HomeMy WebLinkAbout16-1884G
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CITY OF DIAMOND BAR
4WDEPARTMENT OFCOMMUNITY & DEVELOF ENTSERVICES
21810 Copley Drive, Diamond Bar, CA 91765 PRESS
(909) 839-7020 Fax, (909) 861-3117 Building Inspection Hotline (909) 839.7027 FIRMLY
BUILDING PERMIT APPLICATION www.cityofdiamondbarcom buildmge@diamondbarcagov
JOB SITE ADDRESS_ 4 l cV/ .,,l
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DESIGNER
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OWNER BUMMER WAAMTxYM
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inmamo Mew by the 0"Wrarns) I here plamed next to the opolmely emTen Is"It an 70314% and
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OYmY aSnmmm oeaw acknowledge that aaaePtkr mPPnacoal rmidmain wlsch I mWI Para reatlW tamMai «n
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UCEM4W CDN=TOS'S DECAANAMN
I affirm urderporni Aryirythol l amilconaW rnerpmrpl«1aal ChaRarO wY,aSBaon 70"
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Dm DATE CONTRACTOR 11�YJLii.R1Ly
WOMaa'S COMP&MTipM OMABATImf
I HEREBY AFFIRM UNDER PENALTY OF PEfteURT ONE OF THE FDt.LDMG DECWNTIONS
I hna and will tWK* a CftkMe in Conaem to Sot em«e tar Warr'e Campemillon as waited ny
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Bn Prl«manw«k tat wish Mtle pamlllmissuW MyW«kr's Cmpnrmeum llnmrXa CaiNt9nd
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PDUCYWASER /..i&/3 9S/7S-
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open
C«npermshun pmd4aFmm$«aa1O700 NmetabarCade t611wNNmen mmprywmmMaprPaa«a
DATE APPLICANT
Fallen to Beam Wnlnr'6 Carorpxbcn cwem re Is waawful and seat rattBCS n1 rmmlrr to rlminm
Penn" and doll pane up to any kar drW meamand do m DSIOOOOO) in Wa{tlm to me cam m ft amonwm
dymmXe on pow" fain 6w6m13mot the nbaa ono mbrmteadao«ney6Mm
Comsmrnom LEMMAGM"
I MM seem undo Money of pePAiry min Varna IS a Cmsmallm Lw4n Agency In ma Re#«mMns of am wmr for
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LENDER S NMNE
LENDER 5 MORROW
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eon upon nmebore menUanW pmpe(ty t«�InNjw�aOm pu,p66es
IEOFPFMKM V DATE
APPLICATION DATE awi to �/'}} P/C#
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ISSUE DATE PERMIT# T9t112"- /aa
TYPE CONST OCC GROUP
SCO130 of Work /�I(Pl r/fE' Lc /47--Ir& fl" iEQ
0 DWEL UNITS # STORIES a BEDROOMS
DESCRIPTION
$0 FIT
FACTOR PSF
ADJ AREANALUATION
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QUANTITY
DESCRIPTION
FEE
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CONSTRUCTION
PLAN REVIEW
ELECTRIC
PLUMBING�-
MECHANICAL
INSPECTION FEE
ISSUANCE?
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7(pr (2-
SMIP
ENERGY P/C
ENERGY PERMIT
RETENTION FEE
PRE-ALT FEE
BASF
PLOT PLAN
ZONING CLEARANCE
TOTAL FEES
COMMENTS
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PIC �} PAID BY _ VALIDATION
RECEIPT. 3i2'-1 Gr PAIDBY 2 ( 32— VALictATIDN
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