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14E CITY OF DIAMOND BAR
DEPARTMENT OF COMMUNITY&DEVELOPA' 9TSERVICES
;,f 21810 Copley Drive, Diamond Bar, CA 91765 PRESS
(909) 839.7020 Fax: (91)Q) 861.3117 Bwldmg Inspection Hotline (909) $39.7027 FIRMLY
%nwn BUILDING PERMIT APPLICATION
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ARCH/ENGIDESIGNER
ADDRESS
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SIGN
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APPIMNs[
WARKNO Fobae b st o Meese, Campw®ibr eweage s tadaahP MA slaa toned aw weber b clwwrN
pmmeaw W dW Nee op w me III&W OBesard disou (SIMREAL a admw w Ne coa of Ba mmgenetws4
damage a memo loan cumin 370802 the sb«miB W erm W ewre )%I.M
COMMUCTMNIOMMANY
I hereby ad ~ pw^ of perjury Dal More In a CIXstruchM ieMkq Agerr" b the p«t«rerca of the we* Av
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(ENDER S NAME
LENDERSADDP!'SS.
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whoWon Bw above mWored pro" ra evoclwn purposes
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WFIA7URE OF POWMIF DATE 'I
APPLICATION DATE
ISSUE DATE
TYPE CONST
PEE/sCd f /;
PERMIFe E' R �Q "U' .TX
OCC GROUP
ZONING SETBACKS
FRONT...... RW ❑
REAR ❑
SIDEISIDE STREET RW ❑
SIDE ❑
PROPOSED USE _ �T
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A OWEL UNITS
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DESCRIPTION
SO FT
FACTOR PSF
ADJ AREAIVALUATION
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OLiANTITY
DESCRIPTION
FEE
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CONSTRUCTION
PLAN REVIEW
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ELECTRIC
PLUMBING
MECHANICAL
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INSPECTION FEE ^........
ISSUANCE
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SMIP
.40
.........
ENERGY PIC
_.....
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ENERGY PERMIT
RETENTION FEE
PRE-ALT FEE
IT
': SSAF
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TOTAL FEES
COMMENTS
4
RECEIPT R
PAID BY ��D G VALIDATION 7,;7-�—
WHIFE— PapWowd Copy YELLOW — Foorrcg Copy, — Aeoernm Copy, GOIAENROD—file Copy, GREEN —APP0ceR'sCopy