HomeMy WebLinkAbout15-2270CITY OF DIAMOND BAR
PARTMENT OF COMMUNITY & DEVELOPMENT SE /ICES
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21810 Copley Drive, Diamond Bar, CA91765 PRESS
(909) 839.702Q Fax. (RQ9)861-3t17 Building Inspection Hotline ("9) 839-7427 FIRMLY
BUILDING PERMIT APPLICATION www.cityofdiamondbercom building@dlsmondbarea gov
JOS SITE ADDRESS 9194 / &e
APN LOT TRACT _
OWNER
ADDR
CITY ZIP la EL
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CONTRACTOR
ADDRESS
CITY 21P TEL
ARCH/ENO/
DESIGNER
ADDRESS
CITY ZIP TEL
OWW BiRLDERSECLARATION
I txttwy astmr under perieltp to pwjmy that I em eosin; from it" Coosau'a Stato Lkr+are Law mr the re"s)
artl6r ttNdw try the cwedrmsritwi i have;rxed next to fife appec" ttazrlls) ISr aw 7t7314 wo
Cade AAy ctttn or flmi nWlres a prrmrt to � slier. ratprrrwe, dentaNstr, w , ady
atrltr a, print to rts tsalwrw elm ter pir8e tare apWleem tar tka parwt toe a srprrad rlatartfdrts idrd hs or rdw
aAarroadpeixrtattvwas prsxtemffsot a++s�neracwo<'e Stews Lt�csnaa La=(Chtptfr try radrap rrt1A SaeOltt
M Dhmpv I of taw &rutuna sad lea Cool or mat he or N ssempt from Ocanssno and nfa Crags for
the alleged oxempflon ,any vID.!s9m of Sec 7It31 a by any applicant for o prrmR subjects the applfrmd to a r parry
rot mar dfatf On txmdrad dAn Issodj
(jl.p awe ofrhepworty,an7emp"oessomW gesmftrab ailldoUesofrrUDix W
Of the VINK ed the sbllctIn is rd idts's53d of Owed lot Sale roko a 7044, Doolneiss. and Code The
Cortbalwa` Stair License taw does not apply to an omw of property who, through omplayees' or personal f, binds
or Imfirom the Woperty, fxvvided Gnat die anptoveaWds sus not Intended of offered for sail If however ftfe bulKV or
Impmwornent is sold sdthh are year of compleedn the Oviow-Bulldeu will Nwe fhe bunion of proving thld n was not WX
or Imp row tot fhe purpose of sale I
U I, as owlet of the txepevty am r4tusfvety Mistreating we licensed Caroarttdrtr to twwiw the project POOR
7044 Bnamens and Rojassmre Coo The CwUwW State Uoerae Lew dues not eppty to an mner of property rvtu
3rlmprTlwteIllim" aWvftcontracts for fhepr0(lctowitAslicensed Ctlra3+aCfarpui tttTfitheiana'aCtOfe Stake
Lim* Law)
( j I am exempt from Iketmae under dm frnbac s so" Ewe bow Ibr the fotlarnng f
Oy my aigr>Attns berow t eta oat fa ny persDnaf rmddanrs! In waudr i mutt tleve resided Mr at least am
yaw prior ttr wrnplow of an Kwmffwft mom by Me pmtnfu =hoot woolty sell a svuacan No I rwve butt as an
v4ww wider It It line not bawl constructed Mn Its ontlrely by licensed wribacaore I unforstand that a day of the
apokattle ew Section 7044 of the BjWsew and Professions Cad* It wasable upon request whoa ttaEs applIcefloin is
a&WM at at ma followmg Wed site ttf1p4im isgatfo M gdvttalaw "M
LIMEOW COMf18ACTOn DECLARATION
I ftoreffy aflam tinder penalty of port" that I am licensed under pmvsbns of Older 8 {commsncirig va Section 7000)
Of IAvigat 3 of taef��t Cand my Icerm Is : aftd oMeet
LC NS£ UC No Y?
COWITIACTOR
WONa'S COMPENUTION DECLARATION
I HERESY PENAI_TYOFPFA.RDIY OW OF THE FOLlOMNG DECLARKI10iLS
f tan and wit maYfto a Cer4fira of Goosant to SO Inner* tot' WwWs as provided by
Wan 3700 of fha tatior Code, far One pantion ins of the work for vvMch On s taerrind Is Issued
I hone and W madam WwWs Coring wisa n Irwrance as rogWrad by Swbw 3700 of !tin LMa Code for
the pwtmw" of ft ViDrk for which this pond to Owed my worwo Campermdain Insuram War and
POOdy lksr�er
POUC1'NUMBER
on
MOSSE Mk1NEEDNOTBECtOM M F 1W KiM 6FOR ONE IMRJMDOLUIRStt1MORLEM
I tetra drM In Ise perfnxtnsats of the wont forwntit min pennh is Wood I flan not *mptq ern pmm In"marry so is to
t_*4
ectt4 a WorW'Caw'"" 'sCf.' .��... tp Wets r�versge is tatul sId anon srplsc'an empbper i0 great
ponatas and Civil firms up to one hundred thatmand Mtais lit 00 DOD} In addoan to pia oast of me compemailon
damages as ormAded for in se cwan 3708 of the ices€ wen Interest slit atmnwy s Ites
Cava RfIcm tBIDINO AMCY
I hereby affirm wider 9rnatty of p"iy stet 1i se ts a Conshrutlar umdtrq AOgrrCy 11w the performance of frw wont for
whIM"sWink Is fsW (%C 3097.Ck C)
LENDER S NAME
LE"OEN'S ADDRESS
I coMly flint I have red M epplrcatian and state that ttb aboss Information Is correct, t agree to comply with oil city and
aid. and state to building afd trerslry aDlhorti@ of pus Cantyto
for kdspecffon
PEAMITTEE NAME (PRRv
SI m CIA
APPLICATION DATE I - r— ,rryPiC# "~�}
ISSUE DATE .— ERMIT4t P r f ti
TYPE CONST AL.4'/s..,'1e,1 OCC GROUP
lim
Scope of Work
0 DWEL UNITS IT STORIES tl BEDROOMS
DESCRIPTION
SO FT
FACTOR PSF
ADJ AREANALiIATION
SFWADDIREM
ii&sge/C.sroart
w
PatrrTrlYeek
U.
Poot�spa
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Re-F10of
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Cu�efaf
M
m
vehftwlow Adj Area
QUANTITY
DESCRIPTION
FEE
ui
co
a
g
CONSTRUCTION
PLAN REVIEW
ELECTRIC
PLUMBING
MECHANICAL.
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INSPECTION FEE
ISSUANCE
SMIP
ENERGY P/C
ENERGY PERMIT
RETENTION FEE
PRE-ALT FEE
A�
BASF
PLOT PLAN
ZONING CLEARANCE
TOTAL FEW lee, ;7/
COMMENTS
P/C PAID BY tt / VAUDATION
RECE1Pt a PAI08Y G J!1' VALIDA71ON
WHITE — Departrrent Cagy YELLOW -- Finance Copy, PINK — Assessor COW
4 1 1 1,0 1 : A ,
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INSPECTION
DATE
INSPECTOR
INSPECTION
DATE
INSPECTOR
1 SETBACK/ LETTER
TRACT AND LEDGER
FOOTINGS FORMS
SWITCH GEAR
SLAB
COMMERCIAL HOOD
UG PLUMBING
T-BAR
UG ELECTRICAL
INTERCEPTER
UFER GROUND
HOT MOP/SHOWERPAN
SEWER LATERAL
SEPTIC/CESSPOOL
MAIN WATER LINE
HERS REPORT RECEIVED
SEWER CLEANOUT
DEMOLITION
ROOF SHEATHING
ROOF DRAINS
I FLOOR SHEATHING
ROUGH CONDUIT
SHEAR WALLS EXTERIOR
POOLISPA
SHEAR WALLS INTERIOR
ROUGH PLUMBING
FRAMING/VENTING
ROUGH ELECTRICAL
ROUGH MECHANICAL
ROUGH MECHANICAL
ROUGH ELECTRICAL W( )C(
GAS TEST
ROUGH PLUMBING
PRE GUNITE
INSULATION WALL
POOL PRE DECK BONDING
INSULATION CEILING
DRYWALL
I GATIEf ALARM
LATH (PRE)
-FENCE
FINAL POOL
LATH EXTERIOR
WALLS
LATH INTERIOR
WALL FOOTI:NGfSTEEL
GAS TEST
WALL STEEL 1'r( ) 2w( LIFT
SCRATCH COAT
WALL BOND BEAM
ELECTRIC METER RELEASE
WALL DRAIN/ SEAL
GAS METER RELEASE
WALL FINAL
SPECIAL INSPECTION
RO FRAMING PLANNING APPROVAL
FINAL BUILDING
FINAL MECHANICAI.
FINAL ELECTRICAL
FINAL PLUMBING
T C of OCCUPANCY
Mitt of 00
COMMENTS
ROUGH FIRE APPROVAL
FINAL FIRE DEPARTMENT
-FINAL PLANNING
FINAL ENGINEERING/ PW
1 FINAL COMMUNITY SERVICES
FINAL HEALTH DEFT
[FINAL INT#USTRIAL WASTE
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