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HomeMy WebLinkAbout13841 _�,� _ CITY OF DIAMOND BAx � DEPARTMENT OF COMMUNITY&DEVEtAPMENT SERVICES �; 21660 E.Capley Drive Suite 190 (9Q9)86Q3195 Fa�c(909)861-3117 PRESS $�IIDING P�RMTI'APPLICATION FIRMLY � JOBSITE . APPLICATIONg���j,�� NUMBER ���/ 1 M� p ADDRESS '�Tf3� �O�VG. RD DATE r i � ISSUE TYPE OCC APN LOT TRACT DATE CONST. GROUP � OWNER �,L}$(�j�{�--�`-JD I/A7�l1V��+Z.L.. ADQRESS �'�'tE ZONING SETHACKS y¢,� FROfYT RW ❑ � CITY 'DJg��,D �i�IP TEL REAR ❑ APPUCANT TEL SIDElSIDE STREET RW ❑ CONTRACTOR I��-YYl I%.L1�1�1",.j CL}. SIOE ❑ � ADDRES s7�'S�La/ 'L�v77 % PROPOSED USE �S CITY ZIP_�_ 7EL.�'/7�- � ARCFUENG! + pE31GNEA N�7Jt� NO.DWEL. NO. NO. ADDRESS UNITS STORIES 6EDAOOMS � CITY ZIP TEL. � y DESCRIPTION SQ.FT. 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ICEAIIGV 71MT It�751E PENFOAM�NCE DFTHE WDRN FOR WHICHTHIS PERMtT iS ISSVW,� SHALI.NOTEMVlDYM1YPEFl50NMANYMPNNER50ASTOBECAMESU&IECTTOTNE � S U Uj WVRKERS'COMPENSATiOIJlA�430FGLLIFORNIA.PNDAGREEhIA71FISFKKILDBECOME INSPECT�ONFEE � S StIRiECTTOTMEWORKERS'COMPFNSATIONPNOVISIDNSOfSECTION30pOfTHEI.A80R ISSUANCE CODE,I SHALL FORTMW�TN CdAPIY WITH TfJ¢SE PqOV131DN5. 0 p pq7p:����19 APPLICANT: /«'� SMIP � ENERGY P/C WAiNIN(i:FA0.URETOSECUREWONKENS'COMVENSATION RAOEI3UNU ANDSHALLBE �y SUBJECTANEYPLOYEHTOCHIMiNqLPENALilESANDGYVILFlNESUPTOONENUNORE01HOV5AN0 ENERGYPERMIT pOU./1f4S(j100,000),W FUDITION TO TME CASTOF GOMPENSATIDN,0�1.1AGES/S PflOYlOED FOR 7N � SECTI�N9lo[OfT1iEt.ABOACOOE,MtEflEST,ANOATTOFiNEY'SFEES. RETENTIONFEE: � CONSTRUCTION�ENOING AGENCY PRE-ALT FEE: � IHEqEBYAFFIfiMUNDERGENPLTlOFVER1u2YTHATTHEREISACONSTRUCTIONLENDINGAGENC7 a- iOR THE PERFORMANCE OF iHE W�HK FOR WHICH THIS VEPoA�T I515SUE0(3EC.]OB'i,dV.C.). 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