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HomeMy WebLinkAbout1229 (50) .. .,• . � � J .' ; , ,. _ . . . ... _._.. . _ cr ,� �~``r �"��• � CfTY OF DIAMOND.BAR PRESS DEPARTMENT OF BUILDING AND SAFETY F�RMLY BUILDING PERMIT JOBSITE ��,�, , n1��^� APPLICATION-�-,���� ��T��PEMBER CODE ADDRESS C�_\�,- �1U��- ���� DATE �1�L���u � APN IOT� TRACT DATEE �"� -"� Cio CONST.��`FROUP p CROSS STREET SETBACKS "�1O1E1AEN1S °.° OWNER �K� � ZONING ��M � 0 g ADDRESS Co� �� � D A � REAR ❑ W CITY V ZIP9L�La�EL -� SIDE/SIDE STAEET RW � Q APPLICANT P�LC�A ��A'C�'1_� TELS SfDE CO x � CONTRACTOR SEWAGE o ADDRESS 1�� • DISPOSAL � �B� �� W CITY GL-�'�GO Z�p ��. 0 PRNATE SQ.F7./100 GAL � z STATE p11 GRADiNG L�CU.YDS.EXC. CU YDS FII.L � y LIC.NUMBER �,�-\"C�� y ARC � TYPE fl.:�" F/4C.`ii��i;F"S _ ;A P�AtV 1�i:-:.:;;. =' DESIGNER •� �� � 1 •Z�•�vG - C�c�S i�p o ADDRESS �� � {,j;, 2 z CIT � ZIP TEL. � 3 � PROPOSED USE �R t' Z 4 � �" � fiARAGE z NO.DWEL. NO. NO. � PQRCH ^ UNITS STORIES BEDROOMS c LOT DIMENS{ONS � VALUATION 7DL.o `-�� n r i ADJ.AREA c NO.OF BLDGS HOW .`V..�UAN'KrGY ESCRI , DN : °...-- : . "�EE ..• � � ON LOT USED��5�����. s �, I �00 L 7 ��^- ��.D C7 - W '� IJCEN ED COMRACTORS CLARATqN,I Mrehy afM1rm�Mt I Nn Gtenud unda pmvuiont af C4pbr 9(eomnercinp � n �. �'- ���) � with Secuon 70001 af Diu swn 3 0l the&uiness and Praleuions Cade.uN my limx u n h1 farce sud eHat � 3 � �: � OWNEfl BUILOEfl DECL TqN:1 hwe6y attirm ihat 1 am erempt imm the Conrtactw's lcenu law la Gu Idlowi�p r� / � resson ISec 70315, iriess eM Proku�ons Gade�Airy ciry or county whKh repuires+permit to canstruct. .17 � ��R�/ �.�C'P 7•T• 7'`�� o alier,imprwe.Gemdrsh rc rryai arry nrucwrc,pia m ns issuance.alm nquees�he�ppGnnt Iot uch qrmit ...Z -7 � Q m hh a sryned stale nt IM1at he is Ixennd prsuanT to Ik ptwisbns of Ik Contrxta's lirane law�LMptn .,'p] � � - �,�' S i �'v! /•�L � 9(canmercing with S twn 7000�of Oiviswn 3 0l the Busmess and Prohssnns Code�a tlu�M is eaempt thaehom -��. e. arcl Me hasis for aikgM emiption.Arry vidman ol Ssrian 1031.5 hy my applicant for�permi�suhjecb -,'^,�. � (.-�-'/r7YiZ: .S-r'c.'i Eh 7,�� K Ihe ap06cant w a c A penaltY ol mt mare�han G.e hundrM dodais IS5001.1. ,.;J�. W _ � �,�„ ❑1.ax owner f ihe NWe��Y.a m'/empiayees with xages as IMir sde campmsauan.w4 do dn woh.asA . �� _ tlrz siruclure s nol inlertded or oltereA Iw sak ISec.7044.8usinns and Prolezfions Code:TM CMtrKtpr's liunse '�'Q. I f"C:C�c; � �.,htE'i /`�•�� ` Law dces rmt aDply to m wmer of Property win 6mks or impoves�hnean.vid who does wdi wnrk himrNf. � "1�� ' ar Huauyh hrs awn emWayees.prwided Ihvt su�h mpravemenn are not inhnded a o((ned fM 9Ne.M.howmr. ',��� _ �he bmldinq a improvement is wltl witAin one vex al campinim.the aiwnerduWn wAI Am ihe Wdm af pwinp Q y thai he diG not huiM m impaue for ihe puryose af Stk.) '.�' fn ❑I.85 fiwne�at me praoertY.��*duaveFy canVacuny wifh d[e'ued[mUeciw�to ton9ruct ik prqa�(Sx. �.iyf Q 70A4,BuS��l55 antl Pf0�e5L0�d GOdl.ThA�OnIlM10!'S LitlllSf l]W dOtS M i�ID N ONTM�PfOpM1Y WAO `� ' Z hmids oi impraves�hereon,and wAo contrxis fw wch proKcis wi�h a wnnxrorlsl li[aned pesuant m IM CmtrXta's � License taw.� C'r'O � ❑�am rs�P���a�,s� e.b a.c u�n c�,w��i. pLAN REVIEW —�- c Oaie �w�er ':.- F�, C:TRIC:�� ����(�� � 'MINKERS'COMPENSATIOt!UECLARATION;I hneM allum 0at I Aeve a u�Minh oi emunt ro seH•nrue,or ^ / �/� o a cerelicaie af NbiFei Curtpanwiwn Insursnce,a a eadliM r.apy�Aere41 ISx�1,iw.e.�. MBING �.���. f � eo _ ❑ce�nn�e�ouv�s n�«nv����a. , � �:k� �3 ? .'� HANICA ` c�•Q� Q k,;: . F :.��;:.r� C cei�ified copy rs 61e0 w��h me Bw�aing Inspecoon OepraM6t a� Qprmimv ,�� W � CEF7IFICA�E qF EXfMPiqP1 FROM VWFiNEHS'COMPENSATION�NSUflANf��This�etiion neeA ret pe compietAd - ����� ' y d ihe permrt is(or ane hundred(S f00)n Mas.I cemi�Hu'w�4q��vrt!6r wliih Ihis ' .._ ,/� permit is issued.I sheA iqt employ a�ry persan in a�ry ma� �s�az �� Ylh�lqrs'Cnroensa6m � S`M� i+7� olawa ol Caldarnw 'S " � � PARK FEE � ua�e �bdicani ' � � hY1TICE TO dPPLILpNf tl,�her makiig�his Cerol'yale;ot Emnpmn:yw�shaJd'6�e":u6jii'�q�e Wurker's � SCHOOL FEES � CamOenmtian p�wisians nf ihe La6or Code.P�.T�1 tOttlm�,iompM'wiN suA"0!ovapm..9�.tlMs Dmnit sh�A . LL he Aromed revokad. • ti;�' ` / J � dVISIDAI OF INRJSfNNL SAFETY PEflMIT CFRTIFICATIIXJ' i o ❑I herehy�ertdy that no exavatan liue(5)a mae fcel in depiA inW whch a pnson u ieqind m dacad, oe wdl he made in cmMctm wi�h work euMarrzed W tlus pertnrt.W that ro 4rqinp fiuclue,uafbWug,fWaxnk d a Eemolnian a dismantNrg ihereal.wel h mae Aun Hwy'�m 1361 het hiqh IChW.12.6A Z.Art 2,&t W� 341.Ltle 8.C A.C.I s 3 ❑0.s owirer-hudder,I wiY rrot emQby arryon W da�xx4 whkh wwN rcquin�pxmif Irom IM 0'iuyipn p1 ' F. Indistnal Safety,as roted ahare.mless such person lus a pemit ta do au�A rai Imm tlr division � `" ❑°"_�a`�"°'s";'�s''`"�,""�"°. T07AL FEES � CONSfRUCf10N IENOqVC AGENI,Y:I herehy�16�m tlut tMe ia a caotrucnoa le�p�perzy}a tlr�rlumrn Y at the work for whicA Ihis permil ie i�v�M i�c.3W7.Cn.C.). /� }� _ �mder•s Neme COMMENTS P v' �� C��" ��—\ ap Lender's Address 6 CEltiIFICAiE OF C OF ENiR1':1 te61y 1 IrN rpd tlip�OV�Mm rtl fpY . � mz�me m�amaUan n .f m � �I{s�.0 IwR ad riq ' �8uw 6iii6np y construcum. ue+ nxn - Oep+rt d&1iWq aM SrMy ro M�r prepury = ra.wnzn i d ro� oerm d inq imoeenme � � �,,,,,,�d ,a,�,,,, � � RECPT NO.�PND 8Y WWDA WHITE—Department Copy,YELLOW—Finance Copy.PINK—Aasesaor Copy,GOLDEhROD—File Copy,GREEN—Applicanb Copy 85106-7 7/8 • . • , . ,_ � . _, ( !. ; - _k_ � i�- - -- f , - . f ._i,_.. --� �_ ! � , : � , ' , I I I f i � I '. f � � i I i ` i ; ' � � i � i f , � ` I - � , � � � ; � , � � i I � i ..� ( � � , ; : � ' ' i ; I � , I ; ; I � � � � � f � i i � �� t, � �� � ' ; f � 1 �. ; E I � �I I � �' � � r� I i.. � � ! , } i `. � I ' ' �. � � � � � I � i i � � � , � � � y j � � � � �'_-. . .__I_�__' :� � ' � Y r---�-_'- � �-�� : � � _ � � i ' � - � � ' ' � _i � ' j � I ,. 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