl Me p�openY � = t��h i have npPl:eA lo�t pe�m%lar�he purpose A ng mspect� �� ��� I H ` d � sy��ei�c o�upp6c�� �aqe� pa�� REC?T NO. 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