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CITY OF DIAMOND BAD •
y DEPARTMENT OF CtC►&NiTY & DEVELOPMENT SERVICES
�- 21810 Copley Drive, Diamond Bar, CA 91765 "* (=m-4M \\,MCA V.- PRM
(909) 839•7020 Farr (909) 961-3117 Building Inspection Hottine (909) 939-7027 FIRMLY
BUILDING PERMIT APPLICAT104N
JOB SITE ADDRESS
APN LpT TRACT
OWNER
r ADDRESS
CtT'f ZIP TEL
APPLICANT TEL
CONTRACTOR X
ADDRESS
CITY ZIP TEL
ARCH/ENG/RESIGNER
ADDRESS
CITY ZIP TEL
OWNED -BUILDER GECI IVA,iION
t hereby affirm raider panahl of perlery that I am exempt from the CoabacWs Stdo License Law for the reawnis}
Indicated btaaw W Ute cta vinaro) I have placed neat to the applwNa hangs) [&adman "MA Bwtnaes and
F1m4asalatas Cade Any ctly ar casrq that re*dre$ a iemdl to oonthut 4 *fta hieI mre, $ernagsh, or r taalr, my
atruchara,"Ill Its Izz t also, new res 4ta appft= to ltta OMN to A4 a tlBrred g1tabeenani that to ar sire
Is Ntameed "sssue d to this prort$lora al the Caintrataft Sty tit %W Law #i ha0tar Gl wittt Saetkn
of I7ftion 3 of this 9ralron and haftaforsa abdel or drat he or she nt s not "m and €na bash for
Era allegedexa-atanAny vMWWof 7C315Warty agpiieardkcaphisubactsthe applkWlaracWpon"
of nm mere Men #a nunaft ai"m ow
UI,as owner of ft prepinty,ormyem*ymw3thwon a5ih14weoormn8adbn,wigdou&IatwUPortion
of the work, and the atntchua 4 €at Etas or Iftrod far sais tdiprr 7t144 Susiow am Professions Code The
CorroacVW Staff license taw ones = apply to an owner of waperty who through enlorml a porwnal eftorf, a tkds
or fm7ows the property proMa i that the imoviamie d sae not Intinded or ari" M Car s is If tmwewtr, the ou Idlig or
WWYUMd is SM One ors Year Of C11MO T), the OMW BrdiTer VA ham the Wotan of prtndnp tIM it was vac fain
or vs ad tax thep IPMrAZara i
U 1, as ewtrsr of the propettp am exciazah" contracting with 16eensed ConttaCmrs to axmbuct the pr$led 18efoa
7044 Buamesa and ftoiaSStara Cede Jiro CanCacbrs' State License law does not apply to en owner at property who
i WIdsarkn"astIWWand who Garwactstar:baps*tswan aikansedConttacarpursuant tatlsaCtKRrrwtra4'5tate
L"nse Law
Lj I am exempt from Ucensure wider the Cortractar'a State Lkaenae taw firth$ following mason(s)
By my slgnatura Wow I uknwodge that except for my parsonai residence In which I most have reeldad for of Lead one
year prior to completion of the Impow menta severed by ads permit I camel legally call a dtnx trim that I have trap as an
owner tlullderrf"him not been constructed in rb enhtety by Ifoensod wrtbaator6 1 undorsWd that o Imp} ntthb appticMo
ow Sa(dhan 7844 of tit$ Bushes$ a'td Profosslons Code Is avallablo upon request when no apolo ahon le shouted or at
the fooleWkV Ob Soto ldtt *" tegado ca.gowlcalaw html
GATE SIGN
LiCUMIE) DOWro ACTORS OWLARATMW
I hereby &Irm uider penary of penury that I am lcensw under provisans of Chapter 9 icommendng with 5oeaort 7=
of Division 3 d the Bastnese end ProloseIm Cade, and my, gcense 6 m 4force and teffect.
L NG _
TE q C1WMIRIEn � ��
t�€HdFt3�1i iCtAR#TiIMI
I HERWAFRW t11W P£NAM OF PEJR.FLW OIL OFTHE FOLLMN5 DE ATThI NS
_.......... I M" and w14 ntalnfiu @ Car01MOe Of Garssartt to Sett46re for WDdWI Cmrspsr'satkurt as Wgmad by
Saakin 3M or tree Labor Cade, fax tore por#nnnarce of tie wank w wNc h 7tte permrl is Awed
I here and will mamtam Wear a Conperteaton irsrarrce as raoAred by SocW 3700 of tla Law cdAr, br
the Wkirmance at the work far which ors beard is isauad MyWorker's CompenaB4o koura nce Csorter and
Poiry Number ve
CAMO
QULJCt' W"EH
MC SECTON NEW MY BE CONPLEtE D F THE PERM tS FOR ONE HWMED W-CARS 0100100 CM
I ceMIy'HmHI in the partmunce of thewwar k for which Ihle permute Issued. I shan not employ any person In arty mariner so as to
Raceme eublect m the MAWS CanpmrurJan taws Of Cadforma And agree aso of I sha rid become sW 1W to the Worlaeft
Can of Sedtan 37W of the Iadr ' I foritnvlth comply with those pmdn era
APPlJQ4NT ----
WAHNING lu to eawra Madrery C(mperr n mtA
LP11
unto I end shall subject an anplayer ro criminal
pan$Ihea and I tiros up to ono hundred th:t azaa) In addf lW m the mat Of the Wnrpaneatton
damages as phew W hr A section YM of the tabor and altornoyl kft
CONSTRLMW LENDING MEDIC}
1 hereby eftirm under penalty al perluty that there N a ConWvdm Lending Agency ter the pettom oo of the work tar
which tNa perm" is Issued Pec 3097, Cm C )
LENDER'S AWE
LENDERSAOIyTtM
I cer" that I Nava read this appkartion, erm toots fuel the above Information is wnecL 187M m wwhy with s" [ty aunt
ar£fnarrcaa and sit Laws retaft toe rxaldatg coat cte r, and hereby eutfarira reptrortatim of Mis mammy to
ernes upo€ wW pmpaly #a Lnapacdurt Ivoposee
OF GATE
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APPLICATION LATE C 4 PIC#r Irk kr— 41L I„ '
ISSUE DATE � 1 � 1�^-a PERMIT# �R 1 is • � � ��
TYPE CONST OCC GROUP
ZONING SETBACKS
FRONT
REAR
SiOF/SIDE STREET
SIDE
RW L7
❑ W
PROPOSED USE
9 DWEL UNITS — A STORIES
N BEDROOMS _
DESCRIPTION
SO FT
I FACTOR PSF
ADD AREAMALUATION I
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45kAApp[
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Valuation 4-'i , ' \ 49 ,. Zk %,,, Ad]
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QUANTITYUANTITY
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FEE I
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CONSTRUCTION
PLAN REVIEW
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ELECTRIC
PLUMBING►--i.o
MECHANICAL
INSPECTION FEE
ISSUANCE
SMIP
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ENERGY P/C +
ENERGY PERMIT
RETENTION FEE
PRE-ALT FEE
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TOTAL FEES P74/%e
COMMENTS / d
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RECEIPT or ,-PAIDBY J 1C>r '
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VALIDATION
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WHITE — Department Copy, YELLOW — Finance Copy, PINK — Atwrroatr Cola`! GOLDENROD .-.. F"o Copy GREEN — Appllreru'a Copy
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TFI�ICT AND LEDGER
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FOOTINGS FORMS
SWITCH �
SLABCOMMERCIAL
HOOD
UG PLUMBING
UG ELECTRICAL
T-BAR
INTERCEPTER
UFER GROUND}
HOT MOP/ aHOWERPAN
SEWER LATERAL.
SEPTIC/CESSPOOL
MAIN WATER LINE
HERS REPORT RECEIVED
SEWER CLEANOUT
DEMOLITION
ROOF DRAINS
ROOF SHEATHING
FLOOR SHEATHNG
�� ROUGH CONDUIT
SHEAR WALLS EMBIOR
POQUSPA
SHEAR WALLS INTERIOR
ROUGH PLUMBING
FRAMINGM"NG
ROUGH ELECTRICAL
ROUGH MECHMICAL
HOUGH MECHANICAL
BOUGH ELECTRICAL W{ } C
GAS TEST
ROUGH PLUMBING
PRE GUNITE
INSULATION WALL.
P(WL PRE DECK BONDING
INSULATION CEILING
< P-TRAP
DRYWALL
_ FENCE I GATE! ALARM
LATH (PRE)
FINAL i}{)L
LATH EXTERIOR
WALLS
LATH INTERIOR
WALL FOOTINWSTI EL
GAS TEST
= WALL. STEEL Isf{ ) z'!)( ) LIFT
SCRATCH COAT
; WALL BOND BEAM
ELECTRIC METER RELEASE
= WALL DRAM SEAL
GAS METER RELEASE;;
WALL FINAL.
SPECIAL INSPECTION
RO FRWNG PLANNINGAPPROVAL
FINAL BUILDING
ROUGH FIRE APPROVAL
FINAL. MECHANICAL
01)(AL FIRE DEPARTMENT
FINAL ELECTRICAL
,FINAL PLjWNING
FINAL PLUMBING
FI NGINEfMNW P'W
TG OtOCCUPANCYJASL
coml4ILIHITY SERVICES
OEU, of OMPANCY I19AL HEAUFH DEFT,
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