HomeMy WebLinkAbout15-1667I111�I1F I) RAH,
CITY OF DIAM( BAR
DEPAR"I' dT OF COMMUNITY & DEVELOPMENT SERVICES
21810 Copley Drive, Diamond Bar, CA 91765
(909) 8 -7020 Fax: (909) 861.3117 Building Inspection Hothae (909) 839-7027
BUILDING PERMIT APPLICATION
JOB SITE ADDRESS
APN _0T TRACT
OWNER� e
ADDR
CITY #
APPLICANT TEL
CONTRACT ft I A LO r
ADORE 07AK FAIR ....._�i��� f Mot
CITY ZIP E 1O__
AROFI/ENGfDESIGNER
ADDRESS
CITY ZIP TEL
OWNEA-010.01D1 I2ECLAPATIOR
1 hdretrf ffm larder penehy W Fiftry that I am clmmpt trim pta t ra Ir's Sbde ucenw taw For the reason{#
bellow by the chftwwrir(s) f rem plead next to the "M(s) t8 oon 7931.5, Bttftmaa Ond
Cade Arty city or a"* that mom a perttdt to winshrvc� after, lnwmvo, drixillsk W tow, any
ll tt! it ^ priK to 11111 iseeance, atan [1H[eiM #te ptpllcaM I& Iltg peendt b 90 a elyrred atate€ne€ftiaert to or she
leAcanvedLlcameaLax (Mom 9)ComrnertahtgxddrSWIlan
of ptvtalo t 3 at #te Mono and holhoisImrA Cad) or that he or aha to wmM tram kensum and the basis W
the a7ag w arnptim Arry vidatortaf d0rt 7tl tt 5 by any appy ant for a pamuiauts cts the apple and k a cW pnrtBlti
of 4W mate 6tt be instated dallam ISSOOI
v l as ovmet {d the property, or my eftMw IsM WW as their OW wA do U all of or( ) porum
of the work, and the structure Is not hnkrdad or d1eired hor We (SactIm 7044, Bisamess aid Pdasi"s Code IN
ContracnD State License Law does not apply to ar oww of pmpssly who, mmugh emp*eas' ar personal attar oulids
or Improves the praperiy pmvkted that the Improvtrnents we not Intended ar afte€ed to, ash 11 hawel"r, the bAidkg or
k pravoment Issold wttAn ono yearof tEmpteton sra OwnK Btdkser will havethe a rden of Wwlrq that d was naf buiY
or Improved for Me pWppae all sate)
(j I, as owner of the prapettdt am exellsrhety M ritnau [ng with 9eatacd Co"naetas to cart rhM fhe prated €5achan
7044, lkar ass at Rvkt*m Coda The contractors SUM Lea low dais not apply is an ciiiwisir of property who
In" or inprwea thwaon and wha mrhmcts for the pmpm wim h t oensed caftraCtar pursuant to the Crxuwmrs State
iicareaa I
(j I am exempt from iicerisure undkr the cordreeters State Uvenso law for the tollow ng mmorew
nN algttabye bebw t aekrnvt a trai —ptfw nitypereortid realemin wOO I mtrst have ra WM For M twist one
yper I 0 oartipletIon of the —red by this parurir,t ra M Wolf ca9 a Mien that. I ham bulh as an
awrw W4dar0AhunotttwomstrucrsdinteMretyhyIa+ansed =Vneemn IaderstaWthat amfforlieappkable
Law Sir€ 7044 of the Business am kofeasktns Cola is avaBable span resood when this applwhon is submfted or at
e thowirq well s tg h1 vrww IegkRa ra r,Y.araw hhtd
SIGN
uCBM CWMCTORIS nEaARATNDI
I hereby alfrnt wider penalty W penaty that I ass kensisd arwar provlalm or Chapter 8 (commencing with Sedan 7000
of OMislen 3 ref am Btai€ opq and Rousseau Cade and my kwrra Is In � _ and
LICENSE QAt3 3 LX NO ��
IIA7E - — CONTRACTOR
WONKM CIDhtPENSAT11IN OECLABA
I HEPtEV AFFIRM UNDER PFNAM OF PERAIRY ONE OF THE FOLLOMNO DECLARATIONS
I have and wls mamram a remecata of Caraent to 8aft Imi r for IlVarker'a Camttereatarr as prwAdw by
Skctwn 370ii of ttm tabor Godw far the peftmum d tea w* fat which this perwA tff Ismand
Ihave endwill inal nWcr»'sCompensatanIrsutena,asrmpwItddbySection3700a!theLOWCodehx
the partarnwenco of the work Yv wh h thIs permit Is Ia Compensation Insurance Carder and
Paley Nu
POLL,( rn1MBEA 4co 14
(fM SECTION FCC MY BE€XWlf W IFTIE FEINT' 6 Ftkt #'dKE � l7CLlAkS IS1gO} ORI�
1 ratrtoy ttrat tr ttse Imrfamreswcaal the wade farx�itit trs pantYt fa 13ffi3ied I rrtor orvP Itanparr In awry rrratttsr sa as io
sk;od to Ins'Mnker's Cmipainsation Laws of Caittanla And egret tal IF I skW a ie radila to the Wanrew%
Coarooletim mtpwLadmi's
on 3700 of tso fatty £sale f silo it faldhv#i it trA p ov
I1ATEiCW
W N Ft Ca€r tarn toveraga to irl l tFpe t to Cd
parOUN and hail up to ono hurakad ftusot4 Mara €5100 OOM. in ltlm the matt a the carnpaaatft
danragon as provided W k1 sechm 3708 of the rntemst, and Imornay's tics
ClM6tAatMV14 LENDING AWNCY
I hereby aftxm antler lira y al pe wy that Mere 1a a 0matruchori Landing Agency tar at perf mace at the work for
which tltrs permit h issued (Sec 3fF37 Div C )
LiNOWS NAME
L�)EH S AOOWM
I that I have rod tus apoombion ahW state met to Ohms salla imials i is taredI sgras as compill watt ON ply and
ordinances and state Isis reiexng to buhdmg constu:ton W twetty eutwonxa representatives el this emnrty to
wW upon Ira above mentoned p gwq fix' Irspechon purpossa
PE>iN iiTEk NigSt €P qIF
- j
%RKATW OF PEf#NME
1
PRESS
� �% IR1t LY
APPLICATION DATE a,411:f wig ,, , P1C#
ISSUE HATE ���2j0tr PERMIT#
TYPE CON15T OCC GROUP
ZONING SETBACKS
FRONT RVy
REAR
511DEISIDE STREET RW
SIDE
i�
C7
I]
❑
PROPOSED USE I
it DWEL UNITS # STORIES # BEDROOMS
DESCRIPTION
SO Fr
FACTOR PSF
ADJ ARE"ALLIATION
SFWADDIREM
f3waf3elCarlxr't
I
GfS
PailoII)OCk
W
U.
Poolispa
ft-ROUT
MA
M
Co mterCiai
valuation Adl Aroa
j
QUANTITY DESCRIPTION
FEE
l
i
I
r
J �
I
i
i
CONSTRUCTION
PLAN REVIEW
ELECTRIC
PLUMBING
MECHANICAL
INSPECTION FEE
ISSUANCE-
SMIP
s
ENERGY P/C
ENERGY PERMIT
RETEN71ON FEE
PRE-ALT FEE
+� • dt� '
BSAF
TOTAL FEES
COMMENTS
RECEIPT A ,.,,. 5 61 } J PAID HY' +q'�' S VAL TI0N
.._ _1:: _
WMT'E — Dooartment Copy, YELLOW— Rnance Copy. PINK— Asseasar Copy GOLDENROD— Film Copy GREEN — Appliwi a Copy
CITY OF Dl,(%AA-DND BAR
INSPECTION RECORD
SETBACK/LETTER
FOOTINGS FORMS
SLAB
UG PLUMBING
UG ELECTRICAL
UFER GROUND
SEWER LATERAL
MAIN WATER LINE
SEWER CLEANOUT
ROOF SHEATHING
FLOOR SHEATHING
SHEAR WALLS EXTERIOR
$HEAR WALLS INTERIOR
FPAMING/VENTING
ROUGH MECHANICAL
ROUGH ELECTRICAL W( f C ( )
ROUGH PLUMBING
INSULATION WALL
INSULATION CEILING
DRYWALL
LATH (PRE)
LATH EXTERIOR
LATH INTERIOR
GAS TEST
SCRATCH COAT
ELECTRIC METER RELEASE
GAS METER RELEASE
SPECIAL INSPECTION
FINAL BUILDING
FINAL MECHANICAL
FINAL ELECTRICAL
FINAL PLUMBING
TC of OCCUPANCY
CENT. of OCCUPANCY
COMMENTS
TRACT AND LEDGER
SWITCH GEAR
COMMERCIAL HOOD
T-BAR
INTERCEPTER
HOT MOP/SHOWERPAN
SEPTICICESSPOOL
HERS REPORT RECEIVED
DEMOLITION
ROOF DRAINS
ROUGH CONDUIT
POOL/SPA
ROUGH PLUMBING
ROUGH ELECTRICAL
ROUGH MECHANICAL
GAS TEST
PRE GUNITE
PDOL PRE DECK BONDING
P-TRAP
FENCE / GATE/ALARM
FINAL POOL
WALLS
WALL FOOTING/STEEL
WALL STEEL 1-T j 2h0( ) LIFT
WALL BONO BEAM
WALL DRAIN/ SEAL
WALL FINAL
RO FRAMING PLANNING APPROVAL
ROUGH FIRE APPROVAL
FINAL FIRE DEPARTMENT
FINAL PLANNING
FINAL ENGINEERING/ PW
FINAL COMMUNFTY SERVICES
FINAL HEALTH DEPT,
FINAL INDUSTRIAL WASTE