HomeMy WebLinkAbout14-5012+! :; CITY OF DIAMOND BAR
DEPARTMENT OF COMMUNITY& DEVELOPMENT SERVICES 0%
21810 Copley Drive, Diamond Bar, CA 91755
(909) 839.7020 Fax: (909) 861-3117 Building Inspection Hodlite (909) 839-7027
BUILDING PERMIT APPLICATION
JOB SITE ADDRESS vl o - Ir- L'76k3t+t 4+
APN LOT TRACT
OWNER C_, r cn Ca& 0",
ADDRESS -01"U- t- Gn',—J FD,
CRY s,..r .}y~.,.1 (3,r ZIP TEL
APPLICANT TEL
CONTRACTOR L
ADDRESSla t
CITY Lli—xn ZIP o'llUN TEL 00#5 431i- i1)0
ARCNtENGYOESiGNER
ADDRESS
CRY ZIP TEL
OWNLVBUDM Cn3ARUM
I Whey items wder With, of l el oy lore I am eumoi ewe Dw Contoder'a Stan Lamm Lew for dW rmsueW
reRead bible By er 01:10261A 1 bwo oxw not W we &W"* dr* Peaks, fmnA ewpsms 1,111
Ftaes>bss Cade A" dty a edady on mSrmm a Vomit W tpgfn4 NMelvermw, dmmbh,w repaN, em
fANellmle a m m#Wma low NPPMMA For IM prodt bon a aplml rsamsm i on baehe
le dmms1,d prarmltte ma pBsSbmatbetmtramke'NSmmttanaelaw Pmol pf CmlmwlrmpwlN.iatlMa
1®a EM"WIlei no, beellem wes PtitpdOblr Cpk) w Wt he or rm Is asenpt kanammaNa ave Drha$whe
OwaepWd ptm An va*awn ASeclont MI 5 by "W11,204ero WIMUbwf.Wma W WA1100&A WON
d M moa mm0rehoared dams IS`+DOF
Utes ower of M womrlyor myeervghevem awpe9 as Wr ole moweverbm,wilooUea eau portMa
of the worK ma me drwhom Is An mihmet a d'aM lot Me (Swim 7044 mamma 1,N FmInse ie Code The
CmDecmn Sate tJceme law Mm(W eDpN loss ovx`er o(DmDnnY who DVonds BmpmFms' wpm" hutla
aklmmm pw aoDr1Y, pro.Mm iMt the nlavwamnb we we Xdendod a onwm M sofa N Mwrr da DullmrW R
Implavemtnt Is ado wlBdnaae ymrdtomyatlm ma0wmr Bminpr will have mo Laam d prainp mat It was net Dem
IXI(nweYwl la metNxwea d gab 1
70 bas sena or l InopaM eCo Code
The Conwatem Saexit tlmmed, cow a 1,e b *mored the of who
lON Burmese end Pdeedam Cbdb The fon!Ywtba Sbm Lfeer6e lax dor 1,i apphY m m par d pramty sdr
adleee Lee) tsmamn era wlmtaltramn Mahe Dmktnwlmepcemaa Cmbacfa pwwallllNlho Cplbemb11'S4m
ILmereelesv
U 1 rn enwo hem fi mmNa "a the Cmbacm a Stale Mama In. Ir 0w Idrwmp rWehhw
By my apraNm Gebel i0molelew M wMert b my PesoYfal taknnme ft who I hotel Mex smMed M of low
yeapriormtm telt olLMImprmmlmb Derrbfmopemrl amen fepaY 1,e AebpENretlmtlMa slipmm
oeslw wdber lire Nm rplMmtawmsmlmin lnodery hYD<elmadantrammra,ImgmnwldatamopYerea opppmhr
reef Setlmn
pw Iloansm NOPpre Bunn®ria R 0gwfw CndOmNYmmaaapa rodmmeMaDtl48pp5madMkalhmmmaet
dlowlnpWeD e1vnw ler"tl Dmlmlaw aonl
DATE SDN
LICEIMCONVIACTai'S DECLARATION
1 herebYaMrm u�r Isanaeya parpry pp[ I lore hCenieO under pm.loana aCnaptm 9lxmmermnp exit SaNml000a
d 01dNon 3 a pre Busa�end PdevmnsCMN and mY Ikeme N m is ton:aam eDwt
LICENSE CLASS, C `17 oC NO 61114 1 Pa
DATE DA
WOR Ut'S COMPENSATION MLARATIOM
I HUM AFFM UTAER PENALTY DIF PERAPY ONE OF THE FOUDWM DEQAR TICM
I toes em w1, nwnmsr, a UaN5oan of foment m Sell brae for Wntaah CorenWee, a pnMdm by
SeMn31m d0a tahoLioe MlM pwbmwted Dmwotic mrMadsdmpwmA nlsmMo
lMmamwlDnmbinm Wonxr§ IIS1inlee mreAURad Fq SaiM DlmdaxesaaCOm,tIX
---rgpmtmmrcaafMsaodehawNgl Rds paMtnlssvea nYWakesh NmammO Cwarwm
Fsmq AVmto are
PIXLCY NtdA6ER 1atG 5 - 4 °i
OMSWIMWEB WBE aW1ETEDFT}EPEW LSFMDW WIAMCSI ¢ARUM
I oawo Wert INteAraeaala ersmrwhdsmtspaslanttlRO ISlmmmghNwgprsn»Nmynaarttasmt4
bemrzw ad$oa m dm WaYah Coaasaaba toss d CaNaMa.wtl � da d 3 dI11J¢ bemNw pA1xs wda W'oimh
CmWr®empmbkraa5x9m31md6e{ehprCat IaepibONAmta�ymASvlop�v.SinB
DATE APRICtd(F
WAIM*M FAA" he toxwo aWloot ranpa®Ba mn:mpe b wOW and shoe al 1,'s enipim{ai m Wwhol
Wileft love def inn W m 1,r Aimee v.Wa wave DlmpeW, in BMW m IM Wi are Wo mi5ateo
doww070AW W A sWee 3106d ft one, mm newest 1,0 after"
CONSTRUCIMUW#o AGflKY
I Daoby a Wm onda Wftofwooly dms plea Is a CameocWs Le Wil Wrcj to M pef emoof da wok tot
rAacn tnapamn b ismad is l; mel Ov C i
LENOERSaet,E.
LENDERSAOORESS
I wrl,y W shave mai Sim aphl� and We No [be rpm miamedm b gyral i apme b=M OW a dty oM
aanty atle®n ab om Nib nes sorer wow on wowsen wd FaeaYNvmaln raresennthes d tdsowrry m
woo upas dw aM+bmmhorryyyl piny to Irtperhon papoam
�n 1 w
PERhoflE � 1
on
SNOdA F DATE
I � 1♦
PRESS
FIRMLY
APPLICATION DATE / �n PIC#
ISSUEDATE !II„�1 OWY PERMIT#
TYPE CONST OCC GROUP
ZONING SETBACKS
FNT
REAR
SROIDEistDE STREET
SIDE
RW ❑
❑
RW ❑
❑
PROPOSED USE ba C IN n t<
# OWEL UNITS # STORIES
L
# BEDROOMS
DESCRIPTION SO FT FACTOR PSF
ADJ AREAIVALUATION
.................
SFFVADDMEM
Greg>1Cerpart
N
W
PpbaPak
LL
Pool/Spa
IS
Z
Fte RDW
9
Camnerod
in
Voluatlon Ad] Area
OUANTITY DESCRIPTION
FEE
CONSTRUCTION
PLAN REVIEW
ELECTRIC
PLUMBING
MECRANICAL
INSPECTION FEE
ISSUANCE
SMTP
ENERGY PIC
ENERGY PERMIT
RETEN71ON FEE
PRE ALT FEE
�M}
8SAF
TOTAL FEES
COMMENTS
ys
RECEIPT PAID 6Y `
VALIDATION
Y
WHITE— Department Copy YELLOW — Franca Copy PINK—Aseassor Copy GOLDENROD— File Copy GREEN— ApphunPs Copy
CITY OF 'MOND BAR
COSIJANA INSPECT 6'14 RECORD
INSPECTION DATE
INSPECTOR
INSPECTION DATE
INSPECTOR
SETBACK/ LETTER
TRACTAND LEDGER
FOOTINGS FORMS
SWITCH GEAR
SLAB
COMMERCIAL HOOD
UG PLUMBING
T -BAR
UG ELECTRICAL
INTERCEPTER
LIFER GROUND
HOT MOP/SHOWERPAN
SEWER LATERAL
SEPTIC/CESSPOOL
MAIN WATER LINE
HERS REPORT RECEIVED
SEWER CLEANOUT
DEMOLITION
ROOF SHEATHING
ROOF DRAINS
FLOOR SHEATHING
ROUGH CONDUIT
SHEAR WALLS EXTERIOR
POOL/SPA
SHEAR WALLS INTERIOR
ROUGH PLUMBING
FRAMINGA/EC AWB- 3
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) , r, i/ i d
FINAL POOL
LATH EXTERIOR
WALLS
LATH INTERIOR
WALL FOOTING/STEEL
GAS TEST
WALL STEEL 1-( 12 ND( ) LIFT
SCRATCH COAT
WALL BOND BEAM
ELECTRIC METER RELEASE
WALL DRAIN/ SEAL
GAS METER RELEASE
WALL FINAL
SPECIAL INSPECTION
RO FRAMING PLANNINGAPPROVAL
FINAL BUILDING /
ROUGH FIRE APPROVAL
FINAL MECHANICAL
FINAL FIRE DEPARTMENT
FINAL ELECTRICAL
FINAL PLANNING
FINAL PLUMBING
FINAL ENGINEERING/ PW
TC of OCCUPANCY
FINAL COMMUNITY SERVICES
CERT. of OCCUPANCY
FINAL HEALTH DEPT
FINAL INDUSTRIAL WASTE
COMMENTS