HomeMy WebLinkAbout17-7050I
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IFt,IIIiI��i BAR
CITY OF DIAMOND BA
DEPARTMENTOFCOMMUN rY&DEVELD IENTSERVICES
21810 Copley Dine, Diamond Bar, CA 91765 PRESS
(909) 839.7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 FIRMLY
BUILDING PERMIT APPLICATION www.ettyofdiamondbar.com building@dmmondbarca.gav
JOB RPB SITE ADDRESS .Qy I_e'7 1b &M:U`...............U' t '
LOT TRACT
OWNER
ADORE
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—-�"i5S5APPLICANT
CONTRACTOR
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ARCHIENG/
DESIGNER
ADDRESS
CITY ZIP TEL
OWNER-SUUER DECLARATION
I hereby Rearm undM PN" Of pmlary' :hat I am export from Cow Corimmon Sate UCen9@ law for the rmaonp)
awtats balm by me CkCkmalk(S}, ! hal Puma emR to the epplk'dpe Rail (9"M 70$1 N, &Mlmu Ina
Pmlemiom Cade Any are m tow" NMI legwrme pmmlt to MVIUK aroma wpma tlmoalk m WwPr' arm
sMwhm paw to IM bwarw0, elwtwgme the eppfleamior Nwpm MM Nb A No swbmemgad NAm aro '.
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Na deAedmempaat Airy eolaMm GRO(WA 7D31 Shy anyapWral pmDatat WUtM appoUnt W ICNA W"'...,.
A int mems Nan sea handed doAaa 13500}
U 1,m novel mNwpro", or my emDNyme RAM mmeh salemmp0net, wall An an of or Upemmaj
Of Me wart, inns Uw shudbre N not ihblwed On altered Is, Sale (Section 704.4. wvmn orb Pmfmamns Cade TOM
Coroctary' Slats tkMes Uses meg not apply an an carlproparty 0ato mmrpl anpbyaep' or promal effort, xON,
in Improver the prostarty pmvldm that the Implmamanis vend Intended or oNamd an said R howl the eliding or
impmvemam ovoid Wttln bine Ina, of amOhun, Nm Owmm-Rusd W11 have NO bAdan Ilpmv1l that it win no! %M
m Impm2C tarter RurPma olaooe j
U L as, mar mthe prgwrly, An, etdNmhaly'mnbwftmods LOW" CemradWmb d,~ 0, PDOO IUON'
7044 RuNnem"Aofmdbm Cade The nnrmmbm Smffi trams Law Ewa W sp dor m a perm of property wins,
bdkb ar Mplwas mmaN1, emwain comacs for the NUOUwM a 6tt+ued Cmlheeta pulpard OR ftor Contlnantal%tp
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By my eigmlum clow I RNmoMithas me euep: no my pemona random In whch hrn;st have (aided Aar At least We
yam Ve, to MM09Ww the'dpNwmwme mood by and PemU aenm sheary set a abuclum mal I haus, INK awn
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applkade low, Smtion TOIN of the BrSMea sand Pmmeebno Cade Or Robinson, apon maim %low Nes ardso an is
xubmniNar mAw IDmAaIA WabaUe ttpJoxwigp4¢acalWv/alawlxlN
LICENSED CONTRACTORS DECWMnON
I hereby amm oeda p,ewty of pedery men l inn ikmaad ung vod*m of chapter oxnmmxm Alm Seeten YOM
of Dropper 3m Ua febassrow a'wPMeaelmaCones,
Jer�}tl�my uare4 a at full NU and exist
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EXP DATE CWdTMCiD% ,(�)�t"� C Wt
WOPIAERS COMPS NSATtON DECLARATION
I HrAFFIRM UNDER -RALTY OF PERJURY ONE OF THE FOLLOwMG OEC]MATIONS
•J I have and *It ftftn a Catllf" at Poland m Soot kawe far WoM1ar a Compensation m Dmetmd by
Semon 3]ODMNN Labor Casa twtlw peDmamrcaot tiawoM1 bwMM Wf ptrtNt Ie eNad
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f,N1SSEC1mi NEW NOT DE CMPXU N THE FEWATIS FORONEHUND EDD(DaRS 6100 O%LEM?
ICmM M V ftmdo� tttha war ANyfinmene NmNtsinaet I wren mlempby"wind hely mannar&t hate
Lamm,VA¢wfmwaters Commwm lana MCaBmme. kid Alone meld I stw Ali, mb"olmtheww$
CwrgN'apbnqutrMxof Berton 3700 intro La" 0*er I sw WMAM am Not 6w%IXwk"
DATE APPLICANT
WARNWG Peputer m sente'f arbor's Wmpemdm mwead a is welawM, And "I awdoo an whipaym to Ar mmei
pemmes ani Chat anis ad T And, hundred Uw d drewa {$100000), In addition to the per of 004 mmmmalbn,
dtmepm n PonNed for In twbw 3706 Of ON labor hada 1,#~and a wafoes
COWMUCTOIN LEWL"AOEBCY
I oatoosy a rm under penalty of p" mm mere Is a ComTCfkef iii Agency for the tedommws or Te work for
emem thin permits sued(Sm 3097, Cs, C}
LRIDEWSRAME
LENDER'S ADDRESS
I amly that Imere read Dm app Oke na cera mm the eDdve mlmmM.m� yb. mrRCI. I agora m anney waA 9s, Nay and
energy alkm WYam Mm mballgU Construction and ,MMOODY rpmeanmlNEO of an$ Ram to
Brdawppon" lam memmmd mpeay tin purowl
5110 gewrl
PERMRTEE NAME {ffaj.�..—
SIGNATURE OF PER01RE DATE
APPLICATION DATE 7 y _ PIC#
ISSUE DATE 'T tt t PERMIT# !1a
TYPE CONST OCC GROUP
Scope of work
k DWEL UNITS AI STORIES
N BEDROOMS
DESCRIPTION SO FT FACTOR PSF
ADJ AREANALUATION
SFRJADDRREM
fleage/Cm'pom
W
PatlNDwok
PoeBSps.
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ROGt
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Valuation
ADJ Area
QUANTITY DESCRIPTION
FEE
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cp
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CONSTRUCTION
PLAN REVIEW
`
ELECTRIC
PLUMBINGi
Js
MECRANICAL
INSPECTION FEE
ISSUANCE
SMIP
ENERGY PJC
ENERGY PERMIT
RETENTION FEE"
PRE -ALT FEE
BASF
PLOT PLAN
ZONING CLEARANCE
TOTAL FEES
COMMENTS
PIC PAID BY
RECEIPT 0�i6l111r — PAID BY Z 47tq
VALIDATION
VALIDATION
WHITE— Department Capt' YELLOW —FINVOU Copy —Asoma Copy
PH - Ae WON*' I ffs:- I vi
INSPECTION DATE INSPECTOR
INSPECTION DATE INSPECTOR
SETBACK! LETTER
TRACT AND LEDGER
-FOOTINGS FORMS
SWITCH GEAR
SLAB
COMMERCIAL HOOD
UG PLUMBING
UG ELECTRICAL
T -BAR
INTERCEPTER
UFER GROUND
SEWER LATERAL
HOT MOP/SHOWERPAN
SEPTIC/CESSPOOL
MAIN WATER UNE
HERS REPORT RECEIVED
SEWER CLEANOUT
DEMOLITION
ROOF SHEATHING
ROOF DRAINS
FLOOR SHEATHING
ROUGH CONDUIT
SHEAR WALLS EXTERIOR
POOUSPA
SHEAR WALLS INTERIOR
ROUGH PLUMBING
FRAMINGNENTING
ROUGH ELECTRICAL
ROUGH MECHANICAL
ROUGH ELECTRICAL W( ) C (
ROUGH MECHANICAL
GAS TEST
ROUGH PLUMBING
PRE GUNITE
INSULATION WALL
POOL PRE DECK BONDING
INSULATION CEIUNG
P -TRAP
DRYWALL
FENCE / GATE/ ALARM
LATH (PRE)
FINAL POOL
LATH EXTERIOR
WALLS
LATH INTERIOR
WALL FOOTINGISTEEL
GAS TEST
WALL STEEL lst( )2w( )LIFT
SCRATCH COAT
WALL BOND BEAM
ELECTRIC METER RELEASE
GAS METER RELEASE
SPECIAL INSPECTION
WALL GRAIN/ SEAL
WALL FINAL
RD FRAMING PLANNINGAPMAI
FINAL BUILDING
FINAL MECHANICAL
ROUGH FIRE APPROVAL
FINAL FIRE DEPARTMENT
FINAL ELECTRICAL
FINAL PLANNING
FINAL PLUMBING
FINAL ENGINEERING! PIN
ITC of OCCUPANCY
FINAL COMMUNITY SERVICES
ANY. of OCCUPANCY
FINAL HEALTH DEPT.
FINAL INDUSTRIAL WASTE
COMMENTS