The URL can be used to link to this page

Home My WebLink About17-21215I an d y _ CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT ✓ICES 21810 Copley Drive, Diamond Bar, CA 91763 PRESS (909) 839-7020 FaTU (909) 861-3lI7 Building Inspection Ilotbne (909) 839.7027 FIRMLY BUILDING PERMIT APPLICATION www.cttyoldmmoodbarecm buildmgy@adtamandbareagov JOB SITE ADDRESS �ZJ56!,u APN LOT TRACT — OWN P filli cz— ADDR:5S CCTVJ i.-MiA xvzop TEL Z APPiJCANT TEL CONTRACTO ADORES jr7lii k4.1,11 CITY ZJPi TEL ARCH/ENGI DESIGNER ADDRESS CITY ZIP TEL OWNER-BWLDER DECLARATtM I harmy Boma under PBIflAr of "" out I am amrrµd tram the Cpmmcbve Sace Jana Law hY the rBawnis} hunkered below by the candrial I wen pound no it to The emanate wmta) tafto Tail E, and PMNU oa rah Arty City a wmNY awt MWM a pima TO rmnstrtmt, wtv, hgaon, demowb, Or from, mom mmewa, pdar to Its weuanoe, elm motion an i pllemtt for the me NO fNe a stpwd outormnt twt NB m aw he tleawwd pt rothe prawhimm of the Contractional smta Umua Law Choorbr Bi Cammencli wNh Seafm 'N00 of WvMm 3 of the Bodtms and Ptdsutm Cagy} or trial he v we la Bremer an llmneUre and the beirm for meat more than On Odd dome afSacwn 103iblot ayepplkanitorapwmnabJorname epPyawrlmadNi Nhnty of not rrare Hatt flue n;ndmd dollare ($5W} UI, aawnew 0 the gap", of my empyyaswSm wapp a their ale mmpena , Wif dal U AN at m U Pot of me work, a9d the sawrum a rwl Intended at otemd b no 1Bacapn 7044, Eudam and Proh a@om COO no Cwtlmcmm' State UCmwe Lmi not RIPON town rtwi pmpedy Mw, Nlmugh MPioyae' m perSOMI Man, Duly@ ofwourmeto Prey we year Of witoebw MY Miare not Imwyadm Me mrsaletftal twbupdtngar Impvmmefla In, mpos payar1dwmplBUm,tw QWiwr Suiymwlli here me ��reenmprwimt maIRwa npt Dull[ a.• Improved lot the pwmme Ci caw } U 4 as owner of me gromerty, wif mcmali mnt dWQ wM Ecenad Comecmre to mamwt the proem Search 7044, BAIrwae and Proaslmw Code 7' be Corpactors' Ststa Jmrtre tan aka no apply to an owrwr, of property who bimprpmree maroon, ad mnimew Air the projects remaNamed iSrarepmrpursuantto the Cwmappra'SW, LWw Last} U l am exwapi from lkenmse un ftcwwaemrl State Umnse law tote fWkwtng maon(s) li Caro __------- —Sort ...... By my apostate Wow I acknowledge that wore" my Aerial madame in whah I mud two mi rot at low we nor wort, mmwodan Ci the ImprOremants WYHed by this potmltl cannot Iapwy air a shwa re that 1 hem wit 0 owner hold" IT it ire rot man conaWded in its erdrery by burned wmrawo3 I unamwitand that a copy of The appn tri mho, SKUM 7044 of ma Budna3 and PtOhe9k�eeAL'.a�dmaIs BYBNabla ONE muteft wwwn this Uptcnwn is $Ubmlbd m mine t lWMg Wet eto nMMww Bgur+o CB T"^ "'^ rmlll LICENSER C.ONTRACTOreS DECLARATION I twee, affirm wrier sty of poi met I am invited under'nasums at chapter B(mmm liv we smoniti of NwdOn 3 a' the MLre and Ptataaiam Code and my If is in V farce and mind UCENEE gA.CSUC NO 7 DATE CONTTWCTOR _r-� WORIafl'8 CMipENSATlON DECLARATION I mo'AFFRM UNDER PENALTY OFPERARY OW OF THE FOLLOMan DECiARATIDNEi _ I have and will memfem a C.—tgM of Content to Self-meure BY WOYBera Compensation, at aided by 5m90p 37W al me Tabor CCt'e fertw pet44'mme0 w me wOmtm which flda pennn N 1eW Bd —I moment Wit mammin Wmlwr a no npermanpn lawman, Be amurad byliecut, 3700 air labor Code, for mBpadoRnaPceofineworkimwhkhmwPw*dtlalsmwd MyWmlwt'6 ImumnOOCarnerflM Pi Number are CWHER [� Pi "am ITrILS SECTIN1 FEED NOT BE COMPLETED EI E PERMIT B FOR ME IUNORED WI LIRS $100 OR LESS? I cwpy that In the performance of wo wait mtwhlm mW pent W und I WE not employ any Demon M any mwmmm5 into bawNna 000 to the workers Opinmonal Laws of CNdamN And OWN Mai al would heatme aubNc? To me Water CommmNknproAeya7Saudi 3700Cithe Labor Code t Shia t&Mwah oltnNYwMmine prod m OVE ...... AFPUCAw4 WANNG FUJI to Boma Warm, a Compho m an caterBOB 'a urli we shot au lam an empm}er m Ltamna penalties and dMl drlea up to one hurl a wound doeare ($100, }. In oW*" to Ow cos'. of the mniprattat p, damps a pra'ad for In atctiol3l0S Cabe raft Cade, Intereef, and Bibrtap etas COFSiRWMM LENOINO AKWV i wmby, anrm mhr penally of perjury that them m e Cmlmmi off AS@X}' far the pm'.mmaree or me work (or Wban in I berme Is hand (1 3007 CM C I LEIOERN NAME....__ ........._- LEWERSAOORESS I comfy that .'wW tad'ta9 app(IL@S:fAI Ord Stara min me 3dam iirfn(hBNan la mnBCt agfteterpR' wNt et.' CRy and LorN mdlnenm�a)9er%tl atria tans nlrvg to bullalrm Lolwmtcnor+, ax nBmbY euthorha mxaerdaiires of ink cwmy to enia> upon 019 a(r)' d cP Mt brl air on Wrpoaac PEPM NA fI RR87} fyry�ll�jtRR't�(�TI'�, fyt� SIGNwTJ OFPERMITTEE�TE APPLICATION DATE I CS i _P/C# ISSUE DATE r� I }PERMIT# FIR 2.1 VS TYPE CONED OCC GROUP Scope or workL J at1.. DWEL UNITS # STORIES # BEDROOMS DESCRIPTION SO FT FACTOR Pi ADJ AREA VALUATION SFNADO/REM GarnOUC�rt ,,,,,. PahoJDock ... LL Poovi 2 Re -Roof ''. 9 Gortxnewhial m Maluetfom_. Ault Area QUANTITY DESCRIPTION FEE CONSTRUCTION PLAN REVIEW .. ELECTRIC PLUMBING MECHANICAL INSPECTION FEE ISSUANCE _ 4 3 .q SMIP ENERGY P/C ENERGY PERMIT RETENTION FEE PRE-ALT FEE BASF PLOT PLAN ZONING CLEARANCE ii TOTAL FEES i 2 I . U COMMENTS P/C ----�t /ltt rP?PAID BY _// VAUDATION ........ � /' RECEIPT 0 �I.is._.zs.,,J— PAID aYn(.....-- ....ON