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CITY OF DIAMOND BAR
DEPARTMENT OF COMMUNITY & DEVELOPMENT SERNICES
21810 Copley Drive, Diamond Bar, CA 9176 �+' PREW
(909) 839-7020 Fax. (909) 861-3117 Building Inspection Hotline (909) 839-7027 1 RMLY
BUILDING PERMIT APPLICATION
OR SITE ADDRESS N
N OT TRACT ____SST rJ_
NER V
A tD IESS 1#4,vkd Par 131vd
CITY if ' 1P L_ TEL —
APrLICAN TEL--
CON.TRAOTEfR
ADDRESS
CITY—iL ZIP TEL
ARCR;'ENGJrDEStGNER
ADDRESS
CITY ZIP TEL
04YNEA-SUIT i OWURAWN
I hereby Arm unoor fatty of pqwy that I am exempt ftnm tlw Cerdrs='a State Uxrso Law tur the •aasmsl
Indicated babw by the, GnedmarKiii, I nave, plarad next m Me 8000tis ftV) [Seater~ 7W 8, i#usiness Wild
kuhalions Cade Arry 00 or taa y Mont rerprlres a purro 0*onstuot. orb Improve, drni$W ar faink, srri
McIvre, prior to Ib Issuance, also regne o the applicant for ft pm* to fife, a Wgnod ab>mrwa 1111at he or dw
to ftioneliod parettism to the wimAtions of am Coritinw o Liciense Lary CCtraptor 9) Co my re wish Section
at plan 3 of the 8ntnasa and Prrfasslorsr CoM o drat he or Ow is arem pt ham Poonsfue and the tads for
to Welied exerngtionAMMatwnafSoMen70315byany apptcantfor aParrot WASthe app " W a CM ymisity
of wit mo a Oran qve lwndred dollars 1T5;W
U1,asoamior€d`the property, ormyemployeeswtthwagmasMow ro{Wrmn ,will de,UolnterL)ins
of far wmlk and fie si -mbre Is rent intended or offairg for We tSaboo 7ir44 &mnm and ftelmiorw fork The
Lka;w Law does net ai b an owwroi Saopwty who troughemploywor personal eNort buleds
or Improves ttw property mudded Brat ftnn are no Intanded orb W ses f however the Iiumnp or
ImxovemwR is sold within one year of wm~ fie, Omer Iiubder wi'I have the berden d prnyrg that it was nai tarn
or Imported Ice fro prise at sale)
U 1, as ow11417 Of ttw milporty, am exrtuanoty CDOITIONWO 1101irised Car ibectirs to Wisp= tuna proiact Pecfo+r
7044 Buakreea and Kofoams Cade, The Omtrockis' State Ldenso law owe not =ply to an owner, of property Nft
millds a, triVrovm mommi. and wndcontractsfor theaIknnsedtheWntractors'Sate
Lit" Law t
U I am exempt terns ke iaue order the Gormacta's Stop LkM W for the W40ri9 ems?
* my olgnatum WM I a#f.•toWWgv that eacepl for my jlmsorw tes4enoo In which I rental �Uvs rasdod for at least me
ar pdrr to rarrrmi r or fee inavovenrarb esvarrd ov ft pit card al I y %f a WIrwua Ma; I fare burl as an
builder Ifrttraanot t constrixted m fterifty Whrmisad contracto€undGEla;ftdltuia mppltcable
hw SetUnr 7044 of the Saner and Pmfesaions Code inavxtri2a upon raquoO who" this oppliceibon Is satbntled or at
ft kii®wirr Web ate TdtptwVA taginfo:a g€ vkaiow html
SIGN
LICENSED CONTRACMISOKLARMON
I fievaby aC[mr urlder penalty o1 perry € at r am licensed under powlsions of 9 IrammonLing ante Section XW,
of Usaln 9 o1 ths GA Bn and Professions Cafe anti my license Is in twee wd aftacL
UJCft n ttC Q/"
Gt`daTi kZi I L..
WORKERSCOMM TRSN tl�I
I N By AFRRM UNM KACY OF PEkk& W OF Ti* FOLLUMNO DWWtVW
I irm aurd wil mainrdn a Cart # for rt in Sot Ins'ars for Wni*?x i onsebon: ag prmridlic by
Section 37W at iho Labor Code fm the por"aru:u of It $ work for vd=tch #4 pgrirA is Issrred
_ I have ar4 ww maantainworlierk Camponsab in hesivoica as roiIWraU by SWian "VW of tho Later Cade for
fffe PFNmWK3aD1 me work forwbldi this VETTO is bMtd My Worker 8 trecrance Carter and
Pplr.y Rambo am
CAFAI t
it Z 5fI:I f1EEO NOT BE ISNeT3.ETE01FTW PM0IS FOR ONE�klNDFED DOLLAM ¢1r1f1i ORLim
tcar" Tat Inthe perfatrxinwdthe work trwr*hthlap t Is UM iWW.rod empldlarl ninsarwarfrarsoasn
auhdoct to the, YrUrk� ff Co xrPensafon taws of Gobfrrtsla. art Asa trot f I almWd 6�are �1 trr Me workePe
P.ye n 77r30of lira Laha U comply With fgse provfstonil
— —
YrARN7,".
to Sa.re Wors;ars i;vnpansatkr' acMs qa la unietwhA and 4trol S0109 an emogw to air nal
tan nNa end Chit rings rep to moo kind ed fmrsand "lam (S100 OM kr %dwom m tea cast cx M coimponsaw,
cianageoi as pmvktod to In seebm 3708 of ft tabor code Intow and aftnit" 4 teas
I hereby Arm Linder per ally o1 penury mat here is a Czasinuction Landing Agency trthe wrrforrrussue d Goa wok for
wne,rs thlap� wd tsar 3W,rA C f
LENDER S WJ&
LENDER S N1VfESa
Icorlify that f fave raW €tds apPlcabon wi1 sbft #fit Gin Smte f a natim Iswrroct I die ti7 Damply with all city and
a dlnenaera and stabs Is we relating m buWuV orb, and herebyal>Beorise refxrrsantafvasa! ihIs county to
enter upon Me above maribo"d property for nepection purpovis,
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SIGNATURE OF PEWftiTJ TE
APPLICATION DATE 1 �I 1,,,,,,,,, Px#���
ISSUE DATE i�•��r~ 1 PERMITit «k•
TYPE CONST OCC GROUP ;
ZONING SETBACKS
FRONT
NEAR
SfDMIDE STREET
SIDE
Ruff 7
RW C
PROPOSED US h
# DWEL. UNITS q STORIES
# BEDROOMS
DESCRIPTION
SO FT
FACTOR PSI=
AW AREANALUATION
SFFIlACrOMEM
Garaq€ot�AuTxtrt
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lu
Pailoli3diCk
rLL
j
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RIrP#not
Ca^rrraa
,�y
P"'�
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I
Valrssstla
Ad}
Area
QUANTITY
DESOMPTION
FEE
pp
R
CONSTRUCTION
PLAN REVIEW _.........�..�,,,, 'y�
ELECTRIC
PLUMBING
MECNAN€CAL1
INSPECTION FEE
ISSUANCE
[
SMIP
ENERGY P/C
ENERGY PERMIT
RETENTION FEE
PRE-ALT FEE
BSAF
TOTAL FEES
COMMENTS
i
f tl
ti t4
KCI;IPT S Q51"Ill PAID aY r l
VALIDATION
WHrM — Aepardment CoW, YELLOW — Finance fifty. LINK — Assessor Copt, GOLDrNROCI -- File 00py, GRIMN --- AppficarWs CoRi
CITY OF DIAMOND BAR
INSPECTION RECORD
SETBACK/LETTER
FOUTINGS FORMS
SLAB
UG PLUMBING
UG ELECTRICAL
UFER GROUND
SEWER LATERAL
MAIN WATER LINE
SEWER CLEANOUT
ROOF SHEATHING
FLOOR SHEATHING
''SHEAR WALLS EXTERIOR
SHEAR WALLS INTERIOR
FRAMINGIVENTING 02f
ROUGH MECHANICALROUGH ELECTRICAL W( ) CROUGH PLUMBINGINSULATIDN WALL
INSULATION COILING
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
U of OCCUPANCY
CUM ofOCCUPANCY
COMMENTS��T=.a�S�-a►r.�-
R
TRACTAND LEDGER
SWITCH GEAR
COMMERCIAL HOOD
T-BAR
INTERCEPTER
HOT MOP/SHOWERPAN
SEPTIC/CESSPOOL
HERS REPORT RECEIVED
DEMOLITION
ROOF DRAINS
ROUGH CONDUIT
POOUSPA
ROUGH PLUMBING
ROUGH ELECTRICAL
ROUGH MECHANICAL
GAS TEST
PRE GUNITE
POOL PRE DECK BONDING
P-TRAP
FENCE / GATE/ALARM
FINAL POOL
WALLS
WALL FOOTING/STEEL
WALL STEEL 1 n( ) 2" °( ) LIFT
WALL BOND BEAM
WALL DRAIN/ SEAL
WALL FINAL
RO FRAMING PLANNING APPROVAL
ROUGH FIRE APPROVAL
FINAL FIRE DEPARTMENT
FINAL PLANNING
FINAL ENGINEERING/ PW
FINAL COMMUNITY SERVICES
FINAL HEALTH DEPT
FINAL INDUSTRIAL WASTE
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