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Home My WebLink About17-937429 L' I i2 0 P1 1- 4 11 VION1111a1R m* CITY OF DIAMOND BAR ' vW 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 PERMIT APPLICATION wwwcttyofdtamondbarcom buddiag`@dtamandbarcagov JOB SITE ADDRESS ;-�i S—nl D(— APN LOT IS TRACT OWNER It'Its ►JarnG ADDR SS h CITY'1��rb 11c, TEL APPLtGANT UU Riat. .ten t-IE_IEP 'S�TELL. CONTRACTTORR,,,.T l At ADDRESS6?0(i—.. S CITYAV*4—j�[7,FH.!-4-- ZIPYL TEL ARCHIENGI DESIGNER ADDRESS CITY _. ZIP TEL OWNB4tn.OER DECLARATION I humby arm under badly of century that I am edam{$ imp me Cpmmacr'a Sao UCmiSB taw er the reERPM) Indicated asow by the chadmatruhh, I here plaoea msd w the sumble MmcN (Sapbao Tans, Butt"m go Prelenhru Coda Any city or caMy that rerprhe, opWndfA mndwa altar. Inerma. dmnaM, or repair, any etnmwre, prior wits lnuRne, pee mguiree am apt Harare parr ifo file a signed shhmwdthat he ;she lallcaneed puma tw her pmtahas of the Colib'actor'$$Ub Ltanea Uw(CMpW 91 C=MWWMWdbsomm ci Dlatelan Dos mN atarld Hoheelnnb Coaela t7wt 84 or sanpiboth iwanetmmasisfor in aatgpdaaanfnyUot SRn T05!DbY 3aaMIMaulaca the eake4)scml Pdnaty !.. rpi m9m than mree hundred dpiptesDDt ..... I, as owner of the property, or my onVtMe with wages ea need new Wn, an m U ag at wink, and gw strvature Is not t)pmm a ofwmd for agile (Secmii 7044, t4t0n and Protesekna fie CCnneCwS State Lcme9 Law does me apply to an owner It property who, mTA„m amGioyeas' a personal shut opens or ImPmrea Ina Ptopaty, Provided that the ITprovse ens we m'n IrMnmtl erctwrm Ernels dim rear, the iwlMng a Impmremmk is Enid wont one Year of omMusaxi the Owner Bulbar will have -0 WNsn ofprmdng fdt d was not had or Improved to, my pwiwea at sew 1 UI a a eNTBr, at the pNR" en1 e4'Iustany Mnbafgng wine ef9n9nl' (bnbaClBm to c011Y{NCl ft pmfout iSemon 704 Harm and One The CMUMJMM StaW LuBrs Lew am NO apply 10 an Winne 9' pmpmty who ba'.Idaalmprovastrelaai sea wtm caGmote for the Niminawer alkenuarco encfarpuMUatOdMCmpstl99 Swte Uomse law) U I am axffW from Ilcenmae me, too ConlreM's State Loose law for din IdwWWg reeson(e) Dam Sign By my' beawl etknwSMo mat Except fa my parennel Taluns m rmlce l" have reached IwVew map year purIS mmpwMn M the Iminturnmrs covered dythin p MILI Wool repay wit a stvexa that I hays tr ldaa an owner Mercer d It rot Wean mn$Uu in Ifs antreta' by gnmsed to*mtl9re I a+sraipd that a copy of me ! Smtvaa epNisbw Me, bn 73" 0 the Busllcese and Cme'�.a prelatie upon must when thin application a aubmmmaMima Cawing Wgb pm hlm/wwral�Motd Darislav tans LICENSED CONTRACMA'S OEC9 TIDN Ivmby affirm under paneity of pm$ay mat t am turned uder Pwnawrs of Curfor D immmecing am Se kn 7000) m DMdon Entire Buerasaand Pmiargipn9 Cade, and my Icanna a w ha 19rta and nNEM L.EME CLASS UC NO ERP DATE 470R WMWT COMPMSATION DECLARATNIN I hElmRY AFFIRM UNDER PENALTY OF PERJURY 010i 0FTW FOLLOWING DECIARATIM _._ i AM am wit mtlnam M Continue at Cmwt m Sat Insure for Wotan Owpn$MW, a9 burned ey SeCUn3700of the tabor Code for neap 0 the work for which Mr, pmmtls issued _ I Mcce 9Mxis ormndidn Worker's Cn Tr nsatbn iushmfce.. uniquired by Section 370ttol the Imor Cate, for Me PerlamaXO Mpocamirtor which Us permit lamia9 My Wafke!'9 Canpa'wB."en a!aINMPCa Gartwr Bntl policy, Manomrps CAR ER POJCY NUMBER _....... ... ' C,HS S€ IION NEED NUMCMUTEDIF-.K PERMIT IS FOR 7EtalNtmED DCUARS $700 CRIES$ IGt9eItFtftartIn1w stm!d 1p !nldpiiomvreattryany Yemn mmaw*ap_mwsCI thwart tm0aln!mneWr®okass et9s iIs±AasnuDdeldwa,gXihs ppmemNmSmICri9n lW01wis,370701a APPLICANT r yDA� WARNINU FNidm la Eeeum Walter a C9lmpanaatis swerso s ureawtul and shot subpn an am; art( m criminal muskies eat oYi MAN up to Ma timdred th umnd Scope 110 MM In addition to the mat of she tompenaatlon, Semagea a9 pmYdadmtIn t37DR 01 the laoawda inWes9 and attomay'9 fees CQt4TRLPCTIONLENOMAOEMCY iScenewa Cpnshucdm Ianang Agemyis the pertnmmima ct "ro wpdtb which aft Fatnnt is lsueq (Sac $W7 Cr,Iy C which aefdmunderirwit (30 LENDER'S NAME LENDERS ADM$$ i Denney matIM1 m@I:nl9 appriancon At Sam mat the domes IMormatbP Is istmoD I ma to mmpry with a'I city ad adlsncea and Spain fret hitting Ice bai es san drichal. and hereby sudlonae mpmwnmtAs of Iola munry m Par now Me adore mmdlomd proper for mspeGTron purpose ..1. SIGNATURE OF Ifflir APPLICATION DATE ..... ..... PIC#�—11M^i— ISSUE DATE Z -�z � "—r � PERMIT# I _ P>�C `._� TYPE CONST OCC GROUPP Scope of Work', Azt56r #DWEL UNITS IS STORIES #BEDROOMS DESCRIPTION SO FT FACTOR PSF ADJ AREANALUATION 9FTg±ADOIitEM Oomgelcarpod Ice Pnu4/Dock PaaVSpa 0 Z Re RW 9 ! Comerwelal — YahsBelafn Anti Area QUANTITY DESCRIPTION FEE iYLI cT G uY emit 4 Re Io Cqs L 4nd(4 a (io{a 5` a S T3 vea. j fleull, aWL #7n aS a! J U r I g o -Cwtc a CONSTRUCTION ^'' "T PLAN REVIEW 1sp qqZ "+T ELECTRIC PLUMBING f Z'7 20 MECHANICAL i o ci . 40, INSPECTION FEE ISSUANCE _ i44, 48 SMIP g _ar3 ENERGY PIC ENERGY PERMIT RETENTION FEE PREALT FEE y • 00 BASF PLOT PLAN ( CD ZONING CLEARANNC7E�-Y3.' TOTAL FEES �fT COMMENTS /t4(tQTT PIC ...�..r.... PAID BY VALIDATION LG RECEIPT 7-r PAIDaY �040 VALIDATION .I499 WRITE —Department Copy YELLOW— Finanpe Copy, PINK —Assessor Copy