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CITY OF DIAMOND BAR
DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES
(� 21825 Copley Drive, Diamond Bar, CA 91765
(909) 839-7020 Fax (909) 861-3117 Building Inspection Hotline (909) 839.7027
BUILDING PERMIT APPLICATION
ADDRESS lqqV Or- '9 l0 6-cAte Dr.Sut
APN LOT TRACT
OWNER _L,.i:f�..�t�
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OWNER BUILDER DECLARATION
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CEASE LAW FORTHE FOLLAWMO REASON (SEC TINT F BUSINESS ANO PROFESSIONS OWE ANYCITY OR
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DATE OWNER
LICENSED CONTRACTORS DECLARATION
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WORKERS COMPENSATION DECLARATION
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SECTION AIET INANCA COTO THECOST Of COMPFNSATIOAEMMEE AB PROWOEO FOAW
SECTION iT0AtlP 1H6 LA@CIROCOE WLEREST ANO AttpPIEYS FEES
CONSTRUCTION LENDING AGENCY
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cWtTAMTEAN AN) HEAEBYAUTNORO.E REPRESENTATN£S# THIS COWRY A) EAtERWON THE
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DATE_ .-t"t7 /
PERMIT I
NUMBER f f A
TYPE r OCC
TYPE „ A r GROUP
ZONING 9ETBACKIS
FRONT
REAR
SIDEISIDESTREET
SIDE
R1A+ ❑
❑
RW ❑
❑
PROPOSED USE
NO DWEL NO NO
UNITS STORIES BEDROOMS
DESCRIPTION
SO FT
FACTOR PSF
ADJ AREAIVALUATION
SFRtADDIREM
�
WPTRIA
Dock
U.
EARCSPe
RB ROM
_2
CGmmemw
VeIDBRIM
ADJ AREA
OUANTITY
DESCRIPTION
FEE
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E[
W
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CONSTRUCTION
PLAN REVIEW
ELECTRIC
PLUMBING
MECHANICAL
INSPECTION FEE
ISSUANCE
SMIP
ENERGY PIC
ENERGY PERMIT
RETENTION FEE
PRE-ALT FEE
G� k
TOTAL FEES
COMAN NTS
/
RECPT NO_tm BY VAL DN Gw
C—Assammor DO t. T.Cmt.GREEN—AedbnrA's Come
CITY OF DIAMOND BAR
INSPECTION RECORD r-
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SETBACK
FLOOR JOIST
FTGS/FORMS/STEEL
FHA REOMTS
ELECTRIC GROUND
UNDER FLOOR DUCT
GROUND PLUMBING
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
SHOWER/TUB TEST
POOL ELECTRIC
EXT LATH/SIDING
POOL FENCING
WALL INSULATION
POOL FINAL
CEILING INSULATION
OFF SITE IMPS
DRYWALL NAILING
DEDICATIONS
SEWER
FINAL ENG
SEPTIC TANK
LANDSCAPE/IRRIG
SEEP PIT/L L
ON SITE IMPS
GAS AIR TEST
FINAL ZONING
FINALCONST
FIRE DEPT FINAL
_
FINAL HEATING
HEALTH DEPT FINAL
FINAL ELECTRIC
DEV FEES PAID
FINAL PLUMBING
ENERGY
COMMENTS Oy- it �a'G,Y�► 6�'~a 7c'i� y_
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SEPTIC TANK SIZE
SEEP PIT/U SIZE
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