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''"� CI�Y OF DIAMOND �AR pRESS
`..;, •�.' . DEPAF�TMEiUT OF�UILDING AND SAF�T1' �'IRMLY
`^^ BUILDING PERMIT
DDR'ESS _��"�l ✓.�:'%v<�( �!-_l', ./� � DATE CATION �BER�'L�CODE
ISSUE ��D _ TYPE OCC.
a APN LOT 1'RACT _ DATE Q CONST. GROUP
o CR05S STREET SETBACKS
a��o ,,,. .<. , r`. — ZONING ��N15
OWNER i�-��.�.< <-/ .,'��%. � � - FRONT RW ❑
o ADDRESS, ,._. .,:: ;•:�. <,�',•�/<;,. .. ,�^�,!-� REAR ❑
,� CITY ��ir �/r%���_�. ZIP TEL. SIDE/SIDE STREET RW ❑
o APPLICANT TEL. --�-- SIDE ❑
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� CQNTRACTOR � �.��f.. �£z'r:-,�'r`� .,�; ,
� o ADDRESS f. . , �,:';��'_f�' .,:,�; F'�� SE WAGE ❑ PUBUC PMT�
'-� ..�— �'�: , . — DISPOSAL ❑ pRIVATE SQ.Ff./100 GAL
W CITY �ll. �s^ .�`�''i ZIP , .�`��:pi:,�EL.,i '�'„•I"F s7
� a STATE 7 �!yl
� uC.NUMBER �` �%�._%;3' .� GRADING � CU.YDS.EXC. CU YDS FILL
y ARCH/ENG/ � TYPE SQ FT FACTOR PS AbJ. REANALUATION
"' DESIGNER W 1
n ADURESS __ _. � 2
� = GTY __ZIP TEL. fVM,._ � 3
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�. PROPOSED USE "-_.":.v�`„':�'{ �,j',;"/�"',:' ' � 4
�. �'��J��a•y��l�.S ,i t. G-' f".,.� J � GARAGE �,
Z: NO.DWEL. N0. N0. � � � pORCH O
�„ UNITS STORIES_�_BEDROOMS� G �
� � LOT DIMENSIONS _ m� VALUA710N � ADJ.AREA
o NO.OF BLDGS HOW ,, � T ouaNrirv DESCRIPTION FEE
W• ON LUT USED 1,' ;'.;-'y:�`�^-;.,,••''�: a
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~ :ICENSEO C�NTRACIDAS f7ECLAFATION I herehy athrm that I am hcensed under piovisious of Chap�er 9(commenciny t-r
� wnh Secnan 7Uf1171 0l Oimsion 3�t!he Rusinexs and P�ofessmns Code.and my hcense rs in full fo�a and ellect W
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�±- ihVNER UUILUFN 0lf,!AkAI ION�I here6y afhrm ihat I,m e.empt Lom tAe Co��vactm's licxnse I.aw for ihe fdlowmg
Z�reasnr.ISr.r. 7031 5,yuswess nm!Proless:uns Cale Any cny or coumy wluch requires a permn to construct, (.'y
o.�aher impiove.demo65h,cr repan a(ry sVu:ture,prmr to ds issuance,also reqwres Ihe apphcant inr swh p¢rmn Z,
� tu fi!e x signrd sta!enr.nt that he is licensed pursuant m Ihe piovismi�s�d�he Cnnuacmr's L¢ense Law(LhaO�er �
� 9 immmenung w:tl;Sacunn 100111 uf Diuismn 3 ul�hx Busmess and Pmfessions Code)or tAai he rs e�em0��herefrom g
d� and tbe 6asis for tlre allepeJ z�empUon Any vidauon of Secuan 7051 5 hy any appl¢am for a permn su��ects �
x Ihe apFlicant w a cwil DPnalty nt nnt mnm!I:an hve hunAred dullazs�5500)I ¢
W' � t
n'' lJl as o�ener o1 t�e pmperty m mv eaip�oyees vnth waqxs as�hr.0 sole comCenuuon.wdl d�lAe wruk anA
i ~� ihe smctwe�s noi mir.ndv!ur olfe�eU loi sale ISr.c 70M14,Busn;ess and Piofess�unx Code The Cammcmr's License Q
� Law Jues�:ut aV01y lu an owner of OroDeity who Owlds or!mpmves ihereon,anC who Uces sucA work Nmselt. U
' oi thmuah his awn xmpinYees,pr�wideA ihat snch improvr.meres are not mrondeE or ollered fo�sale II,however, z�
m� ihr hudJu��g nr irt�pmvemeni is SnIA wnhin one year ul conipleuoq tlie owner�6mlde�will I�ave�he bwaen ol piaving Q
� that he diJ r.ot Lwid m nnp;uve lor the PwUose ol sale.j =
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en' i_JI,as nvnrer o�A�e pruVerly em eulusrvety cuntracUny wnh h�ensed mntrauors m ronstm�t the pio:ect�Sec pj
�� 7044 Bunness antl Pmlessions Cotle�iM Comracror's l¢ense Law does not aq�ly io an owne�of yropeny wha �'
�' nmlos m:nipimes Ihr.renn,autl wno enmrer.ta Ir,i sur.h prn;ects sviiL n conbacioqsl lica�sen pmsuanl m the Com�actor'S "- -"
�' L1e0S2Ld`"' TRUCTION ri�� �
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�` L�I am e+en�pl under sr� .e.��.e ia,��n r.e��,n���e�. PLAN REVIEW
o' u��� ow�e� - ELECTRIC -- — ----
� '.YGRKERS COMPCNSATION DECLARATION I Lere6y alhrm Ihai I have a cenihcate ol consem ta seN msure,or
�, a ceruhr.ate�NNrkei�f.nmpensatbn Insnranoe,nr�reru6eA oopy thereal ISec 3800,l.h C 1 " ' PLUMBING
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� �'i-e'w��i�:�uv�,i�P��n�r�x�„i��a J MEGHANICAL
o ❑ Cr.nrfied cnpy is hletl wrth the Rmldmg Inspecunn�epartment m Depaimient Q
W ��' CfATIFIf.ATf OF EXEMPTION FHOM b1qAKEAS"COMPENSATION INSURANCE This seclion need iml Le mmylekd �SS CE � O
� il Ine pe�mn is lor one hundred ISI00�o�Ie�,;l.;cpyvfV that m the pedormance af the work Inr wh¢h thrs �, -
�ermrt rs issned.1 shall nm r.mplq��any p�iso�imany.map�er so as m he�ome suh�ec�to the N6rkei.s'Compensation MIP � "�'��
� lnwe ol Cxldorma ?.'..i, )e,, .,,-; ; .— — � .__
o �; /?-�`�:::<i::..<' W PARK FEE
p Oate_ AppLrant
� Nl1iICE TI7 APPLIf.ANi It,aNer maMing Ihis Cendka�e ol Exe�npimu,you sMuld beCum¢sehjeti to Ihe Nbrkei'S �- SCHOOL FEES
---�.' CmnpensaUan y�ovismns ol Il�e La6m Cude,yqu musl��ilh comply with such prwisians nr tha pe�mil shall "��� ,
� he ueemed revokeC .} r� �.y�; '��;�";E'�.,� — � ' _____
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� @VISION OF INWSTAIAL SA E Y FFi1MIT EATIFICA7I�N �_,��-1�l. f�� I�� � I � ' � f� -1'��' . �•/d�' '
W P.�. 1
�� LJI here�y renrfV ihat no e�cavatmn trve 151 or mo[e feet m d¢plh.�Mu'whmh a peisan is reQuaetl to tlescen4 , J' �• •� (t""..: ' t' "�f ! -��' 1 -!_'
� will he madr.m r.nnne�unn_w17h wprk�autl�o�ded•�y�this,permn,�an6tBat'no'huddmg svucture,scaffuldmg,ialsework, ��/ �r a : ' , � / t�
ni Aemulnina oi d�s inn li i IlieiHrf,'wdl Ae�more,�n n;thu�-5i:,-�361'i�et�i h (Gie 3 2,Gry 2.Att 2,Sec �"�1 f / /`r(`.��,i�": /' r
q,l�J r.D.+'a ,�,y. 9 0 �'%'!' , "' �`/� , f . /+',� � J
W341 TitleB.CACI �..s. : - ''�F.� ' � � '.
�, 3 LAs uwnerhmlJer,+l wAl�not'empby anyone lo Jo work which would rcquire a pnmu 6om Ihe Uvision of
1— Intlustnal SafMy,as nmr.d aM1ove.unless such persan ha:a permit to dn such work from fhe drvrsmn.
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W. ❑avision ot Industual Safety Peimn No �
� CONSTPUCiION IEN�MG AGENLY�1 heiehy alhrm�hat�here is a consnuc�ion lending agency lor�he perloimarrce TOTAL FEE �
Z ul Ihe wark for whah th�s permn is issued�Sec 3091,Civ C� /
� tender'sName OMMENT$ �.-�/• `
m Lender's Address
¢, CFHTIFCATf Of f.UMPIIAAICE ANO AUTHOPoZIITION OF ENTqY�I cnhly I have read th�s applkmian and state
�h ihat ihe inlormalion y�vai a cmren I agitt to eomply wnh all sta4 laws a�eiry ordinaneu rtlalinp l0 6uiNiip
� cmislmctmn,anJ autho�ite a ie0�esentatiue al the Department af Building md Saiety m mter ipan the Waperty
,= kr whch 1 have apP��ed�tM1is permn lar 1he qryou of makinp inspectrons. � ,
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��plqant m Ayent •� �% pe�e RECP7 NO. PAID BY ��� VALIDATION
WHITE—Department Copy,YELLOW—Finance Copy,PINK—P.Ssessor Copy,GOLDENROD—File Copy,GREEN—Applicants Copy
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