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HomeMy WebLinkAbout1170 (14) =°� ��� q d-o�l G " �� CiTY OF DIAlV�OND"BAR��� �� �"" �� DEPARTMENT OF BUI��ING Q�ND SAF�TY P�ESS `�^ BUILDING PERMIT FIRMLY DDRESS � DATE CATI N _.��_�N�MgER�CODE �� ���� UE /J,,,_ ,._. TYPE OCC. ` APN LOT_�TRACT�� ATE ` � CONST GROUP � CROSS STREET ='7�7E�"1'l-�"C..r�ya5'� ZONING FROT�CKS � ��►�rs � OWNER /� T- >G�G ,rC�"L.L, o ADDRES$ ��•�S�i sE-'CC?J� �E . �f� REAR _ ❑ ,� CITY ��JJS%�i� ZIp TEL.�% `"�� S�DE/SIDE STREET RW ❑ = APPLICANT TEL.� SIDE [] z 4 CONTRACTOR SEWAGE C� PUBLIC PMT#t o ADDRESS DISPOSAL (] p(��VATE SQ.FT./100 GAL w CITY ZIP TEL. z STATE GRADING ❑ CU.YDS.EXC. CU YDS FILL y LIC.NUMBER PE Q FT �ACFOi� F?S ADJ: AREANA 7'If3N y ARC /ENG/ ��l� ��,.��C. � 1 rr " DESI ����':' I�t4 s,s� �f to8a �o � ADDRESS���'�`j�a,'�; �� B"L,�r,a uW. 2 IZ ?.3D l2°� �t.�l� 87� O z CITY ��2, J,��`>� ZIP�i'?L^ 4 TELSi �7� � 3 o PROPOSED USE �P�" � � Z 4 � ��C�� � 6ARAGE o NO.DWEL. NO. NO. y UNITS STORIES BEDROOMS � PORCH � LOT DIMENSIONS � VALUATION � ADJ.AREA o NO.OF BLDGS HOW i�lAN4rTY �„1ES I(�I"{QN'; , ��� W ON LOT USED ,Q °� ❑ t� = x ~' LICE4SED CON7RACTORS DECLAflATI�N:I herehy aflirm ihat I am Lcensed under pmasions oi Chapta 9 Icommmcinp Y wnh Secnon 700UI ol�rvison 3 of the Business and Professions Code,and my IKense rs in full loae and eflect w 3 � � LL OWNEB�Bl11L�Efl DECLAflATqN�1 herehy afhrm Ihat I am e�empt from fie Contrxror's laense Law 1ar Me idbwing z ieasnr.;Sec 70.1i 5,Business and Professians Catle AnY cilY or caxfty whKh requires a permu to conitruet. (� O alter �mD��e.demohsh ar repai�any structurt,prmr lo its issuanre,also reqmrzs Ihe appYuant lor w[h perml 2,` Q to tile a signed slalemenl ihat he is 6censed pursuant to Ihe prwismns d the ConVacfar's L'eeme law(Chaptrr ,m� ¢ 9 jcammencing with Secuon 7D00)o�Oinsian 3 0l�he Business and P�alessioirs Cadq w tlat he is eMempl Nerefrom 'g � antl ihe hasis lo:Ihe alleged e�emptfan AnV wolalmn al Secimn 70315 by airy applicanl lar a pe�mrt subp[ts � W the applicant:o a crv�l penahy ai not mare t�an frve hundred dollars(55�0�.� Q � ❑I as owne�n�Ihe prooerlY.ar my empbyea with wages as theu sde compensatian,wdl do ihe wwk,and — � the strucmie is no�imentled or offeretl for sale ISac 1044.8usmess and Protessbns Cade iAe Cwtrac�or"s ticense r� Law does noi aoGly to an owner af pmpeny wM10 budds a impmves therean.and who dres:ueh xmk himselF. (,) ' or thrauyh his awr.employees,prmided ihat such impro�ements are not intendN oi ol(ered for sak.If,howe�er, z m the 6wldmg nr'mprovement is sold withm one year o(compktion,Ihe mmer6uildn will have Ihe 6mden ol pmring Q y �hai he ditl noi Mnld or mprove kr�he purpose ol saleJ .y{] � ❑1 as owner uf ihe property,am excwrvely contractmy wu0 I¢ensed contracrors ro wnstiu�t Ihe Drqect ISec. uJ 0 7044,Business and Prufessions Code The Camracmr's License Law does not apply b an oNrier ol pmpeny wha S„� ¢ Ixidds or impm�es theiem,and who comncis lor such projects with a conirxbr�s)licensed pursuant to tAe Cmirxta's 0 `"�"5e`�""� CONSTFiUCTION __ ��L� � ❑�,�e,emP���a�se� a e vc�n�n ce�tirKarci. PLAN REVIEW o'ZS r S� e oe`e °xiner ELECTRIC � WOPKERS'COMPENSATION OECLAFATION_I herehy affirm IAat I have a rerMi�ale ol oon:em lo sdf-inswe,a a mnrf¢ate af Worqers'Campensalion Insurance,or a cerulied copy thereoi ISec 360D.Lah C1. PLUMBING Q� � MECHANICAL ❑Cernhed wpy is AereEy lurnished. o ❑CeruheA copy is hled wnh�he BuilGing inspecuon�epartment a Oepartmene Q� GRADING W {w� � CENtIFlCATE OF EkEMPTION FflOM WDflKEflS'COMPENSATION INSUflANCE TNs section nxd nm he compkted �J ISSUANCE I •O� y if thc Dermn rs for one hundred(51001 w less I cenrfy iM1at in the perfoimanre M ihe vrak lor whkA th's � � permit is�ssueC I shall rot emplay airy person m any manrer so as a became whject to IM1e 1Aforkers'Compenwtim SMIP � = LawS nh Calrfornia W o � PARK FEE o �ate �ou�"' �• SCHOOL FEES NOTICE TO APPLICAM:II,afte�makin ca � P�.vW slauld becwne subjen ta the NMrker's --� Campensauon pravisions oi Me Labar ' s�Ja¢fhwi tomply witA suth paruions a thn permit sheA � be dcemed revoked ✓� � "'y�, ��c:,.» � � pVISIpJ OF INWSfRiAL SAFETY PERMIT CERTIFICATION: � ❑I herehy certdy rnat no e�c tp� e�5 w more 1 h nb whkh a person ia raqWred m dpemd, � will be made in conneqon with�4/Zu�¢��pe at m hiiWinp struclure,wlfddinq,fabexorN, or Aemol�tion a dismanUing� �"�r��6e�ae n i 38�len hipA ICheO.32.Gry 2.Art 2.Sec W" 341.LtleB.CAC1. — x 3 ❑AS owne��nwWer.I yxY�n�F e�np�µ,aeyqne,�tm�dq Aroit iWt�"c� �urte a PKnit fmm tlx Oivoion d �... Industrial Safety,as naudaho�k,inles�Stich defsEfilias�ap[�iViir'M de�i t�oti Fran 1he di�risian. e�e r• �`!":'';•" `=,i'i� Cf;�;i'�( � J �,�:�_� ; 4: W. �o� �Z� `" ❑°'"S�°m„a��`�ai s�7°"�'m�`"o, TOTAL FEES a ,� CONSTHUC1qN IENOWG AGENCY I herehy affiim�hat tkm u a eamtruetion k�d'nq pm�y lor tlie perlomiena O Z af the work fm whuM1 Mis permrt is issued�Stt 3D97.Civ.CJ. � leMer's Name — CQMMEMS m Lmder's Addreu a CEfRIFICATE Of CONPUANCE AND AUf1�Po2ATlp!OF ENTRY I eatily I luve ntl IM�pp6euian yd sLee V.1 Ihat the i�amaLon yven is[aren I agree to amply wilA all su0e hws and eiry or6tun[ec nhEnp b hiil6np ywnstruclwn,antl authori:e a re Reentatrve al IM Dprtmenl of BuiWinp and$ahry tp pnr iqqi Ihe pqrrt� � ta which I �ea@9��p1" a,Ili pe/r�Fi[for the p ou al mekinp ia4yxUons. `• / �� ' '�—���� RECPT NO. ��PAID 8Y �- ��� VALIDATION Sipneeure ol Appl ant o� t piq WHITE—De�artmeM py,YELLOW—Finance Copy,PINIhAssesaor Copy,GOLDENROD—File Copy,C,REEN—Applicanb Copy BS106-17/89 �� ° . �,�.' a���� : �..'��<a. �.,o � £������ ����� ������� . a�E�� �;?;�`:��`:����;,�". `- ' : ,� �� ..:�: .�..� :� � �x�t��i .! <�.�#'` ,�°3' � �; ,��• �'s� =c a�:a> _�" ,�: � � ��`�, ,����< "�,,..i�.; �' '� w.,�.'� �.a,.�'°5����' , , > .,� .� ,�> ..� .�.�. � �'�.�<, � .�:.�' . 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