HomeMy WebLinkAbout18-25565me
YY
n
s
6
0
a
z
a CITY OF DIAMOND BAR
DEPARTMENT OF COMMUNITY& DEVELOPMENT SERVICES
21810 Copley Drive, Diamond Bay CA 91765 PRESS
(909) 839-7020 Fax (909) 861-3117 Building Inspection Hotline (909) 839-7027 FIRMLY
� BUILDING PERMIT APPLICATION www cityotdwmondbarcam bmtaeregtgdiamondbarca gay
JOB SrrE ADDRESS'r C:C7%U -`eC-ti.nN::,,rt\,taps., L -V-\ ..._
APN LOT TRACT
OWNERO HC -1a, 111
ADDRESS � m 'L 74-^�loP se/1
ORy!iba lti�ZIP K1 I6a TEL
APPLICANT .%TEL
CONTRACTOR e -
ADDRESS
CITY ZIPL'LJj-CqL TEL
ARCHIENG/
DESIGNER
ADDRESS
CITY ZIP TEL
Fa OMLARATM
I haeaM am. wdm pmviltY of myself NM f we emmDt har Dm CmWazbfa SOM mai Law b me mawnw
metal bow by as atmMnmNp} I Mm Owed not o by aapf4ane WmtaT recina WA, a1MYWN aid
Ca61 "we--" a aLeamfaw a PMmilo aa",Ar vI Am NaP , Oman* ar"aM "
Mcbn W7a M ftwu .aw"40" ft go~ 10"PMO IN Ne eneval NI - anti Newdm
=of small
maSMaan, m0)meewmae MwA Any how
hewlO ormano nseason may
yaAxwpml
TMIDdONWaPM amaraoeamSeAoiwot Caal warts MarNm maaamtiMn kAmlee mtlam bedabr
amaaeaedenmpWn AmmsMiMrmSWffin 7037 5§y aatwDaraM[mapamdt are matMloenalM
M not aae amn 1&s IamMtd dOLMa ItBOR
LlEaawnw Mao Pawsf.amJempbleaa.iDiwWweaBroretrit *10m E}sa afarUPMamm
ad as work W9 to MAVere Is nm blamed motbmd by a& taxable 70" feemobee MM Familia, Code Tim
Cwlbaeem!Soe Lkanf taw ear WY saw, b be awMtd Po" ab, maxia rabomme, w patent what away
mn"wtho Dmwr7 RADwmror ftervublaw
knpmamal b wmwMrMonp4aw M wnYiTypn hm Ownw W W haYapsmIXda sD�Nroti CwaY rot ddR
m ImMoagd brma pwwawe� i
U i adawmelaame mwelly, r e¢kaireN' emm'w.bngaiAsieOneap CaCaCRYam CaMauetam waJaadsOYian
T04d, Bumr^.eee ea wataebne Caa TM Wnaxbrf' SaN twaw tear aae4 ant wPh W a waw m prmeRywaM
Umber impmaa Mwaa antlwMca-Uacnbrtlre plo�e4MUe&musai Cunil Pu2wnibroa SIMe
dance lawl
U I am eaemDt ham ImMmae male, are Canblos, aSWM Loans, law ex We Idenews mantle
Dmf Sma
By my algWbmauto Imaymmdaabay, meati far myarwal moulamlle In Whkh I mon e" mated fw owes oft
year Prior M wm*Wn. all to ImPm"ememe my,wed by tem wmMd waved lewdy, ea a Aboom dw I IWw WM 49a
owner Wader N u he, not bean cmmtmded M be amlraN by Ikwaad anbtal I aaronPA LWI a May, Of ttm
vocable law, Sacral 7044 of the Many, end Wbbways, Con a mmnb of awn mgwm wea rda warear, m
wbsDed ar M in bamena Web aha hlibeww kOh.ta.aoetaflWw has
LICBBED CON@AGTONB DECLARATION
I Wmw alitrm under Wmbhy al wrlury MM I am hotel Da9rDmn6Mrm S COIwW D (wmmer" your Sarin 706p
AINrmM 3 w me BDAfIPR antl RPIBisaA§ Cae e[m'l''my b]mRnf�a�m,m,-f�ub(Ml�ae endbpa:L
IxxMCL*S� LIC NO
DATEEIP Z.. ` COITRALIOa
WORM'$ COMPOUTIOM WAAMnON
f HEIaBY AFFRM CNOER PEOLTYOFPMAY ONE OF THEFOLLOMIK ORIARATIM
I Was mm We mMrmo a Cmnoale at Combat M SoN-0Wura for Worker a Combination a PnMdad by
Seem 9700ware tabmLaia b Ne aaomawd Ma yoolkfiryohmr Nb wand a blued
_�-limwardwama Am� Wm/ar a Caapnwlon iamaee onworag Saban 37GOof thb ula rCade or
aepemmmeercammeaorkbr Whkh OMpwmR miwaad My WPlkar'e (bmpaaaimnlMwaae Cosar ad
itecy Nun
elm
CMMER `- x `••"` � '1'aca's'�cfrt=OEM's
POLICY NUM.PER
jT16 SEGigN NEEONDrBE MWIMEO E THE VRwrz IS FOR ONE MNOREO DOLL" 1 OR LER
IwRtythMMdm d0mwadrorwheRaAPPantmtArid l9hMMelrqugaOY PamaMLnY.^aWfamm
aPWnmam>axmdMWapmte Lacepdtllatliliw.Nn8d80daNaaMhwmnawtgwimtlmWpl{ar'n
TmgMMaffirr MSwSm 379datastehmCadR14eI91ranwDr cmrmTYwln xaa Rramfkae
saTE ARN.raJei
wAMnIC FeNaa m awe Wamw'a aammae a Woods ea ansa Abid n ano w b adWrel
Dar>ew cent PMI awe am b ao babooleal Oavwad ddtve (1100 end m wwrar, o Bea as of Lha wmaawWr
damaaet awmided forinzmbn3768smw ohm as as &ten
Cd4TRVCMNLDWRGAGDW
IhweOTaflRm arbrPaMry
Car,
MDW}mT)Cfe Oe tm�np ApgnRiw ns sma weals ire
aaatldtparmammwasacOORT Gb C}
IENDERSNAML
IENDERSADDRUS
i wMy'tlMt I bnaa rami dm ePPlodlon wd tlmt tlm a mm mbnwan m anent. t vara m mode waA aI cit Mrd
�Nmaronem arts M�MasreMMramadMav aMRama mrama:a Mtraomnym
aWM eamwatl Pro�a`pY� br1 wlPaaa
<—, —
SIGNATWIE OF FEAMFUEE
0
n
0
a Will -
APPLICATION DATE 15 PICO F"— {.p..T
ISSUEDATE 'GLSa"ERM�ArTe Tial Xlt— QSSC.S
TYPE CONST OCC GROUP
SOOPO of Work Ndu fY....
e
R DWEL UNITS M STORIES
eV. . NW
# BEDROOMS
DESCRIPTION SO FTFACTOR PSF
ADJ AREh'VALUATION
SFP/ADD/REM
FweDeYCarpom
.............................
W
PaaloYDeck
lora.
Pmoarsba
pe -Boor
r�Za�
3
CGIYmiwatal
Veleetl
Ad] Aroa
QUANTITY DESCRIPTION
FEE
1�1-7t7l}z
CONSTRUCTION
PLAN REVIEW G,D.
ELECTRIC
IIII Lxa. Ain
PLUMBING
MECHANICAL
INSPECTION FEE
ISSUANCE
1 SMIP
0a \
..._
ENERGY P/C
ENERGY PERMIT ..........
RETENTION FEE
,'... PRE -ALT FEE
ta_. _TDA
BASF
r.k
PLOT PLAN
ZONING CLEARANCE
TOTAL FEES
COMMENTS
PIC PAID BY /
RECEIPT} ' it PAID BY *tai*;O
VALMATON VD
VALIDATION
WHITE—D,ernlnen Copy YELLOW—Rrmr aCopy PINK—Asseaaw Copy
NOR • i i
EIRE # # ' i
i#
INSPECTION ATE
TOR
INSPECTION # INSPECTOR
SETBACK/
TRACT AND LEDGER
FOOANGS FORMS ......
SWITCH GEAR .........-
''....SLAB
COMMERCIAL HOOD
UG PLUMBING
T -BAR
UG ELECTRICAL
INTERCEPTER
.......... ............
UFE'GRID
HOT MONSHOWERPAN
SEWER iATERAI
SEPTICtCBSPOOL
''. MAIN WATER LINE
HERS REPORT RECEIVED
SEWER CLEANOUT
DEMOLITION
ROOF SHEATHING
ROOF DRAINS
FLOOR SHEATHING
ROUGH CONDUIT
SHEAR WALLS EXTERIOR
POOU/SPA
:SHEAR WALLS INTERIOR
ROUGH PLUMBING
''.. FRAMINGNENTING
ROUGH ELECTRICAL
ROUGH MECHANICAL
ROUGH MECHANICAL.
ROUGH ELECTRICAL W( ) C (
GAS TEST
ROUGH PLUMBING
PRE G,TINITE
INSULATION WALL
POOL PRE DECK BONDING
INSULATION CEILING
P -TRAP
DRYWALL
FENCE /GATFJALARM
LATH (PRE)
FINAL POOL
LATH EXTERIOR
WALLS
LATH INTERIOR
WALL FOOTINGISTEEL
GAS TEST
WALL STEEL Rv2" I LIFT
SCRATCH COAT
WALL BOND BEAM
ELECTRIC METER RELEASE
WALL DRAIN/ SEAL
GAS METER RELEASE
( WALL FINAL
SPECIAL INSPECTION
NO FRAMNG PLANNING APPROVAL
FINAL BUILDING
ROUGH FIRE APPROVAL
FINAL MECHANICAL
FINAL FIRE DEPARTMENT !
; HNAL ELECTRICAL,%0 jt ,e 2 -//-?I
FINAL PLANNING
FINAL PLUMBING
FINAL ENGINEERING/ PW
........
T G Of OCCUPANCY
FINAL COMMUNITY SERVICES
OEISf. if OCCUPANCY
FINAL HEALTH DEPT.
RNAL INDUSTRIAL WASTE
COMMENTS