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Home My WebLink About15-2432M A A"9A CITY OF DIAMOND BAR FIN& DEPARTMENT OF COMMUNIT14& DEVrfLOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 PRESS (909)839-7020 Fax; (909)861-3117 Building Inspection Hotline (909.) 839-7027 FIRMLY BUILDING PERMIT APPLICATION wwwcityotdismondbar.com buildin&dIandiondbarcagov JOB SITE ADDRESS ZZ'95-7 1 0 Qj APNI — LOT TRACT OWNER A T.,2 ffi7� ADORLSS CITY ZIPC TEL APPLICANT TEL CONTRACTOR cQ r- C- ADDRESS-i�-.� C"Alearv, -Zoi ............. . . . . my!�afa ma lro-zip S-4402lTEL ARGHtENat DESIGNER ADDRESS CITY ZIP TEL OWNER-BUILDERMLARA'nBN I namby offirmxider venally of perjury that I am mmpt from the Cuntracter's State License in for the reas0s) indicated below by the dmckmarkl9j, I boys placed nod W tha applicable bm(s) [Socbm 70313. Business and Riedesommis Coft Any cdy or camnly Met molum a permit to construct, altor, ninprove, demolish, or repair. any Structure, prim to As asmoncv, also mduams the applicant for the permiit to fibs a Signed slarlormert Met No or aft s licensed pionsuant to Be provisions of the Coinlarachars Side I.Imenso Lew (Chatimir 9) Commencing with Section ?WO at Onmoon 3 of Ift fewsmess and Proftextobid; C401 or Iftel he or she is exempt from Izenours and Me III for the afloM exampten Any violation of Solon 70315 by any spiolcant for a permit %MI the applicart to a civil periatIr of not more Man two hundred dollars ($5001 ( j 1, as owner allow property, or my employees with wages Iitltheir a* compensation, will do I all of orL) Pone" of the work, and the ianxitire Is ro intended or offered for sale (Soctlon 7044 Busirim and "essim Code The Conl1rectois'State II Law does W apply 10 an owner oftaporly who thloUgh erep"wor pots" elm toads or Improves the property provided Met the aprovemorrits am not Weaftd or allow far sole ? hooviow, the building or Improvement Is sold wIMIn cm year of completion Me Owner -Boll der wilt have the burden of proving that A was not TYA or improved for the pumm of sale) (-) 1, as owner of Me property, am miuslymy mobacce wift icanion; oxifracmni to coris" Me protect Isociton 7044, Business and Prufseeibm Was I Coribectom State 1-1conitia Low does na apply to an awneir of property At* bonds or Improm thereon and *be aw"M tr ft projects with a Acansold Conexior pritm to eve Caldraebrs' Stria License Law) 0 1 an altempli from hicensure imiler She Cordrai State Licem few for ft blo*4 readorI By my Signature below I SW*Nwp III SAW for my Personal mom In Which I must have reekled for at leffil 00 year pw In -WA- of the coverierf by this WMKJ MvV (904 90 a SO -eta Met I have built as an owe hAom 0 it has not been coWaW h Its aribraty by loonser! corlb3clors I wideirsbood that a copy of the wheable law Seclow 7D44 of the Business aod ftesnos Code Is avauale upw rewest when this application is submMad or at the following Web site nawWww, legmto ca owicat" html LICENSED COINFIRACMR'S DECLARATION I hereby affirm under penally of perjury that I am Kvised under proviskmis of Chapter 9 (commencing; w0h Sectior. 7000) of DII 3 of the OusMoss and Pribsons Code and M I cerim is in toil force and eI LS, LICENSE CLASS C 41� el LIC NO D I - ATE - /�C;f CONTRACTOR all wilRoiI COMPENSATION DEGM-IiTo I HEREBY AFFIRM UNDER 9EmAI-TV OF PERJURY ONE OF THE FOLLOWING OEGIARAIWNS I ran and wit mailman a Catkato of Consent to Self Insure W Worker's Compensation as provided fry Section 37DO of the Labor Code for me performance of the work for which this parmill is Issued -.1 1 have and will maintain Worker S Compan3abim Insurance, 0 roqumd by Sedan 3700 of ft Labor Owe for the perlwmance of the work for which this permit Is issued My Worker's r4movensaten Insurance Carrier and Policy Number are CARRIER W C-0 1!9 101 Sk POLICY NUMBER 72 11 r 4'r, _ 14 M%S SECTION NEED NOT BE CIDWLETED IF THE RRMIT IS FOR 4 HURD11D WiARS WOM OR I car" that In the pelieraiancie of Me wont b which MIS permit is WA, I go nod witilay any person in any friannor So a; to owns subled to, re Workers compensation Lam of CaMorria- And agree tried X I shoI beecroes Sidi O to I Worleh's Corwensm of Section 3700 a!( &M Dde, -Lfp�fut� With Mow prw4ans DATE_ 9 - A CA 4( to WARNING hi secure workars Compemicahm cower is imlaww, am & -*ci-- employe, In criminal parches and cirid fina up to one inx4mid Minnarell dollars (StMODO) in seddim to has cm of the damages as Provided for in new 3708 of Ma to* oods InII and slkinWs too COtgrAUUM LENDING AGENCY I hereby of wider penalty of p" III Uwe * a 0:.nMdt.un Ler4fig "mj fat the pwWnimca of the work for which this oomrath; Issued (Sac 3097, Cly C.) LESIDER'S ADDRESS — -------------- — --------------- I comily Mail I have reW Into applicution and sale that the sham Intormat4n is corirW. A ogres to comply with as city and county oeltriances and stalla laws rota" ID building construction and tWoby aftrim repres"livw of Mj; county to Saw upon the !t!l *a property n purposes &Z% C V\7c 5 WAMIM 10M (PRINT) SI(AAW OF PLRMR;ir- j '/ — f DATE APPLICATION DATE t!3 P/C# ISSUE DATE 4e E MIT# -fp, ir ' J-� TYPE CONST OCC GROUP Scope of Work p ,oAf 4&0bS - - --n I0 — - 64-- ki-I Al e3 lip o rQ J C DWEL UNITS — ----------- #STORIES — #BEDROOMS DESCRIPTION $0 FT FACTOR PSF ADJ AREA/VALUATION SFRIADDIFILM Garage/Carport Palo/Deck LL Pcelfspa 0 z Fle-RI Commercial Ad, Area r WANTiTY DESCRIPTION FEE ca CONSTRUCTION PLAN REVIEW ELECTRIC PLUMBING MECHANICAL INSPECTION FEE ISSUANCE SMIP ENERGY P/C ENERGY PERMIT ............... RETENTION FEE PRE-ALT FEE BASF I -ON PLOT PLAN ZONING CLEARANCE TOTAL FEES COMMENTS -------------------------- PIC — PAID BY VALIDATION TAP PAID BY -Z�41 �rl VALIDATION WHITE - Department Copy, YELLOW - Finance Copy PINK - Assessor Copy 032JAM14 CITYOF DIAMOND BAR INSPECTI'ON RECORD N ----------------------------- INSPECTION ISETBAWLETTER DATE INSPECTOR i INSPECTION TRACT AND LEDGER ----------------------------- DATE INSPECTOR I FOOTINGS FORMS SWITCH GEAR SLAB COMMERCIAL HOOD UG PLUMBING iT-BAR I UG ELECTRICAL 'INTERCEPTER LIFER GROUND i HOT MOP/SHOWERPAN LATERAL SEPTIC/CESSPOOL .SEWER MAIN WATER LINE HERS REPORT RECEIVED ------------- SEWER CLEANOUT DEMOLITION ROOF SHEATHING ROOF DRAINS FLOOR SHEATHING ROUGH CONDUIT SHEAR WALLS EXTERIOR P00USPA SHEAR WALLS INTERIOR ROUGH PLUMBING FRAMING/VENTING ROUGH ELECTRICAL ROUGH MECHANICAL ROUGH MECHANICAL ROUGH ELECTRICAL W( )C( GAS TEST ROUGH PLUMBING I PRE GUNiTE INSULATION WALL POOL PRE DECK BONDING INSULATION CEILING P-TRAP DRYWALL FENCE I GATE/ ALARM LATH (PRE) FINAL POOL LATH EXTERIOR WALLS LATH INTERIOR WALL FOOTING/STEEL GAS TEST --------------------- WALL STEEL Iv( )2N*( )LIFT SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELEASE I JIM 4- op t WALL DRAIN/ SEAL GAS METER RELEASE WALL FINAL SPECIAL INSPECTION Rai FRO ANG RANNING APPROVAL FINAL BUILDING ROUGH FIRE APPROVAL FINAL MECHANICAL FINAL FIRE DEPARTMENT FINAL ELECTRICAL FINAL PLANNING FINAL PLUMBING FINAL ENGINEERING/ PW T C of OCCUPANCY FINAL CDMMUNrrY SERVICES CM of OCCUPANCY FINAL HEALTH DEFT FINAL COMMENTS