HomeMy WebLinkAbout1170 ��� �o-�� '"� � CITY OF DIAlU�4ND�BARM�� �"" ' /����/_ DEPARTMENT OF BUILD�NG ANb SAFETY pRESS ^�° OC `Tx,P BUILDING PERMiT FIRMLY JOSSITE T -1 APPIJCATION /�T PERMIT � ��/^� USE ADDRESS � I�'1 N DATE �-�"o�Zc�-'"i U NUMBER�L!�CODE � APN 1.07 TRACT� S TE�� " �Lt� TYPE OCC. o CROSS STREET`T���L-��!-�/�S� CONST. GROUP °-' OWNER-�f4?�'r CK ���.: ZONING FRONTCKS � ��+rs o ADDi�ESS f��� &'C�TC'2 Y • s REAR ❑ W CITY ��°�-`��57'�2 ZIP T�L�'��"�y�¢ SIDE/SIDE STREET RW ❑ g APPLICANT TEL. SIDE ❑ Z a CONTRACTOR SEWAGE [] p�gu� p�# o ADDRESS DISPOSAL ❑ pR�VATE SQ.FT./t00GAL „� CITY ZIP TEL. z STATE y LIC.NUMBER GRADING �CU.YDS.EXC. CU YDS FILL y ARC /ENG/ ,/, . � 7YPE SQ FT FAC'TOR PS ADJ. I�tFCEA/�/fC A�I�IV : . `—' DESI �'�j,G��fi�..�S�'�G- ;W 1 '7 J�'-J�b �� �O o`Z SS�.�• o ADDRESS�%f•� ,�i?� -��� ,��.�r� � 2 ��jp 2 ' R�/ G . ..7a, Z� = CITY t�,/.A� `�5/�-�' ZIP 'e�[�� TEL..'%'15��'i'' �e 3 � PROPOSED USE � f� Z 4 � �� � GARAGE o NO.DWEL. NO. �d1 NO. STORIES BEDROOMS � � PaRCH y UNITS ��� �- /�' � LOT DIMENSIONS_ � VALUATION ADJ.AREA o NO.OF BLDGS HOW t3UAN1FITY (1�5�`�j�`��jN:^: . '.:, �� W ON LOT�� T�'.�¢.�'?G� USED °C � U x � ~ LICENSE�CONTHACTORS DECLApATIUN I Mreby aFhrm that 1 am Gcensed under pmviaons ol CheD�„9lcommencinp �F-� — Y wnh Section 70001 0���vision 3 0l the Business anE Pralessions Code,and my IKenu is in full krce and effect. � 0 3 � p�y � OWNEA�BWt�Efl DEC:ARATION�I heieOV athrm that 1 am erempt Imm ihe ConVactai s L¢ense Law tai Ue kllowiag Z rrason�Sec 7031 5 Business eM Pioiessfans Cade Any citY or coumy whirh rep�ires a permit to cansVutL .(!S O aNer impmve,Cemolah.or repau arry strature,O�iar m itt issuante,alm requires I�e applir�m fir suth permil :� ¢ �o f�le a signed stalement tha+.he is licensed pursuant ta the prwisons of ihe Cantrxmr's littnse taw�Chapter m s 9 Icommercmg wrth Se[lion 7000)of Drviswn 3 ot Ne&�siness and Pmfessians Cade)ot IM1at he is Bxempl Ihere�rom �. Xantl the basis for the allegeA esemD��on Any vialauon ol Seeuon 1031 5 hy any applrcant kr a permtl suh�ects � W the appheant lo a wn penalty o1 rot more than five hurdred dollars(55001.1 .,J a � ❑I,as mvner�f the property,or m�•employees with wages as Iheir sole compenuuon,will Ao ihe work,and � the stnmwre is net intended ar otfered lor sale�Sec.7044,Bus�ness and P�Wessbns Code.The Conlr�ctor's Gcense Q � Law does no!aDVly 10 an owner of property who builds ar im0�ove5 thereon.and wlw does su�h woh himxll. U ' or Ih�ougF.his own enployees,promded that sucM1 imp�mements are wt mundad o�ottered lor sak 1(M1owever, .� m the huildin�ar improvement is sold within one year ol completion,the owner-huilder will here ihe 6wden ot poving t( y that ne Oi�nm hwltl ur impmve far ihe purpose af sale 1 y v� ❑I,as ownei ot ihe pm0erty,am ecclusnely camracuny wrth Imensed camwclors to wnstruct ihe project{Sec W 0 7044.Business and Professions Code.The Conu�e�or's License Law dors nal apply m an ewner af o�we��Y w� ',� ¢ �wius oi�mprwes thereon,and who comracts lor such qm�etis with a comrxtor�sl Icensed pu�awnt 10 Ihe Convecta's � �"`"s``a"'� CONSTRUCTION _ �J' . � ❑o `J�r��O I am exempi under Sec ,B 6 P.G�Anxn Ceni6ca�el. PLAAI REVIEW o Oa�e �g ELECTRIC � W9flKERS'COMPENSATION OECLAPATION�I herehy aflirm�M1a�I have a ur6liwte of co.sem to sell-insve,w a cervhcate of Nhrke�s'f,ompenuLon Insurance,ar a rertitiM copy the�eof�Sec.3800,lah C.I PLUMBING Q� � MECHANICAL ❑Cerufind copy a herehy Iwmshed o ❑CeniLetl copy rs tiled wnh fie BuJUmg Inspecuon Depanmem a Oepulmem Q.GRADING W 2 = CER7IFICATE OF EREMPTION FROM YVONKEfl5 COh�ENSATIDN INSURANCE:Thrs secuon neW nol 6e compkted ISSUANCE ✓•��7 yd the Deimrt is lor one hundred 15100�or less.I wmly iM1a1 m tM1e performnce al ihe work lor which Mis � pernrt is iss�d,I shall nol employ airy perwn in any manrei so as to 6ecome subje�l ta 1M N6rkers'Compen5elim SMIP � = Lews nf CaLfomia .rw �,.,�r, � � t�a',; �•�� u PARK FEE e od�e ' '��9`�V&�� � LL� SCHOOL FEES � NOTICE TO APPLICANT N,atter making 16is Cenrfcate of Emnption,you should 6nmm t ro Ihe Worlur's -r Campensa[inn prwisims of�he Laho�Cadt,yau mu9 fonliwilh tamqly wiM suCh pfa/i3iun5 d Mis peml�ShiN � be deemed revoked. T 01VISION OF INOUSTNIAI SAFETY PE W ` . aJ� _ � ❑I herehy certrty that na aHuvation Irve(5)w mare feel in depth into wh¢h a person e repared m dascad, � will be made in connectwn with worY wtha�xed by Ma permh,a�Ihat iro huild'np siru[lue,swHddinp,falfawork, or Cemolit�on or a�smantling�k'�df,:Will; ihaq Mirty-eiz�.�361 Int hiph�ChaD�32,Grp 2.Att 2.Sec � Z 341.TideB.CAC1 ��J,f�...°,'�.•..� :'� ,� _ �,��; r��>.•;. F.,:... �f,,,,._�_.� �V — 3 ❑As ownei�6uiltler.I will nm empby znyane io do'wtirk'�wM'Chrridul�e�uile a permt Irem Ihe Orvnion af �-- InOustrial Safety.as noted a6ave.unless such persan haa a pvlmit ro de such wak Irom the d'xuion. . � �w ❑Phsqn of Industrial Satety Rermit ND TOTAL FEES � �� CQJSTRUCfqN LENOING AGENCY:I hereby aHirm that tlere ia a eonstrue�kndmp aqrcy tor IM prformnx J�_._, Z of Ihe wark for whch thrs permil is issued(Sx 3097,Ciu.C). � teneer's tiame COMMENTS m lende�'s Address Q CERIIFIGIIE OF COMPLIAI�CE AND AU�FIpIIZAIOi OF FNTNY:I certily I hwe rod thu app6ution and iuu VJ that Ihe infamatnn prven is�merl I apra m wmply with a9 snk laws aM tity pdiw�x�reYYrq to h�itlinp y �onsiruchon.and w�M1onie a e rp�sentalive o�Oepvtrtienl of BuiWinp and$sfety to anLr upm the poprry � fa whicA I hayp�a plr 'fa t;�er�rx�for Me pose of making inspsllonc � � � x - ,..�`2`-'�f l� l sqname d mt ai t p�� RECPT NO. � PAID BY ( ��� VAI..IDATION WHITE—D�pahm� opy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,CREEN—Applicants Copy ' " 85106-11189 � � �',�'k � ��_.;'`� �S'`.-s" aff i ta:,,� a: �.��'::����`� �`��: �� � � ���� �����-.: � � �'�z '� -s�'..�sr . . , �}� „ �°. � ..�. - .. �,:..^�^ ��s;�:�=:�°'=.�«�i*'�x. �: •> �' �y�g�; e „ z��s�'. :�a�s'x��s��' s �'� � '`"�,�$��� ��� ..i �.��$ ;`� �� ;� e�` a§• `sz,"q �'� �"� �,;; �, � :.��.�; r. 4^ �� ;;��. � � _ ���:' �.�w . 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