HomeMy WebLinkAbout16-1202CITY OF': AMOND BAR
DEPARTMENT OFCOMMUNITfb VELOPNIENTSERViCES
X' 21910 Copley Drive, Diamond Bar, CA 91765 PRESS
5 (909)839-7020 Fax: (909) 861-3117 Building Inspection Hotline ("9) 839-7027 FIRMLY
BUILDING PERMIT APPLICATION www.cityofdismondbarcom buildinga@diamondborca.gov,
JIB SITE ADDRESS e3frSJ I Elk AL _
APN LOT TRA
OWNER
ADORE
CITY P TEL
APPLICANT _
CONTRACTOR
ADDRESS %0*7 2
CITYfdwt 1.ptA,C.&,nfja c ZIP q01Q TEL
ARCN1ENGf
DESIGNER
ADDRESS
CITY ZIP TEL
OWWgt4RMER OEMACATM
1 amby MM WbIH WARY, Of Pwhey, eat I W aaeaq hOm the CaN&kYa State U1041 LaW fa Be faaM"
Irdkafa beew in, We ttaemnakfsl I as Plead Mn m N aPPllcaae RadmG MOCden amµ Sanwa man
141006010a Code Any only in aunty that nWa a a=* to CMnb,4 aim, hoamdW, demolish, W mine, any
eFNGha'e, pwr ft, Its .so a9111la theapoing IN the wind toflue aln dwaxathat an a as
It fliwaal prnfanmm then Wawwaw of the ranrant" Sim IkBmB Law lOta0m7S} Cpmi ingrind SeCLLen
=of Demanded }of to &MinM WW Eaten Coal a Nei a of ale m ammPt ken kcawure and Ne bad an
aw waged aremPa'n"W WM of Samm 70315 by airy Valmm mr a dental Roadu add appfimm m& CM PKW*
M m mae Than fiR a9f Brea ddBMa {5500)
Ul,aawllumThm DtoPatY,amY wN waaeeaelaaU m wleaudefor{„jPaaeda
of iha wadi add 0* sU iddiv a oa at&n t a adved ra ion Owhen 7w Ikaineas and Rvandsews Cam The
Contramdt'Stifti Laurie law dean me apply no aaweral Or0.'N+M wta thong sa dwede, aama+aatmd many
a impraa}ne prape?y provided ant tint 3mPietEmala ate net imamede, aimed ke Gant n naWawaDa Ua<4ke a
ImaolBmadid aamwdnin ae year of mri, the Owner &ilium MII hard dta Uaan m Prmin0 p+OI II wen timbal
ar Improred mr dw pa,Paeatal0l
70 E a awfmtm then PraPab, ern nadnwety aralSmN vita Ins®d Famecrdsm Caab+k:I are w4itt fSaamn
JDAA DUAtase anti Pmt®iand Aa The CmhAgmta' Stem t!a® law doe lea ePPfy m a envier a pMwry wM
Uinta aPa®aamr almwMwnmeCmlarawpojactrw�eaarmai fnlaCmrwtamamareCmnha�m'S1#
Uandaw,taw )
UI am amended hue Somme dude, ON Co m rtai SIM Leaned any tarr a Idmwfrg faaau)
Sy my alaWlaGmla+fed�thet mplWmywmawi. mwhPbimuslha"famsdfa 61
matae
drarm eknlNaen of Me Invidawmems colas in this pamit Imir Q isettty no a mmaAa"I l Aetna at
maer dada 9 it tied nd ban cynhim."d m b and" by ieafwa mnheLkra I uderandal mat a aQy of Thnd
adol a de new Daemon, 7001 of The GLUM ail Nafaag9 Caen Is WaVA teal cement WfM bad MMOM 19
6ubmiDada etdemewrigwen Ba MDYMWw mamea 9ewldaW IInnI
LACETM CONTRWrOR'S DEC ARATM
I hereby affirm ult Peary of wrkaY met I an amended oft menu m of Chader 9(garmi wan Sweet 70M
of pWemn 3 of the Student Add Raaemre e. and my is sa is in mli fmGe and new
Low QASV
conaaAacti
Wwm,siD XSArm DECLAaAnat IF
I AfiGNi UNDER PENALTY OF PERAW ONE OF TNEFOUMNCOEWMIJOW
and Wa mantas a c4rwkcft of Coolant m Seed -mane W Wakes a ComwnAtme a pme ad by
Scbl3700a f1e LftbT Coen mr maPeitamate a NevakAawadlVY8 amkl Ie issue¢
jg=-Thawa amwili madam Wadml's Caelpulealbl maumKe m mhlaradby Swmlm 37mf m then Iaba Cam, is
the of N work larwheh this Pamlits aead My WdMra Canmenstlm Insumate Calla And
PoUEY lAAGIfX t�t
(DeSSrti110Nt®NprDST1#rDaaeBFCa D}l1NtSRiDACRiESS7
demand
Da Pm Vem%Wmawwakbwane01 laedaebkA now
wfan sound
NPwianatymmrem®m
hdtama SAWbfa N'mma'e Iandm(o,i Nhu bft& tomd id, hitappa ab}admthe Wodke'e
=11=msegim }7Cpmaa tabs Cae,1 dal m2mmlmmdywM tlyaapW,dons
APPUCANT.+Mr...-
WAflfPXG Yankee In score W*Wa e n tawuage is anneal and awe uaAal an dembYa to 09*W
0aama wen ud flnPd aP m are tinwaM iha6md tlame a{SIDHM n mlabl m to taI m rife tPAmpamaka
amapaa prawmad Rr In aacdm }700 m anmbaradBNOWrill atraa7a mess
CM6rMCMLUMIW. AGENCY
I Mmby, alnnn lion, penalty of Wan that Ines Is a Ce wAxtmn Lading Agency far ea panfortni of me wont tot
when Nre wrmn a (aUed (San 3097 CIw C)
LENIERSNANE
LENDER S ADDRESS
l Cadtyawli laws lean tNa one sUU ism Neahare mmmaannPalral Imewlemmamwdlaldryand
oxatlf' odkenres end slam mwi retamg m tadtl¢gaantrucaa ism tndntrawatrn rePeanmo-xs m Drp awry a
ew
ww
waa rant dew amat•madkna propaty fa aWwtikw wtpaa
t
"dGNATUREUFPERMiiiEO' SATE
APPLICATION DATE P7Cr
Y ISSUE DATE PERMITM YrA.f�1b' ,✓t7Z6ol
TYPE CONST lLM't S DOC GROUP 04
Scope of Work
iC 'i1a ,
imae-}eill 491nK.t.z,t'S rw�2-I`e.r F\tA
9 DWEL UNITS ' # STORIES L+�a BEDROOMS
DESCRIPTION
SO FT
PSF
ADJ AREANALUATION
SF%ADDIREM
,FACTOR
cmagalca,pad
PatlaR3enk
w
PWVSR
_z
Pa Roof
Commercial
---
Ya"e meen, Ach AM
QUANTITY
DESCRIPTION
FEE
ca
IP,'I"V-a .r
CONSTRUCTION _.
PLAN REVIEW
ELECTRIC
PLUMBING ACZE, 90
MECHANICAL
INSPECTION FEE
ISSUANCE
SMIP
ENERGY PIC
ENERGY PERMIT
RETENTION FEE s�
PRE-ALT FEE
BASF
PLOT PLAN
......
ZONING CLEARANCE
�f
TOTAL FEES Y,sy
COMMENTS
P/C .!"aatlp PAID 9Y VALIDATION
RECEIPc.A ta 'y PAIDDY VALIDATION
WHITE -Dematment Copy, YELLOW -Fnerma Copy, -Assessor Copy