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HomeMy WebLinkAbout1691 --�--�--.�. � ��, �.. -- -'�` CITY OF DlAM�ND BAR RESS ` '�S � '•�' � DEPARTMENT OF BUILDING AND SAFETY Bl31LDING PERMIT FIRMLY JOBSITE APPLJCATION PERMIT USE ADDRESS 2d � �5 L DATE " � NUMBER CODE ISSUE TYPE � OCC. �. � qp�; . LOT��.TRACT DATE t�� ���� CONST. GROUP � CROSS STREET L L ZONING SETBACKS "'P"""E'''E''"S °" OWNER L FRONT RW ❑ � ADDRESS � a �5 Z � REAR ❑ W CITY h����J� g�� ZIP��TEL. " r I SIDE/SIDE STREET RW ❑ 2 APPLICANT_�.�-Z#yti r,}./C� TEL. �-� � SlDE � 0 ¢ CONTRACTOR �� � ��-(S,n-� SEWAGE ❑ PUBLIC PMT� o ADDRESS DISPOSAI ❑ pR�VATE SQ.FT./100 GAL w CiTY ZIP TEL. — , z STATE GRADING � CU.YDS.EXC. CU YDS FILL y LIC. NUMBER y ARCH/ENG/ + ,� TYPE � � �'� ADJ. ARE/�IVALUAf10N �' DESIGNER ��4,LT ph�'�l-�'S k� W 1 � ADDRESS 2- Y h �° � � [,WL 2 � CITY a ZIP 917 lo TEL. o-O I(o ,� 3 �, = Z ,. � PROPOSED USE S• �J� . _ �a ,Y�-T— 4 � � GARAGE o Na.�WEL. NO. NO. m PORCH y UNITS�STORIES BEDROOMS�'--- �' s LOT DIMEN ONS VALUATION �r ADJ.AREA o NO.OF BLDGS � How CMJANtITY p�gGRIPTION • FEE � ON LOT USED�/���— Q � U , _ w � � . FS- — L LICENSEO CONTRACTORS DECLAflATION I here6y affirm.tha�I am{icensed under piovisians ol Chapter 9(commencing , Y wnP Secuon'000�oi Orvision 3 of ihe 6usiness and Prof¢ssions Code,and my hcense is m 1u11 lorce and effect W _ � �j, e� ' 3 � —� W t, J u- i!�YNE9�8UIL�EF 9EQARATION I hereuy afhrm that I am exempt Irom ihe Contracmr's License law lor Me idtowing -.— = reasnn�Sec i031 5.Business an�Rafessions Cntle Any cny ar county whHh reqwres a permtt m cunsiruct, (a o alier.�^�umve.Jemulisn ar repa�r any struciure,p�or w its�ssuarce.also reqwres ihe aouhcam(or siah permit Z 1-- Io Se a signed staremene Ihat he:s licer.sed pursua�t lo the provisions al the Cantracror's leeme Law IChapler �j � 9�cnrnmennrc wRh Seclmn 700D�nl Drnsmn 3 W ihe Busirest and Pmlessims Ca0e1 or ihat he rs ekempt iherelmm � , � df1E II1P Sd5�5 lo�•he allegea sremptian.AnV uplatwn af Sttuon 1031 5 6y any applfcanl tor a permn suDjec¢ � ,.� the eppirtant to a c��ail pr.naltv ol•iol more Ihan fi�a hundred dollars 5500)b a � ❑1 as canei af ine pmperty ar rn'employees with wages as their sole compensation,will do IAe wark,a�d !�f[SifJCbrtf.�s no�imr.neeC or oNe�ed lor sale ISec]Oa4.Business antl Professions Lode The Goniractor's Liwnse Q � � , � U� � Lew Aoes nat apo�y�o an owner of propertv who buJds or impmves Ihereon.and who does suth wark him5ell, O - W Of:IIfJIlSF ms owr.emplayees,provitletl that such improvemenls are nat intended or oHered for sak.tl,howevei, � m thz h�Rdme or imDrovenem,s sold wrthm one yea�of compleean the owner�6wlder wYi have the burden ol prormg Q — y �hat Ce Anl net 6wld ur impmve loi ihc Ou�Oose of sale I = � �1,as nwnei of the pmpeny.ain eulusrvely conlracuny wi�h hcensed conlracrors m cansiruct ihe prqect ISec W O IOLL,3usiress anJ Pmfessions Code 7he Convaclor's License Law daes not apply m an awner a1 D�opertY whn '� ¢ �uiltls o�improves ihe�eon,anA whe coniracts tar sucA pro�ects wrth a cantreciorlsl�icensed pursuant to�Ae Caniraclor's License law i ONSTRUCTION � W ❑I am eKempi untler Ser. B&P C IAttach Cernl¢atel. AN � - 9 F- pDete 'y'. �wrer ¢ WORKERS'COMPENSATION DECLA, ON I heretry alfirm that I have a ceruficate oi consmt to tetlinsure,or � a ceruficale of Nv:kers�Compensation In�urance,or a cend'ed caPM�heieol(Se�380D,la6 C.1 -� t � � �e-� � d ��.VC� _ ❑Cenified coov is hereov��mshed` ECHAN , Q __--' p �J Cerniien:opy is fiied wnh the Bmldirtg Inspecuon Ilepaitmem ai DeDarimem C,7 W �� _ :ERTIFICA�E OF EXEMPTION fNOM WORNERS'COMPENSATION INSUAANCE This secuon nred nat he campleted _ ' � il �he permn is lor one hundred 1E100)a�less I cenily�het m 1he perfarmance of d�e work Por wAkh tAis �.,,, " y e O � perm:t is issued I shall nat emO�oY aM Personin any manner so as ta hetome wh�e�t lo i6e Nbrk�s'Com�nsat�on W � i = Laws of Califorma ,. ,, ,' ; o : .. . W PARK FEE b 0 oate /+pv�icam "" � SCHOOL FEES `�a Q W NOTICE TO APPIICANT II,after malung Ihis CerefKate al freiMtion,ya slwuW 6ecome suh�ect ta the Wakr's -� Comper.saban provrsmns al the lahoi Cade,you musl IorMwrth COmQIy Wtth SIICII QfWISp�S IX HIIS permi�sh91 � 6e deemeA re�okeU. . S-�_r.� — ¢ pVISION OF INUUSTAIAL Sl+FETY PEbIYIIT Gffl11FICA710N� "U'�'`� — W n- ❑I neie6y certdy that no euavatwn frve 151 oi mae feet in de0�h��lo w�¢h a persm is rrymrW ta OscmE. e�e will he made m conrectwn wnA worY,authyfped by Mis pertnil.�nd thai no huildinp ttructue,raltaldinq.�al9ewark. d or tlemol;tinn ar drsmanllim�ihe,reof,vrill 6e'mmrc.IM1an tlurryaiz 1361 het hiqh (Chap 32,Gry 2.An 1.Scc —_ W' 341.Title 8.CA.C.� . - ' � . . . . ,.. , , _ " .. _ . � . . . . . 3 ❑As uwnerbmlder,I wdl not employ anYOM to do xrorM whKh would reqmrc a pem�n fmm ihe Gvism of � Industnal Safety,as note0 above,unless sucn person�as a permi�m tlo such work 6om the divuion — � W ❑Ovision al InGustrial Safery Pe�mit No, TOTAL FE ES � a. � � CONSIRUC�ION LENOING AGENCY I herehy afUrm C�at there is a conmuction imdi�p'egency for the perloimmce z ot the xarY to�wh¢h this permn is nwed fSee 3097.Civ.C I. � lender's Name COMMENTS . m lender's Address Q CEIiTIfICATE OF COIVPLIANCE AND AUTHOHRAl1�N OF EhI7HY I certMy I luve re�d this ayplicatian and'stne ' ' '� h diat the infwmabwi giwn is crcrect I agree m romply weh all staoe laws ad cily arAi�wntes rehlnp ta huilding yconstructon,and autAonze�represenutive af�he Oepanment o1 Building a�d Sahry to mler upm�he paprtrtY = lor w�K�I have appl; far iha permrt lar�h upose of inekinp inspe�tions � r ` �^�— q � RECPT NO.`�.�!PAID BY��.�VAI.IDATION $gnatue Appl'�cant or - �M WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Applicants Copy asios-�trsa ���..�..�___.._....�„�,,.._.�._-.,..,_...�.........,_......,_.w�.,,...:,�,,.-,-,;�-.,..,�_•� ,�.-�,,..a.,�..,.�..,�..,y,.,.,.��n�... _ ,. ... :... ,.. . . .: . ,.. ; _ - .. .. .. .. . . ..,._ ... ., _. >x, ..:; .:� .;; • :;.�:.: �_� - ,..,-•. ,. . , , . . . , .. • _.... `; . .� . 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