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HomeMy WebLinkAbout17-222150 a u_ s a 0 z x 3 t s IiI,11)ION } R,1Y. CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SE !ICES 21810 Copley Dnve, Diamond Bar, CX 91765 ` PRESS (909) 839-7020 Fez• (909) 861-3117 Budding Inspeetmn Hattaae (909) 839-7027 FIRMLY BUILDING PERMIT APPLICATION www.cityo[dmmondbarcom beedding@diamondbarceigov JOB SITE ADDRESS -1;111 7J�-._YJ T; 4 S{-��� PiL APN OWNER 1A G.ho.YN L�+. J'Sf'P. V1 G1 iRAGT__ ADDRESS CITY IP�Q-TL W'700 _ APPI.ICANI SS TEL r, CONTRACTOR C1nb - ACSDRE i - CITY ZIP TEL ZZ" `7 ARCHJENGy DESIGNER ADDRESS CITY ZIP TEL OWND-MM OEGLAMnON I al mlrm under Penney m barmy fast I am memst four as Cumronfors Sala Must tow for too masoma) mdPftK below Or WA cMrkmadeft, I have Prated (uu or Io appivase Inurand IWVM mass, WWi and Fiat Ion Code AoydtvwmmtyWnrequlmaeAMMWowWkAOt, alter, ImpTOYe, mmpelr, any lelkwm,Ptertent IasueMvi rpWrmo ec ell @U tenor BMr9)Coomanch" wieoaeon IeilcmcedplgeueniWllneA oyh COmncim'e8tDea Lrw(CMIMr BjCanmenomp vNtrBmLon 70Da0f DadBlon O of ot5mnur 7037 Sty my Any woBtWaes and Profmakm OOd Or TMmt he ar she M emmpl Irom Ilmlmme 01tl} floe t ow is maampm nxamptlon Any mpikamkie pamitsub�tlsshe aPllmmWit epettDuts' Hint mine than ave hUndrea aopere iSEOO} U 1,mO atthepropeM, army anmkdAsawM weans An took mle .wlNtla lJ all ofwUpwlam at the watt and Nor sdN4wro is rut Inal or oftsmd v me (5eatlat Too Buell and Pinfilt Cape Tin Cannotons' Ill Licame taw ham not aaiy to an owaar of itaarry Who Mmpat empmyas' of Personal off W brio Or mproven tin Proparty, Panama thn to Impm orb art rat mmdW ar offered tun sine t imwaver, the Hill IS ar Improvement Is Bald *Min me yen of comp@hon, No Patter Be War will have tin turner of aroma that It was out Won a Mprowo for fro "Poser at Want U 1 m pwnardtiro AmlmrtY, ern mmavlrely mnmmtna wtA darlem CWtraOmra W mnsbuct to projen (Sectwi 7Dea Business &e P'ataabn Cade TM Carnival Gate Loome LAW does not Pooh, to sn Owner at pmp0lty win hale Or tin meat; lhar , and won mmradsfor the project won a pmnad Contacts Iaasusmtothe Om*JecWm'Sate kaol Low) U Iam exempt mom llcercura mMar faro Cwmeamr'4 State Lac AND for the WWwlnp memn(5) Dole San By Me SWM bi I acknowsnlye Mail ezttpt for my amevnl mndawe In wool I must have moral V it least you"Ibm"Nowlmthe, eationa m poster hAMm t It no run! been emotional in no mainly by lateral cardre tsars I uaaromo that a oaPy, of der and owe taw ,SBCflmt 70" of um Buanem and Esbtma0n3 Code IS aMW* W usual Bonn pia lonloolon m submt'ad or at trosWlowtna Web sate Ntp^xwo, wonO an awymlew Mal LIMBED CON7RACTOWS OECLAFLAWN I harooy main albeauty cr perjury War I am Lcermd aide proseare of Cnapla 0,1pommanift wash Sectan 7000, Of O MIN 3 at Me SUVU aM Proletariat Coda, am my IICar Is In full farce and meet LICENSE CLASS S��� . C�, �-^I $r aJC NO 9-L D LO i Li EXP eaTE_t(l,'A)_t-T„r„_ Coavrei CTOR WWJ"'S COMPENSATION DECLARATION I HFUY AFFIRM UNDER PENALTY OF PELARY ONE OF 7HE POL MG DECLARATIONS I rave Won Will maaWin a Co acats of Conant to Gat movie run weka's Comanm oil, m vadisd by Sefton 37M of IN Labor Case, tun the permrmanm of the Wart for Whuh thin amall sound _2_,Irun* 3% Wit mWmaln Wateta Canpaftill[room", amoulard by Samoa 37DDa ffeabor Coda tun We the wil far Watch ads pemdt N Issued MyWarkas CDm; o-Mm m usel Quite, and PARRIER be"pre-GSCD sY/JU+vLt C.. CARRIER W PaLC! MMBER LMW BECRON MW NOT BE COLAPLREO FTH P5007, MFORONE MpatPEO DOLLARS $100 OBLESS) I cMN that in tin mane ea TO yAtt far WBhd, ths Permit to NNutl I shall ra etrWIOa'BTynever naq manor As Mtd comma subject to doe Wan.&e Canpmteam Laws Of Coamom, And a" not II I Will bemoe xnji is to Workers Camp mPmmumtiSakoa3Rq otta rob¢Labe, Ixhan taymmlC"7 wit dam PIWAApm DATE APPUCNlT WAWNG Fenno 0 Deputy Wtrka'e Cormermam vrvvaa Is unloosed nM shall subject ai employer 0 radial and dtl flnes an to cola hagred thoumnd dollars di OR to aNJm to the fat of Bin m rannbn annm'seee ao Damon Ion In amtan 3706 otPer mar pool Imorms, andatrnay "as CONSTRICTION LENWRO AGENCY I hereby all :ender bull of perjury thin tern is a Ccmmumm Leval Amory to the pmarmno of the work for weeh No OMR It aNx d (Sae 3097, C v C ) LENDER S NAME...... .... LENDER S N ORM I poorly that Erma shed trhs anin man an late that to all Inommion as prat 1 agree 0 usually with all dN ad county cmmmroa and state awn miabna to bWdha mN9uttldd, ad haehy moral mpsoona lxa at MID dpatt, to nmad re nave MNW*d pm,pfar hrepeclan puroomt G O� k $ PERPdI7iEF�kAME'Qr(M j -� f D (2tt{{? SGRATONEOFtEnsurriV OA'E_... APPLICATION DATE 42A_t© -4 I 're, ISSUE DATE,.jgb2y ] .�7� _PERMIT# T R. l~i Z ?Z TYPE CONST OCC GROUP �... y 0 L.UU OINt� Scopeof Work too- DWEL UNITS 9STORIES l ki�fl%� () 'iflq;i NBEDROOMS DESCRIPTION SO FT FACTOR PSF ADJ AREANALUATION SFFVADDIPEM Fiarega/CmppH . Palac/Deck RwRo rf cZ_5 J Commerdai .._— m Val"flope Ad; Area QUANTITY DESCRIPTION FEE E3 fiv I CONSTRUCTION PLAN REVIEW ELECTRIC ��sA rI2 - . PLUMBING MECHANICAL INSPECTION FEE ISSUANCE EMIR ENERGY P/C ENERGY PERMIT - RETENTION FEE ....__-« PRE-ALT FEE BASF PLOT PLAN ZONING CLEARANCE ....._ TOTAL FEES COMMENTS 'LP PJC PAID BY REGEIPTaPAR) BY VALIDATION _ VALIDATION WHITE -Department Copy, YELLOW - Finance DOPY, PINK -Manuel Copy