HomeMy WebLinkAbout14-4273P
vC
J
ti
^!.. CITY OF DIAMOND BAR
DEPARTMENT OF COMM UNITY & DEVELOPMENT SERVICES
( 21810 Copley Dnve, Diamond Bar, CA 91765 PRESS
„u (909)839-7020 Fax (909) 861.3117 Building Inspection Hotline (909) 839-7027 FIRMLY
'Mye BUILDING PERMIT APPLICATION I I
JOB SITE ADDRESS+50 CAV—Pl0 ?-
APR ............................
LOT TRACT
OWNER `e 1G1�f�CZCt y1`�
ADDRESS
CITY TEL
APPLICANT { ZIP _F�E—TEL r
CONTRACTOR>C't'1t
ADDRESS`
CFIY . IriA WIf{'S SO zjPC14Q9 TEL (®O (,3 jr... PZ$
ARCN1ENGIDESIGNER
ADDRESS
CITY ZIP TEL
OWN84MUMBECLARUM
Law day the nummiai
I hmeM amrm wmer PdeeM SI Pajtay tied I em darnpt have ee c0 macal s SiamR,
�Uu1mI.�ae
nm^aml RBbR by It* daeama up, I have, pared paryen b ew st mkdha awnew pmaka. 1031d, BFANwea deed
Nahasaro Coal AnY dry a aaaaT loaf re@dr¢! a permit m aorehncl, mm,bmmA amoNeA.a repak a1Y
BNRC#e, m# b ibaaeae, W regmmtlde mpplbM # wspmmRm Poe a a41M mabwfM � W a 6Nd
mBtawdmaaeAtmwapmasimamWGtmffia'adaemUr�etar{fd�w[R} Mm
7aIBo1 Dhmlm 3 � ma NWpofe wm tNpbalRte Gael aDacae anal a evaNn kmFtkutdNa aM Ran NPSb#
tlaMaded eaxmptm AryvagemmSa$mYp3t SMameOtmmm#apmtaazgepaRa badv3paaRy
a M mare Ran MB Ma¢Nao/a$ {SSOQj.
ewgAeaemaeaka aa{Jaeaa{}pmvaa
utMeak.W awhadyar
Iswehatee
a ede Oak, dtl the aaucme a rim Odaamd a andeea by sme 44ONar, 76sd, RIPIl1e55 as Anyletsined, Gtln be
Caaallvr' waatkanetsw seas a� b w ef popayMe, eaapnemPkrycee' amsmmNav4aika
a mlaRaspwpmpdPY, [vmaM Rtm Nun Rio rotaoNam#dyavma Ran LmaRtga
nv� vmaneae exam maaleRm, ed pmeaRudner RW sae dun aaam mwmYnRwa Nwak M mR
a bwe ptrposeasalaf
Stcanin we preen FSapan
Lvi, commas oSwb PwWwdcoer e7crmaWBant
mtl Gtlw TeaC , UBcdaed ducy,hwa
rbunemaamPddywe
a In thpayanuenth 2Weeded New
bWdsaiarl emaea+aaMamaana#RmaajaaswimaLLneeeRCmVeela'wasimHmmB(A�1Vama4'6tla
t.nM�taR}
lJ IAmm 14"mlireraae warm ew Cpvaaaorr Stale IICI1aa tawia add humNaR me;dnw}
By my si newna aewm l ape deal. euxpl #ay pesaW resma cen Mvm I meld he" headed # at ham we
Yew warm p7mpleden dew y nmFIN$AIdIB Weaved at Oda PI Whm leddly And 0 AMR)w Red 1 he" hem 0 An
arnwr,WAff 01 w.0idea emswcteUmiaemkey M Paaxacmle,aare I wltlmaaM that cm at the wwwand
Sactari 7pM 011ha Suaram Add Awasptans Cade Is Annette upon reams, when the Spincauan is aftemem t am
thefeiwAnPweLala NOPhYwR aednP eappY(faaw hLnl
WN
LICENSED CONTRACTOR'S DECLARATION
I tme6Yamrm under penally of perjury that I am I¢aded under praaerB of Charade B IwaymexIM;Read Rtmym 700
of pavan 3m the eleavess and Pmesyans Cade and my Indeed a In rrryullFame effect
�and
�
.L"A. W uc ND !'X"YJt
-1�i-WMAUTDR
tj
I..—__
WORKER'S nON OECwATION
I HEREBY AFFIRM tplpER PENALTY Q FER URY ONE OF 7NE Fp URNINO CE(AAAATI
I have and wee maraen a fmhfcaie If Garanl a SAR ensure at Wmid,% Cent ai amaddreal M
Sevtan 37IXFattla Isaa FlTa #me mdxea me woM1 to wtika Rds pemit akixad
I have aM RID mymaawader§CaaNensiim aanratae erreaaM MSmtcn37ODafOre UbwCade. #
the palwmaasatth)eOyakry#vrtdwp�panmtatsy,�i tk(waka§ C&rkr atl
CAR �{.1n71..-
POtN:Y
(IteSSB.'R6N7�NQf tff COtiiftfif➢FTFEFTRWi 6Fpi OtktrRtlfEb Op1NLSI51Fd(d pR i.FAq.
I avaiwainta cfeaR ftaduc owpeadi6kvad Faelnudmmldd aypamn nwyevaem mean
hemtw ad{arF the Wukre laws .aa�dammdleo�h�nenew. eawWere
c( tYaP gtlmim cmwywWN4raa Pmtba.
r �'^���
PRAMlOOdthett:dear
A➢R%ANs
WAAIR Faaae m SRaAe wbaar9 Com onMn ealdeepe a unlawhn way shalt 94d an emmaem m almmed
pw=n am oaP Cues up a as hma80 wnS yd w%av iS100 ODD) In sadacn a mad cast of the [ompetablan,
Ad Ramada far $Oman 3708 of Rw law, code, tmaea, and affar" was,
CONSRODCR thd t BMM ACOXY
I mwm under Rental of pajuve mat eery Is a Camamber, Lend" Apaxy far the Peas Ntd Se MA At
Mind the adman Is aRad (Sec 30B7 ov C I
LENMARS NAW
IRMER%ADDAE':S.
peiltmvorpq tld90ppdpal'aa d110#da wen ea Haoee Yfarmafbna=%LlVmbomowStgidtyand
btlelalCB9 wen xlale aRaRmRgmal aP'B taewKRm etlhereioudeduay rep,= wmmthe Wraym
dean dean ew abao maraMNd papery for nspeden Wpm
t
TEE
�
SP,NAi11RE - DATE _—
APPLICATION DATE P1Ctl to
ISSUE DATE SS (b /14— PERMn'p
TYPE CONST OCC GROUP
ZONING SETBACKS
FRONT
REAR
REAR
STREET
SIDE
RW ❑
❑
RW ❑
❑
PROPOSED USE
20 PrO�1�ci S
N DWEL UNITS N STORIES
&fri
a BEDROOMS
DESCRIPTION
SO Fr
FACTOR PSF
ADJ AREA/VALUATION
SMADDIREM
Gma9alCwpe d
..................
N
FtltUR�dck
LL
Aar
car
2
5
D
Y;&Rpgd
V R NNm
deb
Valuation
^` Act Area
QUANTITY
DESCRIPTION
FEE
Inyt
u
CONSTRUCTION'
PLANREVIEW
-
ELECTRIC
-4 fit)
PLUMBING
MECHANICAL
INSPECTION FEE
ISSUANCE
SMIP
.$ I •3 O
ENERGY P/C
ENERGY PERMIT
RETENTION FEE
PRE-ALT FEE
..
BSAF
V 1. O iS
TOTAL FEES
COMMENTS
~t{
1 C
FECEIPTa U PNDBY"`
VAUDATION�
WHITE— Department Copy, YELLOW —Finance Copy,—Adseaaaer, Copy GOLDENRROD — File Day, I—Adidecam'SCopy