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HomeMy WebLinkAbout1355 (379) ,� �1� � �-�i i� CITY OF DIAM4ND B/�►R pRESS ���' ��` n � L. �7 DEPAR'TMENT OF BUILDING AND SAFETY FIRMLY 1Gti' ' � BUILDING PERMlT JOBSITE d� Ai'PL�CATION � PERMIT `-��� $E ADDRESS � � ' 138UE / TYPE ER�CODE �'. APN tOT TRACT DATE �a�1�� CONST. GROUP a CROSS STREET � SETBACKS . "Mi°'�'"E""g "" OWNER ONING �Q� , , � � � o ADDRESS REAR� � � ❑ '" '� „� CITY ZIP TEL SIDE/SIDE STREET RW � a APPLICANT TEL SIDE ❑ c x a CONTRACTOR SEWAGE ❑ PUBLIC PMT� o ADDRESS DISPOSAL „� CITY ZiP TEL. ❑ �IVATE S�.FT.!100 GAL z STATE y UC.NUMBER �j ��� GRADING ❑CU.YDS.EXC. CU YDS FILL y ARCH/ENG/ �}�- tl'J TYPE SQ FT FACTbR P3 ADJ. AREANALt1Al'iON Q DESIGNER�J��'��e��'�L �I,df�reT�'Y � � � ADDRESS 2 0 = CITY ZIP�11D f TEI�,7q?�1 � 3 � PROPOSED USE � S Z 4 � _ � GARAGE o NO.DWEL. NO. NO. � pORCH y UNITS STORIES BEDROOMS � LOT DIMENSIONS m VALUATION AaJ.AREA o NO.OF BLDGS HOW �t1ANT�TY DESCRiPFION FEE W ON LOT USED � • � _ ❑ � , �' �ICENSE�COMRACIONS OECLARATION.1 IwfeEy�Ifirm IMt I�m icenud unOn prov�vone of Ch�ptn 9 Itonmencip � wnh Sauon 10001 a�avison 3 A the Bueinn�md Pralees�ans Code.end my Iceme u in lull Iwce�nd Mlxt � w � BUILDER OECLAAATpN I herehy aMirm Hrt I�m txmpt Irom iM CanlncWr's Lcense L+w br tlu Idloxing reasan�Sec 1031 5,Busmess end P�olessiona Cade AnY cnY m eauntY whwh rquirn a pnm�t m conslrutl, (} O dirr,imp�ove,demoYsh,a repar ury piumm,pior m rts nsuance.+Im requre�Um�ppl¢mi kr such pe�mil Z � �a hle a siqned anromem that k n licensed purwant m tk proyiaone of the Cm7xtor'f Licen�e law(CMpter �p e6e 9 Icommencing with Secuon 7D001�a��am 3 0l the Bus�nes�and Prv6ssms Cadq a tlrt h u uempt tl�adrom � y ena the basis lor the�Ileped sxempoan Any r�datron ol Secum 7031.5 by���pplicmt lor�permn wbpcte � W tltt ao0��c�nt to�crvil penalty ol nat more tAan fm huMM ddlaia lS500)1 a 0 ❑I.as awrei af the propenY.a my employees wit�weges q�hmr eak compenHron wil do Ihe work.rd the s�iucmre is not imended or ollered lo�eak 13�c 70d4.Bunn�a aid P�ol�s�nix Cede The Cmv�ctar's Licenae q � Law daas nol eOVM w an owner o1 Dropeny wM 6uiids ai imprwes Ihenm.md wM dces�Yth wark hmself, L,) �++ or through hu awn employeez.OrwidM ha1 su�h unprmrements ue nol mtlMeG q otkrod kr s�N If.Mw�vw, � m ihe Ouiltlinp m imprurement is tdd wilhin one y�n of eomplevon,the owne��6uilMr wAI Iw�IAe hwden d qwmp � Ih�i h�did not Eu�ld v improvt lor Ihe pnryou oi,pk.l � H fn ❑I.ea ow��ot�he property.am eMcWsnely tontr�tuny wnh IKmsed tontr�clors m eonstrutt the p'qxt ISec. uJ 0 1[IAd.Business�IN V�O�M910�f Code:7he Comnetd'�L'cense l�w dpn roi applv ro m ewnn e1 Praperry who ' ' w ` �mltls oi im0iowe thereon,and w�o contmcts Iw suh pmKcls wnh a conuxlor�sl hcensed punuml lo IM Conu�cl�'a 0 ���■^:a'�� TRUCTI C� W ❑1 am exemPt uMer Sec. ,d 6 P.0(All�eh CerLliup) PLAN REVIEW H � °"° °i""°` ELECTRI '� ( � . O C7 y +MJRNERS'COMPFNSATION OE0.ARATION I henby dlrm tlut I hm+cerufiu�e o1 ems�m te sNl�n�ue,a �cernh[aa of Nbrkns'fumpen��[pn Iniunnce ar i artified copy MneollSa 3800,1+6,t.) B�NC7 ,� ❑crL�iKa�om��n�«nr i���.e � MECHANICAL p fe�ufKd capy n I4ed wid�Me BuJding Inspecum Ueputmenl a Olputmem 4 GRADING Z p.� � CER IFICATE OF E%EMPTqN FflOM WOflKERS'COMPENSA710N INSUflAWCE iMia rc5on noed ro�M completaA gSUANCE �L,Q �O V y M the permit s lor one hwdred�5100)a Mss.I urhfY Ihel m M�pelb�mrre of ihe werk for wheh Ntis permn�a iasued.I ahaM mt enploy airy pawn n mY mmner w os b Mcome a6�at b 14 Ntr4ns'Canqenq�im SMIP Laws ol Calrtomu 00 �re ��u��P•�-'• Dl/�M�N/� �A-IZ W PARK FEE � AI0T1�TO APPLICANT M,aFW m�Ynq��n�� ' �.rw wwa eKo����m n�waa.•� LL- SCHOOL FEES � Canpensanon prwisrons al the lahor ..yE�,}Guyl•�M.fd6mply with wch provbians a fiis�e�me eh�M �+ 6e deemed re�rokM. !i :L i� .._ ► � pVI510N Of INqISTRULL SAFETY PEqMR LERTiICAT6IN. a ❑I herebr uriily thoi no ac�v n 151 i�ma ¢�a�a wfiicl�pnm u rpurtl w 6uaM. � wiu he moae m cannxton with wor uedY�tlMs�erm ne hiW.q turcun.rcdlaldnp,IYu�rork, a dertwla�on a dsmantliry tMradl��moK!un tAir ��ia 1 I M�� (�D 37.6�2.M 2.Sa W 341,Title 8,C A.L 1 x , ,. ,., � ❑A�ownn-bwlder.1 wiY�elnDbY`��W.�'^�,Iy�o',y�gik'��ihich-rroiYd•�nin�prm�ham N�usion d � F— Indusvul Sdetr.�s mud�hdtie uhle�s wch�,pf�Yp"lys��1rme,b/o yckrprkfrom tlr/irisbn. � i.".��.li:..:. �`.,.;t r•.,.,.,� :J:��� 4:s � ❑°""�°"'��'�'�""'m`"°. TOTAL FEES '�,Q � � CONSfRUCfION LEIDING AGENCY:1 hrehy dlirm Wt tlen u a conmuction Nidxp+pa¢y Iv M perkmuncss t oF th work Irc whch tlxe pvm�i�inued ISoc.3d97.Gv.CI. s Leidc i"•^� COMMENTS m u�r.anare:: '� CEIirKCATE OF C IAICE WU AIRInWZATO!� :I e�ily 1 Wv�nd��pp4�rim rd�h�e � tltil Me otorm' n u carnn I�ee to tamVA' aA sute IM�s and d�Y Md'uwca iM�Yp Y IiilYnp y cansvunian.rd nn a anunw N M nt d 6ANinp rd SM�ry b�n�n yw�Me'raptrry � lor wMcF I lor tlm rmrt Nr tlr pirq�se d Ndq' tio�t X �m � �f �� RECPT NO.�_P�UD BY_�?�� �VAUDATI� Sqnitur�d�pptian�«nqme 0� WHITE—DepartmeM Copy,YELLOW—Fioance Copy,PINK—Assessor Copy,GOLDENRO�—Fle Copy,(iREEN—Appl�ants Copy BS106-11l89 __._.._ �,,,�++�. .. !.r .',�v.��Y'rAr.s.-Yti•�'F:�y,:��f�tiu.i'di� „ � b:..ejyx, � .Y'��. . .}.,. t 6�. 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