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CITY DIAMOND BA RZAS�DEPARTRT MENT C71:COMMUNITY &DEVI;LDP ENHMZ1810 Copley Drive, Diamond Bar, CA 91765PRESS
(909) 839-7020 Fox. (909) 861-3117 Building Inspection FIRMLY
BUILDING PERMIT APPLICATION www cityo(diamon ( t nndbarca gov
40 SITE ADDRESS 2 q 5TC(rq C 4 A5f Vv
[APN LOT TRACT
[ OWNER j -P4 cn +t
I ADDRE 7rg(�'
CITY ZIP TEL
APPLICANT t*Ei3 TEL
CONTRACTOR �`` a �A 0 i- 14,
ADDRESS t}y 0� �' S-1
CITY VO tgf, ZIP1 a TEL O Q
ARCH(ENGf
DESIGNER
ADDRESS
CITY ZIP TEL
OWNER-8II11ID01 in:cu raw
I remiss affirm under pernmy of pmhrry that I am exempt from Ora Corrado'% Sb a tkorm L.aw for ate reasons)
indicated below by the chadurWWAI I have loaded next to the W0104fdo I rjydrmr 7M% Bin and
NvInwis Coder rkry city or comfy that requires a p wnil W 0MOtiet, attar, hV me. demNtsh, or repair, my
structure, prior io its kw anc%mso requires the apo"d liar the psrmri to M1e a tlgned stotsrnertl that he at she
Is licensed pursuart to the prov*m of the Contractor's SbAo Uem ee Law (Cfmpiar 9) with Section
T00(1 of Oh ilsion S W the &ginees wW Profesmis Gods) or that he or she is eaarrgla from kcamurs and tha basis for
Ins alleged exemption Artytimeiondsection 703t5byartyappilmoifor aportnttwtll tyre applicant to advdpenalty
al not am Than Rove hundred Own (SW
(-)t a aowwo(theproperty or my tmkyees wahwagaasthew Wha comocasaW, win do(UandortUpeama
of the worn, and Ifm structure n ad Intended or onored for sale f6ecUon 70" flustrion and Pfatessions Code The
Common State Limaae Law does M am to an ounce d Pop" Vft ttuwgh eupwiree or permw effect bias s
or Improves Ale ply prorided that tics hirprowments are nut Intended or c ad for WM d or
Impmvinnist is add war orm Year d ann ftbo n, the Owawt Buidu wR have ft burden in prmT that it was rict txdli
or Improved for brapvpme*IWe)
(_) I, as owner of the prWarry, am excimloi ty tzolre6ng With kwuled Coiftctwa to conatnuct tits Mood (Sectlen
7044, Ousinass and Professivis Cade The Cmft3dora' State Lime Law does rrot apply to an comer of property woo
bdikts dr Mertes lltctarar i� lrhli Gath�[b f4t lira prc(ads whit H Itcetraett GonDacScr¢ra'8irani tdThe Contradisa' Siaie
Llcsrtstlaw I
U I am *mr* from lioware irrder the Cononewa State License taw for the fadutring
Oato Syr
By my signature below I ackwMedge that except for my personal reaktence in whiten I must revs resided for at law tie
year prior to cnmplelbn of the Impromrnents covered by this permit I carrot legally see a structure that I have bun as on
brdkler If it has not been constricled In Its emrelp oy Ilce+ised contractors I understand that a copy of the
law Section 7044 of the Business and Professions Code Is available upon rsquest when this application is
submh pod or at the fdlov" Web slie retpt ww legxrto ra go0calaw html
UCt71SEO CONTRACTOR'S DECLARATION
I herath' affirm tnndor p onaity of pelfi" that I am bcerism under OM&Io rs of Ghaptor 0 (corrrmendw WIM Sectlor 70M
of OMAkth 3 of ibe Noness end Professla a Code and 7 Iioerlse Is In Rua force and e0ag3
I CWSowaball IC NO r TJV-1L1
UP GATE CONTRACTDR
WORKER'S CO TqN XGLARATION
t NI;KP AFF#IM UND69 PVKTYOF KE QLTii ONE OF TIE FOtE,Qy M 0 IC"TIM
I have and wit maintakt a C,aNficate d Comm to Sox tmwB for Wacker a OynWisaLlort as prortded try
F Serson 3700 of the t abar Catch Jon the pnrrfamnance of ft work for which ft pemmutt Is Issued
I hares and wtK maMM S a6m a Compensation Irmuraned as required by Sector = of due LOW Coda for
tfa pOWMIAM of the wok forr Wh lids MTrA is tssM Nly WorWa Coorpereiaton visurance L'atft and
Poky MA*v are
CARRIER
3
POUCY f#UI4 kTt
MdSSiCTJONWDN0TBECAhRJIERIFREPEMOtSFORONE RAM D SIMORLfS*
E tiai do #w of thtr wick ht sM�ti this pettrt hiaand t strai tot orriP�f wit" p � eilr mariner ao� #d
moo ht Rua WwWo f pnperoation taws of C dearrda And Vrse that f 1 should become subloct to gtB WwWo
Ganpert tiotnp)*=ttSacUpn37WOthe IabarCodsIshall kdmtinawMwOn lrmWortc
_...... APR tCANf
WARMNG F'Mure to secure starker s CompettsatIm cdteraga Is unlawful, and shad subject an employer 10 ahrdnal
and ctMI tines +Rr to one hpn&M Crogrsand dopers {5100000) in addition to the cost d the compensation
damages as provided for In aection 370E of the Iatwr code w4arest end etmrney's fees
0DNSTRUCTIDN U:NOING AGENCY
I Arm under penalty of penury prat there Is a Construction Lending Agency for the parforrrianco d the work for
this permit is issued (Soc 3097 Civ C I
1.E9L1ER'S NAME
LEWEA S AOORESS
I cox* drat I tare read this a•aWWIM 04 state that the above Irnormation is correct I Bps to comply with dl City no
adkmncsa and state laws rataTGp to building castnallm and hereby authodra tapreUntaihos of Into cdunhr to
Mot upon the ahovo merrtmed property for Inspeutbri purposes
IrEHtOTTf.E NAhEE �tii} �.•� #�, .� r
S1PaMATLKOF EE OATE L- j
APPLICATION DATE ! 11 1 t PIC#
ISSUE DATE l 9-" 11fPERMtT#
TYPE CONST OCC GROUP
Scope of Work 3 -T 0 tJ rAQ IzFf4 At,rF, M(- Kr
M DWEL UNITS k STORIES # BEDRtAOMm
DESCRIPTION
SO FT
FACTOR PSF
AD,1 ARE"ALUATION
SFRlADDIREM
Garag.'CarPort
w
Patio/Deck
k
PooUSlaa
_
R"001
Commercial
ca
m
Y#sTita#Tttrai Ad) Area
QUANTITY
DESCRIPTION
FEE
r$
CONSTRUCTION
PLAN REVIEW
ELECTRIC
PLUMBING
MECHANICAL
INSPECTION FEE
ISSUANCE • I Z
SMIP
-----
ENERGY PIC
ENERGY PERMIT
RETENTION FEE
PRE-AlT FEE
BASF
PLOT PLAN
ZONING CLEARANCE
TOTAL FEES+ i?Q.
COMMENTS
PIG PAID BY _ VAUDATICNi
RECEIPT a _30' C' PAitt BY 0y XAtM:noN ,
WHITE — Dspsnmem Ca y, YELLOW — Finance Copy PINK — Assessor Copy
IT v"0' 11
t
' *! /�g�' i t IT# b't' C k; 1 I V
i
N Il i C k; V h U
INSPECTION
SETBACK/ LETTER
Da E
INSPECTORINSPECTION
TRACT AND LEDGER
SWITCH GEAR
D,
INSPECTOR
FOOTINGS FORMS
SLAB
COMMERCIAL HOOD
UG PLUMBING
MAR
UG ELECTRICAL
UFER GROUND
( INTERCEPTER
HOT MOP/SHOWERPAN
SEWER LATERAL
SEPTICPCESSPOOL
HERS REPORT RECEIVED
MAIN WATER LINE
SEWER GLEANOUT
DEMOLITION
ROOF SHEATHING
ROOF DRAINS
FLOOR SHEATHING
ROUGH CONDUIT
' SHEAR WALLS EXTERIOR
POOL/SPA
SHEAR WALLS INTERIOR
FRAMNG/VMTING
? ROUGH PLUMBING
3
; ROUGH ELECTRICAL
ROUGH MECHANICAL
; ROUGH MECHANICAL
ROUGH ELECTRICAL W( ) C { }
GAS TEST
ROUGH PLUMBING
PRE (UNITE
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
CAS TEST
WALL STEEL 157( ) 2"°( ) LIFT
SCRATCH COAT
WALL BOND BEAM
ELECTRIC METER RELEASE
WALL DRAIN/ SEAL
!, GAS METER RELEASE
WALL FINAL
SPECIAL INSPECTION
FINAL BUILDING
RO FRAMING PLANNING APPROVAL
-------------------------
ROUGH FIRE APPROVAL
FINAL MECHANICAL
FINAL FIRE DEPARTMENT
FINAL ELECTRICAL
FINAL PLANNING
FINAL PLUMBING
FINAL ENGINEERING/ PW
s T
T C of OCCUPANCY
FINAL COMMUNITY SERVICES
CEiI'I', of OCCUPANCY
FINAL HEALTH DEFT.
-
f y
COMMENTS
FINAL INDUSTRIAL WASTE