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HomeMy WebLinkAbout1227 (6) � � '"` � ,�-�� CITY OF DIAM�ND BAR �"'�� pRESS OEPARTMENT OF BUILDING AND SAFE1 � F�RMLY BWLDING PERMIT " JOBSITE APPLICATION PERMIT E ADDRESS GG�- �vE TM�R CODE � APN OT TRAC� DATE ! � � /� CONST. GROUP o CROSS ST�ET '� � � 20NING SETBACKS ..�'"E"'S =' OWNER �Z� FRONT RW ❑ S ADDRESS R�� ❑ W CITY ZIP TEL SIDElSIDE STREET RW � p APPLICANT TEL. SIDE ❑ d� a CONTRACTO ��'Q" SEWAGE o ADDRE � a2�• $ " DISPOSAL � �B� �� ,a CITY ZI TEL. � �NATE SC].FT./100 GAL �.a = STATE -26 Z� / �/� �� G 3 � GRADING ❑CU.Y�S.EXC. CU YDS FILL � LIC.NUMBER `�TL � ARCH/ENG/ Vy 'nP� S� � ��R RS ADJ. AREAA/ALUATION � DESIGNER � � � ADDRESS LL. 2 0 � CITY ZIP TEL [� 3 • "` � PROPOSED USE Z 4 � � GARAGE o NO.DWEL. NO. Na� � PORCH � UNITS STORIES BEDROOMS m � L�T DIMENSIONS VA�UATION ADJ.AREA a NO.OF BLDGS HOW auar,Tm pES RIpT10N FEE W ON LOT USED � �v � • 1W � -=-� � � ' "NSEo LUNlflALTORS�CLARATION 1 N�ehy�Ih�m M�I I�m I¢ms�O uMe woviumf ei CkD�B IwmmMrtinp Y wnh non J0001 al Oiwsion 3 of tlx 8wmess�rd Proleamna Cde,md�y km�e o in tuN lores md dfect � 3 � . � QNNEA�BUILDEF DfCLAflATqN�I here6y dimm Met I�m mmpt Imm�he CanrxWr'i Ixence law fa IM Mbwinp rouan(Sec 7031.5,Busmess/nd Professnns Code Any cily ar taunty wluth nqwns a oermil b tonstru[t, O o al2er imo��.demdish,a rzpar my nructure.pior to its nsuance,Yw npunes tlrc Wplicmt far wch pMmi .� � m hk a sqned sutemem mat he�c 6crosed pxsuml m the Rwmom ol Ihe Conu¢mr'a lk�me law�Ch�q � pC 9(eommennng with Sauon ID0010l pvis�on 10l the Buaimss ind Proleniont Codel a Ma�he is�nmpt Mndro � and�he 6esu lor I�e allegee eremDtian Airy vrolotlan M Secuon 70315 hy rry epplrtanl Iw a permn wqe[ a � • • W the applkan[ro a cxY penally d ro7 mon Ihan Frva Fwd�ed doq�n(55001.1 � � ❑I.as owner of�he propeny,pr my qndovsa w�U�wpe�c tlieir�da compmsatlon,witl do�Iro wsrk.end tlie anucwre n mt mtended oi olfered Ia s+le ISec.7064,Buama�end Rofessans Cod�iM Crrtnaer't license �q �„� Law does not app�Y to a�owner oi Oroper�y wM buiNs w mD��s�Mrem.aM who dcei wd�work Mm:elf. (.) � v Mrouph his awn employees,prmMM thet sxn xnprovemena ue no�iiroende0 a offeie0 lor��k II.Mw�wi. Z the bulding a impwemem n wW withm one yer el compk�ron.tAe wmer-builder wdl heva�Ae burdm ol pminp 4 y tha�he tlid nm huik m imprave tar�he purpose a1 s�k I � sn ❑I,as owriei ol the propeny,an eu6:rvely conuutmy wi�A IKlnld COnUN[ora b Wnthup IIN pIO�Kt�Sx {iJ 0 7(W4.Businss�ntl Professions Lode,iEe Gntr�ero's lkense law does rot�ppir ro m armer ot lrapn�y who � = Wilds w�mv�wes lAnaon,md wlw[ontrxls tu�wch propn�wiM+cpMrK[or��)linnsed pursu�nt lo IM Cantncta's " ����^�°uw, CONSTRUCTION � ❑i am...mo���eH sK a.e r.c a+ern amrr.h� PLAN REVIEW � °ie °""" ELE C � WORKENS'COMPENSATqN OELtARATION I herehy Nlum Ihr I h�ve+entific�b ol ep�sent Io fNt�inepe,v �rortArzak of N6�ken'Comperoanon infunnce,u��etdrU capy tMieM(Sec J800,LaG C 1 �.V MB�NC.7 ` ❑Cerufed�opv is MrcbY lumrshed � MECHANICAL p CxnlieA[apy is IAed�wth Me&iWing Mapxbm Oparmrnt rc O�pvlment Q GRA W = CERTIFCA7E OF EXEMPTION FROM K9RKERS'GOMPFNSA710N INSURANCE.TAi�m med mt 6�compkad � d�Ae pemm rs for one AuMred(t1�01 a kss I anfy at in e «iw�n Ihe fr whch Nu y 11Y1 I!KBIMd.I 5�1lA Iql�T per pby rry permn in mv m�n r ro a a wb t tlr N6� !Canpen � SMIP s liws CMrtorme. , w o � _ _ ,� � • W PARK FEE p Oe[e nl • � r+oncE o arai axr x..� ma inp q�ie GrMesie oi F�.+nouon. sha �«r e u,.wac.�'� � SCHOOL FEES � Cdrpensauon prouuions of tlr L�Eor CaAe.yau mist IorMwilh ompy�n1h tueh�rarcnin a tles►em�it fh+ll . � be deemed revoked J � OMSIRI OF NOUSTRUt SAFETY PERMIT CEFffffILAllfMl i �^� ❑I herebr cendy�hn na�smoan Mie(5)a mor�'iefl;iry�!8tl'�jt�;w'h�a w�wn n nwnd b lai�end. a � wiN M mede n cannxWn wilh work�utiv¢d M f�it ��{n�t.pIod.1�rt a9-bw11nY�4uctw.euf4ddinp,hliwak, a 6moRtion a demmM�q IMreof,wip 6e man Ut Mw�"us�391'�h�fi�ph.(�7uC�32.6ry 2.11n I,See W %1.Title 8.C A C 1 S 3 ❑Af ownn�6udaer.1 rriA not work � . Irom Fe 6won d � Industrwl S�hty,a noled�hare.un�w�M�n s�prrt�i b�o�u �mm Ihe Nuftien. � ❑Onnam d Mdueiul Salery Armn Na. � TOTAL FEES CdViSfNtlCfnAl IEMOIAIG AGENCY.I fofM men's'�•[anstruebon.Y�dpp percy,ter Me Ixknnnn � mm.,����«..�n,�rN���.�.�rs�ewer,�..cr•: : • ,. ''v'l r` 'J � 1inde�'N'"" �! GOMMENTS m ms ` CE IFfATE OF OMPIWCE ANO 2ATXM1 a NTN'/.I profy I Irv�nd Mit pp6ral'si�d ppe , �f he NA tun pwn� rM I la tpnply Yr ar wte and a�Y a�cK uYtnp Y hwNinp � msim. e.rep x. e e1 ae oro.� ni.d s.rery r�r�pon+b reoRn r� h I�r n ' tlr p�poaa d i � _ c � r � � ���� � RECPT NO. 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