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_ CITY OF DIAMOND BAR
DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES
II 21810 Copley Drive, Diamond Bar, CA 91765 PRESS
(909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027FIRMLY
BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@diam rca.gov
JOB SITE ADDRESS M LTQC
APN LOQ_ TRACT
OWNER
ADDRESS `�ec�►��P Gt. S Q
ZJ`ZO�L.
ITY
APPLICANT \-
CONTRACTOR -->6 t(Vr
ADDRESS
CITY�l�tr. `�t7 ZIP L.
ARCH/ENG/
DESIGNER
ADDRESS
CITY ZIP TEL.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the reason(s)
indicated below by the checkmark(s), I have placed next to the applicable item(s) [Section 7031.5, Business and
Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair, any
structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she
is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9) Commencing with Section
7000 of Division 3 of the Business and Professions Code] or that he or she is exempt from licensure and the basis for
the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty
of not more than five hundred dollars ($500).
U 1, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions
of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The
Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds
or improves the property, provided that the improvements are not intended or offered for sale. If however, the building or
improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built
or improved for the purpose of sale.).
U I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who
builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State
License Law.).
U I am exempt from licensure under the Contractor's State License law for the following reason(s):
I
By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one
year prior to completion of the improvements covered by this permit,l cannot legally sell a structure that I have built as an
owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the
applicable law, Section 7044 of the Business and Professions Code is available upon request when this application is
submitted or at the following Web site: http/www.leginfo.ca.gov/calaw.htmi.'
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000)
of Division 3 of the Business and Professions Code, and my license isinfull force and effect.
LICENSE CLASS: ` LIC. NO.:
DATE: CONTRACTOR:
WORKER'S COMPENSATION DECLARATION
I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS:
I have and will maintain a Certificate of Consent to Self -Insure for Worker's Compensation, as provided by
Section 3700 of the Labor Code, for the performance of the won( for which this permit is issued.
I have and will maintain Worker's Compensation Insurance, as required by Section 3700 of the Labor Cade, for
the performance of the work for which this permit is issued. My Worker's Compensation Insurance Carrier and
Policy Number are:
CARRIER L�t�Cf
POLICY NUMBER LA1 C—O
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS).
I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to
became subject to the Worker's Compensation Laws of California. And agree that if I should become subject to the Worker's
Compen tion prowskin., o ion 3700 of the Labo\jCQde, I shall tonhw tli comp with those provisiPns.
DATE: — APPLICANT: l dllr.kL h� eIzz—
WARNING: Failure to secure Worker's Compensation coverage is unlawful, and shall subject an employer to criminal
penalties and civil fines up to one hundred thousand dollars ($100,000), in addition to the cost of the compensation,
damages as provided for in section 3708 of the labor code, interest, and attorney's fees.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a Construction Lending Agency for the performance of the work for
which this permit is issued (Sec. 3097, Civ. C.).
LENDER'S NAME:
LENDER'S ADDRESS:
I certify that I have read this application and state that the above information is correct. I agree to comply with all city and
county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to
enter upon the above-mentioned property for inspection purposes.
PERMITT E ME INT)
SIGNATURE OF PERMITTEE DATE
APPLICATION DATE: P/C# O/'[ e
ISSUE DATE: % PERMIT# : P R I t'
TYPE CONST. OCC GROUP:
Scope of Work r�1 d .
1Jo •iQ PS
# DWEL. UNITS # STORIES # BEDROOMS
DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION
SFR/ADD/REM
Garage/Carport
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Patio/Deck
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LL
Pool/Spa
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Commercial
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Valuation: Adj. Area:
QUANTITY DESCRIPTION FEE
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CONSTRUCTION: l
PLAN REVIEW: 'Tip
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ELECTRIC: .r
PLUMBING:
MECHANICAL:
INSPECTION FEE: �% N
ISSUANCE: r .i
SMIP:
ENERGY P/C:
ENERGY PERMIT:
RETENTION FEE: �y
PRE -ALT FEE:
BASF: 1 t 0 Q
PLOT PLAN:
ZONING CLEARANCE:
TOTAL FEES Iroo,
COMMENTS:
P/C: PAID BY: p VALIDATION:
RECEIPT # a1 1 S b4- PAID BY: j�,,-1'SO_}VALIDATION:
WHITE — Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy
Lz..
CITY OF I?IAMON•D• BA -R
INSPECTION RECORD
INSPECTION
DATE
INSPECTOR
SETBACKILETTER
FOOTINGS FORMS
SLAB
UG. PLUMBING
UG. ELECTRICAL
LIFER GROUND
SEWER LATERAL
MAIN WATER LINE
SEWER CLEANOUT
ROOF SHEATHING
FLOOR SHEATHING
SHEAR WALLS EXTERIOR
SHEAR WALLS INTERIOR
FRAMINGNENTING
ROUGH MECHANICAL
ROUGH ELECTRICAL W( ) C (
)
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
T.C. of OCCUPANCY
CERT. of OCCUPANCY
COMMENTS:
INSPECTIONDATE INSPECTOR
TRACT AND 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 1sT( ) 2ND( ) LIFT
WALL BOND BEAM
WALL DRAIN/ SEAL
WALL FINAL
R0. FRAMING PLANNING APPROVAL
ROUGH FIRE APPROVAL
FINAL FIRE DEPARTMENT
FINAL PLANNING
FINAL ENGINEERING/ PW
FINAL COMMUNITY SERVICES
FINAL HEALTH DEPT.
FINAL INDUSTRIAL WASTE
r
CITY OF DIAMOND BAR
j�l I i r DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES
c 21810 Copley Drive, Diamond Bar, CA 91765 PRESS
(909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-70270 FIRMLY
BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@diamondbarca.gov
JOB SITE ADDRES al l 3 I lel ; LIQ
APN LOT TRACT
OWNER , e—r
ADD ESS ;35_i?;i . rr i
CITY �1 > r ZIP
APPLICANT TEL.
CONTRACTOR ALAI Y•leY' - bVt \ �Y
ADDRESS
CITY ZIP TEL.
ARCH/ENG/
DESIGNER
ADDRESS
CITY ZIP TEL.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the reason(s)
indicated below by the checkmark(s), I have placed next to the applicable item(s) [Section 7031.5, Business and
Professions Code: Any city or county that requires a permit to construct, atter, improve, demolish, or repair, any
structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she
is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9) Commencing with Section
7000 of Division 3 of the Business and Professions Code] or that he or she is exempt from licensure and the basis for
the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty
of not more than five hundred dollars ($500).
U I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions
of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The
Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds
or improves the property, provided that the improvements are not intended or offered for sale. If however, the building or
improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built
or improved for the purpose of sale.).
U I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who
builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State
License Law.). .
(� 1 a e t fro li ensur n ntractor's State License law for the following reason(s):
Ugkoall P-Sft. wr
By my signature below I a owledge that, except for my personal residence in which I must have resided for at least one
year prior to completion of the improvements covered by this permit,l cannot legally sell a structure that I have built as an
owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the
applicable law, Section 7044 of the Business and Professions Code is available upon request when this application is
submitted or at the following Web site: httpAwm.leginfo.ca.gov/calaw.html.
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000)
of Division 3 of the Business and Professions Code, and my license is in full force and effect.
LICENSE CLASS: LIC. NO.:
DATE: CONTRACTOR:
WORKER'S COMPENSATION DECLARATION
I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS:
I have and will maintain a Certificate of Consent to Self -Insure for Worker's Compensation, as provided by
Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
I have and will maintain Worker's Compensation Insurance, as required by Section 3700 of the Labor Code, for
the performance of the work for which this permit is issued. My Worker's Compensation Insurance Carrier and
Policy Number are:
CARRIER
POLICY NUMBER
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS).
I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to
become subject to the Worker's Compensation La s of California. And agree that if I should become subject to the Worker's
Compensation provisions of Section 3700 of th L Code, �gha fcytl7vyitll,complywitlrihose provisions.
DATAPPLICANT:Y !►irt�.[
APPLICANT)(—
WARNING: Failure to secure Worker's Compensation coveragily unlawful, and shall subject an employer to criminal
penalties and civil fines up to one hundred thousand dollars ($100,000), in addition to the cost of the compensation,
damages as provided for in section 3708 of the labor code, interest, and attorney's fees.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a Construction Lending Agency for the performance of the work for
which this permit is issued (Sec. 3097, Civ. C.).
LENDER'S NAME:
LENDER'S ADDRESS:
I certify that I have read this application and state that the above information is correct. I agree to comply with all city and
county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to
enter upon the
/'P�Fabove-mentioned property for inspection purposes.
'i 1'Ci L
PER ME (P
SIGNATURE OF PERMITTEE DATE
APPLICATION DATE: 5' -Q c0 1 % (e
ISSUE DATE: S �� I b PERMIT# :
TYPE CONST.
P/C#
f\,e. N
GROUP:
Scope of Work
l o' x atm'
# DWEL. UNITS # STORIES
/OCC
# BEDROOMS
DESCRIPTION SQ. FT. FACTOR PSF
ADJ. AREA/VALUATION
SFR/ADD/REM
Garage/Carport
alio ck app
W
LL
Pool/Spa
cm Cx
z
Re -Roof C rYY�
Commercial
co
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Valuation: S O
Adj. Area:
QUANTITY DESCRIPTION FEE
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CONSTRUCTION:
PLAN REVIEW:
69 S I (c
ELECTRIC:
PLUMBING:
MECHANICAL:
INSPECTION FEE:
ISSUANCE:
SMTP:
ENERGY P/C:
ENERGY PERMIT:
RETENTION FEE:
PRE -ALT FEE:
BASF:
PLOT PLAN:
ZONING CLEARANCE:
TOTAL FEES
COMMENTS:
S ` 1 (p
P/C: PAID BY:
RECEIPT # ' 3Q�a_;k PAID BY: C
VALIDATION:
VALIDATION:
WHITE — Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy
• �' CITY OF DIAMOND
INSPECTION
BAR '
RECORD '
INSPECTION DATE INSPECTOR
INSPECTION DATE INSPECTOR
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
FLOOR SHEATHING
ROUGH CONDUIT
SHEAR WALLS EXTERIOR
POOUSPA
SHEAR WALLS INTERIOR
ROUGH PLUMBING
FRAMINGNENTING
ROUGH ELECTRICAL
ROUGH MECHANICAL
ROUGH MECHANICAL
ROUGH ELECTRICAL W( ) C O
GAS TEST
ROUGH PLUMBING
PRE GUNITE
INSULATION WALL
POOL PRE DECK BONDING
INSULATION CEILING
P-TRAP
DRYWALL
FENCE / GATE/ ALARM
LATH (PRE)
FINAL POOL
LATH EXTERIOR
WALLS:
LATH INTERIOR
WALL FOOTING/STEEL
GAS TEST
WALL STEEL 1ST( )2 ND( ) LIFT
SCRATCH COAT
WALL BOND BEAM
ELECTRIC METER RELEASE
WALL DRAIN/ SEAL
GAS METER RELEASE
WALL FINAL
SPECIAL INSPECTION
R0. FRAMING PLANNING APPROVAL
FINAL BUILDING i1,.7Ef
ROUGH FIRE APPROVAL
FINAL MECHANICAL
FINAL FIRE DEPARTMENT
FINAL ELECTRICAL
FINAL PLANNING
FINAL PLUMBING
FINAL ENGINEERING/ PW
T.C. of OCCUPANCY
FINAL COMMUNITY SERVICES
CERT. of OCCUPANCY
FINAL HEALTH DEPT.
FINAL INDUSTRIAL WASTE
COMMENTS:
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41
CITY OF DIAMOND BAR
DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES
e 21823 E. Copley Drive
(909) 860-3195 Fax (909)ftt-"•19 83 9 'i�2o
BUILDING PERMIT APPLICATION
JOBSITE
ADDRESS 01 eJ-_5 3 _rW t
APN LOT TRACT
OWNER L--Y'9ke_-j S�'COY^C_-Y
ADDRESS A aS 3 T�'Wn S P
CITY 1Z>%<_-rYron, �3r ZIPi?r1(,Q TEL j# • 04$3
APPLICANT TEL
CONTRACTOR hV��15-'hryG�'1 -
ADDRESS -1--i 5 i S —
Pi -
CITY �\ anici ZIP n 11$IoTEL.
ARCH/ENG/
DESIGNER
ADDRESS
CITY ZIP TEL
OWNER -BUILDER DECLARATION
1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT 1 AM EXEMPT FROM THE COfRRACTORS LF
CENSE LAW FOR THE FOLLOWING REASON (SEC%7031.5 BUSNESSAND PROFESSIONS CODE ANY CTTYOR
COUNTYW RICH REOARESAPERMR 70 OONSTRUCT,ALTER IMPROVE, DEMOUSH.OR REPMRANY 3TRW
TUBE, PRIOR TO ITS
ISSUANCE ALSO REQUIRES THE APPLICANT FOR SUCH PRIMIT 70 FILE A SIGNED
STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE OONTRACTORS LH
CENSE U(C
W NPTER F IOOMMENCN00) G WITH SECTION 70OF DIVISION a OF THE BUSINESS AND PRO-
FESSIDNS CODE) OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED EXEMP.
TION. ANY VIOLATION OF SECTION 7611.6 BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO
A CNLL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS (1MI0),):
OI AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITHWAGES AS THEIR SOLE COMPENSATION,
WILL DO THE WORT. AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (SEC 704• BUST.
NESS AND PROFESSIONS CODE THE CONTRACTORS LICENSE LAW DOES N07 APPLY TO AN OWNER OF
PROPERTY WHO BUILDS OR IMPROVES THEREON, AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR
THROUGH HIS OR HER OWN EMPLOYEES, PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR
OFFERED FOR SALE. IF, HOWE VEIL THE BUILDING OR IMPROVEMENT IS SOLD WITHIN 04E YEAR OF OOMPLi.
TION, THE OWkrR-BUILDER W tU.'HAVE THE BURDEN OF PROVNG THAT HE OR SHE 010 MOT BUJLD OR
IMPROVE FORTHE PURPOSE OF SALE)•
O L AS OWNER OF THE PROPERTY. AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS
TO CONSTRUCT THE PROJECT (SEC. 7014, BUSINESS AND PROFESSIONS COOS THE CONTRACTORS LL
CENSE LAW DOES NOT APPLY TOAN OWNER OF A PROPERTY WHO BUILDS OR IMPROVES THEREON. AND
WHO CONTRACTS FOR SUCH PROJECTS WITH ACONTRACTOR(S) LICENSED PURSUANT TO THE CONTRAC-
TORS LICENSE LAW),
❑ I AM EXEMPT UNDER SEC B. l P.C. FOR 7105 REASON
DATE OWNER
LICENSED CONTRACTORS DECLARATION
I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT IAM LICENSED UNDER PROVISO" OF CHAPTER
F (OOMMENCNG WRTH SECTION 70W) OF DIVISION 3 OF THE BUSINESS AND PROFESSORS CODE, AND
MY LICENSE IS N FULL FOReC�T.
E AND EFFECL �/,
LICENSE CLASS 'l LIG. NO. v -. l `
DATEA
. _ ' 50`a CONTRACTOR /
+VS L-0riS nZ
WORKERS' COMPENSATION DECLARATION
1 HEREBY AFFIRM UNDER PENALTY OF PERWRY ONE OF THE FOLLOWING DECLARATIONS:
_I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF-IN3URE FOR WONLER9
COMPENSATION, AS PROVIDED BY SECTION 3700 OF THE LABOR CODE. FOR THE PERFORMANCE
OF THE WORK FOR WHICH THIS PERMIT 13 ISSUED.
I HAVE AND WILL MAINTAIN WORKERS' COIMPENSATION INSURANCE. AS REQUIRED BY SECTION
3700 OF THE LABOR CODE. FOR THE PERFORMANCE OF THE WORK FOR VnQCH THIS PERMIT 15
ISSUED. MY WORKERS' COMPENSATION INSURANCE CARRIER AND POLICY NUMBER ARE
CARRIER
POLICY NUMBER
"SSMONNEEDNOT BE OCMFLEIIDOF THE POW 6 FORCE HUNDRED DOLLARS PiMoRLE35),
1 CERTIFY THAT N THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I
SHALL NOT EMPLOY ANY PERSON
N ANY MANNER SO AS TO BECOME SUBJECT TO THE
WORKERS' COMPENSATION LAWS OF CALIFORNIA AND AGREE THAT IF I SHOULD BEGONE
SUBJECT TO THE WON(ERS' COMPENSATION PROVISIONS OF SECTION3700 IJBOR
OODE. I SHALL iORTHWTH COMPLY ROMs
DATE; II �• I o O7 APDL
WARNND: FAILURE TO SECURE WORKERS COMPFJSATIDN COVERAGE IS U AND S/DILL BE
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AM CMLFINES UP700NEH DRED THIOU"WND
DOLLARS (/100.WD), N ADDITION 70 THE COST OF COMPENSATION. DA11MG6 PROVIDED FOR IN
SECTION 770E OF THE LABOR CODE. INTEREST. ANDATTORNEYS FEES
CONSTRUCTION LENDING AGENCY
1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS A CONSTFAJCTION LENDING AGENCY
FOR THE PERFORMANCE OF THE WORK FOR WH IC/ THIS PERMIT IS ISSUED (SEG 30FT. CIV. G).
LENDERS NAME
LENDERS ADDRESS
I CERTIFY TINT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT.
I AGREE TO COMPLY WOIH ALL CITY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUDDING
CONSTRUCTION. AND HEREBYALITIORZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPN THE
ABOVE-MENTIONED PROPERTY FOR INSPECTION PURPOSES. 1
4— t —is t/—t77r,..YaTIl a -m C N
PlEptn—fitomp-N I— —
OF PERMITTEE DATE
E�Ptwo
PRESS
A 18 ��". FIRMLY
APPLICATION PERMIT PIC
DATE (C� l 8 C4 NUMBER $, O 0 0
ISSUE) O l/ l IO- TYPE OCC
DATE CONST. GROUP
ZONING SETBACKS
FRONT RW ❑
REAR ❑
SIDE/SIDE STREET RW ❑
SIDE ❑
PROPOSED USE
NO. DWEL. NO. NO.
UNITS STORIES BEDROOMS
DESCRIPTION SO. FT. FACTOR PSF ADJ. AREANALUATION
SFRIADD/REM
U)
Garapa/Carport
W
PatWDeck
LL
PQoVSpa
Z
Re -Rod
0
Commercial
m
Valuation SCGbo ADJAREA
QUANTITY DESCRIPTION FEE
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0 -
CONSTRUCTION V I • 0.0
CONSTRUCTION
PLAN REVIEW
ELECTRIC
PLUMBING
MECHANICAL
INSPECTION FEE
ISSUANCE a 00
SMTP 7 sd
ENERGY PIC
ENERGY PERMIT
p
RETENTION FEE:
PRE -ALT FEE:
2e -L
TOTAL FEES , `� • 1 a 1 a 1 • -70
COMMENTS
RECPT. NO. I �� PAID BY �I Ls 'I VALIDATION
`i WHITE—Department Copy. YELLOW—Ftr airwe Copy, PINK—Aasasm Copy, GOLDENROD --FDO CDpy, GREEN—AppIIc;InCa Copy
AO 0*
CITY OF DIAMOND BAR low
INSPECTION RECORD
SETBACK I I FLOOR JOIST !
FIGS/FORMS/STEEL _ FHA REQMTS I
ELECTRIC GROUND --� UNDER.FLOOP. DUCT !
GROUND PLUMBING i I I UNDER FLOOR CONDUIT
_SLAB GRADE ! ! ! FIREPLACE FOUNDATION
TEMP POWER FIREPLACE BOND BEAM
----- - - --- --- -- ----I -- LACE - --- -- --- --- -
WATER SERVICE ' _ ;MID H7. BOND BEAM
ROOF SHEATHING - -� (8 FT. BOND BEAM-
FRAMINGNENTILATION- - -- I FINAL BOND BEAM __ !
ROOF COVED _ _ PRE -GRADING
ROUGH HEATING ; BENCHING
ROUGH ELECTRIC ! I ROUGH GRADING
ROUGH PLUMBING I FINISH GRADING
SHOWER/TUB TEST ! I POOL ELECTRIC
EXT. LATH/SIDING i ; I POOL FENCING
WALL INSULATION j POOL FINAL
CEILING INSULATION OFF SITE IMPS.
DRYWALL NAILING; DEDICATIONS
SEWER -j FINAL
-_ __-.
SEPTIC TANK -_-- LANDSCAPE/IRRIG. --_-------_----- - ----'_ -----
SEEP PIT/L.L. ION SITE IMPS.
GAS AIR TEST ! FINAL ZONING
FINAL CONST.- _ _- ------ FIRE DEPT. FINAL -- ---- ---- -_-
FINAL HEATING -j- I HEALTH DEPT. FINAL -
FINAL ELECTRIC DEV. FEES PAID
FINAL PLUMBING I ENERGY
i
COMMENTS —_
Y ------v ----------_... --.... ----..__...._...-- -- .... - .....
_
SEPTIC TANK SIZE
SEEP PIT/U SIZE _
Inspection Request Form
DATE:
PROJECT ADDRESS: a S \ Y
PERMIT NO:
TYPE OF INSPECTION: a oo ��—�;,•,a �
Contact:
Preference: AM PM Special Request:
Comments:
Required Releases:❑ Planning ❑ Engineering ❑ Comm. Serv.
Special Case: ❑ Code Case ❑ Complaint
INSPECTION DAY: MON TUE WED THU