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HomeMy WebLinkAbout16-2664t ' CITY OF DIAMOND BAR DEPARTMENTOFCC MUNITV&DEVELOPMENT SERVICES ` 21810 Copley Drive, Diamond Bar, CA 91765 PRESS ,,,�•,��, (909)839-7020 Fax (909)861-3117 Building lnspecthon"otltne(909)839-7027 FIRMLY 'Oa'` BUILDING PERMIT APPLICATION www.cityofdiamondlearcom building@dismondbarcagov JOB SITE ADDRESSt 2. OO... *Q �� J%y n �'p} ^'T 190-e 194, APN OT TRACT OWNER ADDRESS CITY a 21P "fEL 0 / ..I APPLICANT TEL A•ar�._tlCt i_� CONTRACTOR ADDRE CITY ZIP it ARCK'L-NU.V ill V are DESIGNER ADDRESS CITY ZIP TEL OWNER BUILDER DECLAMTION I hereby afflan order pare ty MI penury that I am daompt !ran the Cwtractar'a State License Law to me roaeanls) d below, by the checomarkn) 1 hart pland ease to the applicable Robot ISedidn 70315, Busama and Protessbre Code aN oily or wunW Mat requaae a pormM to MMfllat, other, nIMMa, demolish, arapan, any structure, prior tu Us RsomlG, also ragulre, BIB applkenl Av MB penmt to file a agrndstekreanf that Mm the ContracWr'e SMa I.1lmaehaw {Carper• CannraeerpmM SMMn q laeofO own3ofbOnteneubneol0lo ai Ownmr3on nBpenthreand Plm oskos70315 Corky aflot be IN arept the rlfabatrd Merbhoershopwoaandeatbaenkr afovertemNO aloofndreddemot59allm7031SbAMYappdmdlorepwmaaltedaMeeppaMHthatldipenalty of rim eras Man era Manton ddrere ISSO(i U1, as omnr of the property, or Fir toodowa9 wde w9geoo door end condensation, wrA do Lj ad oforU porens of the woo, and vn Moaae M Me Intended or oRemd fa are UIMOM 7014 Rlmneas end PCIX¢s'aw Code The DMtractas' Sty Lkenso taw ines rot apply to an ward, at property, wfn "It emploWes' a dermas effort bonds a mplam pis P@roN pprded Um Me pnpmvwMnM Ne nddl oR8lned aotfetm lases p taawem, tinms67xsga ImpmrwMrl LS Bad wfewr one year of eoMBBedm Ma Owner Balder wig here eta kmkn d MWNO Bed Gwade not bull aongWed is the P"M of Ware I U L as awaon or Bar we", We 000dnow fir aoMduthey with Rm m remimMai Ax MW lsoctim 7D4e Bodooss and Podexhns ik09 The cemo<mn' State yXerMe Lay dais two app)r he an ewer of property who a nreatanwlnwlBxbiailwprBlaiawMa0mne6dCmvaciarW dmUncmaarms'Stan I taw) ear) IU a Mn camps hoer Nordanwhe wear ME caeeconetStafe Eocene low Mr uw fom7.irg reasons) Date Sipe By my siBnadwe baba i etanowdadga Cat, esraTd Is my DwrdnN Marketed No wino, I muY few radded to at kart on rear ale beconaveUm to 0o ayippramBmt Morten By MM pmarc I Meet Wal NO a sewhore Om I bee bell asse, baba d R Ind not beta cmaneesd firs "Mot, by ibe bed co taMora i Mdersdrd inn a Copy of the Bppaetlda Me, stealer 70" of lee Oeemed, Me FYdded" Cate is awflowo upon aqua d weer tree yonee Um ls k&W tad a 9 ere hardy+# Web site Mdowerw Ngieb,a gw7cakwhinll LICENSED CONIMTOR'S DEC"MN I affirm under dedeNy Of Wary that I am tabbed under pmdNmd of (Nolen 0lcanmandng wml Boom 7000) of Mvelm 3 of ere Busboys and Prae tiers Dead andC&rne B to hip two and •Rea /my LIDENSECLASS� LID NO ENP GATE COMPENS4TION 09MAAATM I HEREBY AFFIRM UNDER PENALTY PERJURY ONE OF THE FOLLOWING DECLARATIONS I hate find wilt needed a Cedflate of CasoM he Sat Saba fa Warner$ 0"noapM ae proade d by Secibn37DOMIMLana Cam la#a PMamenle otewwWaawnnn thkpdmetwfsam havdaMwgl rnalnkn Waym sCanpw�aaon maanwa earoquhmby SkOW3700dthoUWCode.kr Mae pwknrcarce or Me work far wnkhthif barred k kwwd MyWaiw'e CMNWNMUM!+Tnaaxd Copper and Why Natter are CAFREA PoLxYNtNd m (iHSSECigHt#iDN07 RE CONREnD IeEtEadilSF Ota tk'AttdS S506 tut IE uIE• �. r6tntaadamWoaDNwakiQ wttlm0ds Rpm# IMMgndmgnyatWea90rinanyneMamnb WAnda muN aookabSa Watafa Car70wsaCat taxi rA CeHMan. Am eOse thffitt I seam #amen atNct thdn Waka's Eanlleaatlat prmxWu N Secem 3700 i en Iota iatl¢ i aria faeMiUs maFf wAA Wine ptalNorn APPLICANT W*OM Fame re aoee, Wakars Carmal®0m Mtt die is onMwhat Sae Worp sabled M BmaMyar to a*" OMAN 8m era No im in and twrrow thawed open WOU 00M w adobe fit Me MUM at tun ow waedm danagea beVWdped for in WOM 37M of the labor0000 bdemeL and Wm" alets. WNSMWnDM IDOOLBACOM I hereby State abed property ad palury that Mrs It a CMaruann LmdsxO Agency or the pods mMCa d IN want for OWN thapamU M MUM perk: 3097 0h C ) LLWMSKW- LLWERSADkIESS I not i have rood bps eppoicaaon and stale thMpn Seen IndormahM Is extend lagwa 7ocompy"In all art' we prenwpme one stffia Iowa rending be bulking mrwhucpm and hereby authMn mpreeenbthm of told curdy to ado open tin•bore manww property let ManneMpapummes yam.— (1 r fEE NAME IPRIN1f .. ....... SIGNATUA E I EE DATE APPLICATION DATE t�l� �1 /1 tc ;^�{ t�P/G# �l!q—...�,t�_{�,•,{• ISSUE DATE I TrZf i � C PERMIT# i ip — -zG f. If TYPE CONST OCC GROUPy *a"C G �1" IGCAb BcDpo of wax 'K I - `t'Rr'�4D t©?tti"� i�j'j-ey�, 1� T —i { --iiX 1-'i'�— T # DWEL. UNITS 0 STORIES # BEDROOMS DESCRIPTION SO FT FACTOR PSF ADJ AREAtVALUATION BfReADD7REM GBragWCarypA ly Patld06ck....... PoaUBpa 2 Re Root _9 canrnerclal an an valuation Adi Area OLUNir Y DESCRIPTION FEE m k sg� c� f CONSTRUCTION o�e0 tot PLAN REVIEW awl' •* %� ELECTRIC PLUMBING MECHANICAL INSPECTION FEE ISSUANCE afca 1�ii SMIP ENERGY P/C ENERGY PERMIT RETENTION FEE Oa PRE-ALT FEE BASF to PLOT PLAN ZONING CLEARANCE4'*� • '^i` yy -1 TOTALFEES Q $:la ` T 3c) COMMENTS P!C 376,419, .a PADDY ( Ask), VALIDATION LC RECEIPT 0 i f YY TT PAID SY I AA5 (,,� p V%IDATION _ Al WHITE — Derearhnae CqN YELLOW -•Finance Copy—Assssmw Copy