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HomeMy WebLinkAbout1195 � '`''� CITY OF DIAMOND BAR PRESS ��'� ' DEPARTMENT OF BUILDING AND SAFETY � ~ BUILDING PERMIT FIRMLY � JOBSITE � APPUCATION NERMIT SE ADDRESS �� � - L SSUE TYPE R �CODE � APN LOT TRACT DATE �—I D�O CONST. GROUP o CROSS STREET �pNING SETBACKS "�"°�'E"'E"'$ °' OWNER FRONT RW ❑ � ADDRESS � REAR ❑ W CITY ZIP TEL SIDE/SIDE STREET RW ❑ o APPUCANT — TEL SIDE ❑ z 4 CONTRACTOR SEWAGE ❑ p�g� pp,R,� o ADDRESS DISPOSAL W CITY�C�}j2��A- ZIP �. ❑ PRIVATE SQ.FT./100 GAL A- z STATE p� , N LIC.NUMBER���{ �Z �'�2 GRADING ❑ CU.YDS.EXC. CU YDS FILL y ARCH/ENG/ � TYPE SQ FT FACTDR PS - ADJ. R ALUATION `—' DESIGNER � w � 0 � o ADDRESS w iWi. 2 = GITY��9�'��'-ZIP TEL. (} 3 � PROPOSED USE Z 4 � � GARAGE = N0.DWEL. NO. 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Z bu�Wi or�myrmas tlineon.a�0 who cwuxu fa s�xA pm�ecu w�tA�cavannlsl�msed puwam m�he Cmv�cwr i . � " � . , -' •� O►JSTRUCTIO ' � ` �.� iK��u uV,� '; , ; 0 � ❑I am e.em0�urAa Set .8.6 PC.IAaxh Cauhuul PLAN REVIEW ' �� 0 0��. a.�« EL I,1?�� � Yr91i1(ERS'COMPENSATW OfClAR4TIW I hereDy�Ilrm Ual I�m�ttrotc�k of tmsenl la�dl.nw�,or �� �urms�te ol Nw1as WnpenuUun Inwance,m�mWrtC wpr qwed ISec.3800 W CI PLUM � j o ���,�� j��8i� � ❑camro coor o nnwr��M�a ECHAN 1 `�, ��C o ❑u�uiKa��er���a w�u nu s�y v� oeo+�eMm a o� m Q GRADING = CERTIFCAiE OF EXEMPTqN fN6Af WGfiKEPS'GOMPENSAiION NISIIfiAMtE.TAu utuon nnA mt Et carykt� � SUAN 0 � A Ne DHm�rs Ia ane�und�ed if1001 a kzs.1 arolr tlu�n pr palamance d tlr wat lar wluch ths • • h pnnul is rswed.I shaY rot�mp�C/ury p��swi m sM m+nnr w is b kcm wE�at b NMk 'Lomycnsaiwn ~ �M�F1 .� ( = lawa d Galdany (�(f o W RK FEE o Dzi. aoaK�ni � IOl[E TO APPI . .�ur m�km9 tlus Cmnlu�e oi Emnpuon.yw ihalG Oecam�su6Ka m�he ►p�: u- SCNOOL FEES _ �OnD�n3aU0n Ww�4O�S 01 Ce�Yhaf�,pd�.1'W mYil 1GNMM tMqly wiih WII1 pfwuW OI 11M2 QU 9 ihal � �C dK�l[d fl�01ld ! ¢ WISIW OF WOU51FIAl SAF[TY PENAYT CERTIi1CAilON W [� � d ❑I heie0y und�ih�t ro�wwuon hve(5)v:iNra�ei.m oepm nq wkcA�pasan a reyuud b dexad. o�e w�M be myde m cmnecum wiA wwY wNuved D j�tlOi yeml.�sad��xo Wrdmi svunu�.wlloldmp,lal�ewak. � a Eam4iwn a dsmanhnp ihreal.w&M maa Wi•ttwry'sM�36�lset Mat(pW 32.Grp 7.M 2.S�e W ]61.Ltle 8.G AL I. 3 ❑As owrotOwWeroted�Ocn.unlnsr�ucll V 1 Ms rbw�b d!��e�4 trom N�imt�h�Ihe Orwon d ' � J L I W ❑G.is.n d Ydusuul Saicry I4�mt No �. TOTAL FEES �l LI COHSfRUCiqN IENDU�G PGENC(.1 M�ahr.aHum tlu�Ufn u!Sa^so�wn le�b?Y.!O�Y��4��+ � = d ihe wat lor w1ucA Quf paml u'1s3Vd ISec h09T,C`+.C�.'••••v�••• �T a ladds Nu�r -,���1 ;-.t r.I.^_ �^t,�(1 r i�'-_1 �1 _ ""° _._.�- — COMME� — p=q luder's MNess C 4 LERTYICAIE Of LOMPIIkNLE ANO ANHOWUT�1 OF ENTN'!:I wtdy I Mn naa tl�u appkaim W WY `u y Itat tlie ntum�uw prven n[aiM 1 qn b[omWy wM Y mu laws�nd ury aMrcn�Wtnp m W�6np y cauvucoon.W wNuue�iM� �1am�W tM Drortmm�d Buddmu ad SaMv o mne Waa R�peWry lu whch I Aave+pled lar U� !�M 1a tle d mat � = DoL w5i^spacWna 1.-, .I_ j� RECPT NO. �PAID BY � VALIDATION .a ppplrtan�a Apm� o. • WHITE—OepaAment Copy.YEILOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—FUe Copy.GREEN—Applicanb Copy . � BS70611l89 i. � ,�. .t ' � """' _""' _'_ ' 'w _, ''' _ ' ._'_' "_ __ ' '_ ' ; I � i ! � '�� � �� I � � i �^ � j � � .-_.i "i -�.Y..__�_ , � � I j i � i . i I ( � � � . 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