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. �?:Pf��D CITY OF DIAMOND BAR -�� -- DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES S E P 1 O LOCZ � 21660E.CopleyDriveSuite190 (909)860-3I95 Faa(909j 861-3117 PRE$S �'��'� BUII.DING PERMTT APPLICATION FIRMLY a A�oaEss � .�,� S Z'7 ���' � ��-� a- APPLICATION � NUMB R /C c DATE � AP OT RACT ISSUE 1yPE pCC DATE CONST. GROUP gOWNER L..., o ADDR S LLL+ ZONING SETBACKS W CITY ZIP TEL. - -�D FRONT RW ❑ � APPUCANT '�L. �Z REAR p � SIDFJSIDE STREET pVy p CONTRACTOR SIDE p � C'DrD(RESS ZIP TEL. PROPOSED USE �"PIG�'�'Z�D�U Y�r�•a��4i� 8 ARCNlENG/ � DESIGNER ND.DWEL N�. NO. ADDRESS UNITS STORIES BEDROOMS N ClTY ZIP TEL � DESCRIPTION SO.FT. FACTOfl PSF ADJ.AREANALUATION � OWNER•BUILDER DECLAMTION p SFR/ADOIREM p 1 HFREBYAFFlqM INDER PEN.tLTY OF VEAAlf1Y THAT 1 AA!EXEY7T FROM ME CONiMCTORSI� Gefege/CetpOff 11J CENSEUWid1TMEFOLLOWIHUpEASON(SEC.7Wt.6BU5WESSANDCROFES5lON5CO0E:ANYdTYOR (n S� COUNT'lWMCMREGVIRESAGERIaR7000NSTRUCT,ALTER�MPROVE.DE40LISH.ORRE0/uqANVSTAUC. 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FEE O I MI D(EIAPT UNDER SEG B,t flC.FOR h115 PEASON a 3 � LLz DATE ONRlEA � F UCENSED CONTRACTORS OECLAFiATION W � 1 HEREBYI1FiIPo1 UNpER PENAIN OF PERA/M TUT INA UCENSED UNOEp PRONSqNS OF CNAPTER ]� �I�MENCYqWITHSECTION)000�CfDNISqN]OFTHEBUSINESSIWOPROFESSqN5CO0E.AND Z `A ��V W LICENSE 6 N fl1LL FORCE AND EFFECT. m � UCENSEGGG/���AAA/S5 ��+ LIC.NO. �� � V DATE�I�I7 f CONTMCTOR � d W � WORKERS'COMPENSA710N DECLARATION a yIHEREBVhFiIPo.AIMDEROENILTYOFFENUqYONE0F7HEFOLLOWWGDECIAfil�TpNS: Z � �IMAVEANOYALLMAINTNNACEf{TiflCATEOFCONSEMTOSELF.INSUREGORNORKERS' _ . CONPENSATqN,ASYROVDEDBYSECTd17�ooOFTHEUBORCOOE,FORTHEVEaFOR1AIWCE U Q OF E WOfIK FON VMICFITIIIS iERMIT 191SSUED. � 1 HAVE M�7 x7LL ACUMAW WORKERS'CdAPEHSATIOH INSVIWlCf,AS R£QUIRED B�SECTlON d J7ooOFTHELAB01iCO0E,FORTHEPERFORMANCEOFTHEWOPoCiORWMICH7T115PERM1T15 � bSUED.MYWOPoCERSCOIAPEH4ATpNl SVRANCECARRIERMIOPO�ICYNIJMBEqARE CONSTRUCTION � � uaaEa� � � p �fh PUW REVIEW _ . (� • � POLIC'~MA4BER �� -! 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TOTAL FEES / I� ( /y�. p. IAGREETOCOMPLYN77NAlLCITYN+DODUHttORDIWWCE5Nro5TATEUwSREUTwo7oBU�DiNO /��r� �\_Y I.. CONSTRlIC71oN,ANONEPEBVAUTFIORREREPRE5EN7AT1YE50iTH�SCOVNiY70ENTERUPONTME ���cir � ABovEJ.�ENTIONED iROPE FOR INSPECTqN FURPOSES. � o COMM S � �✓'� �/� ` m PERM AME(ORItln •{ c�r� (P /� (n TUREO verw o�TE � . RECPT.NO. PAID BY VALIDATION ITE--0epartment Copy,YELLOW-�inance Copy,PINK—Assessar Copy,GO ENROD—File Copy,GR N—Applicant's Copy � �. , ' � � " . . . �i , . . ... . � � .. . . . . , _ . ... . . . . . . � . . _. . , . _ . . CITY OF DIAMOND BAR .� - 1NSPECTiOh! 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ROUGH GRADING ROUGH PLUMBING FINISH GRADING iSHOWERlTUB TEST POOL ELECTRIC EXT.LATH�SIDING - - POOL FENCINCa � Iti'ALL INSt1LATION POOL FINAL CE(UfvG INSULATION OFF SITE IMPS. � DRYWAC.L NA(LtNG DEDICATIONS SEVJER FINAL ENG. � ", ScPTIC TANK LANDSCAPE/IRRIG. .SEEP P1TlL.L. � ' %� ON SITE IMPS. GAS AIR TEST FINAL ZOPJING , . FINF�.L CONST. FIRE DEPT.FINAL � � F1NAL HEATING HEALTH DEPT. FINAL FItJAL ELCCTRfC DEV. FEES 4'AID Ff'�11�,L F'LU?�1BIt�G ENERGY - ;� � �� . �w y��-a %S�2J�^�-��.Y.��.a � '.. • - '.\ \ �ti.��^ . -�� . __ � _- .\�' ' \\ , ': - C0;��3MENTS • ,: �� . , _ .� . :.-:, �`\ ' � - �,,� � �(``, �','i �,� . . �. ���� .r�.+ � ., � .� �,. � ��� � \ �� ' - ;:_.,_, , -� �. ,�. SEPTIC TANK SiZE ;SEEP PIT/U SIZE _, _ .�y�_._..,..__ ,_....� , j ��_ j' � . � _ � L � � � � � �� � � � �_ __� � <r1Y,� . _ , � i _, , . _ i . , .'` ._1\J`` \ ;.� ;\\ i �� . � � � . ... ` ' ..':: ^►••�,n i�. ' � � � � \~\•��\� � ..\ �`� �"f� .�,� _._.� _. ,..,.,......_ ,._.1 �