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' CITY OF DIAMOND BA
DEPARTMENT OFCOMMUNITY & DEVELOPMENT SERVICES
21810 Copley Dnve, Diamond Bar, CA 9176$ PRESS
(909) 839-7020 Fax (969) 861-31I7 Building Inspection Hotline (949) 839.7027 FIRM Y
BUILDING PERMIT APPLICATION www.cUpofdrlamondbarcom building@dlamoodbarea.gov
JOB SITE ADDRESS 1(Ir.,r7._}_+Z,.VOYI
APN LOT TRACT ....
OWNER
ADD SS
CITY ^ B P TEL
APPLICANT TEL
CONTRACTOR
ADDRESS
CITY ZIP qL2LA TEL L151 4b 0 V_
ARCH/ENG/
DESIGNER
ADDRESS
CITY ZIP _ TEL
OWHal-BUILDER NCLANA7
I ?wwy Smmt under penny of pmNry m I am s amP imm me ComecNrs Sime Uwme Law M cow mmSdM
hakat&e heider by ire ehaasanadeff I Iww pdwd red to the UPOMM nam(n 16aeon 16111, Baderms Rad
PM%SMWm Cadw Any CRY or mmlY &A raq drn a pmmlt to wSOINSA. seer, aepmm, dwmftk amp*, any
Mmohae, pdmm fm lumen, elm ratans,(ke epplmrd for atm permo m me a dpW maba that NO be she
Is llaermdp Smdto cow pmdgomof ft Cw&scbwg Sale UmmeLards, (Caepier9) Commmdq Mm Sedco
of Mdema 1 Or t Bottom and Pmftuim Gadel or Met he or Sha h eemnpt from'twneure, and the bash for
the Staged aremptlon Amy vddon of Sectpn 7-3315 by my an0cent its penial mbasm f Stor'cat to a Car money
of not more than tad hued mllere (65001
U1, aenter of the property, a my empioyae with*" a a their Balewmpens0m, MIN U U OR star ancone
at the work, and ft usu m e Is as Intended or offend fa Ohio (Secoon 70" &.Mnesrl and F mtemn Coate The
as marmen ftmI.Nansa tawdcdemlhe lmp an
Wepmformed d INaupeamr sate 0 aawrmMeagtbulla
a RSaDm Use Said wt " Ver of CtsIomthe O es Ypl W91a thebred ran d RIawevet,Croor Net a
thmmeemem msddardim am ydaawmplolWr roll Oawar wNi bare the maawaPlo+al9 taq kion not bulk
w inphoma drtd p:rpweaeke }
U I, ae owmr a the property, am mouth YBy wn9aeore Woo, fi aead cmhbalaam wewWafhb pressa (S ratan
so". abana6e and PMISMUSe Coda The CammaonMe L' Lmr &tee rpt appy, h An owner or moamy, who
enter a Improves thereon, Ord coo canbwa for the pmlea fwa) a kwnam Conammor puaantia the Cantr9eWre'S1ete
lhmm U my (
U i an ewmpt more llCama9 atm Cha 6aaam s Sere Llbenae law lir ft immaenS meaYnls)
Dile GOR
No, mRgDmNrd boom l sckmMeoge Met Yemen far MY OMmt Reamed ase h muq have ro ded far On Goveam
year poato wmpkoon of the lmvmsmaoemmeG ay man am pang dead* seaa mrxwm Vat l lam werat an
comm buom N ft Bae rot baa mnau:md In m eftKy by Nmnxo rourtnumni 1 hmdarCwrhd cal a any of ma
appoewo aw, Sewn 7010 of me Suarew and Pawnsa o Coe B owlage mannoyeast wren roil sm aimmor Is
'�, 6ubmttddnaike tNdwliip Wen qle hiBfAYaw w.dmaca goYJcalewotTO
LICENSED CONTRVTORS DECLARATION
I ha11by amen oder pw"SO MI that I am Ilwmeb waw Pmdubns of Oman 9 Fmthnwpbawdh section 1000}
of UCENSEn3Uta as anaf#r NO end sweat
E1P OA1E llllp ^�"•, GONmAEA'S CHIT/_
WDalaa•s DaatlrsAllnr DEOtQLaahnoN
I PEREOY AFFIRM UNDER PENALTY OF PODURY ONE OF TIE FOLLOfMNG DEC"[' DNS
_ I have and W1 mgrosU a amScater of Cohwmk to Met §sw b Worker's Canperegdn, ae prodded by
SaMlan 370Pmme Labor Cade tar dd peMnnahw atthe ami taref eft nils pometh 4awd
_M wend CINmof ft Watt areCampensWMftii$IWJWMywigmobyarman3700 amsfdha Coda, ton
PdyNumber a modwaktd afilNmMpwmttblriAd My Wnkar§ GNrhpermttrh Ilhwnmxe Cvdawm
Pdky Number m
comme; rAffgl
Pou mosey --L—LAjAM!25 CA
May S8704 NEED NOTSE MWLEnDFTHE PEPMD 6 FDA ONE WVRW DOLLARS $1DO OR LESS)
I DOING, OW, India samermceathe amktor ad, ft want 0atad,Iold hat emPR'ans, pampa In wymarmran roto
Woo artne bola Walker's Conammatm Leas of Camamd And 69110 Oaf C 1$NSAbec R01013 m"Wasm's
Compamom Dia As SMOSS, 3700 of rod lata Com, I "I mmmlm May wan "W am,%"
DATE _............. _APPLICANT
WARNING Poland to Cede Isomer a Compauahon caaea0e IS toe maul, and "I %mord an welmose to emmad
pwdmu and tMi am W to nil hundred tlmaa&d apace MIOO G0M In &Salon IF ft used Of the mmpwaa m,
aw qua praddw tar in no" 3708 of MY iron can, famed, No BimellaYB tam
CONSTRDCWN LENDING AGENCY
I hwwy atflm, tinder termly at or" mat More h e CondrugW brines AOapy for the Whenever at the work tar
this perm@ IF luued On 2097, Oh C)
LENDLICM NAME
LENDER•SADDRESS
[;diol met I neve read Carl mai emUaa and Acte that the above lydwmgm in commas I epee dwmmy Moo go cryad
amRaY W&Mn ON state dna ilMng d ofurg mraWNa ant hwsoy wnnnao repro=fdtre at wile coumY to
momarommonefor
1c h4,Z-
SIGNATUTE OF PMrV
n lirtti E
APPLICATION DATE
ISSUEDATE
TYPE CONST
`_ Pico
PERMIT# Q� j
DCC GROUP
Scope of Work
I DWEL UNITS
ra, f&0 alo
Q
#STORIES or BEDROOMS
DESCRIPTION SO FT
FACTOR PSF ACJ AREANALUATION
SFR7ADDIREM
aara/arcmpaa
Rai¢+Dack
1Z
7_
PoaV:,pn
Ra.Fagot
Cammadai
ATERLL
RIMI
Valuaetadp
Adl Area
OUANTITY
DESCRIPTION FEE
y
m
S'
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CONSTRUCTION
PLAN REVIEW
ELECTRIC
PLUMBING
MECHANICAL
INSPECTION FEE
ISSUANCE%
!2
SMIP
ENERGY P/C
ENERGY PERMIT
RETENTION FEE
PRE -ALT FEE
Z`
BASF
PLOT PLAN
ZONING CLEARANCE
TOTAL, FEES
COMMENTS
,r.•^
PIC//�y/y/::�_ PAID BY VALIDATION _
RECEIPTo, - op PAID 6Y Y�J'T iJ VALIDATION-
WHITE—Dhparrrnme Copy,YELLOW—Perrone Copy PINK— Copy
CITY OF DIAMOND BAR
INSPECTION RECORD
INSPECTION DATE
INSPECTOR
INSPECTION DATE
INSPECTOR
SETBACK/LETTER
TRACT AND LEDGER
FOOTINGS FORMS
SWITCH GEAR
SLAB
COMMERCIAL HOOD
UG PLUMBING
T -BAR
UG ELECTRICAL
INTERCEPTER
UFER GROUND
HOT MOP/SHOWERPAN
SEWER LATERAL
SEPTIC/CESSPOOL
MAIN WATER LINE
HERS REPORT RECEIVED
SEWER CLEANOUT
DEMOLITION
ROOF SHEATHING
ROOF DRAINS
FLOOR SHEATHING
ROUGH CONDUIT
SHEAR WALLS EXTERIOR
POOL/SPA
SHEAR WALLS INTERIOR ,.-.
ROUGH PLUMBING
FRAMINGNENTING `- v, '",, `-
ROUGH ELECTRICAL
ROUGH MECHANICAL -
ROUGH MECHANICAL
ROUGH ELECTRICAL W( C )
GAS TEST
ROUGH PLUMBING
PRE GUNITE
INSULATION WALL
POOL PRE DECK BONDING
INSULATION CEILING
P -TRAP
DRYWALL
FENCE / GATE/ ALARM
LATH (PRE)
FINAL POOL
LATH EXTERIOR
WALLS
LATH INTERIOR
WALL FOOTING/STEEL
GAS TEST
WALL STEEL lsr( ) 2ND( ) LIFT
SCRATCH COAT
WALL BOND BEAM
ELECTRIC METER RELEASE
WALL DRAIN/ SEAL
GAS METER RELEASE
WALL FINAL
SPECIAL INSPECTION
RO FRAMING PLANNING APPROVAL
FINAL BUILDING
ROUGH FIRE APPROVAL
FINAL MECHANICAL
FINAL FIRE DEPARTMENT
FINAL ELECTRICAL
FINAL PLANNING
FINAL PLUMBING
FINAL ENGINEERING/ PW
TC of OCCUPANCY
FINAL COMMUNITY SERVICES
CERT. of OCCUPANCY
FINAL HEALTH DEPT
FINAL INDUSTRIAL WASTE
COMMENTS