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Home My WebLink About16-26000 y 4 a I CITY OF DIAMOND BAR DEPARTMENT OFCOMMUNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Ban, CA 91765 PRESS „, ,, (909) 839-7020 Fax: (909) 861-3117 Building Inspection liotbne (909) 839-7027 FIRMLY BUILDING PERMIT APPLICATION www.cityofdiamondbarcom butlding@dlamondbarca.gov JOB SITE ADDRESS 1,33o C ticisi r toolt- ............. APN �7�, _ LOT _TRACT OWNER V_ P14�,6C _I5i olnuloi ADDRESS fS :G�_ GIN i 2IP t%b__TEL APPLICANT MOLL iVL�_ TEL lktlb 19571 CONTRACTOR 150 t1k"'• L AODR i2q G CITY PZUSl4 ZtP TEL L a � � ARCH7ENGt DESIGNER ADDRESS CITY ZIP TEL OWNEMIU)B MZLVANON I amem under P"ty d patsy an I em ermnpt k em me Columbowd Stmo undowe taw to that marmot Indicant Was, by fM meimd0n{ I flare Owed non to Nm apmk2T90 itslga) I$wtmn TOMS, Busem, and Prpiesslam Coda' Arey chy or many that emal D 3 Penman b termtratf, ever, Wpm, demolish, err n eme say Btr4uWm, pm W Its IWuallas, also mql Me applamn her pa profit W file a entreat otalon., IOpd he or am N ho meC puoumi to the Pleasant of Om cm"da'o Slele Ubad ma Uw (Chapho 9) Catamount with SecOm 7WO of ONWm O of tho &min oW Pmfu9Nme Coda) or dal ne asho le o9empl has final another haemfa theirsugedeaempdm My dulaOm of S9cpm 700f 5byanyappllmt fw a penal aubj"fhO applfrmt toe dvh perwty of not more tlun fire hundred dollars (MOD) U 10(Manor of me propeeti,orMe ellb)"M WM WOW 0far, MWOMpnemxe WIN ueU MI of or partners of the wait: and the an" IS not Mantled a onefed Its We r'Ntlon 7044 Nupneas ad RMeseloo Cam TM Gantramaa State LkMa Lm does M apply Wan order of orders, M10 through east", or overall seem bound or rnome94 the protons, proAkd that the Impraiem8na we nos abluded or Shams fm aan ii however, the erl o Iman emend Is sold Mien me year a conelke, the Omer RAW 04 Mrs the burden or turning that It was old but er Imprond WI me purposes of one ) U 1, ad tender of the prigMy, an !acids yMnMUDwy WO leanaed GMaaaare W oadn Cl the project Ovum 7044 Bualcss and Prdeesues ram 1N0 rLnm-0Flald'Sleet Lkanie Law doa6 NdaY Iobt owemra pemerly rnn 6ulb9almgaminerem atlwigtaNOCNyome preNeraMmepOnfdd Cpmada pesWN;itoOwCantraaas'Stke Li tam ermnroi lean Ikenaure uMeriMCanNaaa4Mam tmerree awiaoha talWNneg maeae(s) Date Stun By my abandon bbwt 0I adept ror elf ;hrdo i mfta In wlmn Intense" towed bear and" Aida If A had a am in bed l7mm flytooaMnmgamm. 9 swmwe Nmtltmsddt es an diner d A h6; not 4 of Efulmoed In be ermtow 67dea Is d I Nat a Coe' a pea aoakabb kw Seoiun Amer a tlra &6aWea and RaF35Wis Gab b 8 Wog rapuad Mrwr ads appYYsdm 0 a arcs Nabwn9 WgpoW nmVwwwieptr�roapatrabw tan LICENSED CONTRACTOR'S DECLARATION I Nreoy afilem under penaly ad polar Dist I ern Nodded under preMlad of piepbr 9 (Commenting wtm Sectim RODi d Ona6nnSnme Busumss aM Roksoam Cade aryl myllmmBNntld tprca nib BNBa. I GLASS ` isto LC N.fo—3S�Cp?-2 �_L Ere DATE CONTRACTOR "s"� 1Ak: WOIINEn COWUM, ON DECLARATION I HERER AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS I here and mill pmamaln a Cem9gte 01 CmsOM W Self boa Is woaer'9 Cournma9pt on os n0road by Seaton 7700 a the Labe Cale to the Wantland of Dw Park for W*n Obe Pennn b Rowed . MeeeMMO malmnn WaNm aibmpermatlal ka4uone OdrerNbedaySMOM37OD0INIoUmr Cola he ma Pedontaxe alM wonkier wnWh�(lhrrt9lNmM,JSam My WMkm'9 Canpomellan hwaana6 Canwrab Fron ranch, Ora 4514ll VJNO( CARRIER FOLICY NUMNRi OM SECTION NEEDM)T BECOM.ETEOFTNEPERM IS FOR ONE WOO O DOLLARS $100 OR LEM toN9fymn ndmpwhueraunw mm0aork W wtrrRmbpOmffid ¢Sad Imraf nM empb7amyperamamay'niHiOwriaaale mmawakatarnrOegOm taws n Dae�na Aldagrm � n igrrmi beamaoopa Coma waters tbnaeto69ai PmCsf ere a Serum 37m tl Nw Lean COO I Nrat ramNm empty w,m mere PebAdoM DATE —APPLICANT Feaom is should wee is Dasrpaemetlan aaarade is moafil Lost trust sol ent a norboym, as named wwm am ow Rurds W be ore bused amended dona0 3100 OD0) n WOW m me Fort of fM AYnPo114Hom, as fain 9oGNai 37NlffWNm bbome0 aaman,aM atWrrm}�afeos COLSTRLCrMNLMMAGMY i nmubyntamotal pet(Sw perloy NW maO ma Com6adibp Lmnnp AgatcYtotne erpawerkto Nerd Paplat plyRmd{Stlt 30@7 tNr G) LE7NOER5 NAME LENO'RSADDRESS I NmtNmee read Din apprptlm aM abW mnme80pta WlMddtlmb mriEG la9mamcorgeywph Oa CdTf ab murNy pdhtarnpe9ald site NW9at�ekdegY m� stspep mmmecam aM Mrear reapmsmleNMea DLLs comdyW miW wi Ptl' �a� __ it fER N P R SIGNATURE OF M TEE DATE 1 APPLICATION DATE P/CAAA ISSUEDATE �r PERMIT% FK f7f !! TYPE CONST OCC GROUP Scope of Work _..... d DWEL UNITS A STORIES d BEDROOMS DESCRIPTION SO FT FACTOR PSF ADJ AREAAJALUATION SFFVADDIREM CarapelGapat '... W PalaDWk neat. Ppol7arpo Z Ro floor Commercial do fD VBluBUOdr Ad) Area QUANTITY DESCRIPTION FEE 02 15 „ $ tr ) fwrA C b'tAt y.3 as as E CONSTRUCTION PLAN REVIEW ELECTRIC PLUMBING MECHANICAL INSPECTION FEE ISSUANCE ,Ica SKIM ENERGY PIC ENERGY PERMIT RETENTION FEE PRE-ALT FEE BASF PLOT PLAN ZONING CLEARANCE TOTAL FEES j 7� COMMENTS PAC � y` PAID BY VALIDATION RECEIPTA uu:) PAIDBY✓ Ia VALIDATIONS'