HomeMy WebLinkAbout15-0549Q
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DI,INI)NO RAR
CITY OF DIAM( BAR
DEPARTMENT OF C( v1UNITY &DEVELOPMENT SERVICES
21810 Copley Dnve, Diamond Bar, CA 91765
(909) 839.7020 Fax: (909) 861-3117 BiLl g IRS ction Hotline (909) $39-7027
BUILDING PERMIT APPLICATION r
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LICENSECLASS I
CONtRACIDA :5L�
*)ORMI CQYJSMnM DECLARATION
I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING OJECLARAPURS
— I taus one will Maintain a Candfinorta of Comord to Sell Insure for offorkarl Componential a powded PY
19mo, 3700 of the Labor Code, for the performance of the work for Mich this permh Is leaned
I haw and will MInurn Woreart Cormansabon Inumace as required Dy Section 3700 of the Labor Code far
the performance of the work for which this frainnit Is MUM My Warkerb (Wriermsefifion Insurance former and
Polo Numberflare I
CARNEA
PouchowmaER -1 1 Jr LA,-) L--. nS I ( ll�l I I r-� I
(MSTBON NEED! i COMPLETED IF THE PEF-M IS FOR —ONE "OM MI—ARla 31 M OR UM
APPUOW
WARNING Famm, be secure, blame s (mombeensaft mormage Is unlawl end turn cutheact an arm mm"
variants and vml Face up R, we northern thousand domes Cil GOO(}, in addrum to the bear 0 the complenicabon
domages as nominal for In Samille 3708 01 the ki MOrnivresh and ffhanneV5 Nor,
GWMUMN LIMMO AGENCY
I hereth, affinfir Manor Panetta OF Phase one lower ch a Constraction Lending Am" for the Performance of the warn for
which to Merrill, bound (Son 3OS7,Cih C)
LENOER S New
LENDERSAINCRESS
I celify that I him real too sookciflan end sal"At Na never eftheralux; is moment I ini Or many will all col and
onficarrom and able Mae ranuffing be among consermber, arm ft" samirmor r@mepbnmtiem of ft warry on
labor W the member martioned pop" For hotel pubaseas
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SIGNAMIEUPERANITTEE WE
PRESS
FIRMLY
APPLICATIO P/C#—
ISSUE DATE' ��PEIIMIT. OJ-A/9
TYPE CONST OCC GROUP
ZONING SETBACKS
RL—
EAS a
FRONT Rval LJ C
s—
lDr/SIDE STREET — RW— CL SIDE
PROPOSED USE
A DWEL UNITS — A STORIES — to BEDROOMS
DESCRIPTION
so F7
FACTOR PSF
ADJ AREAAIALUXIION
SFRrADD,`REM
I
0
PatiofDk
poolrapa
Foo-Rof
cchornemial
far
Valuation Adj Area
fTY
DESCRIPTION
FEE
15b
CONSTRUCTION
PLAN REVIEW
ELECTRIC
PLUMBING
MECHANICAL
INSPECTION FEE
ISSUANCE
SMIP
ENERGY P/C
ENERGY PERMIT
RETENTION FEE
PRE-ALT FEE
BSAF
TOTALFEES
COMMENTS
RECEIPT 0 — PAND BY il— VALIDATION
WHITE — Ceparnalwarn Chop,, YELLOW — Finaholne Copy, — Assessor COPY, GOLDENROD, — FRO COW GREEN — Appolcueni Copy