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HomeMy WebLinkAbout078 __ - �__ ___-�-_---- --- _.. _ ....�.- . - � � f �( (�� �"` �ITY OF DIAMOND Bd�F� PRESS � � '�" ` DEPARTMENT OFBIlILDING ANb SAFETY F�RMLY BUILDlNG PERMIT _.__ JOBSITE APPIJCATION f�,_,/ ��°' NU BER�CODE ADDRESS � 0' � �{�'G'�o� DATE � d ISSU.E TYPE OCC. � APN _ OT . TRACT � DATE CONST. GROUP o CROSS S ET i,� " ��` ZONING SETBACKS '�"°"'E''"E"'s °•° OWNER E` _ r ^ � '' � �42t`� FRONT_ RW ❑ LL ADDRESS_ l'V � �C s� �� REAR � � CITY �-� [,�N� ZIP �.T` TE�. SIDE/S EE �RW ❑ o APPLICANT � ' - ��. TEi'.�1 )" g ----� � Q CCNTRACTOR �- � �' ���� � SEWAGE � PUBUC PMT� o ADDRESS_ ���� �4 �°k��' � OISPOSAL ❑ PRIVATE SQ.Ff./100 GAL „� GITY ZiP TEC.. z STATE µ, GRADIPJG ❑CU.YDS.EXC. CU YDS FILL N LIC.NUMBER y ARC ��t� ,-- � �1'pE SQ Ft FAGTOR PS ADJ. AREANl4LUAt10N = DESIG � '� ��L � ��C�Gi ra` ( � W 1 � ADDRESS � v �Ll">L�� ' Lwj„ 2 z CIT 1 ZIP TEI_��' �' (� 3 � PROPOSED USE � � �t— Z 4 � �� � (� � � GARAGE o NO.DWEL. N . NO. ' � PORCH y UNITS STORIES�BEDROOMS _ � LOT DIMENSIONS m VALUATION ' ADJ.AREA o NO.OF BLDGS HOW caUAru7Rr DESCRIPTION FEE: W ONLOT USED Q oc U ❑ � ~,LY'ENSEf]CONfAAC?OflS DECLARATION�I herelry afL�m thai I am Laensed under prorisians of Chapte�9 Icommencing Y wnh Secuon i�p�71 0`7msmn 3 al:he 9usmess anC Prolessons Code,and my�icense�s m tull force aM eFtect W C 3 � J t!J LL UWNF.R 5UILDEN OECLsFFT10N�I hereOV aflnm ihat:am eremp�fwm Ihe Coniracmfs L¢r.nse Law!ar IAe fallowmg = reasnn IS�c 7C31 5 8usiness antl Prolessmns Code 4ny cilY or counly whkh repwms a Dermit to consVuct, (j b o alier improve ,1enc,ish,m repa��airy slructure prio��a its�ssuance,also repwres tAe appliwnl loi such pe�mrt Z F-- u liie a smnec staternen�iEat Pe is ncrnsrd Oursuant ro the previs�ons ol the Conlractni s L¢ense Law(Chaptei � � 9 I�cmmencmg nnh Seceon 70001 of Oiwsion 3 ai Ihe Busmeu and Prolessions Cale)ar Ihat he is enmOt iherefram '� y anA!he�asis for�M1e allegetl eveno�on Any violavon at Sv.uiOn 7G31 5 Cy anY appl¢am!or a pe�mn w6�ecis ' W t:ie appucam:a a cnn penalry N nm more than fi�e hundmc do�Wrs IS50011� a � �I as awner±I!ne pmCenc �i mY em0;oy¢es wrth wages as iheu sale comD����on,will do Ihe work,and Ine s�ruclurr�s�al irer.nde.J u�a{fered Im sale(S�7�44,Business and Rofesemns Cade The Comractor's lrcense v,( �„�'j Law rees�o�zpply io an awrer o!proDeny who budds m imOmves thareor.and who dces such wo�k himutf (� W nf:h:0uy"h4 own xmployees promGed that suth imp�wements are not imendetl nr ofkred Por sale If hoWever, Z = Rw bwNing nr inpm�cnem¢solA wnhm one yea�of camDleuan.[he ameo-builda wiC ha�e�he hwden nl proving Q y Ihal�e Aitl f�Ct^uiin d imCrave!ar ihe Durpase o1 5a1e) U �J ❑I as r.wr=.�o�the prope:iy am e�clusrvzly ror.trec���y wnh I¢enseC cantratrors ro consiruct Ihe pm�ect(Sec gJ 0 7074,Busmrss and Pmfessons Code The Coniraaror's License Law does not apply io a�i mvnn of prapeny w�o � 6 hmlds or:mprmws therean and who con!racis In�such pm�ects wnh a comranarls)I¢ensed parsuant!o the Comracror's Q L¢erse Lar i CONSTRUCTlON � ` � � e 5 P.0�Au�e ee�atira�l. PLAN REVIEW _ / ����� C�xn esemo�unde�sec e�. � od1e °"'"� ELECTFIC � 1hUHKiRS C�MPENSATICN OECLARAiION.I AereEy alhrm Iha�I have a rereihcate of r,ansenl m sel4inswe,w pLUMBING �_ a�ernl�ca�e a!W4rle�s'Comoensatmn�nsmarce ar a cenitied mpy fiereol ISec 3600,Lat.C I Q ❑Ceru6ed�:oOY�s hereM1y Immshed ,^�j MECHANICAL c L Ceruhea roDY�s liled wtlh me 9uildmg InsD�uon OeOartment or oeva��m���. Q GRADING "' / /D = CEFlTIFlCATE�F E%EMPTION FROM YJOflNEAS'COMPENSA710N INSUflANCE This tectian need not 6e oanpleted � ISSUANCE � d Ihe oe�nrt is for ane hunAred IS100)or less I cenrfy Ihat m the perloiman�e ot Ihe wak Mi wh��ch thrs � y pennu rs issaed,I shall�al employ any person in any manner so as to 6ecome su6�ect m tl�e Vlhrkers'Canpen5auon � SMIP �'�-���' ' � = laws al Ca6tmnia o W PARK FEE __ p �aie Ap����"� �. SCHOOL FE��"� ••� NOTICE TO APPLICANT N,aher makmg�his Ceruficaie al EzemD�ion,you should 6¢come subl��m�he U4xker's � Compensanon prov�vons of Ihe lahor Cade,yoa must�aihwBh compty with sucM1 proviswr�t er Mis pe��shall �t � he deeneJ iewYed J pV1510N OF IN�USfRIAI SAFETY PERMIT CERTIFICATION� fr� d ❑I herehy wndy that no excavatian frve(5)m more feet in Aepth m�o wlu[h a person is repwred ta tles�end. � � �� �-�i7'Si�'dry�a�i���� e�C wnl 6e made in cannectmn wrth work autharur�6y ihis permn.aN ihat r.a huildi(q structure,scaftaldinp,lalsewark, �����1 F�Y^_ 1ni P.I F�e ��,��.�..1� � d or kmolinon oi dismantlirg fie�ea�.wili 6e more ihan ihirry�siM�36)lat h�gh(CM1ay 32,Gry 2,Art 2.Sec _ � �� �y�� ^tZ -- W 341.T�tle 8.C A C i x 3 �'As ownerbudEer I wdl not empby anyone to do wark w�¢h woultl requre a permn irom Me Oivispn of f— Induelnal Safery,as noted aAove,unless such persnn has a Owmit Io Ao w[h work from ihs dnifion � W ❑��=�a o����s,�,a�5a,e,Y�,m��� TOTAL FEES '2. • S a � CONSTPUCiION LENDING AGEIYCY�I AerebY a�firm Net there is a constru[tion lendiiry agen�y fa tlm perk'mrrce Z nf the wark far wh�cn fiis permn is issued(Sm 7097,Crv.C.� � ����e��Name COMMENTS p�p lentler�s Atldress '4 CEHTIFM.A7E OF COMPLIANCE A FI�iIZATqN OF ENTpY I cerrily I hew msd tM1ie appficafion and m�e ' fn iha�t �uan grven�s c ct I a'pree ta wrth all state laws a�city orUina¢es rdatlop m M1wlmnA �_ y t0�5�� nan.3nd au[h e a r senutrve o( .Aejia�tmenl of Buildinp a�M SaMy e.mn ud�1he MWe�1Y e S loi whi I h aP06e for Ih permh far 1hE D makinp inspecdans. � ' r �J ,�J� y �� ` �` ��� —=�-L-i— � t RECPT NO. �� PAID B VALIDATION ,—' we pl nt or Agem t D�tt WHITE—Depa�trt+e�it Copy,YELLOW—Finance�Copy,PWK-0.ssessor Copy,GOIDENROD—File Copy.GREEN—Applicants Copy �• - . . . . . . ��. . . . . �: , ,.,,. .„ , . , ; . a .. . . .,., , .: _ �........ 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