HomeMy WebLinkAbout1102 '�'� CITY OF DIAMOND BAF€ PRESS
�.. �„� ' DEPARTMENT OF BUILDING AND SAFETY
��' BUILDING PERMIT FIRMLY
JOBSITE pATE CATION / „w�� �(,� NU BER � � . CODE
ADDRESS � 3a� .�.�.M!-I t( �Pit L�GL' �2 �-�'
ISSUE ' TYPE C.
4 APN �OT . TRACT DATE _�� `��_CONST. GROUP
o CROSS S7RE�T SETBACKS ���
`�—' OWNER I D�� 1-'-� zONING �aNT RW ❑
o ADDRESS�J'�c� .�.0�`'1� �7 � c:= � REAR ❑
,� CITY�i fi M��� ,t3�'t'2 Z�P��TEL. �a���`� SIDE/SIDE STRE:ET RW ❑
o APPLICANTt3i=�Zc�'Yl- s•3asi�.=c.�i c,;,�,z,F'.�'�"���`t�2it�l�i'7.1, SIDE 0
a
Q COPJTRACTOR C�l=`1�u� a3LtS1�r:S5 e�,4. F'w,`Po3iti1L- SEWAGE ❑ PUBLIC PMT#t
o ADDRESS �L�Z 5z1 PI'�'5�:� 9�.� f'�fi:�� DISPOSAL
W CITY (,v�9'Lt��t7 ZiP ��!`�n TEL�1+y�s�tf31kZ1� � PRIVATE SQ.FT:/100GAL
z STATE
y LIC.NUMBER ol'�(�.`�(o'I GRADING ❑ CU.YDS.EXC. CU YDS FILL
y ARCH/E i cn TYPE �Q Ff FACTDF� PS ADJ. /�REAN/kLU�kT1�N
� DESIGNER � 1
LL o ADDRESS u�„ 2
= CITY ZIP TEL. � 3
� PROPOSED USE ' �� �`'' � `� 4
� �' � GARAGE
x NO.DWEL. NO. NO. ` � pORCH
�, UNITS STORIES BED�OOMS m
� LOT DIMENSIONS VALUATiON ADJ.AREA
o NO.OF BLDGS HOW F�UANTITY DESC�IPTIQ�� ��
W ON LOT USED Q
W � U
x �
~ LICENSEC CONTRACTDHS DECLAflATION I herzby affirm ihat I am licensed under pmNsions ot Chapter 9 icommen[ing �
x wah Secuor 7000)�I�a•ision 3 of the Busmess and Vrofessions Cade,and my 6tenu rs m full farce and eflect W
3 '
� I�il
�±- [M�'NEF�BUILDER JEi;LAflAT10N I here6y a1M1rm thal I am exempt fmm!he Contractnr's leenu Ww for the lollowing
oreasm��Ser,.703�5,Business and Prohssions Code-Any cny or county which requims a permil lo canstmc[, � ���_.��= L � � � �
ahe• �nprove,Jemohsh ur repau any strucmre.O��nr to its issuan[e,also requnes the apphcant tor such peimit �
¢ m hle a sigr•eJ slalemect Ihat he is I¢ense.d pursuant m the pravisions of the Comractar's license Law(Chapter qry �� .-�q� ��j�'�(�ti
� 9;commancing wr;h Sec6en 7000)of Orvismr.3 af the Business and Prolesswns Code)or that he�s ezempt the�elrom '�
� antl the 6as�s lor the alleged eaempuon.Any vialatian of Secuon 7031.5 Cy any appunni la a permit suh;ects �
'� Te apphcxn,�o a cnd penaltv uf r.ai more ihan Five hundred dallars(550011 J
W �
a ❑I,as ewner ol!�e pmgeny.ar my empioyees with wages as theu sale comqensation wi!I do the wnrk,and
;he stracture•s na1 imendeJ or aHered far sale�Sec.1044,Business and Prokssmns Code:The Contraclor's�cense c[
v Law Gees nc�ap�ly m an mvner o!pmperty w•ho hmlds ar improves therean,antl who Gces such work himself. U .
' m Qirou9^hrs owr tmployees pmvided that such.impmvements are nm iNended or offered!ai sale II,Aowever. �
m •he hwldm9 or inprc�ement it tald within ane yea�of[ompkM1on,the ownenhuilder wJl have ihe 6wden nl Pav��9 *1
y ;hai la did rm oui!E or i^�pmve tor;he purpose a1 sale.l �
y ❑I,as awner ot the pwperty am exclusnely motractiny wilh hcensed coniractors m consiruct�he pro�ect�Sec. �
0 7094,B;isiness anA Professnns Cade The Cantractors License Law tloes na a07�Y to an owner of oroDertV wha .,T`
2¢ bwlds or impraves ih?reor„and wha contraots lur sucA pmjects with a coniraclar(s)hrensed parsuanl to the Cnntracbr's
L•C9f!SP LdN'1 CONSTRUCTION
O
Q ❑I em eKempt ander Sec. ,8 6 P.0 IAttxh Cenilinte� PLAN REVIEW
0 oate Owner ELE .�.
� IMJRKERS'COMPENSATIIXJ 7ECLARqTION:I herehy affirm Ihat I ha�e a certificate of consenl lo seN�insure.a
a cernhcare ol Wor4ers'C�mpensanon Insunnce,ar a certdied mpy thereal ISet 3600,Lab.C.) LU MBING ._ .��
Q ❑Ce�uLed:opy is hereby furmshed � MECHANICAL
o �Certd�ed capy is hl¢d wnh the Bwldmg Inspecnan Oepartmem or O�artmene Q GRADING
W �
� �ERTIPICATE 0f EREMPTION PAOM WORKERS'COMPENSATION INSURANCE This sect�an nred not Ce compkted SUAN� � _� _V�
y :F ine Demil is foi one hundied(51001 or less I rerlilv thai m Ihe pedormaure of the wwk lar which this
permrt�s issued I shall rot employ arty person in any mannei so as to hetome sub�ecl ta tAe 1Mfrkers'Compensatim ��
Laws af California W
� pr-�7�.-rt, .3uSiN�-ss u:K.+'
0 oa�e �- a'1- �t e) AppLcant PLUrt��.=-� W PARK FEE
� NOTICE i0 APPLICANf:If,after makmq thi3 Certif¢ate of ExempLon,you Sh011IA EEtOrtC SIIE�fGt�p�II¢WIIfIEfS LL- SCHOOL FEES
Compensatmn pmvismns af the Lahar Code,yau must Fonhwith comply wilh such pwisions ar Ihis permu shall
� be tleemed revoked
J
� aVISIIXJ OF INWSfBIpL SAFETY PEflM1T CER7IFICA710N s„;>p
� �0 , g'=—?. 5,,^. F.i p.�-
� IJJI hereby rertity thal nu e�cavm�on irve(5)or morG���50�'i�l'de�Hh Fq�o wIU'di a person is rryuired to desand,
� n•II be made m ronne�tion wrch woh authwvetl hy Ms,�rmitl���SAatiim�irilding swcture,scafhlding,talsework,
or aemulinon a drsmantlirg thereof,will he mme than thirty-sx(36)feet high.(Chap 3.2.Gry 2.An 2.Sec
W' 341.Title 8.C A f.l
s „�
3 ❑As owner-Euiitler,I will not emObV�Yane�'d��rk fi�hrtfig'waug'y�apryu�l,2Pya permil fram Ihe Oivision al
1— Industria:Safety.as noted a6ove,unless such persa 1�}s�jiermj}.ro Qasu[hpWbfk ttOm the division.
�
aW ❑answn of h�dustrial SafeN Permit No TOTAL FEES � � �
.
� CONSfRUf.TION LENOIRG ASENCY�I herehrzlhtm 8�a'tkie�s,a�;�opstrutinn'kndinp periip'Mr Me perfo�mance
z ot the work la�uhch thia parmn is asued'tSe�c'3097�,,C.�,, . . —
� le�der's N:� - � COMMENTS
m Lender's Add�ess `
4 1►�� � C L- UY��_
CEfRIFICATE Of COMPLIANCE At�AUff10RIZATION OF ENTHY 1 catify I have re�d this appli�atian and sreh —Q 1
'ia that the�nformanon given is carect.I agree ta comply wrth all state laws aid airy ordiimnus ielating ta 6addi�ry
y consvuct�on,and authanze a reDresematrve of the Oepartment ol BuilGinq aM Satny m mta yqn the poperry
= fa whic i have applud ta�this permn Im�he pupose af making inspecdans.
►— T i �
�,, , s�� �CG�• -�"
nature af Applcmt or Agen� � '�pete� RECPT NO. s ��� PAID BY 1 � VAUDATION
�WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GRE:EN—Applicanis Copy
.. . ae�... . .. 'r�:•:�.a _ •�y: :,�a�.. , . . ...: . �vs . , ;em... , , .c ,,, "S�i",':,. ,
�. . . . .. .. . . ......... . . . ; .. . � .,... . ... .. . .... ... .. . ... ...
. ...'. .:. . :..; . . . • . .
..
, :. .... .......... :.... . . . . .... . . ,..... . ... .
(�:��- �d r,... �..:... . :.. :... .: :.
. .. ....... .. ... . . .... .......... ....
.. . ....... .... ......... ............. .. ... ... .. .................... .... ...,.. ..
__... - _. ... ...
.. ... ... ........ ... ... ..... ....... .
...... . ... . .. ... ... .. .. .... .... ......... .... ... _...... . .. . ..
.. .._......__. . . . .. ............. _...... . .. ......... .. _...
.... .... .. ................ ..... ... .............. .......... .. ......... .
.. . . ..... .... ............. ... .... . . ...._.. .................... ..... ......................... . .............. .................... . .. ........ . . .....
. .__.... ..... ..................... ............. ... . .............. .............. . . ...... ................................... . . ...............:
, .. .... . .._. _.. . .. _..... _ .......... _ _ _.. __.. . _ ......._......... ._. _._..
5;: .... . .
,:°: ... ..
: :
.. . ° .: �,�; _....... �.... _....._.
; :.
.,.
.
;:.:...::: . . . .... ......... .............. ........
: ::°:.;:
..:-..�;
.: ..:: : . .....
;.
;::::;..
�.
,.:.::..., .. .. �........... . . ........... . .
_.�:,
_ . _ . .......... .. .................. ..... ..................... ..... ..........._._�....... ..... .�.............. ......... ...... .......,.... . .