HomeMy WebLinkAbout1639 (23) �°� � � ci�rv o� DiaMOND eAR �� _ � �'��
, ,. . �'' P�RESS
�� - DEPARTMENT OF BUILDING AND SAFETY
� -� BUILDING PERMI7 FIRMLY
J06SITE „l,.�,�'vjl RlD ��'��r h'� APPLJCATION y� �PERMIT �/ � USE
ADDRESS ��'*mu,vp «�/��S' DA7E NUMBER_LSE�._CODE
ISBUE ... TYPE �CC
r APN . LOT TRACT DATE � �� d CONST. GROUP
�
' � CROSS STREET ZONING SETBACKS ""�'°`'E"E'"5
OD OWNER C�1�21-'�s w /J'J1��fS FRONT RW ❑
� ADDRESS�� � �� ��p-� REAR ❑
W CITY D1AM�ND k3,9-t� ZIp !7!S L.��•a��� SIDE/SIDE STREET RW ❑
o APPLICAN7r�rYR1•e:s 61/. M�T�J-f TEL���`�2�8��' SIDE ❑
_ -
a CONTRACTOR� - SEWAGE ❑ PUBLIC PMT�
o ADDRESS— DISPOSAL
W CITY IP _TEL. ❑ PRIVATE SQ.FT./100 GAL
s STATE
W GRADING ❑ CU.YDS.EXC. CU YDS FILL
y LIC.NUMBER _
y ARCH/ENG/ � n'�� �� � �� �DJ..AF�EANALUATION
" DESIGNER � � �
� ADDRESS LL 2
0
Z CITY ZIP TEL. �(�: 3
� PROPOSED USE PAT/� GdUF;C� ` 4
� d GARAGE �
o NO.DWEL. N0. NO. � pORCH '
y UNITS I STORIES 1 BEDROOMS �
m LOT DIMENSIONS � VALUATION ADJ.AREA
p NO.OF BLDGS HOW� QUANTtTY DESCRIP`T1ON F�E
= ON LOT � USED � Y�s' _ �
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¢ — —
W I�I v
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❑LfNSEII CIINIRACTORS DECIARATION I he�ehY alfirm ihat I am h[ense�under�iovmons o�Chapter 9(�ommencing `�
Y wn6 Section 7000)ul Oivisan 3 0l�hc 8usmess and Pmtessions Code,a�m Lcense is in(ull force and el}ecl �
� ^ ,.�.
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� �VNtH�UU1LUEH UEIIAAATN]N�I hcrehy ath�m that I am ezempl Irom tlie Cunlraamr's Lmense taw for the fWlwriry "—"
reaxnn 15ar, 7Q{�r� g��smesE end Pmlessio�!s Code Any ntV o!cnunty whrch rtquves a permit to cunstrucl. .O
o alrer impmve.demo6sh or repart any nnx.ture,pnor In its issuance,also requiies the apphcam for such permu '2.
F= m fde a signe.A s�rement that he rs hcPnseJ pursuant ro the pmv'�sions at the Comractor's ticense Law(Chapter ''��
� 9(cm�nnencing with Section 10001 0l Oiwsian 3 of the�usiness and Protessions Codel or thet he is e�empl Iherefmm .g
y and the hasis fnr thr.atleged exemphon Any viola0mi al Seetian 7031.5 hV any applirant kr a permrt suhpc6 �
w tliu appLcam m a civll penally ol nat moie than(rve hundred tlollan�55001 P a
� I,as uwne�ol Ihe prapeny,or my employees wrth wages as fiai sde compensation,will do the wo�k,a�
H
ihe simr.wre ix nm mtendM ar ollereG im sale(Sec 7044,8usiness and Pmfessans Cade.The Cmtractoi s L¢ense .Q„
� Law Aoes nut appq•ta an uwner o(pmpeny who builds or im0ioves iheiean,and whn dces sucM1 wmk himsell. •U.
••• o�IhmulP�his mvn employees,prwided Ihat su[h improvemems are nm mtendsd ar ollerzd far sale 11,however. �,��'
= the huAding or impmvemem is sold wit6in one yeai ol compintmn,Ihe ownenhml�er will have Ihe hurden of provinp �Q� — —
y ^thBl hP.did n01 M1WIII Ut ilnpfOVB�0�the pwpose ol sale.� _� _
V� L..11,as mv:re�ut the prope;ly,am e�clusively mntracuny wtlh 1¢ensea comroctors m canstmct�he D�o�ect(Sec ,�J,E
7044,�nxiness anA Pmtessians Code The Caniractoi's license law Aae.not apply to an ownei o1 propenY who .',�
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6mids n�nnpiovr,s Ihereon,aud who conlmcls fur swh pro�ects wleL a mnlractai(s�haensed pursuant Io�he Cmvacto�s �
license law.l N �/
� L.�I am exr. t u r Sac g e r - ��n ce�uf��arei. , LAN fiEVIEW ��
0 oaie m+'�ef ELECTRIC
� Wi1RREH5'COMP NSAl10N OECUflAT10N I here6y allirm Iha�i have a ceniiicale a1 consenl lo s -insure,or '^
n cerlillcale ol Nbrkers'Campensation Insuranre,or a aenilied copV lhereof(Sec 3800,La6 CI. PLUMBING ___ _
O
4 ❑f.en�Ued capy�s heieAy fwnisAed � MECHANICAL _
o �.�Ceruhed capy is�ileA wnh Me Hwlding Inspttuw Departmem m oeea����,. d GRADING
W
Z CtHTIFIGAIE UF E%EMPTION FROM WOPKERS'COMPENSATION INSUMNCE.This section nced not 6e tompkted �SS NCE �
� if Ihe permit is fnr nna hundred IS100�or I¢ss 1 tertdy�Aal m Me pedo�mance ol ihe work for whah f�i5 —
y permit is issued,I shall iqt employ any peison fn any manner So as lo become Subletl to Ihe N4rkers"Canpensation M�p • S�
� Laws ot Celifarnia.
o t� �� � PARK FEE
p Ua�r. Q � � Apphcani�fb�.� /w. �.�.�..
W NUTICE TO APP CANT II,aft¢r making Ihis CertdKate al Eztmplion,you shouW 6e[ome sub�ttt to e `ke��s . SCHOOL FEES
� Compansauon pravisions af the labor CoAe,yau mLLct tqNwnh comply wilh such pravispns or Ihis permrt shali
� he Aer.inetl ievakel �
�
� CNNSION[1P INOIISTHIAL$AfETY PEPMIT CEflTIFICA71(1N� —
p1 he�eAV cer�ify that no excavatron frve�5�ot;inqre I et'in dEpifi imo,whi[h a ce«is repuved m descend. - _
0. wi be made in conneciwn wrt�wark authaved M;lha plrin�.an'd�tii81 no'hudding svuctWe,splloWinp,idsework,
or demalmnn nr AismaNhiy Ihereof,will he mme•ithan!thnt�+'iii�(36)Icel high �Chap 32,Gry 2.Art 2,Sec
w 341,LtleB,CAC1.
S
� As owner-6uildei,I will nat empby anyone o du woh lvhich,.pBuY��,fiQwre a permn hom Ilu DiY¢pn 0�
r In stnal Safery,as notetl above,unless such�Ers�A hYs a pe�miCio do�icfi:wak Irom the division —
� -
W ❑av�smn of�nduslrial Salely Permil No.
a
CONSTR�CTqN LENDING AGENCY.I Aere6y afhrm Ihat•tliere is e conshuction�kndi�g`zpencY ta the pnloimawe TOTAL FEES ��
Z o�Ile worM for wh¢h Mis permrt is isSiieA�I�etC;309.7,Ciu.C) � � .
� Lender's Name , . (;DIv1MENTS �
m LenAer's Atldress
� CERTIfICATE OF CONPLIAfiCE ANO AUTHONIZATqN Of ENTflY.I certily I have read this applsatian and shte
N that�he mfwmallan ryven is correct.I agree to camply wrtA aA:tau laws aM ciry ordifances reqlinp lo buildi�p
yconst�ucnon,and aNM1oiiie a representative ot Ihe DputmaM of BmMing md SatnY m mM ipon tlk prcprry
= loi which I have applKd for Mis perma la Ih ryrpose al makitq insp[etions. _
~ �"�"`�°�'^"�'���'3'~ `� —���� RECPT NO.�PAID BY ���VALIDATION
Sgna�ure al Apdk��m Agent D�h
WHITE—Department Copy,YELLOW—Finance Copy,PINK—f\ssessor Copy,GOLDENFOD—File Copy,C3REEN—Applicants Copy
�stos-i tras
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