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'f - � J� CITY OF DIAMOND BAR " �/
DEPARTMENT OF CONII�fUNITY&DEVELOPMENT 5ERVICES �
T� 21825 E.Copley Drive
(909)860-3195 Fax(909)861-3117 RESS
�`'%�'� BUILDING PERMIT APPLICATION FI M LY
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A ADDRESS DATE NUMBER\i� q
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APN LOT TRACT DATE ✓ CONST. GROUP
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� pESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
� OYIMER-BUILDER DECLARATION $Fq/ADDIREM
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� I NEREBV AFf1qM UNDER VENAITY OF PEfWRY TMAT I AM E%EM7T FROM THE CONTMCTORS l4 G8l8Q8/Ci01pOR
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� 6ECilON]7aeOFTHELA80RCO0E.�NTEREST,ANDATTOHNEY'SFEES. RETENTIONFEE:
oI CONSTRUCTION LENDING AGENCY PRE•ALT FEE:
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F �-- � WHITE—Oepartment Copy,YELLOW—Finanea Copy,PINK—Assassor Copy,GOLDENROQ—File Copy,GFEEN�Applicanfs Copy �
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' ClT�' OF DIAMOtvD BAR � "
fI�1SPEC i iOf�! RECORr7
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FTGSlFORMS/STEEL i FHA REQMTS
ELECTRIC GROUN� ' _; UNDER FLOOR DUCT _. •
GROUND PLUMBING UNDER FLOOR CU�IDUIT, • �
SLAB GRADE I FIREPLACE FOlJNDATION '
TEMP POWER � ' FIREPLACE BOND BEAM � • � .
WATER SERVICE MID HT.BOND BEAM
ROOF SHEATHING 8 FT.BON�BEAM
FRAMINGNENTIUATION � � FINAL BOND BEAM i
RO�F COVER I I PRE-GRADING
ROUGH HEATING BENCHING
ROUGH ELECTRIC ROUGH GRADING
ROUGH PLUMBING ' ' ' FINISH GRADING
SHOWERIf'UB TEST i POOL ELECTRIC
EXT. LATHlSIDING � I I POOL FENCING
WALL INSULATION POOL FINAL
CEILING INSULATION OFF SITE IMPS.
DRYWALL NAILING DEDICATIOPJS
SEWER FINAL ENG.
SEPTIC TANK LANDSCAPElIRRIG. i
SEEP PIT/L.L. � OfJ SITE IMPS. �
GAS AIR TEST � . FINAL ZONING
FINAL CONST. b-J,,�-pL� FIRE DEPT.FINAL
FINAL HEATING � ,� ' HEALTH DEPT. FINAI
FINAL ELECTRIC � � DEV. FEES PAID
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WALNUT VALLEY UIr'IFIED SCHOOL D1STIt1CT
--- 880 SOIITH LEbiON AVENUE WALNUT CA 91789
CERTIFTCATE OF COMPLIANCE �
With Fee Provisions of •
Govemment Code Section 65996
`
DEVELOPERIOWNER '
ADDRESS o? I O 4,a. f��.o..`Q 'Rc�.�--' Signature of Applicanc
��CIT'Y/ZIP q�'� The person signing represents that he/she is auth��rized
TELEPHONE q O 9 - 4�,$- '7 O�7 to sign on behalf of the owner/developer and that the
information provided is true and accurate•o the be�t of
his/her]mowledge.
NEW LOT ADDRESS USE OF BUILDING TOTAL SQ. FT.
Residendal/Commercial/Industrial
City � '
HOME IMPROVEMENT OR REMODELING PROJECT
A DRESS DESCRIP'TION . TOTAL SQ. FT.
�10�va- Q(�L�r � /�,uyl, I 0.5�
Diamond Bar��Walnut (Be oom, Famil Rm., Kitchen,etc.)
Signature of Superintendent of Bulldings / � Date �O �f��
TO BE COMPLETED BY SCHOOL DISTRICT
��FEE SCHEDULE: The development fees levied by the Walnut Valley Unified TOTAL FEF,S DUE
School Disuict under provision of Government Code§65995 $ �03fv ��
are: (EFF. 8117/98) Residential Development $1.93/sq. ft. Receipt# ,>A�,i '
Commercial/Industrial $0.31/sq. ft. Date
Fees aze assessed on TOTAL square footage "living space" of ALL new or remodeling constructi projecu OVER 500 sq. feet
(eliminating gazage or uncovered patio). �
This is to certify that all fees due to the Walnut Valley Unified School Disuict under provision of Government Code Section
65995 have been received and a building permit may be issued.
� This is to certify that the above described development has been determined to be EXEMPT from the development fees of '
Government Code Section 65995 and a building pemut may be issued.
Exemption Justification: PROJECT IS 500 OR LESS SQUARE FEET
OTHER •'
L�-.^-e� � • .
�/a n e�C_�/o c,�t rs�++i 7`-�'— .
Assistant Superintendent
Fiscal and Facilities Managemeut
1/87 Rev. 2/88; 6/88; 8/89; 1/90';8/90; 10/90; 8/92;6/93; 11/93; 8/94; 6/96; 1/97; 8/98
PLEASE SEE NOTICE OF 90-DAY PERIOD FOR PROTEST OF FEES ON REVERSE SIDE