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CJTY OF DIAMOD BAR C`
_ NPRESS .
DEPARTMENT. OF BUILDING AND. SAFETY FIRMLY
BUILDING PERMIT
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ADDRESS ` G �iV7L b . SPRING' LN- : '
APN P�f ,(.�� LOT �— TRACT .
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APPLICATION �� _ PERMIT SE
DATE / ` NUMBER CODE
ISSUE . TYPE ._ . OCC.
DATE -CONST. GROUP
CROSS STREET dJ,0f1M oNi� �2 jfc. t1p_
OWNER SIAM(�J/gVtrt7nF.NT C'eRP_ u ,V.
ADDRESS 20 o
zONING SETBACKS ; &,"n&WNM
FRONT RW ❑ '
REAR
CITY Q4&Jt10,M I /t-. ZJP�LZ4C TEL
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SIDE/SIDE STREET RW El
APPLICANT �I�(T WIZ T��► QJ TEL .-
SIDE
CONTRACTOR - , f% 0 L ltGc
ADDRESS 9101 b F..L,4j%LMb;',:
CITY 041 :1 h ZIP.1 X: •TEL Z��
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SEWAGE �-PUBUC PMT-,* _
DISPOSAL ❑ -PRIVATE SO. FT./ 100 GAL
STATE'
UC. NUMBER
GRADING ❑ CU. YDS. EXC. CU YDS FILL '
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TYPE
SQ FT
.FACTOR PS
ADJ. AREANALUATION "� - =
ARCH/ENG!
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DESIGNER�yNE BAN 1 pRc>i�lTf'�
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ADDRESS )-QQ 60 l PLE ARP rbn-.
CITY aAu L, zIP�(7L [" TEL'�47
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PROPOSED USE RSTf�T R lW I SOO ...
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GARAGE
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w/NE GEL(.E1Z►�12.�'h-R•12t?�
NO. DWEL' , _ NO. _ NO. ` •.
UNITS . STORIES 1- BEDROOMS '
LOT DIMENSIONS
PDRCfI
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VALUATION
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AREA
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OuANTrr
DESCRIPTION
FEE '. -:
NO. OF BLDGS .: ..._ _.... , HOW
ON LOT . _ _ .. USED
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LICENSED CONTRACTUiS DEUARATgN: I hrtW affirm that I am YcauW order pvvalma W Chapter 9 I q
with Section 70001 W Dvivon 3 a the &Wrwu W hoteu.ons Code; nd ay kam a n la att and effect
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DAUR RA DER DECLARATION I booby ahrm that I an asmpt ham ON Conhxear's lname I" Im IN fail" p
reason ISx. 1031.5. dusuuss aid hotel,— Cods Any oty a carry wW i*mu ! pond b crosuuck
also. mpove, "Mukab, a repair any sbaCb o. pin b its an-". SIN "wes the appkanl a such poem
tt Ids a signed stakrmit that he a kumd poauent b the pwiswd W the Conarom s Lcmu law (Clrapar
9 Icommennng with Section 700W1 a Ovum 3 d the 9usws, and Prafusdm Code) a nut h a tulips thrdsae
W de bases a the atkged tee non. Any vidatwn a Sabo 7031.5 by any applicant a a pod aubNtathe appkad b a civil Finally W rent Mora gar fins hoi died dazes ISSOOI.k.a
❑I, " mm, W the toop"'Y. a mr anplorees with wages as sheer onto compeesaum via do the wok. and
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the structures not mended a offered a sea IStc 70". 6rsmu W Prdau*u Cade, The Ca tractor's txanse
Lew does not spot b m " " of popaty who bends a aWons ttweon, W vibe dos acb work lumal,
or thr ugh ha awn wrOwees. poo t" that such ton powmils of nor mended a offend a sea. 1, however.
the budang a irnpr—'W' is sad withe ere year o(comFarrnrr, the ownerWilder wd1 hors the Grda W proving
that he did tree bud, a erorwe a the purpu d $&I"
❑I, u owner W le pep"ty, am sskmvah omtraang with kerwd unuxbrs b Construct at petit Iso,
7044. fhrntwu W Protasions Code. The Caaxbrs Eicaue law dots but apyy to an awes W pmWy who
bwds a imprwu threon. W who conuxtt a ach pmtom with a caabxbr(sl karud pusuaRl b Oe Cenbxor't
Lunn Low _.. -.
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CONSTRUCTION ��_:_..: --•-- - .. ... - -.._- :-
❑ 1 an eampt Wer Sa. s h PC IAltacb C"hbual.
PLAN REVIEW E °S t lD
Dora _ Ovinar ....,.,.. _.. ._... _. _ _..
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ELECTRIC
MMIRS' COMPENSATON OECLARATOL 1 booby ahem tml 1 have a teefikste W consent to sad -nos or
a cemtune vl Yorkers' Co reenutm ksstorm or a Cane, Catty "oil ISea. 3900. lab. C.I. _ _
❑ Certhd copy a hereby turashtd. -
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PLUMBING _.. .. _ _..... ..._ .... .. . .
MECHANICAL
❑ Cooled trot a Idd with the &Wdmp huoecuon lkpartrrwnt n � Ilrryrtmarsl
GRADING. '
CERTIFICATE OF EXEMPTON FROM Y&WRS' COMPENSATION WWRANCE: This mum need Rol be carplesd
d la pant a a fee b-- I$.OQ a au I certify Viet n IN mamarca d la work a wfech tlen
Feewt a iss ., I man rot eRpay, airy Fortin m any mover u as b becaaw wbpct b do ftwit contw4aonn
laws a Cadarw...
Dora .. Applicant -
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ISSUANCE --- %� • i% V
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PARK FEE -- .. -N• . t 17UJ
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SCHOOL FEES -
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NOTICE TD APPLICANT: R, stter os" this Confute W Eetnpmn, you shoW became hoot b the Vbk"'t
Campnuhn ptrvawta a lu Labe Code. You ourst IWO" comply with suck pwanm a den p"ma sIWbe dared revoked.
UYSIUd OF WRSIRIAL 5AFETT PERAYT CERIVICAIIUk- - - _. -'
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ed ituHS
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❑I booby amity that ro aeunuon hen (51 a more fat n deph into wbKb a per: m is tpwd b dexend
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will be made n tiowtm wait work sulavd by to prowl. W tht ro bwldop shw:laA ughodur4 feWwarl,-
a den wkum a diowd" thooW, will be awns than tarty -sit 136) feat � (Dwp 32. Orp 2, An 2, Soc
341. LW 6. C.A.0 1.
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❑As owner 'bA ", I will but endoY enrae to do work wlock would repave a perm Vim tle Brun d
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brdumel Safety, sic road abort. wdas such poem hu a Fans b do such wale boa she braion.
❑Gwmafidiowsolely room Na
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TOTAL FEES - Q
CWSTRIICiION IENDtaA' AGENCY:1 hreby alum left two is ! teeaautntn hRduq tpdY a de parEarmmra
W the wort la whcb Yen Dowd a osisd (Sec 3097, G. W.
ted"'s New'
lendeer's Address
COMMENTS ..... ,
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CEllif TE OF AW WTHORILITION OF ENTRY: I cobty I haw rased the spPhcataa W star
" the nfor a 1 ape b mnply will al stab bows W city crolames Wsap to his"
tmmrrcam, au a aun of Ik Depenot" a &.1d" W Safely b "IN up" b pwaly
IN whch 1 a p" a d awkeq mtFxbars... _.. _.
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RE FT NO.---J PAID BY _.. VALIDATION "
a d I Agem
WHI —Department Copy, YELLOW —Finance Copy. PINK —Assessor Copy. GOLDENROD —File COPY, GREEN— Applicants Copy
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