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Home My WebLink About16-1771c y 2 L n CITY OF DIAMOND BAR 4WDEPARTMENT OFCOMMUVITY & DEVEM ENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 PRESS (909) 839.7020 Pax: (909) 861.3117 Building Inspection Hotline (909) 839.7027 FIRMLY BUILDING PERMIT APPLICATION JOB SITE ADDRESS S+�.--`3 V R \l P.. .Q,,, ,�)n APIN TRACT LOT ---TRACT �t c� ........ OWNER �y,Ltt_Y' 1e" ADDRESS �- ££ CITY ZIP__ 1�VTEL ` APPLICANT y — TEL 5 " CONTRACTOR -2, Ck f S ADDR,E(SS ARCH/ENGIDESIGNER ADDRESS CITY ZIP TEL OWW-MOM UCWUTION I bereby a" undo Powlyy IX Met" Nat I am woo #irn L'm Conetacwrb Spa ikenee Law fat the meeena} ki IMMed el M the oblair ka) I have placed next 0 the ann hark ream(s) ISINYIN 70M S, BUSIns and I'Mdeeebna COO Any ft a Corw.W Mat mdulma a PMW 0 CW*Uud, otter, krM MB, donaieh, of tapair, any crawls",, prier M 1%nssumxe,ansa bee"lrta Me apdOmnttalnparmn to line a algraA tBMentthathe a Nw to Somali poreasselto the pmvftkm N the(aMtnMMteSfaftLNowLow (CMyMr 91 CmmenainowtM SroeM or DM** G of go Blnshwtamns Protestations Cede] or mid Tea or sty Iselmx tram Dolby M aria dw mm for awaosinadessynoters, Any VW"MWSgtdmr MI 5 UY MY R M tWa fwna EAMtS theathdICNIbaawa Play of roT mein #+en fire huMma dafta{fSpP} Utasoworof Ow woo".. or myonpWyaes WRI M"a9 theirloftoamperca#m,wilydaU aD o1orUpoUMa at are watt eof the Mal ns W Intended or otemd for sale (SecdM 7044, onerssm and Pmhssaem Oral TU Canockia'Stath Lonffi taw does My apply or 0 away, of Monody who#M* wMannews, a Manuel effort bulto or Irnprwas the Pins" Mended that the horoserrouft me rot sanded or aboard tin ads it howner the bu bhg or impMermeel N woo wlNm ore year of compNdon,the owner earn" will hays Pa badan o"I g "hat it was msbu&t or Impoedfix4wpu8 oltareI U 1, 4 ownerdto PARetty, rye esGoalvety rdlvrednp what ItWnmd Commebm k mnawel the pobLt(5ecbon 704E Duar se t and seasonal Cade The Cadmems' Sato LaMoo Law does net apply man M. a presently wins ar tmgweathown, afwwnw cmbw" for da PMNc4 wf a P om co"RaMer pemmadb dw Qadractae' State Losses, taw t U I era eaeernot been la aboara wafts Ore carnival Sala Ikaswe law ear Ma blb'wag raawwa} By no wermmm below l acknween, IV sonvat fix my Moves Mardarriv N umkh I Mesa hMr nowded far at I" one, year pnorb mmreal of Mg Imprwamyda 4wIIed by this peaat I canna "Of reli a abutNo Use haws, Mat an M tlpa Iwdanhisapplaeanis&earstor is and barothatr law Sechon TOW or the anyne8£a�N Caad laavallebk VPM rgWtatYAen this apprmatlM aaAwIrIMIXa or tneawayrom Aredlnaa Does Men Ns, blft4riC Webwffi MiPdwwW leelnb Ca awt¢Nwatny DATE ......... _ SIGN LICntSED CONTRWOR'S ORIARATION Inearby one. undo Mlof PlePyy Mat I am hicallsiolusabor PwWons ofCMpNrI Fornmmaond wan Smmon 70MI ofO'MeIM 3&it* &td Mat Professionals Code and try limas a a full boa and affect -5lD il4 1D jr"j l LICENSE "t .�L�FflRay'igR f e A,. t' ttONNPi1115 fA $1 N� INEYMAPRII&I UNDER PDAROFPGUIRY ONE OFTHE FOLLMNGOEDMIMNS I here antl well melmwn a Cwescaie ar Canaont o Sae Nacre brWoker'a fumpyaaton, as pmddec by SassM 37DO of the Lwmr Cad fur Na cedamMte at: wax brwfiich Lea psrmsla nssuad ttmpwkdolli 370Pdtlw Labs OJOa,far althe orkfw hOltvmtNa isi uede%mquamiMSatCan tMpartamHncg of thewak to wlioh MN cenMtla iataed NY Wakot Comp¢weapon lraurMca Cartier ark fdnsaNism go Dream t U POUCYNUMBEN (INS SICTIMNE DNOTeEslaterEI)FTIEPEWnFOTONEfAWpEDDaLALsMOCUERLin )tarhN Mel Nthe okN umi suwry WannermaeM MesMf Dryers be Weekety 61 torenyme, Nlbsotl b tin 4AiY&M Qanpw®tlnr Laws d �hfmna NN aQr9e tlaf H shoxM tswrns ed{at sf the YMlar§ ape roW9 MS&bM 67tG of the Laha "N"y N"tMepy vaMpdwta ooysorra DATE 4/PPL1CFJrT .... `d"IME ......_-_ WAt#ANG sum M 6041re wmkaa Canpan toreBOe a araMNi end snaN 6UN8C M onpryat b pFrNal peiwNea sea tell ft'w9 ap N one nmidmG ass sa ind ddla'S WOC OM in ORRUM M the = Of one CampygthM, ossoDes a9 Pawgecl ax lnaecbPn 3768Mdw Nba soda Intowt,arb attenieY%k98 CONPRUUM LBOM AGM" I hereby al6ms tinder Dwyedv of Peglty that sooner o a(bnatucton La M 1-0nfloy no da personnel of the ware far whoh No permd is soybean noo 3097 CN C ) LENDERS NAME LENDER SADOM i tarty that I hate read this Matioaam no Sale mat the Means kdomweon Is correct i alma to Mooy with as mtyend Monaeces and 58ffi taws Well to bulldmN m'.abaudmr, and nearby a tWN reprosoyarti "is socially to Most pan the above-ormos ra p9pgry for Inspoil Potatoes Sher fix _ i6u�— now low SIW7AdLNiEOFPmM WTE�— APPLICATION DATE :++W Iy2(di 1(6 PJOa_......... ry aF ISSUE DATE Q/ y X1 PERMIT# � P I -ii1 TYPE CONST OCC GROUP ZONING SETBACKS ' FRONT RW 0 REAR ❑ SIOEiSIDE STREET RW ❑ I SIDE ❑ PROPOSED USE j i i i If DWEL UNITS # STORIES # BEDROOMS DESCRIPTION $O FT FACTOR PSF ADJ AREANALUATION SFWADD/REM GaraoCarpM PasiotDeck Illy Pool 2 Re Root J Gpanntg,i'.ia( Valuation Atli Area QUANTITY DESCRIPTION FEE I I rn :� s� CONSTRUCTION ...... PLAN REVIEW ELECTRIC PLUMBING to(•(RZ MECHANICAL INSPECTION FEE ISSUANCE SMIP ENERGY P/C ...... ENERGY PERMIT RETENTION FEE PRE-ALT FEE l BSAF TOTAL FEES COMMENTS �} ��s ,v. RECEIPT t i SI.�PAID BY _.. �"-LS(� VALIDATION All 1 A� WHITE— department Copy YELLOW —Finance Corry—Avaeasor Copy, GOLDENROD —File Copy, GREEN— Apysroerrt's Copy • i f i 1I i I =011111j; I i INSPECTION SETBACK/LETTER DATE INSPECTOR INS!N DATE TRACT AND LEDGER INSPECTOR FOOTINGS FORMS SWITCH GEAR SLAB COMMERCIAL HOOD ........ UG PLUMBING T•BAR US ELECTRICAL INTERCEPTER UFER GROUND HOT MOP/SHOWERPAN SEWER LATERAL /SEPTIC/CESSPOOL MAIN WATER LINE _ HERS REPORT RECEIVED -.. SEWER CLEANOUT DEMOLITION ROOF SHEATHING''. ROOF DRAINS FLOOR SHEATHING ROUGH CONDUIT SHEAR WALLS EXTERIOR POOUSPA SHEAR WALLS INTERIOR ROUGH PLUMBING FRAMING(VENTING '', ROUGH ELECTRICAL ROUGH MECHANICAL ROUGH MECHANICAL ROUGH ELECTRICAL W( I C I i GAS TEST ROUGH PLUMBING PRE GUNITE'. INSULATION WALL POOL PRE DECK BONOING INSULATION CEILING P-TRAP DRYWALL FENCE JSAMALARM LATH(PRE) FINAL POOL LATH EXTERIOR WALLS LATH INTERIOR WALL FOGTINGISTEEL GAS TEST WALL STEEL 19( )ZIP( ) LIFT SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELEASE WALL DRAIN/ SEAL GAS METER RELEASE WALL FINAL. SPECIAL INSPECTION RO FRAMINGPIAl~l MAPPROVAL FINAL BUILDING ROUGH FIRE APPROVAL FINAL MECHANICAL FINAL FIRE DEPARTMENT FINAL ELECTRICAL FINAL PLANNING FINAL PLUMBING FINAL ENGINEERING/ PIN TC of OCCUPANCY FINAL COMMUNITY SERVICES i CENT. of OCCUPANCY FINAL HEALTH DEPT FINAL INDUSTRIAL WASTE COMMENTS 'i60f2H CERTIFICATE OF LIABILITY INSURANCE DATEWWDOD s," THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, El(TEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES ,. BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE wilimG INSURERS}, AUTS4ORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE FOLDEFL IMPORTANT: R the ewMicate holder Is an ADDITIONAL INSURED, the potiCy(lea) must be endorsed It SUBROGATION IS WAIVED, subject to the terms and condhfam of the policy, cansin policies may require an endoreemmnL A statement on this Cartlficate does not confer rights to the certificate holder In Neu of such an a PRODUCER CONTACT Ax tau}sta-asta Walter Norteaaen Insurance / INSORICA PxaxE {661}948-1003 F101 CA license @OD44424 ADDRESS 1113 Rest Ave. N4, Snits C OWAKRISI AFFORDING COVERAGE NAIC8 Palmdale CA 93551 IMRERA IcAnES ICs C* Of the Nest 27847 DOME MWKA a Affordable slater Roaters s PSumb2ag, Inc. giSURERC 28358 Constellation Rd #698 ROMERO INSURER IS Valencia CA 91355 INBURERF COVERAGES CERTIFICATE NUMBER:16-17 W/C REVISION MLIMSER* THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR OONDITON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS TTPE aF RapleANCE C ER UrMI8 COMMERCIAL GODOML LIABILITY CMSMADE ❑ OCCUR W EACH OCCURRENCE _ PLVMISES 4 1 NED E%P me PwI PERSONAL A AOV IWURY GENERAL AGGREGATE ,,,. PRODUCTS COMPXW AGO S S S e OWL AGGREGATE LIMIT APPLIES PER POUCY ❑ M 71 LOC OTHER S S S AUTOMOERE4AAS1LnM ANY ALL OWNED SOiEOUJ ED HIREDAUTOS QED AUTOS i _.,---. _ D ''., BODILY INAW(Pw Pmaanl BODILY INAIRYLPw seldom PROPERTY DAMAGE�� BODINAD 's S S UMBRmJa L.fAs FrC888LIAa OCGlR G2AIIASMADE EACH OCCURRENCE AGGREGATE S $ DEC) RETENTION' A WORKERSCQSWENSATIOM ANDEMPLCrtfAWLJAEIUYf YIN ANY PROPRIETORIP ❑ OFFICEGHEMBER ExCu)OSO7 {an"Ity In we w It COMMON DE I cPGRATjoRS an,DEL '..NIA �( EL EACH ACCIDENT :WSA503249700 �'�, 1/1/201a 1/1/2017 ., EL DISEASE -EA EMPLOYER '., DISEASE -POLICY LIMIT $ 1 000 ODD S ILI 000000 S 1 000000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AODW 101. Ad*UW W Asmwaa Sdadda, may a a0adwd E mae %ems Isnq~ Sample Certificate of Insurance Affordable Seater Heaters 6 Plumbing Inc 28358 Constellation Road #698 Valencia, CA 91355 Ran Burcham/MNASTE �' s�— Z All rights Taserved. ACORD 25 {2D1461 } The ACORD name and log* are n4sterod marks of ACORD 1NS025mmam)