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HomeMy WebLinkAbout11226 (5) �, - _------------____ �,w____---- --- -_ , _ _--- ___ ---�--�-'`—'�- C1TY OF DIAMQND BAR r�� � COMMUNITY DEVELOPMENT DEPA1tTMENT 1 '�i -.;.Q _- ------21660 E.Copley Dtive Switc t90 � • , _ _ QR��+3s�__. _______---_....___. � �.__ _.-._,�f=-- .�__-------____----- __ _. (904)86Q-3195 Fa�c(409)861-3ItT` _ �'�' BUILDING P�RMIT APPLICATION l FIRMLY Q aDdRESs Q(/ `7�� C.�rt!K.�iL/U�C�'��`t�L�� �)aTE CATIOM1E. P3IJMBER//'�!Z_ E #� 0 � APN . _LOT TRACT - __ . UATE Z�� ! TYPE OCC _. ,�CONST. ." CaRQIJP - p OWNEfi ��N' �.'T� - __._. _ . .. ADDRESS � ZONING SETBACKS � g CITY�. �i ZIP i=�J 'EL d _ �EART_ HW ' ,•� , : , APPLICANT_ __ __ _, TEL - ` SIDE/SIDE SlREET RW ❑ _-_ _.C,_ _ � CONTqACTOR _SIDE .. . ___ 0 � AODRESS-_._ . 6 _ _ � GITY�I�,.e.S�r ZtP_�.�T.EL PROPOSED USE - _ -- _ o ARCH/ENG/ '_ . ; ; , � DESIGNER - NO.DWEL NO. NO. a ADDRESS ` ' UNtTS STORtES BEDk?OOMS � �CITY ZIP TEL. � ' bESCRIPTION SQ FT. 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INSPE ONFEE ._.. . ._ � ..._'�' ...,..' ._.- . . . . ' � SU6JECTTO iT1E WORI(ERS'WMPENSATqN PHOVI IONS OF 6ECTION 37000F iHE LABOR coo�,i sfwi.rcar�n+coeavi.r vnni nias roHs._. _. _ S CE �Q F`� . � o�tE. ��� �rtnic�nr. `'�-- � . _ ._ __ . �-� wuaiNa:f�ivaE ro sEcuaE xioq�cEAs�od.iv�rnr�cov�w�caE is ur+uwFVI:�no siwteE ... _. ._ ..ENEHGY P1G-.....: - - � SUBIEGTAN EM%.OYEN TO CRMINAL PENALTES M1D CML FINES UP TO ONE IKRiDHED TFIOUSANO ENERGY PERMIT DOLLARS(fta0.00p1,M ADDITION TOTME COST OF OdAPENSATqN.OAMA�ESAS PR�VIDE�WR W '- � sEcraHa�wocrt+Ei�eon0006wreaesr.u+o�rrarwErsc�a _ iiE`fENT10NF�: . _ _ � _ ; � -� _ CONS7iiUCTiON LENDING AGENCY � -- ` � - . ___ _ _ PRE-ALT FEE ... __. " Lr IHEREBYAFFNiMUNDERPENALTYOFPEiUUflY'IFIATiHEflE1SACONSTqUCTIONIENDWfiAOENCY - - � d- Pop 7HE PEpWF�AHpE�THE WOqK FOR WHK%1 TNIS PERAIiT IS ISSUE01��.�.CIV.C.). . , , Z . .._ _ ...... . .. ........_._. . . __ . .... ... ..' _ _... ... . .,.� , W . .._. . . .. . ' � LENDEA'S NAME - . . , -.._ . . . .r...... .__ ____.....__.. „ .. . . . . : �. . � LECAERSADOPESS '._ ..... � .. 5 � ..ICEPTIFYTMATIHAVEREAD7HISAPFLIG710NANDSTA7E7FUT7HEABOVEINFORMATqNISCORRECT. TOTAL F�ES �f ' - � � IAGREETOCOMPLYWRHALLGTYANDCWNTVOHDM�NrCESANOSTATElAWSREUTYJGTOBl1YA�NG �� �� - �� / � �.���� , . CONSTRUCTION.M0 HEREBY AUiF10Fi1ZE REPRESEHfATIVES Oi 7HI5 CWINNTO ENTEH UPON TNE . f.�' . , . . . Z neove�Errrbr+Eo vaorEittv coa iNsr[crar�ruqrosEs. CAMMEN7S _ ___ _ 0. _. J � � . � .Tr. . ...._"_ . .. ...... . ...._.. . . .. ..._... . ... . . ' � . - .. - .. ,_.."'..._. , . .___. _ «... . . - .� PEHNfI7Ef (PRINi) � ^� `�� , . �-. . - S iANf1EOFPEHMITTEE CA7E ... . . .... ... ..,. - .� N ... RECPT.NO. 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