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CITY OIL ] AMOND BA 11.
DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES
21810 Copley Drive, Diamond Bar, CA 91765
(909) 839-7020 Fax (909) 8G1-3117 Building Inspection Hotline (909) 839-7027
BUILDING PERMIT APPLICATION, f___ . 1
00 z' C
JOB SITE ADDRESS
APN en 4kOT T CT
OWNER 'j%
ADDRESS 01
CITY ZIP TE
APPLICANT TE
CONTRACTOR
ADORE
CITY
ARC.HtENG/DESI€aNER
ADDRESS
CITY ZIP TEL. ---
g IIC3t OUXARAnN
I hereby atrzm utrdr pormoty of perprry mat I = w*ff d trum the Starts Ltoorso Low Im the masows)
udcfftsd below ty the chockin tktt) I ?%ave precool crest b to apotl able narrOl Clan 7= L Iltminoss and
Pralso as tote Any tilt' ar on* W ragtdrn a permit #A , altar, Improve, de moliah, or repair, any
strsre9sa, ZxWr to th iffiStitP , ate m�a�ae else llptW far tM preNt sib a alyned t that tw or atw
Is Ace need pursalairl b the provisions, of the Cordraew%ffitaOa Ueanw Lin (CNI r Bi Ca mmerlising wo Swoon
at ]Division 3 of the Butirio a mW Prolmlon' Cadvil or oat ho ar sN is exempt fray Iloenafm and the bails For
Its staged exempOm Any violation of Sen m 70315 by any apptcw!tfor a pwmd subjects the applicant to a ova penahii
of rot mare Oran 0fe hundred doilire (SRO)
U I as atimer if the property or my employees wdh wages as their We cornpons coon will do U ell of or U pomxm
of the wo(k, and the structure la not intandad or offered for sale jSoctim 7044 Bualrim and Profs. worse Dada The
Contractors State License Law does not apply to an owner of property who atrough empbyaes' or persorw a'lorf builds
or Improver the property provided that the impmvearetds area not intended or offered far We II however, the building or
improvement Is sold within one year of aompla4on the Owner Budder will have the burdon of praving that it was not bunt
or Improved for the purpose of We )
U I, as owner of the property am ovAlslvety contracting with Ikxnsod Carlow q to construct the pr41ec1(5ection
7044 Business arld Rossawns Cade The Conbec9ars' State License law des not alptir to an owner of property who
ar h iprove3thereon end who conhacts for the projects wfdr a 4r ansed Cbrr6actor pursuant to the Cronhactors' Rate
Llcerm Low)
U I am exempt hnm howsure under the Cant Ws Sta Lilo" low for ft to Ww1d g re ($�
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By cry slgnarae Wow I acknoweclge flat, oxcepl tr nW parswial rasliWCa In who I mist hava resided for at WA ors
year pdortoWrRpletlonofthaImpmmerrbsoared0this parchIcanto lo0tv all aoft"turethat Ituvehulaasan
owner txllda It it has not berm corehp�ted In its wwaty top kwisod Carftcsor s I W44meend that a may of llm apptraW
law; Swion 7W of the lkwi w.s and Professions, Coda Is "4is upon m:Km w." fha apple man is solvri d or at
the 1610*02 Web site rmwwwwloginfacagxkdawmrot
SIGN
UMNSW C7OMRACTOR'S DECLANi471011
1"by ai0rm under walty of Flury Idurf I am licartsed provisim of Chootar 0 tcamm"Ci g yvliit 58:11cm 7WO)
4f Division 3 at the Buskss end ftfeswris Code W d my knout a In MI lotoo and OW
LCENSECLASS LA;
DATE CDNTRACM
WORIBER'S COMP9CSAUDIN GICLAItA"Dill
I HEREBY Ait:3W UNDER P AMT( OF PERAMY ONE Of PIE Pf.Rd,L1YtkIG CEO- AT'IC4
I hz. or,, will rsiakda;n a Csr[ifila[a of i'mnaraM to Sit Irlaixs Ior Wlgrbti� ofCurgnaa "I 0P dx by
Set3700 ca Labor Cade for tie
perrance of Bra work tar %bleh this pemtn istsart�
maintain hwo and cull mainn WorkaY n� Compeflpn Insumllte, as required by LAW 3700 of the LAodo hX
tee performance of Pe woni permit (g C&I"Msanmr tr�rance Carrel and
Policy Number are
CARRIER
POLO NUMBER ad 70/.................
M4S SEMN NEED NOT BE CAM IF THE PERW IS MR ONE HUNDRED OOUAAS(Sr 00) OR LESS)
I carbfy that. in the pertimarice of the wok for whkh this portnit Is Issued I mall not employ arty person In arty mww so as to
became out led his the nbrtwrg Compensation Laws of Ca6tonaa. And agree drat o l twrrMms RAW b the krmr%
Cam76/91t
no d Seaton 3700 of the e I shadf faded 1h ceomp) t th taom on9.
DATAPPLII'1WTj5dorr
WARsecure workerssecure workers Cacwara'a (s unlawful, and 9WI wbpa an employer to dla unlawful, and 9WI wbpa an employer to 1
penaltles end qYh fines up m one hunddaIIEB (SI DB,DDBL In addAon to She post M the cornpemAon
damages as provided form section 3709 code, Inhar� end imumay's tees
CIMMLCTION I.9014G AGENCY
1 hereby affirm under pen" of perjury Wat Ctem Ly a fgnstru'faon Utnding AgerlCy tar tter partW'rrlamx of do worst for
earth Vra permd to issued (Sec "T Cry C I
LENDER S NAME
I94ER S ADOBES
I certify flat l hive read t►a agpiimDoi = arrd am that Ile true lid mabor in xn vd i to offor wkis all City 3'A
wftarrm and state Won Moon to h&N amstfvathxl ark twcbv affl aloe t4weawftwo ofmu* to
enter upon the properly for intpactim purposes,
...............
FrFtiEE t {PRINT}
SGNXrUM 0; PENWrTE¢ DATE
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PRESS
FIRMLY
APPLICATION DATE
ISSUE DATE �r�
TYPE CONST
`PICm J
zt PERMITRI1
OCC GROUP I
ZONING SETBACKS
FRONT RW---- CI 1
REAR C!
SIOUSIDE STREET RW 13
SIDE _....................
PROPOSED USE
# DWEL UNITS
i
A STORIES # BEDROOMS
DESCRIPTION
SO FT
FACTOR PSF
ADJ AREANALUATION
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ValLiation
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-- Ad) Area
QUANTITY
f DESCRIPTION
FEE
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CONSTRUCTIONp
PLAN REVIEW
p
ELECTRIC
PLUMBING
MECHANICAL
INSPECTION FEE
ISSUANCE
SMIP
ENERGY PfC
ENERGY PERMIT
RETENTION FEE
PRE-ALT FEE
BSAF
e
i
TOTAL FEES�i
COMMENTS
RECEIPT o �—
,r
MO 8Y C/ YAtJDATtON
6-1
WHrTE—Depar"ontCopy, YELLOW —Finance Copy.Fnk;K —Aea xCopyGOL.DE:NROD—File Copy, GREEN — Applleani'sCopy
SETBACK/ LMS
aOTINGS FOkIVIS
!R PLUMBING
VD,ELECTRICAL
LIFER GROUND
SEWER LATERAL
MAIN WATER LINE'
SEWER CLEANOUT
ROOF SHEATHING
FLOOR SHEATHING
SHEAR WALLS EXTERIOR
SHM WALLS IN -IERI OR
FRAM IINGNENTING
ROUGH MECHANICAL
ROUGH ELECTROL. W( C
ROUGH PLUMBING
INSULATION WALL
WSULATON CEILING
DRYWALL
LATH (PRE)
LATH EXTERIOR
LATH INTEMOR
GAS TEST
SCRATCH COAT
ELECTRIC METER RELEASE
GAS METER RELEASE
SPECIAL INSPECTION
FfNAL BUILDING
FINAL MECONIM
HNAL ELFC11RICAL
FINAL PLUMBING
T C of OCCUPANCY
cm. of ompucy
COMMENTS
CITY OF -'DIAMOND BAR
INSPECTION RECORD
7 C TRA
CT AND LEDGER
SWITCH
I
WITCH GEAR
COMMERCIAL HOOD
T-BAR
INTERCEPTER
HOT MOP/SHOWERPAN
SEPTIC/CESSPOOL
HERS REPORT RECEIVED
DEMOLITION
ROOF DRAINS
ROUGH CONDUIT
POOLISPA
ROUGH PLUMBING
ROUGH ELECTRICAL
ROUGH MECHANICAL
GAS TEST
PRE GUNITE
POOL PRE OECK BONOING
P-TRAP
FENCE I QATFJ ALARM
FINAL POOL
WALLS
WALL FOOTINGISTEEL
WALL STEEL 1-f ) 2-( ) LIFT
WALL BOND BEAM
WALL ORAINISEAL
WALL FINAL
RD FRAM PMW APPMVAL
ROUGH FIRE APPROVAL
FINAL FIRE DEPARTMENT
FINAL MANNING
FINAII. ENGINURING/ PW
FINAL COMMUNITY SERVICES
FINAL HEALTH DEPT
FINAL INDUSTRIAL WASTE