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HomeMy WebLinkAbout1103 , '"` CITY OF DIAIUIOND BAR PRESS ��: '~" ' DEPARTMENT OF BWLDING,.AND SAFETIP BUILDING PERM@T �IRMLY JOBSITE APPLJCATION PERMIT ADDRESS� 3 �'y� ���Z��'41'���'��� DATE � �'� `"L' _NUMBER ���' `-� CODE y APN �'dr�G'jc"�/"'i �� LOT f�Z TRACT�3 S�"s D TEE G "'��"`T f�' _CO ST. GROUP � o CROSS STREET SETBACKS "�"a�"'E't'S :-° OWNER Pc-a'1-�`���`� �.�,�- d� i�-E'L-!� ZONING �OlVT� RW ❑ o ADDRESS� � i'`f� -�%�'L'`�'�°''`�'� G�2�-� D�'-- � REAR ❑ � CITY �% %� ZIP%�.7�.� TEL:��} "s�"i' SIDE/SIDE STREET RW ❑ g APPLICANT i�it�'s,c`S t'��•� TEL. SIDE_� ❑ z 4 CONTRACTOR r�� %�L%=, ��-`"'� o ADDRESS -��-��' r�'������-� f`�`O'� DISPOSAL � PUBI.IC PMT # W CITY �%�'r A= �' ZIP�f7�� TEL!�.�A�S7'� ❑ I'RIVATE SQ.FT./100 GAL z STATE CU YDS FILL y LIG NUMBER �� •���� a'f GRADING ❑ CU.YDS.EX:.. y ARCH/ENG/ t/y �P� SQ FT Fi4CTC�R PS ,AD.1. AREANALUATION � DESIGNER r G/?,t.�. ��: ..�-� ,r�' W � �.. ""..�.�.�.""'---...,..._._._.�� p ADURESS LL 2 r"�� ` c� � ,- _ _Z CITY ZIP TEL. (ry 3 � PROPOSED USE �•"?"%/e� ��tl�t-c�s'���-�� . � 4 � ,J GARAGE o NO.DWEL. NO. NO. � pORCH � UNITS STORIES BEDROOMS m oe LOT DIMENSIONS VALUATION • �. ''�'� �'/ G' ADJ.AREA o N0.OF BLDGS HOW QUANTITY DE_ C9�IPTlOf+l �EE w ON LaT USED Q """" � — U ~I LIC❑ENSED�6RTR5CTOR5 DECIARATVON I hereby afhrm tlia7 I am i¢ensed under pmviaons ot Chap�ei 9lcommenung � �I wnh Secnnn?OOOi o:Omsion 3 ni the 3usiness and Prolessions Cade,and my Icense is m full imte and eMect. � 3 � W LL TNNER BUIIOFR CEC!AB�TpM I heie6y allirm d:at i am eaenDt from�he Cont:anafs L¢anse Law!or!he fdlpniny reaso-.;cec 70?75,Busi.^.ess and Prefessions Cade Any :rty or caunty wh¢h reqmres a permn w mnstruct (} o ,L•e� i:pio•;e,demo45h u repau any stmc�ure,pna ro Rs issuance also reqmrss Ihe applicant ior such peimrt Z Q to'tle�signeC s[atemenl ICat he is hcenSeC Dursuant to t6e proursions of II�e Condactor s L¢ense Law!ChaD�er m � 9�,r.anmencinn,witli Seaion 7000j oi�wisnn 3 of:he Busmess and Prolessmns Codel��hat ne ie exempt iherefrom '� d and the`asis�or the alle9ed eMemClion Ape�iaiabx�ofc^5v�emia 7031 5�V anV applicam to�a cermit sub�ects � � the aVV��'.��t:o s c.eii penany of not mor¢�i;n_';five•'fiundied'd�llars'�(35001 i. -� o •4. .t,•-`..k.�.�c:.:•S•/ 0. � ❑I,_�mv:ar ct the property,or^�y empluyees.vn�w�ages as Ihev sale coRqensatmn,will oo the work and S�e sunnure is ro!iaienceC oi cf`er�fm sale iSr.c 70C4,Susiness and Piolessmns Lode The Contrdctor�s i¢ense q V�Law 9ues�.^.1 aD01y to an owner el prupeny who huilds nr improves thereon and who dces wah wark h�mself V — o�II'fGllf]h FIS JW1 emplavees aror gt su�impca�em�ts ot mtended or olfered`or sale.If,howevec z m ^ie bwlding or impmrenent;s sald t�iG��ye�ol,�ompletA�^.�4�wner6wider will have the 6mden of pimmg Q � thal h�tliU cet hwlc or�mCraae'ar�e Gurpose o�-S'ale�!•• `''O•�= 2 "' U en ,�I as,rnner�i the pnperry am yxclusivelY�ootracnny wiih 6censm cor.nactors to canstmct ihe pro�ecc�Sec �J o �0;4.Basiness and ProfesspC;�Ade.ih4 Cnm�a�mr's licRnsS Law_daes no7 apply m an awner of pmpe;ty who � _ :mies oi improves thmeon,aM�s��u comracts Po�suehy�h�eciivn��fi a eanlraGWi�5l;hcensedpu�suant to ihe Cwttactm's -- —�--�. / Q•L�ensc La.v` - �i� CONSTRUCTIO�_ 4> �: .�� o ........., ..�_ . ...._ .... .. __� W �i I:n eaemp;��nder Sec B 6 PC iAttach Cerlihcatel PLA w F- � oa'" °viner ELECTRIC � 4VOANiH$ COMPENSATIpN�ECLARAT!ON i herehy alfirm thal I have a certificate a1 consem ta seN-nsure or :rob�=te or S1'vrkeis'Campensa:�on Insurance,or a anilied copy+.hereof iSec 380D.Lah C 1 PLUMBING ¢ ❑�E�����Ea co�is hereby turr.ished J MECHAN ICAL . o ❑:.erofied�oOY�s 51ed wnC the Bwldmg Inspectfon Oepanment or I)epartment � GRADING w _ � CEfl?IRCAfE 9F EKE6IPTION FflOM WOqKERS'COMPENSATIDN INSIIRhNCE 7his secimn need nut he carrv�le�ed o SUA /'�., C% L: � `e�e permd is for one hunnreA IS10U)or less I ceruly tAal in the perto�nance af the worY�for whKh Ihis ' - ,ierma:s�ssue9.I shall aol employ anY Pe�son in any manrer so as ro 6eco "su6�ett Io tlie Nbrkers'Can nsatian SM��'~ r.S� �% � Lmvs nl Cahto ma �, , / �W ' 0 �-���„���.a _ �.�...�.,..- �` PARK FEE 0 7ute�sy ADD�� . . � NfITICE TO APPLICPIVT.II,aNer making thrs Cer�drta�e of E puon.you should hecome suC�eat to Ue Wrc4er�s u- SCHOOL FEES Compensanr.n pramsions af the Lahar Code you must lonhwrth cemply wnh such prwrsions or this permq shall . he tleemed revokeC a � OIYISICIN Of INWSTAIAL SAFE7Y PEflMIT CEflTIFICp71pN� W 0 GI he�ehy cendy that no excavaUon five(Sj or mo�e Icet in depth imo wh¢h a peison�s reqmred to deseerd, � wdl he meAe in comiecnon wR�work autho�¢etl Iry thrs peimil,and that no diilOmq slm[ture,scaflottlfng,falsewu�k. or lemoLhr.�n ar d�smanumg Iheieaf,wdl he more than Mrtty-sis�36)leet M1iqh.(Chap.32,Gry 2.An 2,Sec Z 3C1 TdieE.C��I W S 3 ❑ps�wnerSwlder,i wdl nal emplay airyane to da wark which would reqmre a permit from the Uviswn of r :ndusaial Sale�y as notetl ahme unless such persan has a pgmii w do sieh wark from ihe Eivision. . . . � � ❑o,v's,��o���e�s<<,a��ry�,m�No. TOTAL FEES r' c, � � CONSfRUCfqN LENDING AGENCY I herehy alfirm tAat�here is a cansnuction pndi�agenry for Me perlomanre � ,� � Z ot the worY lor wh¢h mrs permil�i issued�Sec.3097.Crv C L . � LenJer's Name COMMENTS m Lender's AUdreu ' ' ''- Q CERTIFICA7E OF CqNPLIANCE AND AUTHORIZATION OF ENTRY�1 catAy I have read Mis application�nd itate � � �� � -� � � • - h ihat i�e mformauon grven rs correct.I aA�ee m wmpty wnh all state laws a�ciry ordirences rela�ing to buiNing y canstructwn.and autlwrize representalive d the�epatment ot Build�ng and$afMy m enur upon tlie properry " s �a wh¢h I have apPlreO f Mu ce�mrt lor iM puryose of m � -spectrops. �— _ --_ � �?�- - �+ ��r= .r-c-.!�'�" _�-„� �• r,T' /fl • <�I{.� VAUDATION�CT sqnamre ut App�icam m nyene pa�e RECPT NO. �� I Z - f'AID BY . .. _:...,., ., ..�,. .. .,, .,. 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