HomeMy WebLinkAbout15-291291
R
CITY OF DIAMOND BAR #
DEPAR`I ENT OF COMMUNITY & DEVELOPMENT SERVICES
21810 Copley Dnve, DLamoAd Bar, CA 91765 PRESS
(909) 839-7020 Fax (909) 861-3117 Budding [inspection Hotline (909) 939-7027 FAR Y
'^wee BUILDINGPEiLNiTAPPLICATION www.eityofdmmondbarcom buddingCdtamondbarco.gov
JOB SITE ADDRESS 2-1>Y-OL`Tf
IKCIt�7& SP�'1�.1C.OW4
APNDOSS...........
LOT TRACT
rA'"�,�
cr� l
i-Q v
RE
td.Ave__ o.5 G voye
CITY ZIP TEL
_
APPLICANT i.� 1,.2�t�.. �o'OL b Q `J
CONTRACTOR
ADDRESS �'
____
CITY ZI R TEL
ARCH)ENG1
o_-3
DESIGNER o low -
ADDRESS
CITY ZIP TEL
OWNER-OULOM MLARAAO
I homy d&M mils tender A WTny dre i Am meter hoe to Cronsdares Sate Liman Law Fw the na±mNs)
Imkaad helm by the I wool Owed Met to N g kAk $) Pnban YM S &u and
0of tl CWW ART only m windydW taqnnm a wen to mmbuM M6r, mermo, mash, a rein, my
ebUMM, pamor rode Nmamo, On memo Wed awman for era RmmhrCar aopinion aum�tnMawa 00
atpnaa wlsamtto toPmwslmw of ONcwmacatn Dab lemon Law S Gammmlalllgwim$no r
70M of DneNn Saxe xabms and Reasons Coaral or that he wane aintmet had Kra are and the pan for
to allow a#amMat Arty variation of SaUm 7IXHStry alyappheara for amrmy wourrod, tog appikam to a aMl wmTy,
of not more tom Ma Mw#ked dollars (m)
U I, a owner nth# we", of my emebym6 wmwewe a Mir what aaopoamhm, will ualt of or wmor
of the Won, and to worker to not Marred a arareG fa she Owetlon 70", Bedroom ma Perfoeapos Code Tyre
C'Mbamone Sole Lkmmtawdon we apply to on Pool pro" who, domain gmpNyms' a peimnal Aft builds
or anprmm row property Crovted that To Ilnpimmmin row net promote or oRmm err wit I mwomr, Um bulMing or
""word is sN went pm year of completion, Tn Oxvxr, OBIdar Y41 have tin burden A pow,; Mat R was, not bum
a Imam ma Ia the puroms at Sale)
U I, a ewer of On Ropahy, an arcuNnb cmbamng weal banned Camama to Perot Ue mad Ciactim
70a, Bumn6a am RhaadW Code Tire CmbOdae' Sob Ikalan LAW, da9 pad a* to an Power A FOP" who
kftor Comma titamal, and wtp[pests In Ua prq=met e Mommady Connector Memlmt in theCmbasf7m' Sbm
Lp LM'.)
UI am aampt hen bartwe undo owCarni calla Code Ucane Nor No inn mWamomodm or
By myaMmNm bolo, l azWmwtwdda nsa, 9WO for my pmmred MOOM meWhod I more have raded fain dam
yea poor hecxr*om A era ImhuE"w min by ink WMN paa%R Ngnyat ashimem no I ame Wi am
owner More If R has nor ban ovead art N as am" by warned vwhcwyy I andm or" net a ropy of im
ap*" bw, Smsal 717m at inn U,Snmg am ftes*m code N avawft min mRlom whet des mucam b
mbmMmawmeire"warAb hrcew. WftcLgNkm mi
UCE SM COnRACVOR'x DECLARATION
I hereby abm mils WON01 parl mA l are iker6a tinder pmNbme h CapbrU penetration ,path Sw1m 70000
of DMAm 3Adam SaboyeaON RhgnlurColo. omtry Rmaa Is In No lam alp offm
tJC'ERSk tic NO
CONTRACTION f—.__t'- 1
wORNOR'x CgfmDSA770N OiLLARAi O1 J
I HENRY AFFIRM UNDER PEllOTYOF PERAaTf ONE OF THE FOLIMM DEC ARATIOM
_ I ham play wbl cannot a Coibnab A Cmaml le Sin -Rome No Warner Dam( wkn a woman by
Swclhxl 37fx1 a4 Ua tab#Coo for One perlmmrc9 of me Oak fawtom min wmtl IS ommod
_rots am will InahiNin Wa's Canpmadm Iramre ambikm bySwtan 370OP(Ta[npm Cade to
RapalfmmmMA al nawmN Nf wNtll (nbpmmll b aHim ay WO,YBr a (11rilpgllmlMn IIIaSAae Caha6nd
Pdky Nmnnr are
CAMF,1 72tnf�lG�n
POLICYM.IMUER i,)J [,p l L y:01%
MOSSECTIDNNEW NOT REUDIARM IFTNEPOaO SFOR ONE KMMWtM(100(a OR LESS)
wCor mW wle anted lnmN mewanaN
atpammis
TenorsA'Nabove sal RlehM pwmne mAgen Ntla wakw'a
help were Condensation agenttoNI monk hadroer
ofSa's
Wm Is
CanpaaMkrl pfSwWr 3700dme Lebo Cade ls`mamanwM adnPN vAdixawgmwMUn
DATE APPLICANT
WARNING Finab to aware Wotara Comparator, camage ♦s prompt, and snit aeardy We ompoPyer to ananel
pnhea am dye ma as to oat hundred 0muma approval 1100 OCR In ealtlm to dal crop A than cpmpsnsaUm
canon a emvped for In Bal 37M of Nat Nor aide, addren, antl moray a fare
CONSnRUCaOt Luc= AGENCY
I hmAN amm draw piney at wOuly hat Tam N a CaaWCam tmatlrd Agency for as wdmmalaa of to want for
who Ub well IN owed (Sea 3w CN C)
LENDERS NAME.
NEtAf $AOOMS
I W* din i Imo inn UN WaNatn and SAN Um the two t emmthi is wneCL I norm to WKNOW wah ON may and
wino' wed tam Nw9 raNRnota hUammomomwpRas aallmebl'mimmlIw mynmbNwfmmewmeym
enawnn mamom-mglmmmTnbpmy ear Raoam
V
POLMINE£NMiE{MONT
_
SIGMtTffE OF T. DATE
APPLICATION DATE 1 Q 1 1'S INS PICO
ISSUEDATE `--`r"�TS` PERMIT# PR IS!
TYPE CONST OCOGROUP
Scope of Work -- -
0 DWEL UNITS x STORIES It BEDROOMS _
DESCRIPTION
SO FT
FACTOR PSF
ADJ AREA/VALUATION
SFRrAODtREAa
Govagweart
w
puotl'spa
{u�
Z
R0-ROOt
9
CammemlA
s
m
YeN#e _ Add Area
QUANTITY
DESCRIPTION
FEE
Lti fi3
S
u
2
g
CONSTRUCTION
PLAN REVIEW
ELECTRIC ^—" "�w • 'wady
PLUMBING
MECHANICAL
INSPECTION FEE
ISSUANCE
SMIP
ENERGY P/C
ENERGY PERMIT
RETENTION FEE
PRE-ALT FEE
BASF
PLOT PLAN
..
ZONING CLEARANCE
TOTAL FEES
COMMENTS
PIC .tea PAID BY vALtDATION
a'R,
RECEIPT# "1412- PAIDev + i "'iyxCW'5 VAUDATION SrVN
WHrm—Depwumm Copy, YELLOW—Finarce Carry—Asmasor Curry