HomeMy WebLinkAbout1584 ��� � �r����
' ` �"` � �ITY �F DIA�I{�ND �AR
` DE�AFiTM�N�OF BUILDING AND SAFETY pRESS
+..:..
-� BIfILDINC PERMIT FIRMLY
JOBSITE 'g APPLICATION M ~ PERMIT �O E
ADDRESS �_..s..��1]''���-��° _� DATE `� NUMBER
iSBUE t�,.. ' � 7YPE C.
` APN L- c^s I L LOT TRACT � DATE � CONST. GROUP
o CROSS STRE T. Z0431P1G SETBACKS '�`�°"E'"'E''"5
�-° OWNER C.f.�' L•� FRON7 RW CJ
� ADDRESS� 1 - � � � --��' • REAR ❑
W CITY -�� --ZIP � ��TEL: �L'� �� SIDElSIDE STREE7 RW ❑
o APPLICANT_ TEL. SIDE ❑
a CONTRACTOJ3 � � � SEWAGE ❑ PUBUC PMT#�
o ADDRESS �D _ DISPOSAL ❑ pRiVA7E SQ.FT./100 GAL
� ,� CITY ZIP TEL: "'�
�.�
z STATE „ GRADING G�CU.YDS.EXC. CU YDS FILL
y LfC.NUMBER �,�1"" �I{����
y ARCH/ENG/ — � TYPE S FT �ACtOF� �'S � ADJ. REAtVaLUA I�N
= DESIGNER ``;tLi1'�' e't�; G�.��l�V't ua � . - '�l-'z',c' `� I `3, z..
w
� ADDRESS e�. 2 � . i�7z� . r� s
z CITY ZIP� TEL. (� 3 ?- �(p� � ' ''�t� �
� PROPOSED USE � �' � ��'n��-�= � 4
g �f.�(��j�r� a4- 1'�=��p�,-- � GARAGE
o N0.17WEL. NO. N�� � PORCH
� UNITS � STORIES�L—BEDROOMS � '
� LOT DIMENSIONS �IO r � ���� m VALUATION ` ADJ.AREA
o NO.OF BLDGS HOW QUAN�'�rY DESCRIPTlOht FEE ;
� OPl LOT j .�USED �f" .q " � ,r f,e j"� ,�/.cb r�'d"/;t; �
w _ U ' '
� — — „
...
� � ��:� X t7 '_C:�C_�
LICENSEO CONTFACiOHS f1ECLAflATiON I hcrehy aftum thai I am licensed u�cr pmv¢ions of Chaptei 3�oammencmg � `r„ � ,� �
Y wnh Sr.ction 7000)o�Divisian 3 of the Bus�ness and Professians Code,ard my license is m full lorce and effer.l .,,,,� �
¢ - k �^.
p, � J
3 � a
LL� UvINEfl�&11LDEA OCCLARATION�I he.ieby ellinn that I am exem0�fmm�he ComracWr's Luen¢e Law�ar the Id�owmg •-}�^� ,,
_; �easun ISe� 7031 h dnsiness anJ Pmlessmns L'ade�Any ciry nr coumy whith reqwres a permit to cunsnun, O f / (�' _ ^L�
���. O ahec nnpmve,Jemahsli,ur rcpm�any structme,pim�to i1s issuance,aiso requrtes Ihe applicant for sceh pennn z� n
� �� Q to hla a siG���statement ihat he u hcensed punuant to the pmvmons n�tAe Conoaclar"s hcense Law IChapte� '�j� �"` � �
�� 9(cnmmenemp witl�Secoai 7000)of Unsmn 3 al ihe Business and P�ofessions Code�or t6at he is exempt iherefmm .g r,.,
� d antl tM h�sis for tlie alleged=xempnon AnV���avon al SMtion)0315 6y any appli[anl toi a permii suhRcls :� ��..�A r.�[�� � �ty�h J � •� C�
W !he appl�,cant!n a timl pxnatly�I nm marc than irvt hundred do�lars 1f500)L � � ,y: ) . �
t �� UI.as owner ni ihe V'uUeny,or my empinyees wnh wa9es a5 Iheir sale compensatinn,Will Jo IAe worN,an7 � � ������� �� � '�?�
{� ' rhe stniclure is nol inlerxJed or oiferr.A fo�sale ISnc 7044.Buaness and Piofesswns f,ude.The Con[nctoi's License �� f` C.� �
;�5� v Law!lues not apply In an vwner nl wWe�ty wba 6wIEs nr impmves ihe�eon,and who dces such work himsN�, „C>- �� -� f �---- ���
�' W- ur tli�ough h�s own emplayees,provided thai such nnprovemen[s are not imendeA ar of(ered far sak It,Aowuver, '�Z� (/� r��� �,� '� ,�N��
m, the hundmg o�improvement is sold wi�hin one year ai compktmn.ihe ownerhuilda wN have ihe Widen ol prming 4
��� tliai hn Aid nm build ar impiove fnr ihe puroase ot salel ,_ • '
s va, .•V
; �ia ❑1 as owner ot�he pmpenV.am arclus��ely tontratuny wn�I¢enseA mnvacla�s m wnstmc��he O�o�eci fSet '}�j _
, 7044,6usimss and Vmlexsions Cade The Contractar's l¢ense Law Aues not apply to an owner o�propeny wM S�,
�; WdAx m�mpm•es thereon,and wha cantrar.ts for such pm�ecu wnh a com�acmqs�hcensed pursuam tn ihe Coniranar's -' �
�! 4' L¢enseLaw) ONSTRUCTION _ +_
�� .8 5 P.0 IAttxh Canihuiel. L V� � I
; U I am eaempt uMnr Sec . _ /^^� _—
pDate_ Owner GIl�� .t �}l,�J __
J, J.uus-=�-
' W[IRKEBS'COMPENSATIIXJ OECLAflATION�I heretry aNirm ihat I have a�ernhwre ol mnsem�o sdf�msure.w ' �� C:Y"�. ,
a cen�d�te ol Nfirkers'f,nmpensauon Insunrce,ar a ce�litied mpV�hereof(Sec 38aQ Lah.LJ. y�•-�
a; Q"r,e���fied copY���ebY��mshed MECHANICAL _
a� ❑Cerufied cnpy rs fJed with tAe Buddmp Inspecuon Oepaihnem oi �equlmem. � GRADING �
W.
�, CEFTIFICATE OF E%EMPTION FHOM WOHKEHS'COMPENSATION INSUAANCE.This aeclion nred not he campleteA ISSUANCE "` � _
y il Ihe permit is fm one hunAred ISIO��a less 1 rer6fy ihat in ihe pedormanre ol Ihe worN lor which�his ��
peimit is issued,I shall not emplay arry person in anY manrer so as m 6ecortre su6�ect to ihe W4[kas'Canpensation � i`-�(('�
� Laws al Calrfnmia, '- ; "i'• :":�' - �
o ._- ;.,;�,;:`a:*;, ;� PARK FEE
- p^: Oate_� �..> <�/? ADDGcam f� •`�--' i :. :�>�� �,
�fi ryp7�E TO APPLICANT If, hcr maYing�his CnLfwate ot Ezcm io ya sM become sub�ec�ro me w&kir's' �-^ SCHOOL FEES
-r Canpensanon Vrovisions of the La6or Code.you must fathwith ca ly WItM1 SIILA p10'/IBpll9 M this permit sh�ll -�
�+-: he deemed�euoked ,. ,(,.^e r%i F",: �s ..
J� ..�, + ,'-'
Q; fM�V4ISION'OF IN�I15TflIAL SAFETY PEBMIT CEBTIFICAiION;.c,�,�; f;l, F , `�` ' �`...��� .
�-' t:Ji he�eHy cerlAy that no eM[avalion five(5)or rtare�i'in deptlt.in�q�whi[N�a person is�epwrTd to dastmd, '
s will 6e made in connection wrth work auMwr¢ee 6y fiis pei�ni�,affd that no 4iildtnq slrutlure..aa�foldinp,hlsewark,
a' a dernalitian o�dismantlinq ihereal,wAI be mae ihan thiriy�sir�36)feei hiph.ICM1su.3,2.G,m?.An Y.Sa '
W� 741.Ltle6.CAf.t ..'��i,,..� :.`. ,�., � �
x f 4;�Eh. .. : —
3 ❑As uwner�6uilder.I will noi empby an1'�m���'o!M wM1i�h�Luld�FqNroa�pmm�from Ihe 6vuipt oi
F Inausmal SehtV.as noted ahave,unless such person fiAs�°pettnii ro`do such wark from the division ,
�' ,. . J���
W ❑Uvisian oi Industnal Salety Permii No. . . � � TOTAL FEES �� � (f,l
o. ;.
� GONSiNUCTqN LEN�ING AGENCY.I herehy a(i;ipe tlN�IhEte IS a.conshWlion�knd�ng,agmcY lor;IAe perloimmce
2 ot ihx work Iw whKh Nis permn�s issuetl(SeC 309b.�CN1 C�:�,`� ,.�
�
� Lender's Name '-��� ' � � - COMMENT
mlender's Address +�� �
i 4 CEflTIFICATE OF COMPUANCE AND AUfFI0W2ATI0N OF ENiFY�I�atily I ha�s iead tlus apqration a+d stan '
i � thai Ihe irAnmaimn grven a carz�t I apre�m wmply weh all stace laws and��ry ordmxrtes r�4linp m 6wNiig : � �
4
cansirucuon,and au�hor¢e a repreuntetrve of�he DepartmeM af&nWing and Sakty W enhr iqon ihe piapertY
= iw wh¢h I havt appled for�his permit fw the pupese of'rekrtq inspeetions. R �� '-
�' '- V , - ' . ` \ '''"7� �p 7 ( ,,
/\ � ' �l` f�.. �:t :7_ -��
' ``'—'- RECPT NO..�.,.,Z_PAID BY '"��`-� � VALIDATION
Siqnatu ol Applicant oi Apent �
WHITE—Department Copy,YELLOW—Finance Copy,PINN—Assessor Copy,GOLDENROD—File Copy,GREEN—Applic8nts Copy
85106•11/89
_ __
£� � � � ��� ; ;
, , .. '-,�� r
Y ; 7:? , . .. �
A 4- - � � . . � _ "
g-x $ ' � . " , �•
� �' ^w-" . ' ,, . 1���, .
E '� P `;;;�� . , . ' . .:'V _ P�
� �� �
f' ^
� , 1 �a +� J .
\\A �.
� � - � �a � \� . . � . . .
� � y ��
s a � � �a :- : �. � � .
, ., ` , , - . , . . .
V
• �W �; .,.� v �. � . .... � <
�
.._ ,. . .. ., .. . . . Jyh . � :t ;.�� �... �� �� ��c��-'"
;� � N �� � �. ��°
: ' ti , `. i � ~� �,d Q�
: � �
�.
� � � � ,
, � _ �� �
�� � � �
.��� � � �
� �� � ,
; �� � ,
� � f � ��
. , � � � , -
� � � -
—� � y� � .
; �
� � � � .
�:�' _
� �� � �
�
��. � _ _ .
��� �:� �
. :
_
:
_
� � ; �
� �
; � . ..
; n .
�
. :
�� � _,J
��� �
���
3 � �� ,