HomeMy WebLinkAbout17-20178Ax
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_n CITY OF ALMOND BAR
DEPARTMENT OF COMMUNITY & 4 L.OPMENT SERVICES
21810 Copley Drive, Diamond Bar, CA 91768 PRESS
., (909) 839-7020 Fax, (909) 861-3117 Building Inspection Hotline (909) 839-7027 FIRMLY
BUILDING PERMIT APPLICATION www.cityofdismondburcom bmblmg@dmmondbarea.gov
....... ;f6 UK
JOB SITE ADDRESS -05-A .................__
APN LOT TRACT
OWNER G
ADDRESS 00'44 IAy, Sa~' L
CITY %Al t.L WILI$7 Zi _TEL 1/0?—O �
APPLICANT TEL '.....
CONTRACTOR
ADDRESS 10tIll....4j(RZ&55
CITY C./'illttil ZIP �,(7�TEL CJ2b-Rto7--�73R
ARCWENGY
DESIGNER
ADDRESS
CITY ZIP TEL,
OWNER -BUILDER DECLARATION
1 hereby Iflhm Impar penalty of perjury that I em exempt from the Contractors Sole Uano Law fa the wa ampu
mdhoad below by the checsm0rldsl,I have placed next to the appiheae Damp) ISecikm 7031A, &wino add
PmNaimo Code Any city or Demi Dat rpNlra 0 pemdt W Wlotreci, elhOr, k4vwsa, dNnoRa9, o wvelr, arty
ANo4na, 9Aa a ib loueru, abo f0girrn W eWAfWtl AeraO vpWdta 0140 tend AbbnsNN Dmi M o0M
b Ilcarmd pramm to iN proNfeara m Da Cenhf 4tie"A Saa LkMo /4w {Chapar h Cama sale Sestlan
sI DhWan Sal Ove Buabm W PrM4WoM C0� gMm M a vee a oral# kora tcPaase atl tlhe Lank M%
of et mad LAEn$tlen Aced a shares 50Clmn 70313oYamrapplK6'#fIXemt+(rvSehl0.'$tl'xJ Bppilo6t toDtiNi �n6".y
of nal mat tlw. fish Aundad,To'ara ($$BBI
(j h ea Aside of the property, of my empaym wish wes9e a NO rale 0,mparmsilan, tWH As U ail of W LII Dom,
of to Waco. And sY aua,w Is Amusement ur oNNed IF ole { Kft 7044, ks5nM &'W' Flci0;9tpy Code The
Cerkmbnw'SMa LIcAna laY Worq applyPoen ovdwrctpropery M'ha Mmu9th '9rpgwIXai 4gpR
W inpmwa the proLKAe', pimNed Mm the Impmw ra Mehano or aOsud Ira Sae I hrAsag the hftnga
Impmmmem B within said ora year ofcanpb to Owner OW4e will RAW the th"m to Waft Metff and; notbat
« Impmwd ha Oa pm W o of aim 1
iaiaAwl aIng,property.am who km4w Cmm"tocv4nd Volga diecUm
7444, are unbending fade Im Cmrtaeto s' Sa#e License taw data V Apply t7 An mwmr of V pertY rsro
bminWIMVp I#e , And WIN, itthal at"chowaw s"""CaNapd7rpuwu M"Cmmiam"S2b
uUc4no taws
Ism Lamm tali &cal cams Dorm era carmetor'a Iow'ny reaonm
Oymy NgmVne belurtl gymowNga sat amAptta my p&EolawNnAn'tin wnNh mWi NNArodedtx moot me
}w,4piatvomnIieM Actor Ion ommeTA ma res by that by
Famous
c yWm o I mmmuw Mmihasoy she
orale ce to If If res 70 gen a Buormispixxod a its enlerahsto try omnis ovals
V, up I qu wlMa Mata copy ti Ow
epplloaka low, Simko. TOAq N Me Buslrlo9 Bid ProbWans Code is amNabb upon requdd when rale application Is
aubmHep crit Ma byawirq'NeV site ht�WwWlkjntO sa govlCNaw nVnl
LICENSED CONTACTORS DECLARATION
f hereby aDlmn Victor penalty CT pelta that I ern tltmsed "or provisions of Charier 9(commandng with Sgwa+70A
of DMNen 3 of the BBuusmeo ens Prow lom Code, and mr, spends is In NII force and effect
LICENSE CLASS"'��..fyA_ UC NO
leCJ�7 1 7 1
DATE lt Zt.yCONTRACTOR
1 WORKER'S COMPENBATbN DECLARATION
I Insui FIRM TINDER PENALTY OF PFAAIFY ONE OF THE FOLLOWING DECLNWTIMIS
r have and WD maoaNm
lrl a Cemka%of Cm tic San Mara rax Welders Compensation a mvftd by
sic" 3700 a1 as Labor Copy. k! the P»a of me wlMlt Am width Ode What is issued
I ham Arty Ago memaki Workees com meibn hmraWe, a nommed by Sean 370Dot the Later Code, No
da pato.7nan0Amda rgrk CorwNcn Mie pennd abalwd bay y7ctkerR Lympan4pdat DaRmrLad
I;IkY Numbn WE //
CARFSER W
PotKY Nt408ER
FWSECTION d OF COMPLETED FTit PERMIT 6FOR ONE tnNDi4 EXUARS$100 00 (M
Imwmm Ma pwww of mem No %"An mas wm is bought,i mtenphfA7person it w4ynmem Wham
O h9a W$Ws CenPematon taws d OgktMa. And Win ora N l ehNOd Become e9*1a iM Waste
cwmmmAm IXmbbm of Sedan 3T00ct Dw LAW Copt, I Nsd hmnWuh=" or Moo MOM=
DATE AFFLICANT
WARNING FdHNs W datura WCWer a Canceration co vide is x3ewYm, Nm owl Wass W employer to oftrinN
peragae and pbO arra Ip o Are hummd m iia d deism 431000OM In adedpn to the cat of Ne conversation,
damaka uproNded for M MOM 3709 of Me phot rade, ImAram, ad agVM t fees
COMTR=DNLiNOINOAMCY
I Webb atBrca uderbaoan,mpmlury that Marc Is atonamutlbn larang Agency IW I poMm UI Ole wak fa
00 Ma Pem t b bstwd (SK 3097, Lh C)
LENOER'S N8M€
LENDERSAIDDRESM
I amy tlat I have read No eppucauon and state that the nope summits, Is correct I agree M amply with NI i ty And
Wormy ordWWm eco dime him roldirg to building comeucilen and hereby SUMO&e MMSWAOma Wase n m
error upon the above mentioned property for proposal purpura
PE IrTT E NPoN�/r,,��� I D V 17
SHiOMMIE DAF PERMDT DATE � —
APPUCATIOtNDATE, 10 af +t
-- 1—I PIC
ISSUE DATE to .....�.._0'PERMITN
TYPE CONST OCC GROUP
/ef
Scope o1 WoN[ {. L p Ave,A T��Yl�
N DWEL UNITS N STORIES As BEDROOMS
DESCRIPTION SO FT FACTOR PSF ADJ AREA/VALUATION
aFFVADOATEM
Gemgarca pmt ..................
W
PVN
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in
P� s Pa
R6 Roof
CammarcWi
V8ta8#oyt Adj Area
OUANTITY DESCRIPTION FEE
Ax
2 s-kAfi-
CONSTRUCTION
PLAN REVIEW
ELECTRIC
PLUMBING
MECHANICAL
INSPECTION FEE
ISSUANCE �-
SMIP
ENERGY PIC
ENERGY PERMIT
RETENTION FEE S 89
PRE -ALT FEE
BASF
PLOT PLAN
ZONING CLEARANCE
TOTAL FEES • If
COMMENTS
Pic PAID Fly MATION
RECEIPT rt - PAID 8Y a' +� t,L VA p TCGN _—
WHITE— Efortartrabst Copy, YELLOW —FhuunAa Copy, —Ave Copy
im
INSPECTION DATE
Illllllllllluuu
INSPECTOR INSPECTION DATE
INSPECTOR
SETBAW LETTER
TRACT AND LEDGER
FOOTINGS FORMS
--- SWITCH GEAR
SLAB
COMMERCIAL HOOD
UG PLUMBING
T•BAR
UG ELECTRICAL
iINTERCEPTER
''... UFER GROUND
''..... SEWER LATERAL
HOT MOPISHOWERPAN
SEPTIC/CESSPOOL
'.. MAIN WATER LINE
HERS REPORT RECEIVED
SEWER CLEANDUT
!. DEMOLITION'
ROOF SHEATHING'!
ROOF DRAINS
FL60R SHEATHING
'... ROUGH CONDUIT
SHEAR WALLS EXTERIOR
PDOUSPA
j SHEAR WALLS INTERIOR
:ROUGH PLUMBING
FRAMINGNENTING
ROUGH ELECTRICAL
ROUGH MECHANICAL
ROUGH MECHANICAL
ROUGH ELECTRICAL Vi( G
GAS TEST
ROUGH PLUMBING
INSULATION WALL
PRE GUNITE
POOL PRE DECK BONDING
INSULATIDN CEILING''
P -TRAP
DRYWALL
FENCE / GATE/ ALARM
LATH (PRE)
FINAL POOL
LATH EXTERIOR
WALLS
LATH INTERIOR
WALL FOOTING/STEEL
GAS TEST
WALL STEEL is'( ) 2ND( I LIFT
SCRATCH COAT
WALL BOND BEAM
ELECTRIC METER RELEASE
WALL GRAIN/ SEAL
GAS METER RELEASE
WALL FINAL
SPECIAL INSPECTIONRO
PLAMWGMF?tOVAL
FINAL BUILDING''..'..
ROUGH FIRE APPROVAL
FINAL MECHANICAL
FINAL FIRE DEPARTMENT
FINAL ELECTRICAL
.................
FINAL PLANNING
FINAL PLUMBING
FINAL ENGINEERING/ PW
T C of OCCUPANCY
FINAL COMMUNITY SERVICES
CERT. of OCCUPANCY
FINAL HEALTH DEPT
COMMENTS
FINAL INDUSTRIAL WASTE