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Home My WebLink About15-1518Al ti111x111 1i e. to �;�Lbrary CITY OF DIAMOND BAR I. DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Dnve, Diamond Bar, CA 91765 (909) 839-7020 Fox. (909) 861-3117 Building Inspection Hotline (909) 839-702 BUILDING PERMIT APPLICATION JOB SITE ADDRESS 42 3 5.4f 11 1 # biz . ... .. ..... ......... APN LOT TRACT OwNeR'T"G Aeabc.., Om ADDRESS 12A41 Lne-Al` 13 i"CfY'>CZI�P ®`_.._�.�1..�?�EL APPLICANT l nQ9 TEL , CONTRACTOR ADDRESS CITY ZIP TEL ARCH/ENGIDESIGNER ADDRESS ._....... CITY ZIP TEL OWNER-RADER DECLARATION I hereby affirm under penalty of parlmy that I am exempt from the ColVaiar's 5ata License taw hrr the reason(s), lo6c find borow by the checatltwi0l, t have plastid ned to the apptcable ttamt i� [Section TM 5, Bualnoss end Prpll"orga Coda Any e4v or caunty that raquh+ea a permit to corafmtt, alttlr, Imp"o, dinewlsh, w ratedr, argr rdtiwra, paler ID its tom, also requires the a~ for he panrft to file a elgrend stabomept Marl he or open Is IliappieWpeareanttothe prinvishinsofthaConilain: 8Stateuteri"Low(Chepipr9)Conte*M84COM 7I1100 W Offton 3 of alas Rushee and P trine Coded or trot re or she is excerpt "nm kcorwo and the beaN for tiio ea 0xp Any vloiaf)w: be 7031 $ by amy skirl fora prarrrd subject ttia appl: t tea cord pratrp of not, mae dram few hundrud cheats ¢5 wL L)f,its ortrsyrtlthe prapag.su my arrspoyeeswashwages as than sole compensation, will doL)altotorLypar ns of the w(eK and the struclum Fs nak transited €s offered hx sale §ecson 7M, k4mei% and Proilmlionsi Cole The Stale hearse Law don pat appal to an turner art pro" who m o , twice or Improves to p aneety Iavi ded that fen heitiratemsitsi am ni ot ewe for sate if however Iten bowing or inVmineat is said w=bll rxns: year of completion ma Owner -Balder will Iwm lien tu*n IR jasig that iL wai not bull or Imp IV tlro pe:gosa of sale ) Lp 1, ss awtMr of Iba pr l* am ea:ks Y cpnEra Amg wffh fluenzed Codswmrs to oaenOW tiff 4rD1 SxG s IOU ibua!nvu and Fhptcs :s Coda The ioi bwfixV Sills Lkose Law does nm ap* ba ar nww et;tromrty who bolos rr atTrsvm ihm and whe cl,-JC% fDrft pmlWle With a Owned C4eeh;aur ptirseart to tire Cameos' State LLcssis taw I D I am exempt Tram Ih:orrwuro urn Me Cmtranox'a State License 4aw for the following raaaonis) By myorgnatra aelaw I ackmWedge Tat excW fa my pe.-ond residence In which; must have ra*sd tar at one year poor to cirnpletlon of the Imlivvemerps rswered by We perml I carnet IKolly sell a gTu&-n that l have IHJIItes era owner budlderif it has notboan constricted in its entrety by licensed contractors I understand that a copy of the applicable law Sectbri 7044 a the BusIness and Notessioos Code is awadable upon requesl when this applleetlon Is suhmlttad or at the fallowing Web alto htVw ww legl* ca govlcalaw hbnl DATE SIGN LICENSED CONTRACTOR'S DECLARATION I hereby ofhrm under pero t i at pap ry tnat I am stoned under proeipons of Chapter D Icommenrang with Section 70M W Dlwlulon 9 of tho Rusmesa and °mCess ons Gedo and my license Is In tuf force and sff t iJCI:N",,E MA$S LIC ND DATE CONTIA TOR WORKERS COMPENSATWM 13MtAPATION HEREBY AFRFW UIYW PENALTY Of Pfkt MFW ONE OF THE FOLLitsthNG DECLAiUaa IDNS I hwve and wit mesntvn a Geu iftate at Corot to WY Insure for WOrasr'9 Carp"ns n, proiidoof by Snip 31M of the Lai Cttle, bra ft { marts of tits auxin fat which hs penint is oued ........... I le mo and wig reanttain VkrW& Cappensatk krsantnc%as nejunt d by Soctmn 3MG of the Labs Code, for the pee#mrance *f the work for which Garen pwnv is kared my Worker'" cibeemsatirin kqumice ceirw aa#i PofzyrNumber gas CARFUR POLICY "DEP. {tM WGTON NEEDWT BE "ILETIE)FTiiBill6f(AOTE 1sTRREDftkp..l..ARSfSIMOP. I wr* vat in the poilarr"em of the work ter with this permit s issued, I shal not oaTdoy any mrs on n any marmeran as to baane subject to the Wnirkor'a Comgeruban Laws of Wbrma. and agree ter it I should tmome &4W, 1:3 the Wortai Campensa m prmn+oaa of Senor 97W of the Labor Coda. I snag 1amum con" whh those pnpd bn& OAT APPLAL'aNT WARYNC Fdluro to wureWwker'a Cempersahon cmreragn is un%wfui and shall su'blect an employer to criminal penalhux and cavil finds up to one htindrod thousand dollars ,3100,000) in oddrtlon to the cast of the compensehon demages ac prorided'ar in section aMa of the labor code interest and abmey s fees CONST111=011 LENDING AGENCY I hereby ar; arm under ponatty of penury mat mere Ise Construction ending Agemy tx Oro porbar mnce of the work far which this permit m Issued (Sec 3097 Ov C I LENDER S NAME LENOR'SADORESS ------------- I Cenrythat i `,ave raad mis appkabce and stale that the aban Ypamatmr is pact I agree t comity with all city and awmy ordriarim aril slate laws r0aNry to tt W ng =Wpiebn and hereby &MD:tas representatives or Cale dimity to ewer u " Weirsstmrldmad property for kcepechon Pe,Tpaass �! 1 , M14 F E DAiE PRESS 7 FIRMLY APPLICATION DATE Pi — ISSUE DATE 3 "„/J� PERMIT# is" TYPE CONST '17 OCC GROUP ZONING SETBACKS FRONT _ _ L7........- REAR _... 0__________________ ' SIDEISIDE STREET RW 0 SIDE ---------------- E PROPOSED USE _...... ► Al �' ------------wo # DWEL UNITS # STORIES # BEDROOMS DESCRIPTION SO FT FACTOR PSF ADJ AREA+VALUATLON SFRlADD!REM GaragefCeepart PathMeck LU PtwHSpa Re-Fbof Lzf Commercial vat ion [? ? O Adj AW OUAN-nT-Y DESCRIPTION FEE c7 c� I 3 CONSTRUCTION a �� PLAN RE\AEW ELECTRIC L. _ PLUMBING MECHANICAL INSPECTION FEE ISSUANCE SMiPt r ENERGY P/C ENERGY PERMIT RETENTION FEE PRE-ALT FEE I BSAF AA TOTAL- FEES COMMENTS REarPT A MD 9Y YAL)DATON � if7E— Department C.rrpy, YELLOW —FlivnceCopy, PINK —AtawssorCopy OCIXIENROD--- File Copy GREEN— Apphcw"Copy CITY OF DiA fi6N6 BAR INSPECTION RECORD . . INSPECTION SETBACKI LETTER N s i TRACTANI) LF[iGFI� R FOOTINGS FORMS SWITCH GEAR COMMERCIAL HOOD SLAB UG PLUMBING T-BAR UG ELECTRICAL INTERCEPTER HOT MOKSHOWERPAN UF9 GROUND SEWER LATERAL SEPTIC/CESSPOOL MAIN WATER LINE HERS REPORT RECEIVED SEWER CLEANOUT DEMOLITION ROOF SHEATHING FLOOR SHEATHING ROOF GRAINS ROUGH CONDUIT SHEAR WALLS EXTERIOR POOL/SPA SHEAR WALLS INTERIOR ROUGH PLUMBING FRAMINGIVENTING ROUGH ELECTRICAL ROUGH MECHANICAL ROUGH MECHANICAL ROUGH ELECTRICAL V&P C # I GAS TEST ROUGH PLUMBING s PRE GUNITE INSULATION WALL = POOL PRE DECK BONDING INSULATION CEILLNG ; P-TRAP gem fibb DRYWALLE FENCE T GARY ALARM LATH (PRE) LATH EXTERIOR LATH INTERIOR FINAL. POOL MALLS ' WALL FOOTING/STEEL GAS TEST SCOTCH COAT i WALL STEEL 1-( ) 2-( j LIFT WALL BLIND BEAM ELECTRIC METER REUSE GAS METER RELEASE WALL DRAW SEAL WALL FINAL SPECIAL INSPECTION RO FRAMING PLANNWGAPPROVAL FINAL BUILDING z r ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT _-- FINAL MECHANICAL FINAL ELECTRICAL. FINAL PLANNING FINAL PLUMBING TC of OCCUPANCY FINAL ENGINEERING/ PW FINAL COMMUNITY SERVICES CI:AT: M OCCUPANCY FINAL HEALTH DEPT FINAL INDUSTRIAL WASTE COMMENTS