HomeMy WebLinkAbout1600 (9) '''' CITY OF DIAMOND BAR
DEPARTMENT OF BUILDING AND SAFETY PRESS
BUILDING PERMIT FIRMLY
JOBSITE ' APPUCATION PERMIT USE
ADDRESS 5�S' ��m�� ��S ��UE N�R �CODE
� APN LOT TRACT DATE 7 � CONST. GROUP
. o CROSS STREET SET ACKS �►�
°� OWNER� L►'1�►f' YG(��f� ZONING ��� � ❑
� ADDRESS 3 S. R� �
W CIT`�1�►_d�L�,� �ZIP�• TEL�� a- SIDE/SIDE STREET RW ❑
o APPUCANT TEL SIDE ❑
z
6 CONTRACTOR SEWAGE
o ADDRESS DISPOSAL � �8� ��
W CITY ZIP_9 t�D�TEL � PR�VATE SQ.FT./100 GAL
z STATE GRADING ❑ CU.YDS.EXC. CU YDS FILL
y LIC.NUMBER
y ARCH/ENG/ � N NPE SQ FT FACTi�R PS � ADJ: AREANAL TION
= DESIGNER W 1
o RDDRESS � 2
= CITY ZIP TEL �r 3
� PROP05ED USE Z 4
� � GARAGE
z NO.DWEL NO. NO. � POR�
�„ UNITS STORIES BEDROOMS m
� LOT DIMENSIONS VALUATION ADJ.AREA
o NO.OF BLDGS HOW QUANT(TY DESCRIPTION ` FEE _
W OU LOT USED a
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K tne�ppuc�m a i rni pewry W rot mae Uun tne I wdrea aowu It50011:
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� ❑I.as owner a)Ihe paperry.u my empbyea w�N waqes n IMr soM conµdustqn.w�Y du tla wak.W
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= buWs w�mpwu thaem.W w6o conuxu tu wch pryau w�N�wnuxw��)kmud p+w+nl m iM Conu�c�w
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o °'° °wn" ELECTRIC
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� O cao�Ka�Y�na����.�a. MECHANI ��
W ❑t«mKa��t�a w�n a�awa�a,��o�a��a o�;.y,�n, Q GRADING
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GD d Ne pwmn is lu aw hund�td ISI001 r l�i��.1'!aly�'u�n tM D�lamr¢�ol iM wak lor wMch Nu +� {—•���
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R �W�W�1,',D! _�Y minnt[4o u 10 hE[Omt fub�Gl b Y11 NtrYn1'GonW�nsium
S Laws d CalJama. ' - ;`' �1 W
o " ...''-::::-"' W PARK FEE
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� NOTCE TO APRICANT.p.�lur rtutuq tlus Grofuu W E,umpuon.pu snouN Cecm wqect m tAe Mlata'� V- SCHOOL FEES
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o ❑I AneEy wWy�t,m ewvnm fne(5)a mu�ket u�dep1A nb whrb�prsm n Ipwtd b OtlCNd.
� wJl be made n cmc�wn wiN wark.s�du¢ed h tlw D�rma.aid tlw au buildYp wupu�.wfkWnp,lahewwk .
a dmn4nan n divnntl�q;iMeal wil 6e.mu�Wa iMrry�m.l36)he�Aph(Oup.lI.Gi➢4.M 2.Ss
W34i.T�a.e.tac�.�.-:...__ ::.... :'.....; �.. .� ,,
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� ❑o.��d nn"oa S't`n�•�'N'. TOTAL FEES �r �
�,p COIISIf1UCfON 1FN016G AGEICl:1 M�bY dium Ilul Ifa�ii�ConsOu[4on Ipi6ip 10ai[y lor Eu pMlamann -
x d�he wwk fa wMch tlos qaml is ics�ed(See 309).Gr.41. .
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� m ��'s Add�ess
6 CERfYICA1E Of LURl1AN[F ANO AUTHOR�UiDI OF ENTNY.1 cruh 1 Aa.�n+d�ha+VPkMsn and�uY
h tlut the nfam�bon Vven o wrM.1 qw b compY wR6 M sLY Iwvs rd utp r8�r�[�r1Y1n0 ta bdA�p �
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9a - 9v -
�,�,Y.d�,�i p�„i , RECPT NO. � PIUD BY VAUDATION �
WHITE—Oepartment Copy.YELLOW—Finance Gopy.PINK--Asseseor Copy,GOLDENROD—FVe Copy,GREEN—Applicants Ccpy
BS106�11l89
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