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CITY OF DIAMt BAR
1w14111 DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES
21825 Copley Drive, Diamond Bar, CA 91765
(909) 839-7020 Fax (909) 861.3117 Budding Inspection Hotline (909) 839-7027
BUILDING PERMIT APPLICATION
JOBSITE
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OWNER
ADDRESS
CITY ZIP 440•TEL
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OWNER BUILDER DECLARATION
I HEREBY AFFAAL HIDER RE WLTY 6' PSAKEE TWU III EXEMPT RICA ME OYttRAG[OR9 LL
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DATE CAWER
LICENSED CONTRACTORS DECLARATION
IHERESYFFFlHA UHOER PENALTY #PERNiM TNATIAMLICFNSEO I.NOER PIOVI3IONY# AND CHA
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WORKERS COMPENSATION DECLARATION
1 HE RFHY AFFSgi uF$ER PENALTY OF PERUM ONF CA TIE fLLIG W W O DE LTAAiipNi
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DATE APPLICANT
WNWNM fMNPE TO SEWRE YAXMERS WMPENBATION COVERAGE ISUXVMtLLANO SHALL BE
4181KSAN EAP.OYEN t0 CRIMINM, PEW:.T¢8Ag0 CNR FINESUP TOIXVEIhIt1DRE0 iFpUBANO
00LlAfl3RieR S(e7 MMST%SN TO THECOST OF NBATDN EAYAOES ABPROVPJED FOR IN
SKilYi lTtIE#ME IABOR CWE INTEREST ANDATTOATTOPoiEY9 FEES
CONSTRUCTION LENDING AGENCY
I HEFIEWAFF4M INKIER PENALTYOF PMAAPY MAT THERE ISA CONSMOCt%Ri LEXICON; NIENLY
FORMEPEflWAYNf(� OF THE MPX MAPAOCN i WS 'EMT IS
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LENDERS FARE
LEAOERSAWPFSS
I CERTIFY THAT I HA✓EAEfBTHBAPPLIGTDMANk STATEMAT MEABON: PSMANARION ACORRECT
I NIREE TOWMfl_TVAM N CVTYNID CRINfYORItWNICF.SAId} STATE UWS ISLATMTOBUtOPM
CONSTRLCTWN ANDNEREBY AIRWPIfE REPNESENTATNESCF RAE WIRY TO ENTEIIUACH MF
ASOVE NEMTIONEOPaDPEflTT FOR INSPECTION POPPOSEA
PERIAITTEE NAME (PARR)
-46W REWPERMRItt EE �OAL
PRESS
FIRMLY
APPLICATI?N PERMIT P1C
DATE i %:. -r NUMBER � M CX"'I - • �
ISSUE l,�r TYPE OCC
DATE CONST
GROUP
ZONING SETBACKS
FRONT FiW ❑
REAR ❑
SIDEISIDE STREET RW 0-
SIDE ❑
PROPOSED USE. _� 6 �}-e-- Y'GYt't * Q,� =y)C
NO DWEL NO NO
UNITS STORIES BEDROOMS
DESCRIPTION
SO FT
FACTOR PSF
ADJ AREANALUATION
GESADWREM
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QUANTITY
DESCRIPTION
FEE
Otry,e S
214
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two
0
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20
FIT
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4 6
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CONSTRUCTION ty�
PLAN REVIEW 4 -rj Epo
ELECTRIC •. (���
PLUMBING�'d
MECHANICAL +1 �° t• +�"-'
INSPECTION FEE
a
ISSUANCE
`
Shop4 a� (b
ENERGY PIC
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ENERGY PERMIT ss-1 E.SFV
RETENTION FEE
PRE ALI FEE S
TOTAL FEES 4R i sG' CFb,ol� Al7Yyr 3—T
%TJ
COMMENTS
AEC Pt NO
BY L—ap VAUDATI �'Yl
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CITY OF DIAMOND BAR
INSPECTION RECORD
SET BACK
FLOOR JOIST
FTGS/FORMS/STEEL
FHA REOMTS
ELECTRIC GROUND
:GROUND PLUMBING
UNDER FLOOR DUCT
UNDER FLOOR CONDUIT
SLAB GRADE
FIREPLACE FOUNDATION
TEMP POWER
FIREPLACE BOND BEAM
WATER SERVICE
MID HT BOND BEAM
ROOF SHEATHING
8 FT BOND BEAM
FRAMINGNENTILATION
FINAL BOND BEAM
ROOF COVER
PRE -GRADING
ROUGH HEATING
BENCHING
ROUGH ELECTRIC
ROUGH GRADING
ROUGH PLUMBING
FINISH GRADING
SHOWERJUB TEST
40ft�
1 POOL ELECTRIC
EXT LATH/SIDING
WALL INSULATION
CEILING INSULATION
POOL FENCING
POOL FINAL
OFF SITE IMPS
DRYWALL NAILING
SEWER
DEDICATIONS
FINAL ENG
SEPTIC TANK
LANDSCAPEBRRIG
SEEP PIT/L L
ON SITE IMPS
GAS AIR TEST
FINAL ZONING
FINAL CONST
FIRE DEPT FINAL
FINAL HEATING
HEALTH DEPT FINAL
FINAL ELECTRIC
DEV FEES PAID
FINAL PLUMBING
ENERGY
............ -
:COMMENTS
- ----- - ---- - ---------- - ---
-
--,57
SEPTIC TANK SIZE
SEEP PIT/U SIZE