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AMINB BAR
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CITY OF DIAMOND BAR
DEPARTMENTOFCOMMUNITV & DEVELOPMENT SERVICES
21810 Copley Drive, Diamond Bar, CA 91755 PRESS
(909) 839-7020 Fax. (909) 861-3117 Building Inspection Hotline (909) 839-7027 FIRMLY
BUILDING PERMIT APPLICATION wwwcityo(diamondbar.com buddmg@diamondbarca.gov
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OWMEa,M"FiN DECtWTM
I bareby, affin uMa wofty Of pw$ae that I am a7rnYt Care are comatlms State away naw Ow the nummod
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N Oimrm3 dtNe ammaia and rmmubMcodej ortha to arson is exempt Can IraMure arta aw Hula to '.
the aie�tlewseptlm AMdocaro S0Wm7g31 S by airy BlSOmoit mrepemdtaupl0a5g9appdant madMlpaWe '.,.
a nor maetiwr are hundredd Glentltm) '..,.
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and
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of Dw week tab dw ps, I my ta not Ion ppyl a aCae r by Sala dly Men through,
,theles and PMayms lent The
Ibntrdctms Sola Llpalm WaheM caro apYYmonpmwrm PmpaM1Y was aemplBmpmyeMmamerte#od,ingor I
aprawm 5 ma precede weye ilia ble empmYethd O hor Bu durNO ad#Bad male g ung that
Ma is not b a I1
Impmvemem Ideal xtthln me year of compin'mf tlw gwlWr Builder xtN have thB burdendprm'wg thatNwas not built I�
a ImpmNtl lama purimge of sale )
U I, as pwner of The property, am Oaa9weh) mntrairi Ndh bcarteed Contractors to construct the prolect rS
7044, Business eM Praaolaw Cede me Cmbacbm' Seta Uconsa law does not apply to an mmer of properly -he
burgs a lmpromathereon ontl whoconbactm/mth8 prdeCtewlma lkem¢d CnnbactapurwanSetha Cmbada6' State
UcoMe Law I
U; den axwo item huenaoa under the contractors State Ucm9a cow M the lrlerang Mutual
Mem Sign
By my mirmhumbeew l MMiWMadgeM mum by my pwswW remember In myth l must MVa Named for at least and ......''...
year pb to detention a the aeprommenb co en l by buy ammkl No a suucWn town l Saha butt aeon ''...
vara Name, If M Fes not been conaNmted In In andrety, by CnoMed chammeis I urdiwmM the a aK4 a the
epmenals ow went 7044 a the ti omm aM AmemNma Code is swMIW 9 upon momet mown th9 Apps[etmn Is
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LICUMQASS �� LIC NO
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1 HEREBYt6Flght UNMFR PENALTYOF PkA RY ONE OF THE FOLLOWING DECLARATIONS
I Mone pact WN mainpen a Cewtmta Of CaseM he Sat MM to WXWS rarrpNwatnt M Pmalded by
Section 3700 at the tabor Chile for tlW pelamNre at TON work der which Gds Iwm16e wand
_ I hand and wll mmman Workers Cempmeaitn MlWmnce, an reiuired by SaDm 37DO d the tabor Leda, for
Nw petmm�new a the work Irk wbMh dIM pemu[ t41ssIaG MYWNWICQTOMUbm twumre Uniafwd
PrEcy, Number as
CMWER
POUCYNUMBER
f{NSSECINNNNEEDNOTBECtrAKMFTMP Rwfl4FORONE ROAMOXARS $100 OMFa
Icorny mum the the W®r®a/me maktio wraws of pemelio And a m at should
w My Womto
BMM m the Wake's Compensation on laws of Calllmda kW M O the N 1 ehmltl bmone eublxt m UN wamr•e
Can7amdtlpt InwWowa3eNon3100dthe lata CSO, 1 NfaD fa6wANl manchwMthplO POAdaw
APPLICANT
WARNING FaOun to secure Wotets Compensator coverage M anlem{a, and Mum subject an employat to cnminel
pntblles and wit Inc up to me huntlred thousand unions D TDD MCI, In adatlm m do Gael or dw WD Meme,
dwnaMMMWWbrmsecUM3706dftLibmode m[erML end enaeeYa i�
COMSMWrK N LENOING AGENCY
I hereby affirm under priority of perjury Net "m is a Construction Lending Agency for the performance of the wok der
Nwpamga Npwd{Sec 3097 Ch C)
LENDER'S fill
LENDERS ADDRESS
1tyrDiy mitt Ire neon Ods appbmlim adi Uwt NW ebpaaedarMlfanmonied Ia mcolkapwMIodtysM
amttmxesNwaWewws retamNmmdexgmrtstnNtim
and hbvby M"Mwm OIMAw #em
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I, APPLICATION OATE `yl \4a—PIC# —M%W — Qmi
ISSUE DATE Ib I Z/11a PERMIT# P R f b- 23 SO
TYPE CONST OCC GROUP
Scope of Work 017
y 71.1 P G4c In 4:11res e4,A-
. d DWEL UNITS d STORIES N BEDROOMS
DESCRIPTION SO FT FACTOR PSE ADJ AREANALUATLON
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QUANTITY DESCRIPTION FEE
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CONSTRUCTION
PLAN REVIEW Say. oft
ELECTRIC
PLUMBING
_..
MECHANICAL
INSPECTION FEE
ISSUANCES3(D.1'2'-
SMIP
ENERGY PVC
ENERGY PERMIT
RETENTION FEE .OD
PRE -ALT FEE
BASF
PLOT PLAN
ZONING CLEARANCE
TOTAL FEES Sft at& '
COMMENTS S& 41 o
PAD .S2-4aLaN PPAIDSY.31"AIR tI}fny VALIDATION ,
RECEIPT e _ 5 PAID BY "^'I.t'r'!wJ VALIDATION
CITY OF DIAMOND BAR
INSPECTION RECORD
0
INSPECTION DATE
INSPECTOR INSPECTION DATE
INSPECTOR
SETBACK/ LETTER
TRACT AND LEDGER
FOOTINGS FORMS
SLAB
UG PLUMBING
SWITCH GEAR
COMMERCIAL HOOD
T -BAR
UG ELECTRICAL
INTERCEPTER
UFER GROUND
HOT MOP/SHOWERPAN
SEWER LATERAL
SEPTICtCESSPOOL
MAIN WATER LINE
HERS REPORT RECEIVED
SEWER CLEANOUT
DEMOLITION
ROOF SHEATHING
HOOF DRAINS
FLOOR SHEATHING
ROUGH CONDUIT
SHEAR WALLS EXTERIOR
POOIJSPA
SHEAR WALLS INTERIOR
ROUGH PLUMBING
FRAMINGNENTING
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
G
WALL STEEL In( ) 2N°( LIFT
S= COAT
WALL BOND BEAM
ELECTRIC METER RELEASE
WALL GRAIN/ SEAL
GAS METER RELEASE
WALL FINAL
SPECIAL INSPECTION
RD FRAMING PLANNING APPROVAL
fINALRUILDING
ROUGH FIRE APPROVAL
FINAL MECHANICAL
FINAL FIRE DEPARTMENT
FINAL ELECTRICAL
FINAL PLANNING
FINAL PLUMBING
FINAL ENGINEERING/ PIN
TO of OCCUPANCY
FINAL COMMUNITY SERVICES
CERT. of OCCUPANCY
FINAL HEALTH DEFT,
FINAL INDUSTRIAL WASTE