HomeMy WebLinkAbout1458 `'�..�,
'"� � CITY OF DIA�VIOND BAR �` PRESS�/�
- DEPARTMENT OF BUULDING AND SAFETY ��RMLY
� �� BUILDING PERMIT
JOBSITE APPLICATION PERMIT USE
ADDRESS 20957 PASCO CT. SS E TYPEER . � ODE
� APN LOT TRACT DATE � � CONST. �GROUP
�
� CROSS STREET
� ZONING `SETBACKS .�o�►E�
°D OWNER MR. DURAZO FRONT RW 0
� ADDRESS 2�A57 PAG('.� �T_ REAR . �
� CITY DIAI�IOND BAR Z�p91765 TE�� SIDE/SIDE STREET RW ❑
g APPLICANT ROBERT KELLER TEL. SIDE D
_
m CONTRACTOR PETERSON JONES
6 3190 E. WILLOW SEWAGE x� PUBUC PMT#
g ADDRESS ISPOSAL
,� CITY SIGNAL HILL Z�p 90806 TEL. 2�988—�� � `O PRIVATE SQ.FT./100GAL
z STATE 528710 GRADING � CU.YDS.EXC. CU YDS FILL
y UC.NUMBER
_ � �nrP�: st�=F1' .�►cmR �s =_;at�:pREANAlUA1'IOPI ;`
�' ARCH/ENG/ fn '
� DESIGNER °W` �
o ADDRESS (�°; 2
= CITY ZIP TEL. �; 3
� PROPOSED USE Z' 4
� � GARAGE
o NO.DWEL. NO. NO. E'� pORCH
y UNITS STORIES BEDROOMS
s LOT DIMENSIONS �= VALUATION ADJ.AREA
o NO.OF BLDGS HOw �;au�wrrr-ir:dESCRt .PTION� ..; E�i�'"`^'FEE � :�r'". `a.
W ON LOT 1 USED .
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2
~ LICENSE�CONTflACTOflS DECLAflATION:I hereby atfirm Ihet I�m licensed under provitions ot Chepter 9(wmmmanp
� with Section 7000�of Uivision 3 0l the Business and Pmfessions Code.+nd my lemse is in tull lorce�nd eflecl ..,,,,�;. �� . �
3 ❑ .r,�;. � . . �
� OyVNEH-BUILDEH DECLAflATION:I hereby atfirm that I am eumpt from the Contncmr's lkenie liw Iw the fdbwinp p
= reason�;xc.703L5.Business and Pmfessions Cade:Any city or caunty whkh repuirn�pnme to canstrat (7; ' �
o alter,improve,demolish,a reDaii arry sfructure,D��or m itt iswaMe.dso requve�tlx applium for wch permn :"::.Zs
Q m file a sipned:utement�h�i he is licensed Ourwant to the Orwisions af Me Cmtr�cwr's l'ceme l�w�Ch�pta ��
p� 9(cammmcing with Section 7000�af avision 3 al ihe Busimss and Pmteuiom Cade�rc M�t he is aempt Nerdrom �;;
d and ihe basis tor ihe alleged emmption.Amy viol�tion of Section 1031.5 hy any�pplinnt ki�permd wbjecU '�;;;;�'�
K ihe applicant to a civil penalty ol irot more Ihm fiv�hundred dollars(f500�.�: �".-��
W
� ❑I,as owne�of ihe propeny,or rtry employees with weqes aa iheir:ak campenfation,�will do me work,md '
the stmcture is not intended or alferN lor ule(Sec.1044.Business and Prolessions Code:Th�Cmtnctur's Ucenu d�
V Law does nm apply to an owner ot property who builds or impmves Memm,�nd who das such worY himself, •-(�,��;
' or thmugh his own employees,prwidN ihat such imprwements ere not imerded a olfered lor��k.II,M�ve�er zg
m the huilding or imprwement is sald within one yeer ol completim.Ik mmerbuilder will hm the Evdm ol Drwnp Q�
= that he did not huild or improve lor Ihe purpou a�fale.) _�
H
y V. .
❑I,as awner ot ihe pmperty,am eic4uively contractinp with licensed conV�ctws m constmcl tk prqat(SK Wi�.
� 0 7041;Business aid Pmtessions Coda Tk Contrxror's License l�w daes not�pply m�n owmer of praperty who '.?y��; �
= builds or improves�hereon,ond who contracu far wch pmjecis with�conirxtor�t)licrosed purswm Lo tlu Lmtwcta s
a �i�e�5e taw.l .: CONSTRUCTION
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W ❑I am eYempt under Sa. .B.6 P.C.IAtl¢h Cerlifinh� ;,-':. P�.�qN REVIEW
�
� °at °"""" .� ELECTFiIC
� NORKEHS'COMPENSATION OECIARATIpJ:I hereby illum thn I hrve�ar6faah ol crosml m sdl�insue a z°�� r--�
0
a cenificate of Hbrkers'Compens��ion�nsur�me,or a cerutied copr thereallSa.3800,t�A.C.�. PLUMBING _
Q ❑c«er�e�op��s ne�en�i���:nee. ::�,��.��= MECHANICAL
o ❑Certified capy i:hled with the Bwldmg Inspaoon Depxtmmi a Dep+rhemt 4:..GRADING �
W
= CERTIFICATE OF ExEMPTION FROM WOfIKENS'COMPENSATION INSUHANCE:Thit sec�ion nad mt M campktd `ISSUANCE I
yif �he permit is for one hundred'IS1001�ar 6ss+l ceitify that in the perform�rce ot the wak k�which�this
permit is issued.I sh�ll mt embloy'iM perton m enY�minne�so u m betome wbKet b the Nbrkri Campenfetmn �•'�� SMIP
ol�ws ol California. "� " ' �; PARK FEE
p Oate Appliam ��
� NOTICE TO APPIICAHf:tl.�terim�king this Cerofrate,d�Emnption,you sMdE 6etome s�Ajett m the NtrFer s ;SCHOOL FEES
—+ Campensation provisim�_ol�tie�leboi�Cade�you mmtavtlnvi�co�ly with neh paisiam a this permil th�ll .,�%
� be deemed revoked.
J �
� qVIS10N OF INDUSfRiAL SAFETY PERMIT CEHTIFILAiIQI: '� `_
W �.�. �,. ,- '!'. _ n� . �
d ❑t hereby cerfyiihai�,no e�uvnron�frve'.�6)or,more�Ittt ln�depihlinto which�pe�sm u npard oo detcad
s will be made in connauan with rrork.authar¢ed by thu p�rm�_md�Mtl m huildinp�vuctun.suffoldinp,f�t . . .
d w demolitian or�di:mentlirq,tAereof.cwdl'6e'�mie th�o'lhirry�su��6)leee hi�.�pup.3.2,Gry 2.An 2.Sa -
_' 341,Title B,C.A.C.�. . „x;;i �
W
S 1 .;
3 ❑As owner�huiWer.I will irot ertpby myone to do work whieA would rpuin�pamt from tlr Oiveion af � . . .
� InAistri�l S�hry.�s noted�how,unkss such permn Iw�paimt ro da wtA work iram IM divition a����� .
� �.y�:.
W ❑a"������:,�u�s�ry��m"No. TOTAL FEES � �
� casrnucrnN iENoiNc ncENC:i n�aer,n��m,�n��.���o�m�
c� k�q'pee�'la'U"p°'lo""'w
Z of the work for whch this permi�is issmd(�.�7.Civ.C.I. . .
� Lender's Name COMMENTS �
m Lender's Address -
Q CERTIFfATE OF COMPLIMCE ANO AUTfIdtlZATQI OF ENTflY:I relily I lur md Ihn�pptin6on rd�ab � ��
�s that the informa6on�en ie correct.I qee to tomply wiN atl�u4 I�ws ad tily ad'oiree nhfinp Oo hel�np ,
ycon3truction.azd w r¢e�reprttenu6re al tM iment of 9oY7nq ad Sdelr m nar iqon tl�p�eq .
= tn whkh I d far Ihis perme mtliip in�etUom.
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X y�� e , ����� ����a� � RECPT NO. P/UD BY ` v��VALIDATION
WHITE—Department Copy,YELLOW—Finance Copy,PINK-0.ssessor Copy,OOIDENROD—File C,opy,OREEN—ApplicaMa Copy
BS106-11/89 � �
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