HomeMy WebLinkAbout15-0950il1�1.Itl !) BAR,
CITY OF DIAMOND BAR t! 9/A.'
DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES
21810 Copley Drive, Diamond Bar, CA 91765 !/ PRB+ ,
(909) 839-7028 Fax (909) 861-3117 Building Inspection Hotline (909) $39-7027 FIRMLY
BUILDING PERMIT APPLICATION
JOB SITE ADDRESS ;tS_` G �►1 C�
LOT TRACT
OWNER
ADDRESS „4 &zieg <nA
CITY P 1174�S TEL
APPLICANT ZILr TEL 8q77. t6-11
CONTRACTOR �" r
ADDRESS
CITY L ZIP EL
ARCH/ENGMESIGNER
ADDRESS
CITY ZIP TEL
ATM
I traratiy otilrm under Mwty of po*ry Met i am oxempf tt m the Cardractt,r's Sims Lmorim taw far the reasons)
Irdwhad loriow by fire #ecknark(e) € have OncO nW to We app " it9 *) I —Mort 7{K# A Iktdrteea end
hvilossim ! Any !' er =Wft Chet s ea a perrrttt IQ oisrWr fcl, ease; ice. d&Tdmk of repair, any
dipitions, pm9r to Idt I atao rlliqWrox the etle)parlt far the A4rmill to ift e shed statement But he at do
4 lwmd pay"punttthe pmndomotitnt aaft LkwstaUw(cow 9)Cmyne"Ingw tSad$m
?0W of t7tyhtion a of Me awlihosis irduq Profession C401 or that to or she is uorio from ]censure and the basis fo
agagtdo AMv4 donof Whon7C315byvy8ppuerrtWapenr"tsub�ctsthe applicaMk+acmipenalty
at not more that CiveNOW* drdiam I':Sttg1
{j f, as mworftproparty, ormy with rrregaa ae p' bolo compensation, wM do to eb at or Li portions
of the Wort i0 tho sh thuloii to net I;4ta W of oftW 'ar so a (Seabn 7044, BuSlness Wd Prgie69Nns Code The
owttteriorV SUt& tkenw Law does ro app4 to on wvr of pr%erty wv through employees or p&canal errorl bulltts
or Implores line "party arty pmvlded W the Irnpxcwemerrts are not Imsaded or offered for sale If hewevor, the bwiding or
mtprovenmit is sate tiwthm one year of compimlan the Dorm Duudor will have the burden of proving the d was nay built
or w;W"ad for the pa;poBR 4t s041
{j 1, as owner of Ma praporty, sm azalaaheh mtrocdng whh licertaed Caributars to construct the prolad rrreaban
7044 Dulness imd Kdozions Corte The Cardrafts' State License Law does not apply to an owner or property who
hsrldsorimproves thereon andwho mntr tafortheprojectswithalicensedConhactorpursuardtotheCutroches'Smte
license Low l
(j I am olmtrgrt fi um lksinaan undies the Contiuvro. Ststa LNconaa law for the following reasoniq
By my signaoure bel I adlawvdadge that except tar my personal residents In which; must have receded for all least one
yam' prior to U"ollon of the Worovamentt Mvered by tins permit I rannol legally sell a sWCNna that I hate hilly as an
owner toillder if d Tors not hake constructed In Its eadraty by 11panyed oarbactors I lin ip"d Vial a mpyof the appIc"
lour Section 7044 of the PWsirrosl and fhVtes*M Caoa b a upon requeel When this application Isauhmdmd or at
Me fotfnwmeg Wets site httic w leguato ag"I ad m Mail
DATE SIGN
L UNM COVINACTDR S DECLAUTlOAI
I hereby amen render panaAy of paWry that I am incensed ureter provldarn of Chapter 9loommencirtgWitt Searan 70"
or Division 9 of me Basin= hand RDIndons Code and ary lieonsa is In he tame and MV
ul hlS �" .,„. OC ND
DATE --w1 CTDFI
Y�'iF Ttotg
I HEBEBYAFRFM UNDER MXAM M PF&KW 0NECIF TK FOU.0 W NS AAATPDNS
I have and iris mfyw a Ceff4wo of Consent to W losers fat worlwl , as pruncied ey
ffiv Yeu'arn 37DD a[ Me i atw (solo W " of tine WO lorwhio this ouftE s asuld
LON 1 hzaro and w1k MW n Worker`s COMWOOW bWWM as MIpWad try SKton 3M of Me Laber Code tilt
the partnr arnat of the welt tort tat tdn # p� 3a rtira i * WNW $ CXoperoaWn In9ur2nse Career and
Prtihy Isr
Cep
P4LtCY iABEt1 �''�A;nEamwo=
x-
Icii"dratinthe pertrmara of 1% wort W whd this peon Is Issued, I " not oni" ony oemon in any manner w as to
bacrxne aubiact W the ftliefs CorrponSiativ `.awe W f at4* And agrair tZ h I should bacons abject to the W'orkars
Commlsidn9afSrtt�7tif7tA�GW0100ttrcon 14httWiprarlabnssec2t ttdPSS F�Ett?'s to trsauCa Wa1cel"1a aVi!IA and shall auojaGt 19r employer la criminal
panahlea and ethyl f nos up to one hued ed thousand dMars tsloo ow in adomn to the cast of the compensation
dams as pmvidot 4x in secdon 37M of the labor code Imerost and aftrney's foes
CDNSTBUCT1DN LMOIND AGENCY
I harehy a" under penalty of perjury that there Is a Construction Lending Agency for the performance of mo work for
wtwh M pound Is issued (Sac 3097 f lv C I
LENDER S MWE
LEFW S ADDREZ , ....................
i tartly that 1 have Hoed Via appg58don and state Mal the above hrbrmation Is Wne41 I agree to com* wtm all 6tty aN
ready oduumaes and abate lawn r i4ling ttl bwktutg construction and hereby aidhadao mpte4amahves of this county W
eater upon the abvvil-merrtlWaCd property rr5ptlGtlprl puruuaiee
{ +a
SIGNPI.OWPEAMMErDATE a�
APPLICATION DATE�y, /�e�lty+ "1J PIC#
ISSUE DATE t 7 Pid r _ PERMIT#I PA it- J2'ra—
TYPE CONST €ICC GMUP
ZONING SETBACKS
FRONT
REAR
SIDEISIDE STREET
SITE
R4Y Cl___
C -
RW E
PROPOSED USE �
#1 DWEL UNITS t! STORIES
#f BEDROOMS
DESCRIPTION
Sty FT
FACTOR PSF
ADJ AREA VALUATION
SFFVADDtREM
Gdr8WC1UP0r1
w
PailWDeck
rW
pwol/SAa
a
Re -Roo
C]
�
Commarelaf
m
Vativatrorl
Adj Area
OUAWITY
DESCRIPTION
FEE j
Wry
SJ
cS
a
m
CONSTRUCT(ON
PLAN REVIEW +
ELECTRIC
")
PLUMBING
MECHANICAL
INSPECTION FEE
ISSUANCE
SMIP
ENERGY P/C
ENERGY PERMIT
RETENTION FEE
PRE•ALT FEE
SSAF
TOTAL. FEES Li ,
�
COMMENTS
' D
RECEIPT ill t ! PAID
VALIDATION �--------------
M
WHITE — D"rtnnerrl COPY, YELLOW — Fktarice aVpy PINK —AsSessorCopy, GOLDENROD — FGgGopy GREEN — AppUcatM'n Gobi
i A
1.....� .. 1 a. i
SET�3ACKI LITTER
TRACT AND LEDGER
I OOTINGS FORNi S
SLAB
SWITCH GEAR
COMMERCIAL HOOD
UG. PLUMBING
UG ELECTRICAL
LIFER GROUND
T-EAR
INTERCEPTER
; HOT MOPISHOWERPAN
SEWER LATERAL
MAIN WATER LINE
? SEPTICICESSPOOL
; HERS REPORT RECEIVED
SEINER CLEANOUT
ROOF SHEATHING
6614 SHEATHING
DEMOLITIGN
ROOF DRAINS
ROUGH CONDUIT
SHEAR WALLS EXTERIOR
SH£AfI WALLS INTERIOR
FRAMINGA(ENTING
E
POOLISPA
ROUGH PLUMBING
ROUGH ELECTRICAL
ROUGH MECHANICAL
ROUGH MECHANICAL
ROUGH ELECTRICAL W( ) C (3
ROUGH PLUMBING
GAS TEST
PRE GUNITE
INSULATION WALL
INSULATION CEILING
POOL PRE DECK BONDING
P-TRAP
DRYWALL
FENCE / GATE/ ALARM
LATH [PILE}
LATH EXTERIOR
FINAL POOL
WALLS
LATH INTERIOR
GAS TEST
SCRATCH COAT
WALL FOOTING/STEEL
WALL STEEL 1s'( ) 2"�'I ? LIFT
WALL. BOND BEAM
ELECTRIC METER RELEASE
WALL DRAIN/ SEAL
GAS METER RELEASE
SPECIAL INSPECTION
WALL FINAL
RO FRAMING PLANNINGAPF'RDI&
FINAL BUILtliNd
ROUGH FIRE APPROVAL
FINAL MENANICAIL
NAL.FLECTRIML ('t-Lf,
FINAL FIRE DEPAi1TIVIEt+FT
INAL PLANNING
ANAL PLUMBING
FINAL ENGINEERING/ PW
S C. aI OGGUPANCY
FINAL COMMUNITY SERVICES
ZER'L of OMPANGY
FINAL HEALTH DEFT,
FINAL II+ DUSTRE Itd TE
COMMENTS