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' - CITY OF DIAMOND BAR
DEPART ENT OF COMMUNITY& DEVELOPMENT SERVICES
21810 Copley Drive, Diamond Bar, CA 91765 PRESS
y ,,,v., (909) 939-7020 Fax: (909) 861-3117 Budding Inspection Hotline (909) M-7027 FIRMLY
BUILDING PERMIT APPLICATION www.cityofdiamoodbar.com buildmg@diamondbarca.gov
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OWNUI-BI EM DECUPATIIM
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DATE APPLICANT IIY
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CONSTKCMU*DMAGENCY
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LENDER'S NAME
UINDER'SADDRESS
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PERWTTEEMME{PRINT) 1d i1. i tip
SIGNATURE Of PERMITTEf tj DATE
APPLICATION DATE ^- is. - N I P/CO
ISSUE DATE j01 da l I j (!r PERMITA ?Al lP " Z S
TYPE CONST OCC GROUP
3
Scope of Work R?,iI-+-�h rAVa
A DWEL UNITS t STORIES N BEDROOMS
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DESCRIPTION
SO FT
FACTOR PSF
ADJ AREANALUATION
SFFVADDAAEM
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OUANTRY
DESCRIPTION
FEE
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CONSTRUCTION
PLAN REVIEW
ELECTRIC
PLUMBING
MECHANICAL
INSPECTION FEE
ISSUANCE
424. 1,
SMIP
ENERGY P/C
ENERGY PERMIT
RETENTION FEE
PRE-ALT FEE
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BASF
PLOT PLAN
ZONING CLEARANCE
TOTAL FEES
COMMENTS
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P/C PAID BY VALIDATION
RECEIPT der (42,3 PAID BY VALIDATION R"'