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Home My WebLink About15-1237.11 N a fA A vC CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & VELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 PRESS (909) 839.7020 Fax (909) 861-3117 Building Inspection Hotline (909) 839.7027 FIRMLY BUILDING PERMIT APPLICATION JOB SITE ADDRESS APIN LOT TRACT OWNER _ C ADDRESSL CITY—.. k-!3i!`3• ZIP TEL, APPLICANT TEL CONTRACTOR 106-,F N 1AOC.$ �1s'C7%t1�L, J 4 t C r ADDRESS 971 Kj N1�-xicl tAwy W Z'�Z CITY +SAai �"ilwd%h$ TZIP ARCI-IJENGtDESIGNER ADDRESS CITY ZIP—_.,TEI- OWNmoa to OECLAR#TMN I hinaby allhm Under Coal at perjury, that 1 am aimpt yearn to Co orall Safe Lksme Lew or the temp'{al Wrob l below by !re dWkmVO), I have placed rat. to ere amicable Photo) rAKtI 17¢n S, Bush and PMtMians Ledo MY city m C=ft that roqulres a pmWt As coruirucl, after, Improaq dWWM car repe r, any BaueMa, Pdnr to In iMM a 0"NUMAM the apPlMord IN Bra Pam#k Ma n WPPOO Mknmd than No or aM Is Ramnm pv fit to fie promdma of ten Ca cb*s Salk Lkmm tar 04M S! Gamlmrcbrp w Sattkn If OMIM 301 Me Neabrem and Rpteslmu Edda% Of that M W aM la mampl farm Ikeruum and den dada for ft2*W 9amlpbm Arty wool ofSecOm mart Eby MyampWWdfor amonfly Aecb the apOMMID0 CMPgWJry of nth noes den film hundred milers WOO! Utm m mm of the property, or nrY emPkfmanwftwapm an thermal ampwmrlOd,*It 0 U all m aU pnNaru of the rak men the atracbee k "IWmnkd a ~ b sae (Sanm M44 Bmirmla am protaeswm casse The Ga:sactas'smte umn�Iaw Aare Irol trmml carer ctwwem wen mmu�ampgrean'apertuvl anm+a3ka apmp ae ispmpdtY pm y thenthepm on rrwrka:e nd L7snded at Upsfed ideate Ykwaer the nul,Vinga Imprwememis sNd wW%n Coca ymr of oampkkan are Owner Bmlda-MII have the buNen W pmrtnp mIW k was nW buA a mpmYPd h#iha WRY W 99I@ i 70 I, ea inOlmbenpmsda amdeTebdypon StatLomasLa coos nkmtoy to an owner, iha of property who 7Oa4 YImprovadensm as Code Then Cantrecma Stayithama Law dam not Dopykan avermnical whA almprovm Braman eruwhpwrmam lame Plgab wdnaOlownseal CmntractorpuraramkOaCaDtrmba' Sale (YefBa Lbw) U I am ei Tom Aessma uMm pq CanbeW4Ya Stale Lkmam kw for" ea wing meagnt9l BY awdprmre bebw I momawkdnaten wzmfa MY vena mi renders m whichi raw No mauled am abed mre met as mmpetom dole lmPmvwflmocxmad try be aerosol Cmhd LO* Wi a Wocwm that I ama bulk som owner dWGmN dim am bean pplNtrmdadin Rneram" Nvaneed Carocbu> I WNaekialmala capYmece law, Saba) WOO bi me DUMIIe9a and DCa gNmfa� Isavd'able UpoU regUea`.when fib a�katlsn IaeubmiCad a W OIe IdbxnA Wan dal Mp7www lepinkca pwhgiew mmi OARi .. SIGN UCENSEDCGNTRACTOR'S DECLARATION I aaaaY amen ands pBnWtyaperjay Lhml am Ifielaad maMf reaASblu of CtUrar 9ipxrmNyxaW wM SataM 70001 m OMdan 3 d G+a aidr�aq'1Pmrazspne Coda, aXl Cory 6 n Mtlat�mce anp gll0ci. �r LICENSECtASS C— fir.. LAI NO 77 '' '�a WORmN'S GOMPQISATtl RN� 1IEIRIYARMIA UNDER PENALTY OF KiUUW ONE OF THE FOLLOWM DECLARATIONS _ I have and will "Who. a Cereficor, of Consent W Swtdnerrm for Wanes Compenedm ae prodded by SeGUsn S7OD mthe tabor Code, fo the whr:b oos wind Is laeeed _ihavemd will melmm� Weald's Oo-mpansailarlMurenuV ua L4 dMSecWo3700atNL.aan'COW B iha petfq*nnW athe weal krwhkh Om Pedal is l�UM MYWaYsrsPimurende CenNtmd FAaaYNmma the GWNHi POLICY MAMMA OIm SECOON�NEEEED Wr BE COMPLETED F TIE PER OT 5 FOR ONE FRWM DOLlN6 PRM OR LET I m" M In N perbommov of the work flar which day pmv*. a � 100 not employ, my person I, or, mannor, sea to U1 �CLen n Imlamahos auDiopmaan aeni'doYmr tPmnNl PmslDea end Wei hem up to Core hundred Bmuund CWkro pROO,WO in 966ftn to Nn1 coat m then MTOV400M '...''..,. d pmaapmNftkrin aectron 3706mmw kbmsak, mimes and atimey$kfe MNSTRUCnON LENDING AGENCY I Mail aPhm meet Pma y of perjury alai them is a CansNut,Lar Landing APmcy la fM pwr#arnvrw of the waY tar whial this Tomtit Is Wood Gkc 3097, Car CI LENOEN S NAME LENDER SAMAESS I awfify (GIA bon read the app'.com. eM auto that the atom Commons cmnat I a0tm m pompYwoli dl aty end a A the aao and dale alas re6tlm. fo bulltlinq mnatRNdhn and iBmby eumorda rearaps'r'sEris miM1M Dowdy k 4 the Pm-mamsed � oapepd - PE NABTM SW OF GATE APPLICATIONDATE 'SIa1-1i15 ISSUE DATE 5( a1 I I "r*. TYPE CONST P/C# PERMIT# PYi t-5 — 1',n1,j2L—: }` OCC GROUP ZONING SETBACKS FRONT REAR SIDE/SIDE STREET SIDE RW ❑ [I— RW ❑ ❑ PROPOSED USE .. #DWEL UNITS #STORIES At BEDROOMS DESCRIPTION SO FT FACTOR PSF ADJ AREA/VALUATION BFtRIADDMEM CaregelCmpai ' Roalspa I i' RaRoot � in Cammartid Valuation Ad) Area OUANTITY DESCRIPTION FEE ' aa C� c� iI r I CONSTRUCTION PLAN REVIEW ELECTRIC S-1 ZS44 PLUMBING MECHANICAL INSPECTION FEE ISSUANCE SMIP ENERGYP/C ENERGY PERMIT RETENTION FEE PRE-ALT FEE TOTAL FEES COMMENTS RECEIPT Y _ PAID BY' _.. ----,ai:1_%sza VAUDACON )' WHITE —Department Copy,YELLOW—Flnmue COPY, PINK (boy, GOL 0—Fad Copy GREEN — Applkant a Copy