HomeMy WebLinkAbout17-0201CITY OF DIAMOND BAR .
DEPARTMENT OF COMMUNITY& DEVELOPMENT SERVICES
`- 21810 Copley Drive, Diamond Bar, CA 91765 PRESS
(909)839-7020 Fax (909)861-3117 Budding Inspection Hotline (909) 839-7027 FIRMLY
BUILDING PERMIT A PPLICATION wwwedpoldnotiondbarcom buildmg*diamondbarea gov
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OWNEN4WUER OECIAPAlMN
I hereby a inn unit, an" of per any that I im earmat from She COnbacin's State Lima taw hk the rem0rsg
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U I m owner of the properiy, am atmnawa , cootrecliog won IIMAWd CMMMAW to Conervct the project (Section
7044 Business and Pmleedlons Code The Conoacnm' Steio futures Law does not apply to an owner of property who
bonds W atpn0e00N0tmn, and whpEMbade lal'd10 prMmie WNh a licensed Dominican purelantto me ContraztWeState
Lime Law)
U I am exempt IM hewn Under the Cmm Wital State Lkame law fair the Me" meso pt
Date Sax,
By are diffusion bsew I aaaanege 94 mlceptra may so"raNMnta In which I map him mNdee Ina Ipet we
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LICENSED CM70MORS DECLARATMU
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MRSSECIIONiNETD NOTRE MAR711111 EPERaeTEFORONE WOFED DOLLARS$100 OWIESSI
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Compensation amwskm of Sullen 370D of Me into Code I an fn mM comply with Note plOdNam
APPLICANT
WARNING Failure to nwm Worker a Crtsnpeemttal covemga Is unlawful and shall What a employer to crams
#mamas and dal fines up W ono hundred Housend ddlam (S100M In Woman to Me cod of the cu0pensatlM
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SaGNATIME#fEMUo aE,. DATE
APPLICATION DATE t--Ll+t-0 PIC# �—�k
ISSUE DATE "l �.w �\� PERMIT# PTQ N-1 �- GC4\
TYPE CONST OCC GROUP
Scupeotwork J'd'we: 2 Wi.*' 370" car t.
Katy G T%j'tT>eFrt - J0,0010 !)Di&
A OWEL UNITS _�_ A STORIES I_ IT BEDROOMS
DESCRIPTION
SO FT
FACTOR PSF
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VaduaNUses Ad) Area
OUANTITY
DESCRIPTION
FEE
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is
E
CONSTRUCTION
PLAN REVIEW
ELECTRIC
PLUMBING
MECHANICAL ts,k. �6 al
INSPECTION FEE
ISSUANCEo
SMIP
ENERGY P/C
ENERGY PERMIT
RETENTION FEE
PRE-ALT FEE
BASF
PLOT PLAN
ZONING CLEARANCE
TOTAL FEES bil
COMMENTS
PIC PAID BY / VALDtAMON
RECEIPTS SS4Sc, PAID By 4 �n4 LAW YAllcAT*N ibn