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HomeMy WebLinkAbout14-4587W ti 4 s d IV CITY OF DIAMOND BA DEPARTMENT OFCf UNITY & DEVELOPMENT WICES 218I0 Copley Drive, Diamond Bar, CA 91765 PRBS (909) 839-7028 Fax (909) 861-3117 Building Inspection Hotline (909) 839-7027 FIRMLY BUILDING PERMIT APPLICATION ! 3'i L t L (Li ST xaw JOB SITE ADDRESS APN LOT TRACT OWNER 1 i,4_4_,!C,(�LSt mb tCt-- ADDRESS I t% (7 Ftt4F_Y H S I K-K CITY_ ZIP TEL APPLICANT gy TEL CONTRACTOR ADDRESS �✓ ty gq� CITY 13MZ!t- ZIP �'�' TEL '706 D ARCH/ENG/DESIGNER _ ADDRESS CITY ZIP TEL_ O%"WBUAOER DECLARATION I hareby, afRm li r or" of arp,ry Mat I W sweat fmm the Connactab Seas ',!cease Law per me reareal mdkd@d below by fie clwr*mibute) I Nye Ordered need to pN applcabl a Ilem(s) (Sawa nail, Rminan and RakWw Code Any dq a County that rMdrea a paMt m Cmwuct or* lnn , daaOlah, or repalr, 8, "Mtn. Lrtia to #a swaths. also "K emea on appilC M for fur permh to No a elgmd Nabnwit that As a am NO Prawartt0#N poliftm at itN carbatmh Sam um taw(CUM Or Cermnmwag eurat Swaim 01 utMebn 3 0l #NaWkaoanaa0 PrpYm�o CPdo) or Om hea alga b BaamPl Imm Irermrre arN the belie M ear wemPM PnyymiaawotSa 1931 S by myaplKadfaragamlwbwab the apO=IlatNXpwa#y d The IiNm mm two hundred dowers Ci W L) 1,hadeeper athe property. a ear Assertions won areas aetheir ser ensagm,wbl doL) as of orLJPmmrm of the wwA, acd dN soncture Is not Ivarded or altered for sale (SapCm 7044 Bbeilera spur Profirwayer Came The Conhwto'e• Lmeraa Law tices nut wryyman betas! Property wtw mrxOh ampbyaw' apnmaal e#mt, brAma a Improves ma proparty provided that me arcre anlgntiarp na intended oroDmed tau see If hawown the maldmg a imprwemwd(smm wipdn me rem al ca�atsur aNOrma 8ulmer mN mndre piNen d Pwsp mat d wv rot both a Impmadfa tl�a pimomef e#a ) U Lee bwata of Ina papedy, ear eewash" CEURCN g wtm saereed f4daaChHa m camayxl the Protect (secdm 7045 Base= erN Independns Code The CaNa:mss Swank Wass Law does not apply or an awlar to protest, wlw ,knprwwllrwea,.And whocontracts fa ftOrejLCawana opened Contractor pemuwtto the CMtrwmre' Star LEa.se Law) U Ian unread from Iloersswe borrow, Me Contractors Sfato Bryan law fer the following masers) 9}9ywn' rpAbovekvrle nsowartpewmtmw'n WacwNxiadOa den scmat!for by his pffm1iLl d ale gaN xIRa AdWhCaWvarerehdadfaaielas ihatltmwduiRes an aladag4 Aarm6een mnemCtaem RBatirelypy lk0nrod caN'atiaE Iur10aflarW ihatatmyaineapplkaAk aw Secffire 74+em#p arwram surd Code bave!sae ul»nwhseieaa epplhabm awbmmedaa ma maomrgw'ha sou ntlpNwwlepkdo agwt®aw non �� SIGN DCENWO CONTRACTOR'S DECLARATION I herebyaftam utiar pensery of pe dury that I atn Massed ads "Iyans of Chapter 9 (anmanwng wooh Sectlen 7DOG 01 Charged 3 Of me SWand Rapwab Cam end MY XaM It In NN fora and 69W tXls'N$ E uAss G t�? ue ND t•I DR95 �'el la_vt -t�cAao�s.at R wU f $ DOMPBOATWH CECLkR# oN I HEREBY AFFRA UNDER PENALTY OF PE2RLRY ONE OF THE FO-L"M OECtARATONS I toes ard will madam a Cernham or Consent to swo-tam for varier a Companea'm, as proWead AT �. Swaan a7D0 0l ma lahOr beds tame De#anNnCe of mawwiciawhmhtNs path#! Is i�ua.' _!lw,w ettl+wX melrrainYfakef6 swurena asrp7risrzd oySatk1n 370gol the Leah aktlr for Polk, Nmnwca a me wok%wfiksl geePamN pbaueo AH XNkwYCanpm9adm IdrrIRMB Cyder aN PoIkyNumwar are PODCY WMBM Pis SEMNEED ACT BECONIFLE 1ffTHEPBia9T'SFOR ONE HUCTO 0010mso00OR LESS) f CaaymafataparlsmNxA mewoik mrwhckmw pwmtbkaw alalrmtemptlW anypaem Nary metre work" seams abDnammaflotSm{'a37Mot IaaraCaDmdd..Mtl> gal# YNNd babe#wgatmaw Wpkar$ Campat98Um mwamrdot5wmm 37CRabNUdq Cab IwadtagrMarrpaiRNY ham mare pmTdgtx. APPLICANT WNWW Fmkoe m Upon Wakes i pww bm beverage a unlawAd M and su rept at WOW m odnmal Insurer fana9t #on" doll" (SIOO WM. in soprano) me rant be as I hereby Bran mar penalty of poDay that dare is a Cmssaumfon Lamar, Apwtry try the psee nonce of the weak ear the Patat R bound seen 3097 Cry C) LENDER S SLNAE LENDER $ ADDRESS. I perhry, halt I hire road thampafter surd ems Val ON arm offers ri is deposal I rasa m valley wed all poor ern owimc r av Bare laws tola:Mlg m budding wnwUGkn Wftf Who "To we (rNnOaad PM" fer Inspection purposes Ew" APPLICATION DATE ©" t " P/C#_.. C7'CG j ISSUE DATE t'ANXIXG.- PERMIT# F'tZ 14-- TYPE CONST OCC GROUP I ZONING SETBACKS FRONT RW ❑ REAR ❑ SIDE/SIDE STREET RW ❑—' SIDE PROPPED USER 1 w4TE4 t..l._ SCE V MP TL Q_ I FptZ LL1ta42.6Lwb P.T EU T1P%%& Or - us — K*-,Te5! # DWEL UNITS ___ # STORIES # BEDROOMS DESCRIPTION SO FT FACTOR PSF ADJ AREA(VALUATION SFFVADD/REM OemgelCapart m Ne PaCoiDack I rwi. Pool+Spa z Re PR f O J COTT8fCI81 m I ValuationZ, Anil Area OUANTITY DESCRIPTION FEE i i00 AdA^P C.LA-&,A&a-I— C_ I %ZX-V f 2ei4vbt.T I 110 I I CONSTRUCTION I vq PLAN REVIEW Ups- • —7 ELECTRIC r•-A', • SQ l PLUMBING I MECHANICAL INSPECTION FEE ISSUANCE •i t . iR}. SMIP ENERGY P/C ENERGY PERMIT RETENTION FEE �C PRE-ALT FEE BSAF TOTAL FEES 6\ . SIB, g COMMENTS RECEIPTa_ 1 PAD BY ......._r,3Q SYALA=ON &V_% WHITE— Department Copy YELLOW —FwrtanrN Copy PINK— Asoesaar Cop/ GOI D—FINCopy GREEN —Apiukant§Copy