Loading...
HomeMy WebLinkAbout113 (11) '�'� ���ITY OF DIANiOND ��4R `�' PRESS ���p '�" '� 1�._1ARTlIAAERtT OF BUILDING ANQ SAFETY ��^ UILDING PERMIT FIRiNLY JOBSITE fJ�-',�; ! APPLJCATION PERMIT U3E ADDRESS �'�-�`' �--} � ��'�' % •�� �'`'— SSUc , .�- �TYPE�R �� �CCODE � P CONST. GROUP y'• RPN _ LOT �_TRACT` °� DAT�E ��.;,�„Z.,�� .-'• �; CROSS S�. T�. 4"`' — „ SETBACKS �+�+��►� a�' OWNER�].�� r �� Z..lVING F�dON7.--.� RW ❑ �5 ADDRES��--��iL.' !� � � R�RR ❑ u;', CITY�.���C y't�"1� ; ZIP{ c', �._TE'' L.�=r � � I � J z � � —� S{DE/SIDE STREET RW ❑ ��'�I APPLICANT_ __TEL. __ -- SfDE ❑ C:� a:: — — � — �� CONTRACTOR �:� a:: Q., SEWAGE �� PUBLIC PMT� �;, ADDRESS DlSPOSAL ❑ PRIVATE SQ.FT./i00 GAL �'.; CITY_ ZIP TEL. _ _ _� STATE � � � � �� a: L!C NUMBER_ ������� �� CU.YD�.EXC. CU YDS FILL V.' ��� ARCH/ENG/ ��TYP� ; ��_FT' �ACTOR P ,�ADJ�AREANIetLUATiON `-'•!DESIGNER � 1 � o::: ��' F�DDR[SS �, Li� 2 i �� CITY ` ZIP _TEL. �r 3 � �:: s, PROPOSED USE �� �3' I ' '� ' 1% � — 4 �� — �:�� 1 Al � . _ ���; ,� GARAGE �NO.GWEL. NO. � NO. �`--� ��; � POt�CH �_,;UNITS. STOREES SEDROOMS _ � -----�--�-- o:: LOT DI�IENSIONS VALUAT!OPJ__ ADJ.AREA ���NO.OF BLDGS HOW qUqPuTl7`i D�SCrf�IPT1ON ��� '-���I OU LOT _USED � ` o:'l—._ — - — U �y ���❑ /°;� .'�/J' ~"I LICFYSED CON?RACTORS OECLCRATION�I herehy alfirm that I am hcensed under pmvaions of Chapmr 9 Rammennng !� ---�s-"-V -- � "1 oe �}�nl•Secua:i 7�Cpi�;I Ilrvrsion 3 0l'he Business and Pmfessions Code and mr Ikense is in fu!I Imce and r.11ec� �� I __ ei � � -1�— 3�� �..� u:;.?oVVEP 3UIL�Efl C(CLARAT!ON I hereuy alhrm ihal I am e�empt Imm!he Convacm�'s License tar.loi thz Poliowmg —"— —'---- �.. ao-an�Sr.: ;031 5,f3un�rcss dnA Pmlessions Code Any nry or mumy.�h¢h requires a permrt Io conelruc; (!S C:i el:r.' �in�irU're.tirmUlish �r r¢�a��any 5!rllClule,pflnr ip 1(5 155UTIIt! d150 fPQllilES IhP 3DG�Ifdni IOf SUCI:pOffllil YL -- —'--- —� 1-�� +o I 1=a smne�l statemem tnat he is licr.r.sed pursdart to the Crovisians of the Conlracroi s L¢ense Law(Chxqser � p�. 9 icanmennnq w.1h$ectmn 7000'�a��roisw�3 0l Ihe Busmess aM Gmfassions Code)ar ihai he is e.empl therefmm g --- p:, arJ'he,oxais+m L•m aGeged rMemp6or Any violation at Secuar.7031 5 hy a�p appLcant�or a permil suhans � �'� the appl¢anl ir.a r.���::1;r.wll5'cl nc+^�oie thar.five hundreC dollars�S50CI1 J —�— a ����C: as nw�ne�ct tl•e p�nperry er^�y empleyees vnth�wages aa Iheu sole cempensaLm�,will Ao Ihe work and ~ �me srar.mrr•s�:nt rnrrned or ollered Im sale�Sec 7041,Business and°iofessions Code The Cono-acta�'s L¢ense CCi I La�v dres w!npn'1"tr 3r o�.vncr of o e�l�who Cuilds nr �,�} '----" Fr p y �mymves iherean,and whn ticee such work himself, _ "•�;u�9ira:,y� �!ia nwr erClavecs Ororcetl Ihat such imD�o�r.mer;s ere nM�ntenoed ur ofle�ed Mr sak II.howr.ver. � 0�1�nt hirl9riq�r impmv�menl•s sold withir.one year ol complMmn,Ihe owneo-6uilde�wdl have tho hurden ol proving .y �• `ui:i,.r.iE no:buiid ar i:np•c�e!or Ihe pw0ese ol sale j � ui; � �9��.I d;]nrer 91 t^e piopErly am e�clusrvely conlra[nny wrth:icensed conUactor5 lo construcl the prolect�Set � -"—"-- �.�i;il1G,Busuess nrd Prolessions;,otle T�e Comracmr's l¢ense Law dae5 noi aFP�V ro an uwne��f piopertp who 'L"" p;;�bu��lAs m:mDrOm�s IAe�eun and wh�:onirar.ts ior sucn pro�ects wnh�contraclarlsi 6censed pur;uant ro the Cortrar.la�'s —1"---'� �r.:���e�s��a„; ?CONSTR�l�Ti(�N ._ �:�� -- _ ��a L�I 2m exr.mD�mner Sec _,B b P C iAnxh Cend¢ateL !PLAN ,�tEVI��fV _ • � �_; Ua�r. (Iwner �ELECTP.iC � �i� �PJfiKERS f.OMPENSAiION UECIAqATION I heieCy affirm Inat I have a certihcate ol cartsem ro self�insure.ni � —' n�erchearc al�",tixers Cnmpr.nsaDon InsuraMe or a cerLli�vl capy therea�ISec 3eo0.�ai:r,i i FLUIvIBIkVG ��I C Co:u`.iee capy is herehy iurmahee ��MFCHANICAL . ��,/: Cq �Ce�tdicd woY is hled wrth Ihe Bwlding InspttLon Depar.men;or p¢panmem. rr'�,jRf�DING �• !F�„TE OF E%EM1IPTION FROM 1WRKERS'COMPENSATtON INSIIRANCE Thrs sectmn neetl not be�om ktea I ~� �:, cer;T e• v O�ISSU{51VCE �;= I •he perr.n �s tnr one'�undred ISIDO�or lexs I cerufy Ihat m the Dedmmance of the wm4 lor which thic F` �-- _ 7ermit is issued i shall am r.m0loy any Oe«n in any manner so as m hecnme sub�ect ta tne blb�ke�.s'Canpenuhon �S`M�� �:' Lawx nl Cahinmia W — .� �:> � PARK rEE C:: Ga!e Applicam_ -- u.� ,y�J7�rf TO APPLICANT I! after mak�nq thu Certihca1te'o'F EKd'nptiori,-y,�xi shaJd hecwne suh�ect to the Warker's� �- SCHOOL FEES --+ C^mpensatmn prmuions al ihe La6ar Code,yon 111054 I%AIIWItIY�EpIflply WI(F�iUCM1 pfpV14UW W thrs permn shall, u:: he Aeemetl ievoked _. . -, � __ _ '., :' �'— —'.___ g;• qYISIUN OF INOI15fHIAL SAFFTY PERMIT CERTIFICA710N� u.i C:� CI ne�eny certify tna[no evcavatian Irve 151 or pgrr�_�eet m depih inro whiph?a persan is�eauird to deuend, ` aecc wd�tce made�n cannr.uian wifi wort authorued 6y this'perm�t,end.t��t na'6iiiking�slm[ture,scaifoldmg faisewark,j i� or Aen��ol�tim�m eismantling therzaf,wili be irore'tlian'tCirry�sic'(361 feet high(Chap.32,Gry 2,Ar1 2,Sa I _____ ��� 341.Ltle&,C f+C i E �•. I _ 3�� ❑As owner6udde�.I will mt enqloy Bnypne Ip do-�Work wNyF wauld requiie�a`permit�from Me 6wsfm d� �.... Indusvial Safety,as noied a6eve,nnless s�ch person ha5 a permrt to,da such work from YM diii�ian �. -- ieE � !"' °'' ...:� . .... . ,.. - : i ya ❑GHsion ol Indusinal SMety Permit Na ���� I TOTAL FEES � G.. �_� LONSTRUGTION LENDING AGENLY:I IcereGy aHirm that Ihert is a[onstructwn lendi�apency Mr Ihe perfvmance i 7:, o�tlx wor4 for whith ihis permn is issuzd(Stt 3D97.Cm C I � �/ J` �;i tender's Name_ — E COMMENTS�f � 8 ���� '.v L:.� (�� '� lenda"s AdAress aa _� /,w��•�r� «� CERiIFIfATE OF COMVLIANCE ANO AIRHOflIZATIqtl OF ENTRY i cnu I haw read tlis a ��� �'�"'Z (y pplratian pM state �; �a Ihat ihe m n grven is correce I agree to romply wrth all stale laws aM ciry wdiiunca nlating to 6ui16np �.i cnnsinc n.and Aaiue�r tative af�he Deparlmem of Building and Satety fe moer upon fhe p�operry 3:, lo�wh�Ch I have app d f s pe� for the purypu af makup inspectpns �� F• � �� � �`� � � I REGPT NO.! '�f PAI�BY �% �VALIDATI N � Signat of plcant or ppent Oate� WHITE—Department Copy,YELLOW—Fin�rce Copy,PiNK—Assessor Copy,GOLDEhROD—File Copy,GREEN—Applicants Copy 05106-11i89 ,-. . ,. , . . . . .. . . „ . • . , � . t �� . .. ' - . , .. .. . .. . ... . '.3. .p� . . . . . ., . . . , '�,.. �_ . . , . :, . ... � . � � . ' . � . .... � . .. _ � . . .. ' . 4 y ' . . .. . .. . ., . ... .. ... . " . . .. . .. . .. .. .. ... . .. ... .... . . . � . ... . . . . . � .-- ., .- .. - -,-... -.. _. . .. .. ..., . .. . . ...� _ _ _ . . .. . . .. . .. . .. . .� . . . .. . ... . . . . .. . ... . , - . .... . . . .. . . . . .. .. . .. . .. . . .. . . .. .. ...... . . . .. .. , . . .. .. . . .. . . . . ....... . . .. ... . . ... ,. . ... . .. . .. . ... ..... . . . .. ' .. . . . . . . .. . . .. . . ..... . .. . .. . . .. . . . .... . . . .. .. .. . .. . .. . .. _. _ _._ _ " .. .. ... ... ...... _ _. . . . . .. ,... .. ... .. ,. . . .. . . .,. . _ __ _ .. .. . _ ._ ' _ _ _ _ . .. . . .. . ............... .. ' .. . . .. . . ,. ,. ... . . . . . . .. .. ... ... . . ... ..... . ... . .. ... ..... .. ... . _ .. .. _. .........� . . ..... .. ... . .. . .. . . .. ... . . . . . . ... . .. . ..... .. . . . . . . .. . . . . .. . ... . . . .. .. . ., .. . . . ..... ... ........... .. . . . . .,....... .. . ... . .. ... . ... ... .. . . ... . ... . . .. . .. . . . . .. . . . . . .. ......... ... .. .. . . . .. .. .,......,.... : . .. . .....,. . .. . .. . . .. . .... ..... . .. . . . .. . . .. ... . . . ... . . . ..... ., .. . .. .. .. . . , .. , . . . . . . ... . ..... . .. . . . . . .. .. .... . .. . . ... . . . . ...... . .. . .. . ....... ... . . ::. .. "�'���:[� .:. +. . .... :..-�... .�.. . ., .:, . . . .... ..... ..... .... . .. . . .. .._. ........... . . .,.. . . . ...... . . ... .. ... , � . � :.�.:�.�'�'. . ... . . . . ... , . . . I . . ...........r..... ^..,-... ' .. .... . , . _°,�.�.'S, .'� _ •/�'�r , .•'"[-