HomeMy WebLinkAbout15-2188CITY OF DIAMOND BAR g l �
PARTMENTO COMMUNITY4&IDRVIa,I,OPMENT RVICES
21910 Copley Drive, Din Found Bar, CA 91765 PRESS
(909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 FIRMLY
BUILDING PERMITw APPLICATION wwcttya(diatnundbarcam bulldtng@dMmondbaov
JOB SITE ADDRESS • 'Z�'
APN LOT TRACT
OWNER
ADDRESS
CITY --- zIP TEL.
APPE 3CA94T C� d�.r��� TEL
CONTRACTOR
ADDRESS
CITY ZIP TEL
ARCHIENG/
DESIGNER
ADDRESS
CITY zip TEL
OWNt3 49RUIM 66CLA9AItION
I hmaby afnrm under Knany of party hat I am arampt km ttfa Contractor's State License law kr the raaton{s)
NEffied bow by Doe I have placed ne rt t the spoldble its") lam+ -% Ikssi+ea and
Ifs C adr AM cry or pyr" mat romp" a PE At is crwatw i WW, GtgV^ dwisfiNh, err repeh, my
sbuctwo, prier t Ito tesltencs, aw fawAu t" appllud In ft Patin$ t ITT a signed ftwient stet he or die
is Ikattea6 plrrausnt to set OVASI of trim 17 Mam'a $lift LONme Lora (MOVIAT gl Car -wing weal SKtxn
7000 of Division i of to By0m #W Poftssleirm C-oft) or first he of do is u wW tram flcamm" Key to basis W
thBaHegodexempW Any vtolsoorr sd Sebdaxr 70315 by any appllcam l ra peem rs4" Ole applicant io a cwi p ifs
d not more flea owe Kfted dutara MM
C.}iavtlwnerstopcWerty,ermyomtdo}saaagtlr'rXag�asttrercsgts ,rrilltl0(,Ielto€{ }tom
of the work, and gm stmom Is nat weW w Mered for sale (Section 7044 kwws end Profesalow Goo* Ttas
' Stales L3o"ma Law dooa not icy #s arI psvrrr of Ixoperh wfia Mich a o IN+mw etrait br
or Improras lie p€opeo M Mtded awls N ImprDWROMare gal Intended or DOM is male 11 tttsvevpt tfaa b IMV m
snpnovemem to Ski W" ars year of oompleikslt pre i r-13WIder will hose the Wrdr of pWng thsl It waa TO bu€n
or 4nprured for rho p pose of xdo f
U I, as owngo of One property, am oCkoyely MMUWUM WM hnereed Ca ftectme to Donat44 ft Itmoisct pr0on
7044 Business and profssftts Cott ft Cotbaotore' $eta Lboresa Law Was not appN tD to mw of property who
in" or hnpreMe3 tlwegn �d rrtto a�tiracLv fo sloe prp�tg a a tlpBri9ad {karltraGesr Dsrslatr� W tlae Ca atom Stale
tkwm Law j
U I am a,oe1w hem Inceneate ter to Camrac aea SURD Lice" € m 1WetrETel foWXV rsesonm
By my slprtatur9 below I adutovAsrkp they macopl for my porgDnal rassidenca let Wfith I must hays room for at 4e8at one
year prior to coaviagm of the Inwmemexa curmm by Oils pBnm I rarirtot wphy ad a ehr"o that I Chloe bAh as an
rmmer If It no not been ardAichod in fie entkey by laemte9ti tmnaae€aas € undannand MM a copy d sae
NlpkahB ", Sedod AM of me Swim and Mamma Code Is wfiabla Lpw rmuw when We app4caum is
mownitted cx at Use folowing Web €fie Mlpir w ce gw/cafaw hbW
RAISED CONFRACMR'S IDECLARATIN
I hereby alitm Vv* penalty a1 pegwy ifal I am kensed radar provLalaru Of Cater D {+kra`rromxlrrA with SxNon 70"
of Mlrsoon 3 Of ft &MUM aM Pm*Mtorfa Code, mad roy kaw is In hta farce mId 4tfm6t
UMSECAASS 9 C-44 UC NO
DATE f1-3l--1 tx€ Wit'
WORM'S CWPMA'TRkt OEQAPAnuN
I HMOY AFFIRM 1.111111M PEt1ALT)f OF PUWRY ONE OF THE Filt.LtTWM NAAAATTONS
I have and wyl rrralftho a Ise o of Cdn5atil to S,ff-Imxa tcu Mantis Compereabart os pI1M 40 by
Sedan 3700 m tie tabor Caft to the periomkTce of the work fur whfcfi this permit ks WM
I have and will mahrtelsl WorkWe Cornpormafim haseraece as aeptsred bit Sseboo 37M d n tabor Cade for
On performancedftwant for whiteCieperntIsIssuW LoyiY sLampansBtKinhwnr f uTterarsl
Pdky %irnbee DER 'Ile err
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POMNUMBER
iIT1( SEC MN MUD NOTSi tfc"Ftt1EpiMWISFORO1ELtt UEDM IM41MORto
i raerllfl' vial d Ere pts€ho€mNate rd 0ro molls lrrvrtdrXtt slim ptihiMl s issued I dtellrrk erty a"Y psmaolt tit entr ntarmlx soar lea
�r CaIra1� A.tfd agree dad s I i begCfrM! k,l�rlG1 CI far! WGtlrar'a
I thoonajy t000larw�lorka. iaeaspmasaYora dSeLsm37O0o1 � i �"
APPLIEW
WAR$ K Fa6urs to sere WerlW B CompanMiIsn QWW is wIlawful aid shay abjW an wn*yx to sunk,
po oom toil dvil Totes up to am twood f 4 swW dakin (3100 000) in aft9on to ee =9 of the oompwao r ,
dgirbagee as prowdeel for bSeOM 3708 of the {ato DXt.ItdNM,'sv1 attorneys fees
CONSTOIF nONuNORGAGISI CY
I bur" affirm totter pmaNry, of WW aid thin Is a Cowhxftn ieadmg Ap my for the lserforroarrbo of the work for
wig he pmmit Is I6oad (Sac 3D37 Vv C )
LEMOER'S NOE
LEMXR S ADOWSS
I arty first I have read this appsmuen am auto gist the Abevo Itlumalka Is €€ wed I spree to tltlrrglty WrIti at try Wd
ooardY o:d&mrias aid I;iat haare relatlg lea arileti grad IiaraLy ausic€ira repreaerriatlims d fill � Yt
orttm��up,,Qndw+remambrtetlprop�r�x4 fiaalpsssea
PEA4M ��
SIGNATURE OF161041107EE DATE
APPLICATION DATE �s%"" PFC# g
ISSUE DATE ,�}�#/ �•M{i � PER#
TYPE CONST JE eA0 OCC GROUP
Serape of s€cw �� A`
# DWEL UNITS # STORIES # BEDROOM$
DESCRIPTION
SQ FT
FAMA PSF
ADJ AREAIVALUATION
SMAI1GiVFiEM
tiarxgelCarpr�i
w
T'atNa+fivaok
to
u.
Po&Spa
_z
Ike-Iyw
Carnnrrrearti:ral
in
I ahMtt10 7 jdL*-- a'aV AdI Are"
QUAN'TTTY DESCRIPTION
FEE
c�
z
'm
NNW
U
CONSTRUCTION
PLAN REVIEW
ELECTRIC
PLUMBING
MECHANICAL
INSPECTION FEE
ISSUANCE Y
SMIP A
-ho
ENERGY PIC
ENERGY PERMIT
RETENTION FEE VA A
PRE-ALT FEE r e% E
r
13ASF
PLOT PLAN E
ZONING CLEARANCE "
TOTAL FEES
COMMENTS
PIC PAIR 6Y .y VALIDATION
IIECEIPTO 9�&X-3Y________ PAID BY VALOATION
WHITE — Departuwat Cvpy, YELLOW ---Firwr4eCopy PINK -•-Assiesm CMV
CITY OF DIAMOND BAR
INSPECTJON RECORD
INSPECTION DATE O.
SEIBACKt LETTI"R
FOOTINGS FORMS
3 SLAB
3
UG PLUMBING
UG ELECTRICAL
UFI R GROUND
E
SEWER LATERAL
[ MAIN WATER LINE
[ SEWER CLEANOUT
ROOF SHEATHING
FLOOR SHEATHING
SHEAR WAILS EXTERIOR
SHEAR WALLS INTERIOR
FRAMING/VENTING
ROUGH MECHANICAL
ROUGH ELECTRICAL W( ) C }
ROUGH PLUMBING
INSULATION WALL
INSULATION CEILING
DRYWALL
LATH (PRE)
LATH EXTERIOR
LATH INTI Rl
GAS TEST Flow[
E
SCRATCH COWPOR
ELECTRIC METER REL
GAS METER RELEASE
SPECIAL INSPECTION
FINAL BUILDING
--- FINAL MECHANICAL
MECHANICAL
FINAL ELECTRICAL
FINAL PLUMBING
T C of OCCUPANCY
GENT of oGCUIPfUICY
COMMENTS
INSPECTION
DATE
INSPECTOR
TRACT AND LEDGER
'
SWITCH GEAR
COMMERCIAL HOOD
[
T-BAR
[
INTERCEPTER
[
HOT MOP/SHOWERPAN
SEPTIC/CESSPOOL
HERS REPORT RECEIVED
DEMOLITION
ROOF DRAINS
ROUGH CONDUIT
POOL/SPA
ROUGH PLUMBING
ROUGH ELECTRICAL
ROUGH MECHANICAL
'
GAS TEST
PRE GUNITE
POOL PRE DECK BONDING
P-TRAP
FENCE 1 GATE/ ALAnM
FINAL POOL
WAILS
WALL FOOTING/STEEL
WALL STEEL IV( ) 2-) LIFT
WAIL BOND BEAM
WALL DRAW SEAL
WAIL FINAL
RO FI AING PLANNING AL
ROUGH FIRE APPROVAL
FINAL FIRE DEPARTMENT
FINAL PLANNING
'
FINAL ENGINEERINW PW
FINAL COMMUNITY SERVICES
FINAL HEALTH DEPT
FINAL INDUSTRIAL WASTE