HomeMy WebLinkAbout16-1182I
CITYOF7 AMOND BA
I v` DEPARTMENT OF COMMUNITY&DEVELOF ENTSERVICES
21810 Copley Drive, Diamond Bar, CA 91765 PRESS
(909)939-7020 Fax (909)$61-3117 Building Inspection Hotline (909) 839-7027 FIRMLY
BUILDING PERMIT APPLICATION wwwcityotdiamondbar.com building@diamondbarea.gov
ADDRES,,,,,„„„„
ANSLTE
LOT TRACT
OWNER �I.na
ADDRESS
✓dLi 'pr-
CITY _+_ZIP J j f-6 TEL42Zd, a _Z`
��
APPLICANT (99X aA w t.1`fAAMI, m TEL
CONTRACTOR f
ADDRESS -
CITY ZIP-fj7&WTEL.
ARCFVENGt
DESIGNER
ADDRESS
CITY ZIP ......._-_ TEL .... _
OWUM-OWtDni BEIBANAt10N
I heeby affirm ume pasky d pequry #W I am resumes free hN Ctrumster'e Sum I.Cerm Law for Na resumes)
k4w e7 babe by the ) I Wre pared me b dte Ansexim wm(s) IEectme TO3/3, Salmn etd
Paakedw Cade Any* ar candy thel nqulm6 a Boma M emubnct der, Museum, mopes. any
ebucWm Paor M ON lNu nce,✓ wrequires Ne APPllowel Air ft Work to too a speed gts%MM Nat to m ene
al pursuant b tp pwYwM d Ba CmtresN's Sure Licsae txyr (Chepear el Cammeneug eclat Smibn
seashore alVreaiWnassM Cadet ar NnlsadN mepmpl from lkanwre sus th Utltt to
tlNdn ae:empdm Arty WgetlmWS[Bm7D315bymyaPpSmfarapeRmisibOMineaPOh Wa ad W"
dw mews Thai roe nweretl rimers OR
(.}f,nawreat Ne napeM.mmyarlYPlaymawMwalaonNMreaM wmW(jaRMa(j Porhnam
al the musk, end Bus drucen is ter Intense a Manor he suet (Seem 74ee Suarkes aim Rotas Code The
CaNacbe'StistatbwseLaw Wa nd#Whfomuwrerspapdty arse, iNaga 'arty®sl eftalbulds
a hi@rma Bus ptapwty praedBll Nor sal ae llM started IXalkgad Mr gab dlsavwM as wmnper
knposwrMaa 6 flaffiwhMtdm YAW M anpletwn, bW L1rre &dBus will pare tlN bnMwf dppip Oust h was M>Rai
d wprermNr NainapeAtel she 1
ae awimr WOmpaPmtY.em enalWweMmrtbmunO wiN amnMd Caibactpa MaoemNr die PNect lSmiNn
70I
70e4 &Nnaa and Ppt§adMs aWe am CalhmNra' SmN Ctmee Lfey tle09 Wt eDA9' M m ansrd popery war
x lmprwmdsimn,vNwbptaxNacsw NepgectsxMalpaWWiDmtrappr puraandbNetbimacta6 State
txmlm l8r/)
tJ I we smmpt ham Ilcamaw unow" werie fe State Excess, law ire eta NhdnlnB reamn(q
&7 PIT swhm w4av I acknDwtmAe tat unrest fa I" terminal realwnce Is WhIch I must hen rwdw brat Nast are
M b WmpNhon Df the im{xmNrneMrm Weerm by like peml61 rur at may mI a MrXhure tad I he" bulk a9 A,
wader If it law Dd seen rMWiahad m a wArdy by licensed WnmmWu 1 mNerstand Pet a cem' of a6
amicable later Seem Mao of Ne kriftesur aid PdeeWam Cede IN ammd@ mine mWO wren dre spplkaWo Is
mbnsm addle b&" Web sus t6fsMxW ngDdoce govicBlaw hknl
ucer�cwiiRAciarsBnxnxairoN
thereby shrink RlWrpasaYl penury Iha1IamI aids epbSone of Daptw Bipxnnwrc4+g WnSe<Bon 70Xs
d UMsim 3oltM &mftu M Podassns Cade In luB Idceand eNaA
+eMFn7erafsets
LICENSE ants (LC LIC NO rSrr��
LLf !l CONTRACTOR L'tn*Nl"
WORMER S COMPENSATION DEOtARAi1Mi
I HEfERY AFFIRM UNDER KWTY OF PULFURY ONE OF THE FOLLOWNG OEQAMTe1NS
I ham aM will masmin a CaUicstn of Cement to Sam Man ex WxWs Corn wastert as pmiWd by
Smakr3700dleeI brurCow twihe per(amarced NBwwk Forwhkh rem pwmmmeared
ltsromd WIlmdnwn WWWSCpmpatsaeon Inm nea,ategUiadby SOMM3700drem Iabmibde to
thepBRemmteaf the work mr WuMthe serer.. is lamed My WbrW$C"rAOlbn Lim CarrWV4
PeM�YNumamaa
CNWEfl
(M-gtlMNEED WE HE COMPLETED FTHE PERMIT SFOR of WRED DOUN&IStogOR LESS)
e effipibpsmds� Lin hit m®N
ftul,aeara
s I shewedrNPeaeknedAssa
basma teCjo tawC l2Rfm¢And Agee qaA ptapAd OmmN st{eGffiBN xNnkd'9
orshis 4 CX WftLem,
CmwasMlm Poelstrasd Ed9mr 37B4dihe Law CAW 19ae MrRMNmmpyw191PWeIawlWYs
VMW"ci SO
0.47E ri-y o! (e AM ACANIT "'7iLZ�ial"
WARM Priests Is smrs a WOWS Ornamentation mrcnga Is udenaa, and shah a.M W m empbys is aimed
pwwd" and Ise l flees W Is one taaahw seam owe (6100OOO}, he maws c IN aml at fro
damage n PwMm to In 9eebW 3TOadme IebmmW biwmt eW atNnley a (etl
CDNSTRUCMN LENDING AGENCY
I hdabT Munn tombs percher of pyi7 oat them Is a GwaballW Larding tomes, her N9 pwreeme of ON nark Is,
w1mchtN9sermAsiaad(Sm SOB] Cu, C)
LENDERSNMff
LENDERS ADDRESS
..
I cerofy that l hem raid aaa pplCalbn ere 8mle the his resume kiMrld4n Is Wrika l Al recently mist all city and
am ffiaullbntmpxpMer rest heavy magr'ma te(x o(Nm camyb
suer epm�N/e eboe��a[[m�tenl�la�np_d� Pr�opeiry�ie ILLnwecUm pxpDse3
thea emenbWpoWty
ALGA
PFfmOEiffL2+"1.+.+"^'
SICAATUEOFNAMOT E DATE
APPLICATION DATE e+f✓ .`LAC# PICN �' : test ' l
ISSUE DATE 'e" 1) b PERMITfr _Via 16 — 11'4l,'�r,
TYPE CONST OCC GROUP
/1
Scope of Work 2--9a
d DWEL. UNITS A STORIES d BEDROOMS
DESCRIPTION
SO FT
FACTOR PSF
ADJ ARFANALUATION
SFFVADNREM
Garage/Cppmt
P.Dack
uW.
Powspa
zRe-Reot
Co.emi
m
Y4aheBBarr
Act Area
QUANTITY
DESCRIPTION
FEE
CONSTRUCTION
PLAN REVIEW$
ELECTRIC
PLUMBING
..._
MECHANICAL
INSPECTION FEE
ISSUANCE
SMIP
ENERGY PC
ENERGY PERMIT q,y
RETENTION FEE sJtlrLli
PRE-ALT FEE
BASF GIG
PLOT PLAN
ZONING CLEARANCE
TOTAL FEES S*
COMMENTS
PIC 2MM'Si'v PAID BY 41 "M*—o' VAUDATION
RECEIPT4 Zm\ as PAID as,—M 41?181c::x VALIDATirkl
WHITE— Depa .Wt Copy. YELLOW — FNm1Ce Cops,.—AaaMURa Caps,