HomeMy WebLinkAbout1701 (670) - - _ - -- -----
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''�` � �ITY OF DIAMOND BARI`�� ��� �f� � � �� � �
��. '� � ' DE�ARTMENT OF�UILDING AND SAFETY
� PRESS
Bui�oeN���RnaiT FIRMLY
� APPLICATiO PERMIT - U§E
ADDRIESS F �� �. U ^� � j DATE ������ NUMBER,J.�� � CODE
' IS�UE r' �^..�.� TYPE OCC.
r APN L TRACT DATE �_����=LS�GONST. ' GROUP
� _ . . . ,.� . ,... _.... :
� CROSS S.�REET SETBACKS ��
°° OWNER --���aE' \.�-� ZONING FRONT RW ❑
� ADDRESS "�- 5 ` � �� REAR �
,� CITY �. �',1,�`.�--� Z �TEL�I�1�7�f`�� SiDE/SIDE STREET RW ❑
o APPLICANT TEL. SIDE ❑
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a CONTRACTOR�`'�Y�{�'�;r"x-- ��` ' � SEWAGE
o ADDRESS � `"� !% , �-E'���F'�'��:A- - DISPOSAL � PUBL.IC PMT�
W CITY���''��j�Y�✓g� ZIP �t'��� T�� r r' � ' ❑ PRIVATE SQ.FT./100 GAL
Z STATE GRADING ❑CU.YDS.EXC. CU YDS FILL
y LIC.NUMBER
y ARCH/ENG/ �7 � �YPE SC� Fl` �ACTUR F�S . �/Ab,l. AREAlVA A�IOIV �
DESIGNER 1'7 � '#�/°z�'t'�,;�,C , W 1 I '�Jl', . � '
oADDRESS� 1�:`�'� -Y--�CC'_.c C..���.. �, 2 r"..e `• �.'. �1 ` � e �.'�'
= CITYI,�'-�-r`f� � i`�C�� ZIPCi`.�4�{�:.�EL.�;�•°�r.�ri �r 3 y ''�.,, .7f,: G r` " �(�r� �?.L�:-
o PROPOSED U5E ' ` ` ' Z 4 �l �" ��
f :�C n ik^ S '�
� ��}'� -t-F�fV ��r'� �._�t Ll�%'r'i���A, � GARAGE
o NO.GWEL. . � h' NO. � �y�?L.f= � pORCH
_ UNITS STORIES BEDROOMS
s LOT DIMENSIONS m VALUATION •� � ADJ.AREA
o NO.OF BLDGS HOW QUANTITY �ESGRiP7'�ON ' F�E :
W ONLOT USED Q
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7�ONTflACTOBS OECLAqA710N I hereby al!um that I am laensed under pmhaans ot LhaD1n 9 Icommencuq �U
� .�rth Seclron 7000;u�Oimsion 3 of Ihe Busmess a�d Protessions Code,and my hcense is in full IorCe and eltecl �
3 � W
_ OLVNER�BUILOFR�ECLARATION I hereby alfiim that I am exempt tmm ihe Contracloi s L¢ense law fo�the fWlowmg
reasm��Src 7031 5.Business anA P:olessions Code�Any ci1Y m county whch reqmres a permn ta cunslnet (}
Odher,�m0�ove,demulrsh,oi repmr arry sfruclure,prior to ns issuan[e,also repwres Ihe app�icant foi such permn Z
Q ta Lle a signed sta�enem that he is!icensed Oursuaot Io the,�roris�ons al the Crnlroamr's Lrcense Law!Chapta m
� 9 Icommene.ng wGh Seaucn 7000;.ot Orvrsion 3 of ihe 8usmess anA Prolessfons Codej or IAat he is erempt theie�mm �
� and the Casis�ur t�e allegnl eremDLon Ary violau0n ol Sectmn T031 5 hY any aOD�i[ant`o�a pe�mit suh�ecls �
W tCe aUDhcam tn a c,vil Cenalty ol not more ehan Fire hundred dallars iS500j I: �
0 ❑I as owner c�t!ie prapeny ar mv enployees wit�wages as theu sale compensa9or. vnif do the worY,and
the st�uclure is�ot imentled or oHered ior sale ISec 7044,Business and Piof¢ssians Code-The Canirocmr's License q
� Law nres n apply ro an owner cf G�openy who hudds o�im0�oves thereon.and who.1ces such waM hunsell L� --- --
W or;InouS•^his own emFloYees,prm+Wed thal such imp�ovemenis are nat mtendetl w offered lor taie If,howeve�. Z '
m rti>Gnild�ng or:nprovemem is solA withm ane year oF[ampletion.Ih0 Ownef�bullGPf Will haYE Ihe hurden ol Oroving q
� thnt he�id ra[�ddn ur imD�ove lor;he pwpose ot sale) �
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V� ❑I as awnei o�ihe,;aDerry,am ettLu�veiy conlmcnny with Lcensed comraUors 1a construcl�he pro�ect(See W
0
i044,8us:oese a�A Professions Code:The Camracim's License Law does not apply to an owner of pmperty whn '�
6 l•unds o��mproves thereon,and who contracu 1or such pra�ects with a contracmr�s)I¢msed pursuant ta ihe Gminclor'S .-.-•�-•--------^-�...`.� /
Lir,ense Law� �C.Q�1(�,5������f , �r�? t"1". £�L3
� ❑I ain eaempt under Sec ,s 6 PC�auxn Ce�maatel. �t'PLAPIE REVIE�N..__ �..(~�� C '
p �ale ��� . ELECTRIC
� WORKERS'�OMPENSATION OECLABATIqV I heretry affirm that I�ave a cerbficate ol consent io setl�insure.or � PLUMBING
e cerbhcate ef Warkeis'ComDensaimn Inswan�e,or a cerrifie0 coW thaeof(Se[3800,lab C)
0
Q G Certd�ed w .rs herehy immshed � MECHANICAL ..._
o mlieA copy is ftled wnh tAe Buiidmg Inspetlian Depanmem or Oepartmem <L GRADING
W
= LEPTIFICATE CF E%E�YIPTI�N FflOM WCMNEflS'COMPENSATION INSUflANCE This secnon need irot be cample�M S'�UANGE.__ 1��i 4..��
� d the pemmt rs lor nne hund�ed�5100)or iess I certily that m the pertaimance af the wmk lo�whKh th�s � ....�--� r" —
[A
permu,s rssued,I shall mt employ airy person m arry ma so as to e suh�ect to 9ie NVukni Compensaum 1� S'� J-� �
oLaws al CaLforma \ ti " "`� pqRK FEE
p Oare \�—\—�v App6c W
� NOTICE TO APPLICANT II,aher miking this Ceruficate ol . ou k ome su6�ect ta ihe Worker's u- SCHpOL FEES
Coinpensa6on prrnisions af the Labor Code,you must iwthwith compl �Ih ums or this pemiit shall
�'- be deemed revoked —
� —
� pVISION OF INOUSTitIAL SAFETY PEBMIT CERTIFICATIpJ: ,--, —
� " .
❑I heieW cernly that no exaw��on live(5�or nore lee�m deplh in(o whch h peiim n rrymretl ro tlestend,
p�e will be made in canneetwn wne worY aulhorveA 6y Ihis pe�mn.9iM tli6r n0 dlidinQ 5tru�twe.ac�ffoldinp.�alsewart,
d or tlemolmnn ar d�smamli�thereof,wbl 6e mare than Ihury�ux 136�Ieel hgh (ChaO 3,2,Gry t,An 2.Sec
= 341.7itle8.CAC1
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3 [�qs nwner-huilder,I wi�l not emplay arryane 10 do�jo0ilf wh¢h u�nui�ieqwrE�7r�¢Iniit from Me tiwfion M
H. Industnal Safety,as noled ahove,unless such peYson has a perinit Io da fu�h'wa�k frdn 1fre db6ion. —
� •
W ❑Dhrsion of Industnal Salety Permil No , '
a TOTAL FEES �' `-`�
� f.ONSTRI�TqN LENOING A6ENCY:I hereGy aHirm that there is a anstruction k'dinp apeMY for Ihe perfortnaMe � .�
Z of ik war4 fu wM1Kh this permit is rssued�Sec.3097,Ci�r.C 1 � �
� lender's Name `
COMMENTS �`�--
= Len�ei s Atltlress i
m
Q CEfffIFiCATE OF C PLIANCE ANO AlRFqPo2ATIqY Of ENTRY I catify I have read diis�pplic�tian rM sbrc
y a[Ihe intormation is cqrect.I agrea to comply wnh all state laws and ciry o�dinancK'abtinp m 6uildinp
yc n,and aWho� represenWtrve oi tlie Departmenl of Buildinq aM Sahry h enM iqon tle qaperry
= for w DIrU fo rmn lor tUe Ourpose af makiiq mspee�ians. . . ....��
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, '��� ��v RECPT NO.��PND BY � VAUDATIO
Sy , a w �yen o�rc - � -
Copy,YELIOW—Finance Copy,PINIhPssessor Copy,GOLDENROD—File Copy,GREEN—ApplicaMs Copy
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