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CITY OF DIAMOND BA
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DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES
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 wwwcityofdismondbarcom bmlding@diamondbarca.gov
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APN LOT TRACT
OWNER MCnrlc,K
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APPLICANT TEL
CONTRACTOR Ar
ADDRESS VU
CITYMnaa PdAak ZIP 102-7--L TEL 3 ii222
ARCHYENG1
DESIGNER
ADDRESS
CITY ZIP TEL
OWNER 811111.11131 DECLARAT=
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LENDERS NAME
LENDER SADDRESS
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MATLAEDFPERMITfEE DATE
APPUCATIONDATE_Z �-'7� ,,,..�j P/C#
ISSUE DATE zi 3 TPERMITA R &R - Cl 3 --
TYPE CONST OOC GROUP
Swpe of Work
0 DWEL UNITS f STORIES 0 BEDROOMS
DESCRIPTION
SO FT
FACTOR PSF
ADJ AREAIVALUATLON
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QUANTITY
DESCRIPTION
FEE
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CONSTRUCTION
PLAN REVIEW
ELECTRIC
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PLUMBING
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MECHANICAL
INSPECTION FEE
ISSUANCE
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SMIP
ENERGY P/C
ENERGY PERMIT
RETENTION FEE
PRE-ALT FEE
2 .00
BASF
PLOT PLAN
ZONING CLEARANCE
TOTAL FEES
COMMENTS
Z.1 2j - a �,
FIX +� PAID BY / VALIDATION ' }
RECEIPT J, PAID BY VALIDATION �w
WHITE —Department Copy YELLOW— Finarlce Copy, PINK—Assesaar Copy