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HomeMy WebLinkAbout1121 (5) j � � , �� � '� CITY OF �IAMOND BAR PRESS � � `""` DEPA�ENT OF BUII.DING AND SAFETY ��^ 9 BUILDING PERMIT ' �IRMLY JOBSITE APPUCATION PERMIT �� USE ADDRESS � DA7E ;NUMBER CODE ISSUE ) ��TYPE OCC. 6 APN LOT � RACT DATE ��J~���1 CONST. GROUP aCROSS STREET � .avsrae�ons °.=' OWNER /� ZONING SETBACKS , �'` FRONT RW � o ADDRES 3-��+%I Bfe��'7"/� C�.i REAR ❑ W'CITY f"' �" """ ZIPC�TEL. SiDE/SIDE STREET RW ❑ o APPLICANT -'' -'TEI.. -�'-'-"'°"'" SIDE ❑ Q CONTRACTOR '�� �, � ~ � SEWAGE . � �. o, ADDRESS�.�'��9 �''���"��-"=_C"��tt�2, " -� 0 PUBUC PMT# DISPOSAL � pRNATE SQ.FL/100 GAL ,�; CITY � y ���'�ZIP��/,�TEL .t`j�G?� W;' STATE < < GRADING �CU.YDS.EXC. CU YDS FILI y LIC.NUMBER '�/��� .�� � � � y: ARCH/ENG/ t!} T1FP� SQ'FY•FA�� t�S,.. ..AE'?�f. FiEAIV' UATIQht '', : �'' DESIGNER W � �: ADDRESS �1�y� 2 o_ � CITY ZIP TEL ;(�` 3 x: �'; PROPOSED USE '� � 4 � �k � GARAGE ;a; NO.DN/EL. NO. NO. �` PORCH � UNITS STORIES BEDROOMS �` LOT DIMENSIONS m VALUATION ADJ.AREA �, NO.OF BLDGS HOW QUANTtT:Y ��SGRIPT=14Ad: ` 'FEE,:. ,. " �� ON LOT USED � � � '� U �~� IICENSEO CONTRACTOflS OECtARATiON:I herehy aSfirm ihat I am licensed under provisions of Chapter 9�eommennng �.n . '.oi with Secnnn 7000)of�ivision 3 of the Business anA Professions Code,and my Ikense is in full force anA sftect �`- � �; ,`�� � �...W. ���+-w- Ol^INER�BUIL�ER-0ECLAflATI0N:1 hereby eftirm Ihat I am exempt Irom ihe Conireebr's Licenu Law for the foliowmg - `a}' �eason�Sec.7031.5,Busm¢st and Professions Cade�.Any ciry or couNy which requires a perm@ to comUuc[ (�}�.; - - 'Ot' alie��impruve,demoVsh,or rqpai�any.�imcture,prie�[o its issuance.also requiret tAe applicant tor cuch permtl �I.� �/—'. m hle a siqneE statement�ha�he is licensed Dursuam m�he D�ovisions af the Canpacloi s tiCense Law-IChaDle� m'. � -� '(�;: 'J(commencing with Section T000)of Dlvfsion.3 of the Business and Prolessions Code�or�hat he is exempt theretram �:!- , -,pw; and the 6asis fa�ihe a�leged exempoon.Any viWation of Smtion 7031.5 by any applicant for a permit su6�ecb .�:. `�.K:: the aD0„�ant m a civil penalty of not mare ihan five huMretl tlollars IS5001.1: . �r . ��; ❑I.as owner at the property.or my em0loyees wiPo wages as theh saie compensation.will do the xrork,a� _. ' � - ihe s�mcWre is not imended or offered for sale(Sec.7044.Busi�cess and Pmfessions Code:The Cantra[tor's Uceise v�':: ��� ;V:taw docs not apply to an owrier of property who 6uilds or improves Ihereon,an0 who dces such work hunself' (,?: � '_�-�.,ror ihrough his own e.nployees,piwided iha�auch improvements are not Intended or offered for sa�e.If,however ,�z." , _'oG;:the huilAing a impmvement is mid within one year of wmple�ion,the owrcerhuilder will hane�he burtlen ot provmg q,, � . .-_) _yn.�Ihat he did not 6uild or impmve for ihe purpose of sale.) - � -U. � -�?- ❑I,as owner of the propeny,am exclusivefy conlractmy with licensed comractors t0 eanshuct the project(Sec '�}. ° 71194 Businecs ard Pmfessions Code�TAe Contracror's license law daes nat apply m an owner ot propeny who �' .:! - :�Z; bwWs o�impmaes ihereon,and who conlrac�s fa�s'uch pmjects with a conlracIDr(s)licensed pursuant to the Convaemr's , . �-6`���License law.1 �.����,L`�N5^TRU'L`T��N `p^; -W'� ❑1 am eKempt uMer Sx. ,8.6 P.C.(Atta[h CerGf cate) ";PLAN REVIEW 'N. i o° oa�e u.v�e� : ELECTRI : :,_�``� WUAKER$'COMPENSATI�N�ECIAflATION�.I her , - . eby atfi�m Iha1 I have a certlficate o(consent ta sHf-insure a .. a cenAir.ate ef Warkers'Cnmpensation Inswance,or a ctttified mpy ihereof(Sec 3604 Lah.GI. :� P�-UMB�NG �����¢,. ❑Certifietl copy is herehy turnished. ;�,- CHANICAL r � '-a.' ❑Cenified copy is filed with the Bui�din9lnspecDnn fkpartment or �Oeparhnent d-:GRADIN � W �;: �/ p�, .,�; GEATIFICATE Of EXEMPTION FAOM WORKEflS'COMPENSATIINJ INSUBANCE This fection need not be cumv�e�� Q��. ISSUANCE JC �`�4 d ,y� if the permit is for one hundred IS700)o�less.�urfify�hat in Ihe pedorm of the wark for which ths .. .. _ _ � permi�is issued,I sha I not employ arry Person in any manner so as to beeome � t ro_Ihe N��keri Canpenution �"'` SMIP - =� iaws o�caia���a r ` o- - > �, �;PARK FEE p= �ate � � ApPlicanl� /g � " �;�g NOTICE TO PPLICANT:II,atter making this Certiikafe of Exwnplmn,you shouW become s ject to the Nbrker s �'��SCH00�FEES . �-�'Compensation provisians nf the laMr Code,yuu must im��co��ly wiM such proviswns or ihis permn shel� ,,,� ;�+-���he deemetl re�aked. S'�t.. t�;'` y��'�'"� �. �; ��;� d�VISION�F INDUSTRIAL SAFETY PEBMIT CERTIFICAT101J: � -�'v�:� :... - - ,W ...�r Y .,: _. '�- �I hereby cerlify thal no ezcavauan five(5)o�mme leet m deD�h inlo whicM1 a person is requiad�a descend ���p�e;� will he made m cannection with work eulhw¢ed 6y this permiL and that na building structwe,scafkWinp,falsework '� oi demolition or dismantli�ihereaf,will be mwe}}i��t&�y�sjY,l3fj�,tetl��p.32,Gry 2,Art 2 Sec .::_: 341.Title 8.CA.C.I. 61� n� � �y - n� �`"3 ❑As owna-builder,I will not empbY anyoice to do wod which xroWd rryuire a pttmi��mm Ue Urawn of ;� induslrial SaMty,as noted above,unless sucppn�rsot�hps dp�Jtnt�o�da such work hom tAe d�vision. ,.-.�,. . �. 6 v�i� :...+� �d ...�p �� ':;�-: 'W� ❑avision of Industrial SafeN�rmit Na. '';� ".` ��.ill f:� � �- CONSiHUCf�N LEN�ING AGENCY:I herehy afl m I�at�tAere s a construcLon fendi TOTAL FEES ��ntv�1«me pntormance b��a. �:.Z:� ol the work for which ihis permit is issued(Stt.3091,Civ.C.1. `�'��� LeiMer"sName �M� � � -;m� le�er's Address ��-6. CERTIFICATE OF COMPLIANCE AND AUTFIOHRA710N Oi ENTflY:I catily I hava read Ihis applitatbn and sta4 . - ��a ihal the�nformation given is eaiect.�agree ro comply weh all state laws a�k ciry ordinairces«latlng ro buiNiry � -�`-y constmction,and authonzB• represenWtive af the Deputmenl ot Bu�ldinq aiM ety to mter�qon tlm properry � . ,:.,= Por which I have aDPlie RO tAis peimn for the purpose of making inspections. �r � Signalu�e oiW �ar A����� Osre RECPT NO.-=:r��PAID BY VALIDATION WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Applicants Copy '8 51 06-1 1189 _ _.. _ _�. _ __ ��.. n � --� — �� � � n , `> a + � � � r� t � � �e � � � p I � �."€ �, �- � . � � �T r ' ����z�'- � � � i I 1 � t �� �"" ,� � q ` ' , � € +t t".' ' � '�,. i : � _ � € e i r ..�s r . 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