HomeMy WebLinkAbout17-04359
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CITY OF DIAMOND BAR
DEPART ENT OF C( UNITY & VELOPMENT SERVICES
21810 Copley Drive, Diamond Bar, CA 91765 FIRM
w, (909) 839-7020 Fax (909) $61.3117 Budding Inspection Hotline (909) 839.7027 FIRMLY
BUILDING PERMIT APPLICATION
JOBSITEADORESSLJ+^v.4 CrVi-ker Zino Ln .
APN LOT• •••...... TRACT
OWNER
ADDRESS J .S.i 0 C F) `1'•i'
CITYninrY)OY3ti !]Y ZIP TE r ,5
APPLICANT L, TE SJI
CONTRACTORAf:!EoVia�,)P.ii)crrer He tars
ADDRESS -2Z _CQ rll }.ra I , L_4I_
CITY Vn l e n Ct o-- ZIPQL{.J'5, .. TEL 4 £4 5 -Q 0 AZ
ARCWENG/DESIGNER
ADDRESS
CITY ZIP TEL
OYNU BUILDER DEWMTFDN
I hems a wrier penny of penury 0et I am 6apmPf horn rift QMMXd'a State U ,fhW Iaw rer the W3*3l
W41OW blow ty the cluicumarke I haft OWW W to me *Pp we man(o} I$wdbn ton M, BMWWed
ftknWm node tort GUY he twinty that mWA= aWrmit tPmmbuct, sib, Mquirse, tlanellak or c*O, Wy
xbwhmm, now he ib swo=, abm ca"" as switom to IN pwmlt he no a SW W mb "d Mart be or she
Is um EOd pmsudgtmth pm w m w Uri CmNa minus Sb otl,wme W @w*BE Carmwming wit States
of Ohgain Sal g»gtmlrWm aW kaftakm Carla] or mat he o, she is Mason hoe ozone and Na has iw
the alleged ademptlaeMy ykdwp,, of Sermon ions S ay am app Ftelthdr a permit autt" Me apPlicantur a civil penalty
at rot more than ova hundW dinars (5500)
UL a9 Owner III the property; car my wrodyemwdh wagma Mr WI¢ cmnppnsapm, And do U aft of he purlieu
of the prod, and The ,aaeaee Is mI Needed or MIAMI rw zte N"Wtlu+ 7044 Suaneae and fttmiorm Cede The
tadmclas SMO umlaw � notndy AW W mowed who mumh pmpwm Onpalmmi elfon,bolds
Or imlamma the pmpert%prodded bet W onwwamdlW art my *W W or ended be sue q hawari the buldup or
WPVnMOM It sold whim ere Year s=VOUM the Orman Bantu MR ]am the WNen of ammo list it AM, IWf built
a mpar9d as the purpose Of erne)
U 1, as mow at the pmpeC{ rim e.ebmhay, contraebnn With ircansad Corbactpra to aomtruet to project ISWdon
7044 BireiMeb and P,oftesbne Ode The CorVa tam' Sotto Leenew taw Cu68 not apply W an Omar of maimmy who
mdmd+Ppmvaethaaon and wine antracufar tho innesp win a sawed CarWeem pursamd tottmWNecura' Slab
Llama Law}
U I WI ass vMOM ldpmum Odd the ox*amreDOa Ummp law AFT "WaO'mg maeW(ak
By my simun sebW i acknowledge that smWtfdmy dermoal resource In WAch I must have maded for at hudd le
year Pks to conanamor, of the impmanat, WvdW me this pant I mm Wooly asM a Amerce that l have bait a SW
Owner buiderttrtheated peon constructed in pOddrdyby thaured Cmnmddol understood MAR Wpy of theawksbe
now $Ockm 70d4 eM, Bu5Finas and ProlmadW Code is MIWW upm yo ram! When the application m sub rftW oat
the mbmnn Was aW hftp mr bgleo mgwAzl whoa
SIGN
UCBPSEO CONmACYOR8 CIUMTION
i*soy alum under monattq at perary that I rim acdmW umWr Pmct%xm of Chapter 2 (Momenctral With Secdon 7000)
at amspm 3 of the Business and PretesAOns Cede end my noun, W m full b,a ad Glut
LiconsE C _3 (p W;. 713 l0 8'
GaWIAClon
1 wgxl�t's mNpunazrcay ggnAiunat
i HEREBYA F W UNDER PENALTY OF PFAAIRY ONE OF THE FOIL ORNK DEGlARATOWS,
I min and WE mau>tvn a Car m¢b a Cement to She hwme in WmNwY Compensation, as WTA W by
Same 3700 of the tabor Oaa,fn de p9mcmnWae ON. were Awwitkh the Found W Wwied
I have and t14 maryamGonserla CmrpeW Inaminco m recar4W In SecOan 3700ethe lebeCuds to
lice pRtmWn us wort ldwtdnl the Wrmmm WasW ay Woddb Campduaton llmumnre Camddd
AMAY rva
5'iiidN NM NOT BE CONFL UED F T K P8 WR 5 FOR OW RIMM M lAgS $ I001 OR LESS)
gemyfat d tlwpmsanaxmemA Oak I,TwfikA mWpdmma AA a tahal MampR`a,ypmsm'.n onY manor®au
Onalbtut2arc yfineara Carpdssaron tawsa CaNky !bar mcthatrt Arauld p e eupAclmthe WWda
fampum don dSwdm 370O orihe Ike V9W;tmtlmecanpy dm9�pmeWlev
I..,} APPLCIAT ti7 Q�e. E�
WAR Fat b samms Worrarl sddn evmrem N deawful and "I subject W employer at criminal
M mAm eW ON Marine to" m aded Rlowarel dada LTIGOOOR, O Wdroom b the Fast at" W, PROM
derness pmvldodM lode er,3708of the Uncoils WANarid attana/W fma
CONSTBUCngN LENWmAGENCY
I a,ay an'M under panels at palmy Mae theme a Conatrucion IeMlp Agency for the perlwmaWa of the vurl, for
wmkm thb Rind W bsuW (Sec 30$7, CN C)
LFNIXO S NAME
L.ENDEASADDRE4i
I tees Cal I era rod NNE eppkmw arc dab net Ere saw, IeormaaW to maWL Ianre s W mmpy Aim W coy arc
artimmuss and IW O him reteb t; W bu dbq aambus9m, and MIN aimmnae,eptaEnUtivm a ere tomato
enter upon the ahmw Prompted property tar magntbm purposes
PERMITTEE F, gLINA L
SIGNATURE OF PBgunEE Of
APPLICATION DATE 3I I"} P/CB
ISSUE DATE ��\""ti PERMITq
TYPE CONST OCC GROUP
ZONING SETBACKS
FRONT RW
REAR ❑
SIDE7SIDE STREEt RW rJ
SIDE ❑
PROPOSED USE
ROWEL UNITS q STORIES •" Is BEDROOMS
DESCRIPTION
$0 FT
FACTOR PSF
ADJ AREAIVALUATION
SFWACWREM
GaralloGaport
try
W
peticVDaok
Poo08pa
awry
�+
Ra-Roof
CGmmareal
'.
Vatuabon Ad' Area !
OUANTITY
DESCRIPTION
FEE j
I
&.......__
I
(� L 1110
ca
t
!
uu
CONSTRUCTION
PLAN REVIEW
ELECTRIC
PLUMBING
MECHANICAL.
INSPECTION FEE
ISSUANCE
SMIP
ENERGY P/C
ENERGY PERMIT
RETENTION FEE ci} - t7Gm
PRE-ALT FEE
BSAF
I
TOTAL FEES, i 1t-
COMMENTS
RECEIPT q PAID BY �/_=�T'l VAUDATION __
WHITE—Devart. tCopy YELLOW —Flnamce Copy. — Assesav Copy, UDL' DENROO—File Copy, GREEN —Appilewt 3 Copy