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CITY OF DIA IND BAR 01111
PARTMENTOFC( NUNITY&DEVELOPMENT SERVICES
21810 Copley Drive, Diamond Bar, CA 91765 PRESS
(909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 939-7027 FIRMLY
BUILDING PERMIT APPLICATION www.cityefdaamomflarcon budding@diamondbarcagov
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LENDER'S NAME
LENDER S ADDRESS
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ID/A-V 19.
PEAMffTEE NAME rT'
SIGNATURE OF PEA IfIF - DATE
APPLICATION DATE P1C#f
ISSUEDATE 11"16 PERMIT# w-as
TYPE COAST OCC GROUP
Scope of Work
# OWEL UNITS # STORIES # BEDROOMS
DESCRIPTION
SO FT
FACTOR PSF
ADJ AREANALUATION
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QUANTITY
DESCRIPTION
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ELECTRIC
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MECHANICAL
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ENERGY PIC
ENERGY PERMIT
RETENTION FEE
PRE-ALT FEE
BASF
PLOT PLAN
ZONING CLEARANCE
TOTAL FEES . Gj
COMMENTS
PIC '� �/ PAID BY t j ) VAUDATION
RECEIPT a 4? AT PANDEFY �a {_E_dw,� VALIDATION
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