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�'�. '`� CITY O� DIAMOND �AR PRESS .,, ��" DEPARTMEIdT OF'BUILDING AND SAFETY F�RMLY � BUILDING PERMIT JOBSITE ' ARPLICATION PERMIT � SE ADDRESS � � ��S JDit9 /�>�l� � DATE NUMBER CODE 1SSUE ��^.C�'Q CONST. GROUP � APN 1:0T TRACT DAT'E o CR05S STFi ET SETBACKS "''R0''�""E"'s �,q� ��•�. ZONING '-° OWN,ER = , FRON7 RW C� � o ADORE 5 �I d��� � REAR CJ � CITY �T� � ZIP�TEL. "� �, SiDE/51DE STREET RW L� o APPLICANT_ �' �"��� TEL. ". SIDE - --- - ❑ x � 4 CONTRACTOR � e'��D�� ��� �' SEWAGE o ADDR � � � `7b 0 Pl16LIC PMT� DISPOSAL [] pRIVATE SQ.FT./100:GAL W CITY c�� ZIP 7 TEL. z STATE �� y L{C.NUMBER �_It! ��.� GRADING CJ CU.YDS EXC. CU YDS FI y ARGN/ENGf � TY$�� -SQ;�'.� .. `:F�� ... ` A�.,�I� ` ' ,#:,UA'TlC� �'` "—' DESIGNER ,��;. 1 �: ADDRESS �it_ 2 � CITY ZIP TEL. � 3 � PROPOSED USE ' � � �; �, �._� �� �• � CARAGE� ' o NO.DWEL. NO. ��•� �` PORCH y: UNITS STORIES BEDROOMS �, � - VALUATtON ADJ AREA eee LOT DIMENSIQNS o' NO.O BLDGS HOW QUAN3'� � 'r.�C:_�P"!`I��: _ F�*�^ .;. r�.. �; ON T USED �; :�' W� V 2- '- � 4`�. ~'` �ICENSED CONTRACTOflS DECIARATION:I here6y affirm ihat I am(arnsed under provisions of Chapter 9(�ommencing � i � with Section 7000�oi Division 3 of Ihe 8usiness aM Professions Code,anU my I�cense is in full torce and eNect �: � � �: �+-�- 0.NNER-BUIL�ER OECLARAT�ON��here6y altirm that I am exempt imm the Contrector's Li�ense law fo�the Idlaxinq - _ . - reason f���7031.5.Busirress and Professians Code:Any ci�y or county whirh requires a permrt to ronSiruct (�' � +; O` alttr,impmve,demolish,or repair any structwe,prior to its�ssuance,alm requiras ihe applicant foYsuch permrt �; , . . . �� y:�.� i=;� m file a siyned statement that he is licsnsed pursuent ro ihe pmvisions of!he Contractor's�License Law 1Chapter �y-. � - � -� �� �9(commencinq with Seclion 7000)of Oivision-3 0(the Business and Profesaions Cod¢)or that he it exempt therefmm �`: � ' p�; and the basis ior the alleged ezemVtion.AnV�iolali0��ol Section 70313 hy any applicant kr a permit su6je[ir �,;; . � the applicant ta a civil penalry of not mo�e fhan five hundred dollars(35001.): - ,�' _ �' ❑I,as owirer u�Ihe V�oper�Y,nr mY��7loyees wiM wages as Iheir ioie compensation,-wAI do the woik,and , . - ', 1 F the tuucnrte is nui intended oi oltered for ule ISeo.7044.Bpsiness and Prntessians Cade:The,Cantractor's.License � _ E ��Caw does nat apply to an owrer nf pmperty who 6uilds�ar improvw th�enn.aod wiw dces such work�himseH �; t; � � a Ihraugh his awn emplaYees,provided IDat such impravemenis are no[intentleG nr oftered fir sak.If,howevei � . � � 1' o�pni�[he 6uilding or improvement is-so!d wilhin a�year ot compia�ipi,�he ownerAuilder wilf have the hurden of pioving +�.�-, - yf', tha[he did nol huiid Or impwve for ihe purpose ot sale.� S-'. - � �, c/at:❑I,as owner of the u�oueriy;am exclusrveh�antnctiny wiN licensed cuMractors to constme�the pmieci�Set ij,[- . _. . - - � � . �;.�.7(144.Business and Pmfessians-Cudx The.Cantractor's�Lice�se taw daes nm apply-to an mvnw af prope/ry�who' ""�-- - � - - . �-huifds or.improves fherenq and wha caniracts fa such D�aR«s witli a canitacWr{5)licensed pmivant to the Ca+tracta s - - � -� �1Le�Se��w� „' CONSTRiJCTION _�.__ W �„'❑I am exemD�under Se¢ ,6.5 P.C.iAttach Ceniticale� �,:.p�qN REViEW o; Date ��e� �'�`� LECTRIC � ��� _ �;. NpRKERS'COMPENSAT�ON OECLARATIW:I herehy atlirm Ihat I have a cereficare o1 conseM to seN�insure,w ,; , - a cetlificate of Workers'Compensation insurance,o�a certified wpy ihereo�(Sec.a000,La6.C.1. � _' ❑eena+ea�o�v�,ne�eey r�,�:nea. �?MECHANIGAL Q; p; ❑CerMied ropy is filed with the Buiiding Inspectiw Oepartment -z �H - �g Oepartment �.:GR x�� CEflTIFICAiE OF E%EMPTION FROM VAAKERS'COMPENSATIIN�,(fF�U��h�iasec(�en netd not be ro�,k��a '" SSUANCE - � � _ y� il the permit is for ane hundred IS100)o�less.i ceAify�ha1�n Ilt�perfdrfiiant��6Ythe wak�or which"thn ` - - � :j permit is issued,1 shalt not employ airy persan in any manrer,sa.as[o.become suh�ect w tM N6rkers'Compeasalim '�'s' � �� _' laws ol Califamfa. .. .. . . . . . . . . . .:.._ .. �= �. , �,h ,�� _ � PARK FEE __ Q- oare "P� � �:"SCHOOL FEES W 1 NOTICE TO APPLICANT:R,after makinq ihis Cenificale of Ezemplion, a� ' sub�at m ihe Waker s —�+ Compensation prmi:ions uf the Labor Cade,yau mus�(athwith comply wiM such prai:bns a this permit shdl ; - `g.; W: hedeertadrevaked. - � �` aVISION OF INWSTHIAt SAFETY PEflMIT CERTIF '� ����� �����r,Y� . . , �. �, � � .. , : - ❑I hereby certify that no e�cavalion f"rve�5�-o���Me t�et`�tn�Aepid fio�kp a..pflh@��;7eiptirEd ro de:cend �a*,e ¢' wili be made in[annection with work eutha¢ed 6y thu permit,and Wt iro huildinp siruttwe,stafblEi�,faisewwk � . � ��:-b demolition or dismamling thereol,wi�he mae man th'vry-six I�)f�t high.(Chap.3.2,Gry 2,An 2.Sec � ` z�� 341,Title 8.C.A.C.I. �S �:`. �_ � . ��' �,". 3.. ❑As ownerbuilder,I wiil not empby s�rya�re la do vrork which would require a permit hom tAe Oivisnn af � . �`�;' �--: Indistrial Safety,as noted a6ove,unkss such person Aas a permit ro Eo sucM1 worA from the divuroa . - � � ;, } � ❑av�,�af��str,0�se�aty��mnNe. TOTAL FEE �'� v CONSTR11CTpN LENDING AGENCY:1 hereby aNiim Mat there ie a wnstruction kndi�eqmey fof Me perPormmke . 2 a}tM1x wark iw whi[h Ihis pamil is issued iSm.3097.Civ.C.I. - � . � ���s�� COMMENTS p�p� Lendar's Addiess - #•`. Q CERTIFICqTE Of COMPLIMCE AND AUfNOPo2AipN OF ENfIIY:I urtify 1 Faw resd this applitation rd shle , � � �a�� that Ihe infamation��mn is cara�t.I agree ro mmply with all shre lewa md ary ordirunces tek&g�o fM+ildi�p . y canstruction.and authake a iepre4maWe oi�tment of 8uildinp and S+fety ro aiw�qun tl¢ptoperry � x For which 1 hs applud iw Nis pei it Ia Ihe ng inspextions. � - � � � � ����� RECPT NO. � AID BY VAUDATION - $ignaiute ol Applcsnt or Apent Oett . . 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