HomeMy WebLinkAbout15-1025 (9)ili ABX11 BAR
CITY OF DIAMOND BAR
DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES
21810 Copley Dave, Diamond Bar, CA 91765 PRESS
(909) 839-7020 Fax (909) 861-3117 Budding Inspection Hotline (909) 8.19.7027 FIRMLY
BUILDING PERMIT APPLICATION
JOB SITE ADDRESS._L
APN LOI TRACT
OWNER
RW
RW
❑
❑
❑
❑
PROPOSED USE
yt DWEL UNITS k STORIES
SS
APPLICANT
DESCRIPTION SO FT FACTOR PSF
�� rr��
CONTRACTOR &,Lw3_
ADDS141
CITY Zt TEL
ARCHIENGtDESIGNER
ADDRESS
CITY ZIP TEL
CMnLEIpOLDE t GEMARATMN
I h=W athtm under pmmy of wr)tsy, gut I at a®mp ham the Caimaaas't We Law Law nor bin Monis)
III by the CWCWRNW I tars pfd nee[ b the Vokable an* ]S UM Ani-, Nmmam aid
Pmhmims Lein Adry dN W CMBdy ity raaarm a prank m rsmtuc{ eNr, lmprow tlroftlk r u ir, are
stecbue, pt mIN Imaa mammon Ow appli am Mit pan& miles signed Mnbfewm Cmltwdm
Is Nm%W pasuammhro pferialsrmsttlmfArlNeNara Rod Lkmmetaw(Ch pM O)CommwlWpr Seem
thea]oyWvm3sfIM Bummer and PpNwebt5 Cada]or Nat tlw M
tforstisa7ampt'mmtloeneum be
the abed exBmpkn Any ublatbn dSactlrt 7O3i S bi anyeppllcent farapemstsuttAcbtha eppllWmm a Uw!permity
d wtdmra don tNe trintlmtl doparm i$e55,
Lyl mows c4as prodadN or my empioymewthw4p's mthew We cwpormftn, Al do L] ae of or L t yeartlons
Of the worm, and No tructum is not k*iWO by aided for sale Obard, TMs ]from sill Pmmmlem We The
LwNadWa State Lnanm taw does lir appy in an;Ar at P'opend who Mewsh ' or personal CNotL bums
or unprovesthe wopmy pmYmad We the im ate not lmamad or ono for It newewf LM Msbag or
marwBnmd la nam wayan ens yead mmpiedm tltOOwher-SUist@twilltw the tAiidBndprody datd wag tint buff
ar improrm M tlm pumdaedaNe 1
U Lm ower d the pmpmty.em eadusmly mn"nng swh unused CawimsbR m omabapOm pw room
7541 emhlem and ftDmm Cede The CW"-WM Stare, L W taw doa trot apply to m Pwe( at property who
bakeso, regrows thaapn,rid win wryars for the agnea with a hvanses Coaxed punuantto Cm tbttrutas' Soda
Lkvm u.l
U i at Powertrom ilcraum saRkf the Contnerore State London row, for the rallbwlng Await
By on, dpuare View I ecestWadpe wed, excep[hr my hundreds msidv!m In AM: must ham m isedfw at kmt ax
Yiarpkraarmdellon dthe Indsmeammamsemd Dy this permd,l canfgt apaaY iba a Ministrant have bilk man
omrerb>a yrs irmmx2ndppawpydta
rI,*BL@n ramm:dedbteMmty by Ihmnaee
764 upon
aw, 5a1irn YMad tM &vmtmss way PrdsmbmCme b available upon iEpuaMwrNitlda appNWWn Is wMMiadar out
NeipOavRtp%4A ala Inlp'aapfeppGO mgxymawnfm
DATE SIGN
LCOM cONmACTOR'S DECLARATION
iherby Oanasyd enGlq wt3Waont00O!
3ouadBr
PNhVmatINde A y MuswainsdmadtMust
d aWebn 3 d Ne�eM P'M}poee�gm CdiB artd ari Must, m in full rorce NA effect
rCONMCTOR
L M Gl -I-zrj�—
WC KER'S COMPENSATM BEM"TNIN
I!fETESY AFFIRM UNDER FENNSY OF PBLLRY ONE OF THE FOU4W GOED"TONS
I caw: and W a =Mm a CemdWa at Consent In Sed Mem, M WIXtr 4 CompenUMM, m pmwded by
Sectron 3700 of the taar Cps, tar Oa perfamanoe of thewadt arwhich Me pemet to issued
IIow and will memWnrPodsw'wCAmpwudm blptlanm mreWW by action 3700 of Ove, LAW Cuba . M
the partanunGd or Me work frwdaU, thrprms Is toed key Wooveri c n pipmmdm bate'wrwTaw and
odwor hnddr era
CARRIER
fNOd£R
_.... .. -
POLICYMNeEa
(THE SECRae NEED NOT BE COMPLETED PTHE PE NI SFOR 0@E NIFAtt®OIX3AA3 l6'S!
I cetoty flow btu Powerhouse d Te worn IN AM ths.pen+ hall int' pwwn in sly manner w nth
Mmrne adidK'n Cm Waixrs Qrnp¢nsslbn Lalli wrtla Hah@ud(bamme wpapta the WtpYmt
(pm Wolin 'f Cxffi I' vet
--i /bin LLiCki y ....--
m st naaNila and stn eume HM1 a tdm
WAPANGwaked.
m ovi {Si 00000) in a of the
m me WM d the cpnpafmmm
pwtatlm all dud Ikm cN a mM w
on
t; few
as pmHdm M b saMm 3700 d me IoW cede btmast mgaWrcYk kis
o,
CMTMMN LBMGAUM
I hemby affirm under survey by pmPdy thin mere a B GonsMeWrt taaadp sgwaT M the prMmsnce ofOn, wMt M
wink dao arms a asumism =7. Ow C)
1EWERSNAME
LENCERSADDRESS
(
I sadly than imus rase this applicaft at state e'at the above Inkrmadw to one I adw, to o mply with as dty are
toumy, atdressm ad III bwa r "'C 11 buldin th atkn apgtld "Way a mEd a mPmaematN" (a MID wil dy b
anal upon the efts Ment mp@rtyfplm prpa4 e>a
PFAMftTEE NAIVE (PmNt} }TJ
Sn DATE
APPLICATION DATE _PIC#
ISSUEDATE _ .�f PERMRJI!,r �` �() J}.
TYPE CONST OCC GROUP
ZONING SETBACKS
FRONT
REAR
SIDMIDE STREET
SIDE
RW
RW
❑
❑
❑
❑
PROPOSED USE
yt DWEL UNITS k STORIES
A BEDROOMS
DESCRIPTION SO FT FACTOR PSF
ADJ AREANALUATION j
SFFVADDMF.M
I
GeraOo+Carprt
..........................
�
rn
pmin+Dack
...............
i
ICwi7
Podws a
Z
Re -Rom
o`
!
Commercial
m
'
Valuation Act Anda
1
QUANTITY DESCRIPTION
FEE I
(
G1
(
u
m�
S
d
I
CONSTRUCTION
PLAN REVIEW
ELECTRIC
PLUMBING
EjD D j
MECHANICAL
INSPECTION FEE
ISSUANCE
SMTP
ENERGY P/C
ENERGY PERMIT
RETENTION FEE
PRE -ALT FEE
BSAF
TOTAL FEES
COMMENTS
, p$
7
RECEIPT* RAID DY
VAUfiAT10N
WHITE— Departmerrt Copy, YELLOW — Fksace Cary, PINK — Awarded, Copy. GOLDENROD — File Copy GREEN — Appeoart5a Copy
CITY OF DIAMOND BAR
INSPECTION RECORD
INSPECTION DATE INS�PECTQR
SETBACK/LETTER
INSPECTIOX INSPECTOR
TRACT AND 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
POOUSPA
SHEAR WALLS INTERIOR
ROUGH PLUMBING
FRAMINGMNTING
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
GAS TEST
WALL STEEL 1ST( ) Zuo( ) LIFT
SCRATCH COAT
WALL BOND BEAM
ELECTRIC METER RELEASE
WALL DRAIN/ SEAL
GAS METER RELEASE
WALL FINAL
SPECIAL INSPECTION
RO FRAMING PLANNNG APPROVAL
RNAL BUILDING
ROUGH FIRE APPROVAL
FINAL MECHANICAL
FINAL FIRE DEPARTMENT
FINAL ELECTRICAL
FINAL PLANNING
FINAL PLUMBING
FINAL ENGINEERING/ PW
T C of OCCUPANCY
FINAL COMMUNITY SERVICES
CEfff. of OCCUPANCY
FINAL HEALTH DEPT
FINAL INDUSTRIAL WASTE
COMMENTS