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CITY OF DIAMOND BAR
DEPARTMENT OF COMMUNITY& DEVELOPMENTSERVICES YY
21810 Copley Drive, Diamond Bar, CA 91765 /t PRESS
(909) 839-7020 Fax: (909) 861-3117 Budding Inspection Hotline (909) 839-7027 FIRMLY
BUILDING PERMIT APPLICATION www.cityofdiamondbarcom buddmg.dinmondbarca.gov
JOB SITE ADDRESS3r+
APN LOT TRACT
OWNES
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ADDRESS
CITY M
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APPLICANT TEL
CONTRACTOR
ADDRESS
CITY ZIP TEL
ARCH/ENG/
DESIGNER
ADDRESS
CITY ZIP TEL
OWNER BUILDER DECLARATOR
I hereby hurt under penalty cepapoy that I am sremp[ ham Me Contractors Siet1epeLMw.e�o�u taw tar the INhm(hl
beleard bels« by the M clonarkl5) I have placed req to bm apPlkabla a"$) (R9ohan 70715, 00inM ad
Rhos Cada Any city or County mot mgwras a Pere rt to construct, ober, Improve, darrwlah, or Moir, airy
Wvcmm, pnorto as [=once, also recuo®tlr appbcan for the pomdto file a agned ammmmd that to or Che
as horMl pl ntto the pmYmargofMe Cwrbeemr's State Liam Law(CMMu D) Cummocmgwdh wounn
7= of Dmaon Sof Me Busmesa and Prubma m Cade] or that he or she Is ammptham Licensure and the ones tar
the alleged ntoWon My orbital, of Secbm 70315 by any apPlicem for a Mu lR subjects the Moslem to a Win rawly
of net more then five hundred Mass (SM
jd I, as owwo4 this Mu arty, or my wM:d sea with wages as their We compensatwn, mh drej*9 atm tJ parbmre
ofUre we*, and Ma struchen is not Imw>edd or dlaed for sane (Samlon 7044 DuoWss and Profeaewla Code The
COMamwaSwb UcMrea Law Oaee a apply to an awor A yopaliy via Imagh emplayme' err Mramel elbk hole
or ImpmWs the refinery wrorldided Omit the Indent"Winder are not Inwnhd or offered by sale If mwevm Do WIGnOa
IMpamman w sod whh one ymr m mmpkhn Bre Dearer BUXdawlll!avetlw bOmen IN Fvsvvq tlm B wva Tat butyl
or Impmvao for 0w purpose of War
Uf, as awarof the Prouty, am tentatively aomrwTng with Informed QorWa:mm her caMdnaa the prgear(Sacrel
7044, Boob hd Pulossus Coda IN Conbamas Stam Lterce Lew hes W sky W an seem of ur" wta
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awed A H Lou 70 been ewmmmmerrobe s, les dwslo by oca Is C l&t u a t mats IN Us
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LICOM DthaRACT@n DECLARATION
Iba&ry sham url pmWty of above ant i an essential India pmdamrs of C=W0{mmmenw(g weh Salam 700M
at OM1i0im8c{rta wd (tire and mylwin nu taeeerG atwCt
UCBXSECASS ...................— Le: No
DATE COMMr M
WORM-SCOMKSATWNDECW TION
I liEWDYAFRRM UWER KWilYOF FEU" ONE OFTK FZtiDWING OIELARATIMNS
_ 1 here and win matin a f,edlfceU U Coram to Sell Iram for Maker's Cmpens an rendded by
Session 3700 of ted La6u Cada to the mrWmapaolbe work W which Mrs perm la Issued
t harewd aril madman Wmkafs Cmpel�rm Imurar¢e as raptured by SeWon 3700IN Uataba fob for
bre woamamce IN b%whlh (Prvavch thwpemNt191atuad My WOker'eCmipensieon Insularxe (&da aid
Pdlry, Numbed em
CdtlXO
PODGY NOMBBt ..............
{M6 SECTION NEED NOT BE COMPLETED IF THE PERANT IS FOR ONE HUNDRED DIXUFS(SIR OR MW
I ca'Uly bed In Me perhanorce of dw work for which this penin w I" 100 WE amPby, airy palm In any manmr as w W
Wealth WNW W bw Wakers CPMIWOW taws m Larlo n r. And epos beat N I should become subject W the Welkars
CanpwAm wmw mm at Sedeon 37M of the Labor Cede I shall fmhwtlt comply with beam pinions
DATE APPIEDINT
WADMNG FNbre to secure Wora l"e CoenwanhBan cowemga w unlawful and Won warm[ an empwyer to Criminal
whereas and civil Mos up W acre hundred Maeand Doors 0100 ODD) th eddman W the east of Uw rwtpenaehm
namagmmpmNdedforhssdon37O0(XNolabtu'oode Mlemsi mdaWmay'afm
WNSiRWnUN LENDING AOENCY
I harbor weaken hour banner of penury Met mere Is a Cmsbueedn Leming Agency as Me performance of she wok for
which thea phndw Earned face 597, CE. C )
LENDERS NAME
LENDER S AMFM
mamba&tits+eanedaakiownrwngtotffiKN=%I ane anrnmamwwnamIagreemtixmofthla9bgad
coumyaNMmn:ed and s1Me Ions rNaUpg W bed.yN cgm4ruciml, and hwaYi aAtanae ra$esanGa+rea IN Uaaoumy he
emarsupun Use "nyfar infDed a
STI
5GkAm ' 7 - DATE
APPLICATION DATE // P/Cg
ISSUE DATE Z&yC?jflll&__PERMITA/JY_t
TYPE CONST _ u.K� OCC GROUP
Scope of Work
N DWEL UNITS R STORIES
it BEDROOMS
DESCRIPTION SO FT FACTOR PSF
ADJ AREANALUATION
SFFVApprT3EM
Gamga/Carport
W
Patio/Deck
Iwi
pagan"
zRa
Roof
_a
Cororoerodl
in
in
Valuation
Adr Area
QUANTITY DESCRIPTION
FEE
vs
CONSTRUCTION
PLAN REVIEW
ELECTRIC
aStY..iS X�
PLUMBING
MECHANICAL
INSPECTION FEE
ISSUANCE .......
SMIP
3S. G
ENERGY P/C
ENERGY PERMIT
RETENTION FEE
PRE -ALT FEE
.............._---
o%DO
...
BASF
....................
PLOT PLAN
ZONING CLEARANCE
TOTAL FEES
COMMENTS
�l
IS�i 77
PIC � 1' PAID BY
RECEIPT o _ffA&! � _ PAaD EW , &al
I VALIDATION
VALIDATION
WHITE— Deparfrtrent COPY, YELLOW— Ferturce, CORY. PRM— Assessor Copy
INSPECTION919
' �E
IN"CSO INSPECTION DATE�u uu
''.. SETHACKt LEITER
TRACT AND LEDGER
FOOTINGS FORMS
...- ...- ......
SWITCH GEAR
'. SLAB
COMMERCIAL HOOD
'UG PLUMHING
T -BAR
UG ELECTRICAL
INTERCEPTER
UFER 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
i ROUGH PLUMBING
FRAMINGMENTING
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 IST( ) 2N0( ) LIFT
SCRATCH COAT
WALL BOND BEAM
ELECTRIC METER RELEASE
WALL DRAIN? SEAL
GAS METER RELEASE
WALL FINAL
SPECIAL INSPECTION
RO FRAMING PLANNING APPROVAL
FINAL BUILDING
ROUGH FIRE APPROVAL
FINAL MECHANICAL
_
FINAL FIRE DEPARTMENT
FINAL ELECTRICAL
FINAL PLANNING
FINAL PLUMBING
_
FINAL ENGINEERING/ PW
T C of OCCUPANCY
FINAL COMMDNITt SERVICES
CERT. of OCCUPANCY
FINAL HEALTH OEPT
7rrT+rumn
COMMENTS
