HomeMy WebLinkAbout17-26789CITY OF DIAMOND BAR
! PARTMENTOFCOMMUNITY& YELL 4ENTSERVICES
;' 21810 Copley Dnve, Diamond Bar, CA 91765 PRESS
(909) 839-7020 Fax (909) 861-3117 Budding Inspection Hodine (909) 839-7027 FIRMLY
BUILDING PERMIT APPLICATION www.cityaftfumondbar.com buddmg@diamondbarca.gox
JOB SITE ADDRESS
APN TRACT
OWNER
ADDR
CITY TEL
APPLIG T TEL
CONTRALTO
ADDRESS
CITY ZIP TEL
ARCHIENCJ
DESIGNER
ADDRESS
CITY ZIP TEL
MOFWi BDECudtdnDN
I homy aim OWN Magety M perjury Aran I inn a papa from the COn WN" Soon L"M taw for me Magmga)
Inelmtul bNPr by the phactmpk(s), I has played Non In Ole eppbstee IMISI (Sedge MS. BYelnes end
ftO"ma Cede Any dty orcome/#0 regmra a pn*to 041ft & elmr, gopraie: demPM, m mpg,ally
elryemm, pNmmBe �rWmraam �mrtlapemt%m BIea YSlmd ammmmd Bmtaeasho
maeaetl tousruaimasprviummoftheCONraagr'8SmmLmeae law IChapmyigON ansocmgMin Suc an
7WOot BIvWm3ftaw Balms ad nataaNaucaaelailrk iagr she Ie eawrN Iranhceraurgend the boa lay
pre alaqud a MOM Airy wawa+ N Sadtlm 70315 ny Any NNOM fora pain.[ sibecmcm applicant IN a Civil perelty
no any imm than 996 klaimd dials ISW
U1, a Magner of Meplynray: or my exoMeNts wdhwages a Om canpwaaaoaw101usetAUpmneu8
d, and me worn the pue Is ago emir el no aRwed Nr aaa {Spam I, guNmae lay,P�manON Ors The
Canbapmm State Merge law dogs tax apply to an agency nap"win 9=0 pnplMyNS' a pereopel intent aulds
a blarou[o the pgpeM pmndM ma pN bigfPpmaltl ma11a TAtwned a olmra Kyoga atgrsra din buie nu a
a11plPameN d sw wlthn as}epa Cam�inn the Ovnwr BUgdw Ma Iave pn arttlan a prwag ihn n dmallN Wgl
a'
aowlry.
i
Beasaanse
MNDNm3pt8fol P8 pr�epa Ma ep dfumoemrwlmlma mtlw Caa8Lia0'Smm
Low)alhpem,and
Ucees Low)
UI am exenpt ben aemam under gm Carmorwro State umen, law am dN enmMng rea or
By my elgrshan, War I WAADMOdge Bab e tr my apparel raldeaM In wash! mapease rsNed No an hastam
year lMam wronfeMan at ire lmproverelmnnamd try" pwmN l cpmmt lopeilyNA a smeitne that l have bust a an
Mena WM R It hie W been sml uctpi in a adoety by Interned WMICKa I unceawn that a alpy of the
Ragoon, Code N e0444 Leon MyRatl when as appireaNgIs
applmsne New Secbm 10a Copy, Bw1�na�$.
.a�nd
mdlmmpdanMin YML Lem IRpMww Gd.gP7amw hMl
LICENSED CDNn MOR%GECLARAnwi
I hooey earn unclear pff.M of palmy Mani our IEmaed amm prowlso N 01 DNptm a wat ROOM 700
of Dhtdm3aae B4akieg Co((da''aaeal N a w one, ern effect
uC{NSE CIABS uC 0 ja1+A..Y
DAN CONFRAC'IDN
WORKM CDMPaiSATtfy DECURARON
I FERRY AFRRM UNDER F'EIVILTY OF P IUM ONE OF THE FDILINING DECLANAnONS
I has and WIR merman a "Cohn If Covent m $eB same for Warkar's OWNxinsaban as pawba by
SecUw 37D0 d is Labe Cure for the porlom fool iawua b vndh thls pem+t Is L"wd
— Ihaveand MIImalmm� WoWs Wmpm tmbwaslne atpadmtl ySesilm 3700 of thetabor Cadeto
aw pafb sot mawmdax whnh PapemIHN 9a(M WaNa'e Canrpansaan hssmns Cd:tforatn
P n Nu s
POM NOW
{iNSSEcN*cu EEDNOTBE �ti'It.AMfr BEpR n{Ete,NgED pIRt016¢1agOR tfSi}.
I �tlFy oan pwpw%amm®a tlnwwako wNfAHW Dents Naawd I p4Bgplprp&}gry poem m
OamlBdWpXsbaio Wbliataon 0a W Maaasm
d lanpaediaa cONnrole Wtaiste
Canpp4'nP+pMhiMaot4ieCim 370001 petabarCoda iawl Ia4rMtltmlrWy+M@tdppapiwova
Mut N Leper intent,
DATE ApPIdANT
WNUdNG Fohae IN sane Wolool Cmnwreabar tMrMW to UNMU, and 9%0 subeft an aonpayfi on ammaa
peafla and ❑W Dna w he age Weaken housa d dWaro. ($100000) in addNbn m em Nea or am smpp®bin
images as pm.ided fa In 90M a 3708 of Me Law scow, amrust, aM N'mmey's tees
CBNSTMCTMN LOONG AGENCY
f hpfay afore, Wer pe"of perryry mN spa Is e DMadtalMili Lsndag Ageruy ha the pedauaace at the vMk fa
who fob permit is enuaf Day, 3wON G)
LENDER S NAME
LENDERS ADDRESS
lCaDty anti nave reed as sM smm inotrw abMA Nimmm(�laCarM agRstacon withaNdNand
agnly and amm Inge; rapag on bedding Ce1MnKVae Me hersy sehorNe f�t85pRt1s2St41116EIXm!) m
pnp wan My above-mwdblrel aroaMany Inspecting aawaea
1,.�\a. �a✓ia V
PTRIKI Ef WIE "OM
-- DATE
9(Jiriti ENNITTEE
,.. �C.TIO a�
ISSUE A s
. CONSTIIIIIIIIIIIIIII I I I I I I I I I I I
. ILL.. yyyy,,
)+ — r
O4I I C GROUP
Scope oof Work I
DWEL UNITS STORIESBEDROOMS
IIIIIIIIIIIIIII
CONSTRUCTION
PLAN REMEW
ELECTRIC
PLUMBING
MECHANICAL
INSPECTIONISSUANCE
RETENTIONSMIP
ENERGY PERMIT
PRE-ALT FEE
BASF
PLOT
ZONING
TOTAL FEES
COMMENTS
\% i1• II j
IIIIIIIIIIIIII
WFISE—Department Copy.YELLOW— Andnee COPY,—Assnoaor Copy