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CITY OF DIAMOND BAR
DEPARTMENTOFCOM UNITY& V LOPMENTSERVICES
21810 Copley Drive, Diamond Bay CA 91765 PRESS
,,, (909) 839.7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839.7027 FIRMLY
�0 � BUILDING PERMIT APPLICATION wwwcttyofdtamandbarcom bu3ldmg!�adiamondbarca.gov
JOB SITE ADDRESS 'y Atl35r 7>s LfA.1++nnt.,
APN LOT �—'—TRACT
OWNER r LLL_ Jr, // ._o_ 40
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DESIGNER
ADDRESS
CITY ZIP TEL
OWNER $LnUER WAARATION
I N own, aMrm under porosity of mmary :at I am erehry*. man We Conhadats Slate Law taw for the reesawsI
IOW bdmv oy the Chwuff09s) I hale ;Wood ned to the onsocede Item o) (Sedan MI x 0uyhdds and
Pmamveiaw Cedw Any abs er Sawty, tit negative a permit m mnemect, anter, Impmoae. dmn0sk or dentrak,MR'
eWc4aa, prim Me loathe, oma remdrve the applicant far to "Mgt m as a slow meememren the in Mw
WecarwedWm ntm the pmvblmmINOwCoaamemr'e anmtkenaetaw (CmpAo7RCommem6p with Svemon
7tmO at Mrtalan 3IN #ro Owinvee ad Pedveaow Cordal ar trot NawM'a W arAmpthom gerneule arid de bmW fir
thsa®eselm#mptlon dry Mdahond SS W70315 by wyappllcambapfltmRglhjeEleme wolpam too Doi on"
of not an than an humbled dorare (TEA
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of me work, art tort unxmre W not Intended a dared 4 Who (Se don 7044, Boomed req Pmteamxs Code The
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or Impmra the pmpeitp pmWtled that the Impmvam ids We rot Imedwd a dared to Sok X howeror the buldbp a
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BY no NgrWure Who, I enkaatagr amt aaoP fa my prr®ai rsldeaa in which4 mat eyes mdded}M at Westom
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LICENSED BOMMACTOR'S DECLARATION
I hereby affirm haWar;realty of today that! am Imwwm grow Proust a of Chapta9 an mmmcrhi Win Bannon 70000)
of DIOS& 3 or flay Baffi�n ruse,
eendd PMw wsones Cara, mmy Itar is'h NII Mce ad olYet
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LICENSE CLASS 4e_�W jC No klz ar%" 7
DATE 1Zr"Aif 19 CONTRACTOR V s
W(MKER'S COMPENSATWH DECLARATION
I II AFFIRM UNUR PENALTY OF PEA RNW ONE OF THE FOLLOWING DECLARATIDNS
I more and end m8mban a nam mrd, of Cwsrm to Sit bhaea our Wama a CompaOetiw, sa narrow by
Brennan 3700 mins LAW Oom, ea me parformarce of IN emk for Min mW permit Is Issued
- Ion" and one mile ar Wwk&'e Compw99tion Imurems, s nop rad M7 Second 3700 of the Labor Com W
fm panomm and he Wank an wWA in%dortet is nesend My WokeYs Compensation Inamrc9 Cama and
Rosy Numberve
came ? t4A,- i eli_
POLICY NOMMEA y l'+#' '6t #i" LDL/
{OE&CEION NEED NOT SE lATNEPERW ISFORONERIAFD $100 ORLM
fmr"lmt WOWpamec Of aewmemr Mkhdmpemaemad Iandl ap emdpodry pamonhary nWmhrrmrob
Cemme mAteat mdW OFSOsM3nOofMLeeedCe�sme Am Ryeo thane Moat teeam mngwtmde Waka'S
CwmemMlmhpiw§esmdSapmri 3760 ddesetiv CaO Lel¢ tadrnNr omerywM tlso5e Oratdam
nPKX:AW
WMMG Falvum is 9eaim Waaler a COMMMON rororepe W w d AA, ana vow WRAT an amploner m CMM
;voids and awl dyes Lw to arm nomNw DaAMim dogma aHODOOM to adMow m Oe cost of am wmparWMlw,
roma es a9 drmf0w or M oeCJw viteidthe am me, %smart, and aaamS's fee
CONSIBUGRCN ESNOING AGENCY
I mused, ammh under perahs d proury man man W a CwaWdw Lending Agency for Me VernmTwna of m00a9 fa
Mseb"a penal W lssaal Gas 3007,Cm Cl
LENDER'S NAME
LENDERSA6UIESS
1 Fluor, ami trove read cols applkMlm and � that ire Shove Inmamtiw W named I agree Wcampy Well, Mr. Far wed
mouldy admacve am Mata Iowa Notigt m Maidmg Wee m soon, we brands audmrira m{erw manes M this SoWty, to
wtar,pen tan abo» mruanm propan7 IV mephaddem ppPdave
PER
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ATUR FPETW7r
DATE
APPLICATIONDATE•
ISSUE DATE �..../. /177
TYPE CONST
J� • J .syp PIC# .
PERMfT#
OCC CROUP
Scope of work
If DWEL UNITS
# STORIES # BEDROOMS
DESCRIPTION
50 FT FACTOR PSF ADJ AREAIVALUATION
SFFVADOIREM
Caega+CSrpoR
PaUNOwk
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Pconpe
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Vetuenon VOIRv Adl Area
OUANIITY I
DESCRIPTION FEE
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CONSTRUCTION
PUN REVIEW
ELECTRIC
PLUMBING
MECHANICAL
INSPECTION FEE
ISSUANCE�mr
SMIP
ENERGY PIC
ENERGY PERMIT
RETENTION FEE
PRE -ALT FEE
BASF
PLOT PUN
ZONING CLEARANCE
TOTAL FEES
COMMENTS
r�
PIC
RECEIPTA
PAID BY po VADDA11ON ` _
PAID BY Otf.3 VALIDATIDN �T�—
WHITE — Depwtmanl Capt',YELLOW — Fmmhce Copy, PINK— COPY
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INSPECTION DATE
INSPECTOR
INSPECTION DATE
INSPECTOR
SEI BAW LETTER
TRACT AND LEDGER
FOOTINGS FORMS
SWITCH GEAR
SLAB
COMMERCIAL HOOD
UG PLUMBING
UG ELECTRICAL
T -BAR
INTERCEPTER
LIFER GROUND
SEWER LATERAL
HOT MOPISHOWERPAN
SEPTICICESSPOOL
MAIN WATER LINE
HERS REPORT RECEIVED
SEWER CLEANOUT
DEMOLITION
ROOF SHEATHING 7-7,9-17(
ROOF DRAINS
FLOOR SHEATHING
ROUGH CONDUIT
SHEAR WALLS EXTERIOR
PODLiSPA
SHEAR WALLS INTERIOR
ROUGH PLUMBING
FRAMINGMNTING
ROUGH ELECTRICAL
ROUGH MECHANICAL
ROUGH MECHANICAL
ROUGH ELECTRICAL W( )C(
GAS TEST
ROUGH PLUMBING
PRE GUNITE
INSULATION WALL
INSULATION CEILING
POOL PRE DECK BONDING
P -TRAP
DRYWALL
FENCE / GATE/ ALARM
LATH (PRE}
FINAL POOL
LATH EXTERIOR
WALLS
LATH INTERIOR
WALL FOOTNG/STEEL
GAS TEST
WALL STEEL 15T( )2 NO( LIFT
SCRATCH COAT
WALL BOND BEAM
ELECTRIC METER RELEASE
WALL I PAL
GAS METER RELEASE
SPECIAL INSPECTION
WALL FINAL
RO FRAMING PLANNNG AFMX
FINAL BUILDING
ROUGH FIRE APPROVAL
FINAL MECHANICAL
FINAL FIRE DEPARTMENT
FINAL ELECTRICAL
FINAL PLANNING
FINAL PIUMOING
FINAL ENGINEERING/ PIN
FINAL COMMUNITY SERVICES
Cm. Of OCCUPANCY
FINAL HEALTH DEPT
FINAL INDUSTRIAL WASTE
COMMENTS