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1111�1 )� r1^�Ilx�HAR,
CITY OF DIAMOND BA
DEPARTMENT OF COM1 ITY & DEVELOPMENT SERVICES
21910 Copley Drive, Diamond Bar, CA 91765 PRESS
(909) 839-7020 Fax: (909) 961-3117 Budding Inspection Hotline (909) 839-7027 FIRMLY
BUILDING PERMITAPPLICATION
JOB SITE ADDRESS S 34
APN LOT TRACT
OWNER p
ADDRE / D 'r- 11 A f V z
CITY Y 0 ZIP E
APPLICANT O d.M Etta TE 4`
CONTRACTOR EC'CY��a�w_�.....----
ADDRE 4 s1 t�
CITY +'\ ZIP /'' TEL 909 " l 7 - / l!
ARCH/ENG/DESIGNER
ADDRESS
CITY ZIP TEL
01ryNER•90tLOER MIARATKIN
I herevr affirm under oenty al partuy that I am exempt ft= the Gass 9M a State U;eme taw fir the m4wnta3
imfcam blow by the chawarfda}. I hm placed rasa to the appYcehte hm{s� ISectloe 7111NA Rugtnm and
ft~Am Cads Any"or tacitly that raWlim s ParmR W wtWOM anger, IRnpinira, damoUrik of repair, any
dinchm prior 10 Us wwtience, ate& requkm the eppiloard tar the permit to it% a sipwd guilanteirt 1Mt the or sire
$Ikwwd pwauant to the provtwaa at ft taarh4acmr's oft License, law 19 ComnW44-C wm Sec*n
7000 of DWItift 3 of to evisrseam mid Professions CM) or fiat to w %N is exempt from kcensuaa and ft bi sta for
the aged exempc9rt Any vicigon of Sectior 70315 by any applicant for a pwrW subiacbr the to a old penalty
of not mom than foe hundred do to a t3W
U I, as owner of the property, or my empleyeas wit wages we thaera* wropema" , will do U ma of or C3 perldons
of the work, and IN sibuehre w rd Hard or oft m9 lor &* 6ectbn 7044, Busiom end Frdesstatha Code The
CaCaclotV Stale LKen 8 t,aw does trot 2pohr to sn owner of wwrty mo, thrat9h virIH or Pal eftd Wills
or impmvna the property provided fhet the imprGreti "are not Whinged or dferad for am d however ate Widlag or
enprovement is add wnhm one year of comoftit arse Drama -Builder will hew the burden of troomg that it was m burl
or khhoroved for the purpome of s* )
t, as corner of the W%Wtx am o>uAaaiwety carhecUno with IlowKed Caftufors to construct the pnoJett fSKbm
7044, &Mina= and Prdeasiosm Coda The CamecOts' State Licanae taw does nix apply to an owns, of malady who,
bukborknprovesthereon and whoop,at Ilorthe prooctwMaliterdedCmbactarpursuamtoftCor form Stab
License Law I
U I am exempt from licenaure under the Con waoir's Stets License law for the DtOaMng reasonlak
By my sgnature below I ackrawsadge that except for my perminal redden In which r must have resided for at least an
year prior to completion of the tnpronemeh,a rnaered by We permh I mnol bgadt' Sell a structure sat I stave bull as an
ewrar-twlider if n has nal been owsshvieci In IN entirety by licensed contractors I undersUnd their a copy at"spplkabla
law SW ..0 7D44 of the 8vakseas mc! Protesabra Coal Is ami able upon reo6w when ft application im submitted or at
the follow" Web We W p*^ legrdo ca gr7mdlawrdml
GATE SIGN
LICENSED CONTRACT01I'8 DECLARATNIN
I hereby afWm odor penaty of parAhty l hat t am 4cansed umM D;trrislons of Cnapier 9 foommenicing with Se dior 70M
of Divtsiar, 3 of the Bvsinewa anted Waselbm Cade and my fta.w Is in t h force wed elect
a leecct
tJCENSE lic tees .f J/ I 1 _..-----
�f .� MTRACTOR S?-e%see Girjr- L_ ci"—
WORKER`6 CONPF#SATION DECLARATION
I HEREBYAFFRM UNDER PENALTY CF PERAI?Y CNE OF THE FOLLDMG OECLARATKI!IS
1 bare and wds meirdein a Cmilfiwte or Corwd to Salt Om for Woftl Compori aeon, as pm*Aded by
Section 37M of the labor Cade for the Pxformanw 0I4to work to wt;Ch Ito Wmit is +slued
I here and will mwalrhtdn Wo*b`a Compenwbon YnC.rara, ee mitred by Section 3700 d cw l sbor Code for
to petiwrmance of the watt for which lire Wmh is issued fay Wo keM Compprenon lose since Catner and
Polley Number are
CARFIER
POLICY NUMBER
MAS SEM NU ROT BE COMFLEIFD IF THE PSW IS FOR ONE 1# "M MIAR; 010 OR tom" 7
I osrtly Oat ki the padartnance, at fha work for which atb pamnk a issued, I sdhad not employ any parson in wry manner so es to
Ih, r etsblact te14Wonfja x Cornponsatbn lavr d (�e(orrJa agree that 0I d Won re mu*O to the Work&A
cam 5ecbon 370pof Cate f BIBII Ixvraxxfl
DATEAPPLICAP f -
WARNING
eassrra Wmket'B Camparimaaon Coverage is iaaawfilel W Ethda "act 0 employer tocriminal
pdnardes 8+4 cMi doss up to ate hundred thoumd dollars (PO000Q in Mditn f» to tact of the comperh Wo.
dam spits as prerided ra in eaetirn 37� of One tabor coda, kgaresl and aWr Wy a hies
CONSTRIMM LENOW AGENCY
I hereby W" under penally of penjury that awry is a Carstruction Listing Apwsy for that prrhsrmarim at the wwk for
*ik h ass genial S issued Ow =7 CN C )
tF�s uv�E
tER`S slim
I certify tat I rave fs fhb Lid abbe that the move' . b correct I a to Y with air city and
a rty ontimm W4 ataa laws retathq to bwrnp stru a^d hereby authorize tip. d this corny in
wZIA,
iM ahme pnhterty ptrpoaem
ln 6�t $
E t
SIG+iATU1 PEiMITfEE DATE
APPLICATION DATE P/C# �y
ISSUE DATE ,/-V+1 1� PERMtTtk Pl �� ' � � 1 t
PE CONST OCC GROUP
ZONING SETBACKS
FRONT RW.....................
REAR ❑
SIDEISIDE STREET RW C%
SIDE Cl
PROPOSED USr" _- _ - CAai
9 DWEL UNITS 9 STORIES ill BEDROOMS
DESCRIPTION
SO FT
FACTOR PSF
ADJ AREVVALUATION
SMADDtREM
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Valuailon Adi Area
QUANTITY
DESCRIPTION
FEE
aL
I
i
CONSTRUCTION 6 TV
PLAN REVIEW I
ELECTRIC
PLUMBING
MECHANtCAL
INSPECTION FEE
ISSUANCE
SMIP a
ENERGY P/C
ENERGY PERMIT p
RETENTION FEE LfttO"Q
PRE-ALT FEE
BSAF
l
TOTALFEES
COMMENTS
RECEIPT w - ---� MD BY VALIDATION
WHITE — Department Copy YELLOW — Finanoe Copy, — r Copy, GOLDENROD — File Copy GREEN — Applicant a Copy
SETBACK/LETTER
FOOTINGS FORMS
SLAB
UG.IPLUMBING
UG ELECTRICAL
UFER GROUND
SEWER LATERAL
MAIN WATER LINE
SEWER CLEANOUT
ROOF SHEATHING
FLOOR SHEATHING
SHEAR WALLS EXTERIOR
SHEAR WALLS INTERIOR
FRAMING/VENTING
ROUGH MECHANICAL
ROUGH ELECTRICAL W( 1 C ( 1
ROUGH PLUMBING
INSULATION WALL
INSULATION CEILING
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
TC of OCCUPANCY
CERT, al OCCUPANCY
COMMENTS
CITY OF DIAM �R
INSPECTION RE IUD
TRACT AND LEDGER
SWITCH GEAR
COMMERCIAL HOOD
T-BAR
INTERCEPTER
HOT MOP/SHOWERPAN
SEPTIC/CESSPOOL
HERS REPORT RECEIVED
DEMOLITION
ROOF DRAINS
ROUGH CDNOUIT
POOL/SPA
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 IST( ) 2"0( ) 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