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'"` CITY OF DIAMOND BAR �
� ���� DEPARTMENT OF BUILDING AND SAFETY PRESS
��-j BUILDING PERMIT FIRMLY
JOBStTE f� APPIJCATION PERMR �E
ADDRESS CX������ DATE NUMBER CODE
� ISSUE l�._4�}� Gj'O TYPE OCC.
► APN LOT TRACT DATE <</ U�� �� � CONST. GR�UP
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e CROSS STREET i � ZONING �p�CKS � Q j
� OWNER A - '
o AD�RESS ' REAR ❑ �
� CITY ZI TEL7'� S SIDE/SIDE STREET RW CO i
o APPLiCANT.�� • "i"dx TEIe�J3l6� � SIDE C❑ �
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4 CONTRACTOR SEWAGE ❑ PUBUC PMT#
g ADDRESS DISPOSAL ❑ pRNATE SQ.Ff./100 GAL
W CITY ZI TEL
Z STATE GRADING D CU.YDS.EXC. CU YDS FILL
d LIC.NUMBER
� ARCHlENG/ � NPE S� FT FACTOR PS ADJ. AREANALUATION
� DESIGNER W 1 i
� ADORESS lL 2
Z CITY ' IP TEL. (►� 3
£ PROPOSED USE z 4 �
� . ' � GARAGE '
o NO.DWEL. NO. NO. �• � pORCH
y UNITS � STORIES BEOROOMS �p
s LOT DIMENSIONS VALUATION A0.1.AREA
o NO.OF B�DGS HOW ovarnm DESCRIPTION FEE
W ON I.OT USED Q
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o ane� enpwe.Eemohs�,a repar+M n�:tive,pior ro rts asmrct.Msa reQuief the eppirmt la s�ch permn 2 G
` to I�k�srg�ed statenem th�t trt n kensed pveuant m the pwisbn�d Me Cmexta't liceroe ltw 1Chap�a m � Q� �� p�e'J Q
p� 9lcanmenn�g w�th Secum 10U010l Uwsan�d I�e&n:ess�M Pro4fsa�n Lode�a M�t k e en�l IMrehom � �p.,
y aiM+�e Msn la Me apeqed em�pDon.Airy vidauan d Sectron 703t 5 Ly��ry�ppiaam fa�prrmil wL�ects ] «8 ' �. �`J
W tht»phnM ro�rnJ penatty ot rot more Cm five huMred dollx7 IS50011. a .
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W A Mrcoupn h�'s ew�n emplorces:po.�ded�+at sucA m�pimnenh v�nm mtrnded a vllertd fef f�k.H.Aerei,er. :Z , i .
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vf ❑t�:owrcr ol rtie poperty.Hn eMnrveN comrmmy wim IceroM conoxtaf ro wnmul de paat(Sec. W
o )04d.Busircis md Palissans Code Tht Convxtoi s lcenu l�w das 1rot apply tu an oaner ei papatY wAe �
= hoMs a��Mn tlr.ea�,e�d wno�onneru la su�pA;ecis wnh�tonnxmis�Mm�ed pursu�nt ro 1M Cd�trKtei:
< <K�^x��� CONSTRUCTION
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o ❑CenlKd topy n Iiied wrtA th�Budding Mspection peprtment a D�pxtrneM � C,t '
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= Lnn ol tddmma -
o W PARK FEE
� O7e �"�°� u- SCHOOL FEES
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� Ca^R�'�+nen pa.mms el Oie L�Der CaAe.1an must faMwrth c7mW w�sucA prwami a lhi�Rrm�fh�A �
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o�e wd he mMe n camecim wi�h woit iuihoreed tr�rtw perme.mA iMt no Mu7duq mocfun.a�IMd�nq.IYsewak. .
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� InA�mW S�hry.u rottA�Em�e.unlnf sucA prson Mf�perrm ro do such waY from tM di.nian.
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W TOTAL FEES , d
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� i�'�N,^+ COMMENTS
mlmder's aeden
t LER11fC0.fF Of LO�iPIIAFCF ANO AUTIqPo2ATIN OF fHfRY�.1 wtify 1 Mw nad Nis�ppicttian ad fbh .
N Mii Ihe nlRm�lqn qiven i!fwrtfi.I iQK 10 iOmDM wiM)1 Shl!liW CdY MdIM1a[q M1EIq 10 6uibn0
y mnstructan.md wtlwr've a rtprtse^vnve d d S�hry te riw iqo^ Pelertl
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� •` � �� � RECPT NO.�.�L✓�!PAID BY 1 VAUDA��-1-�'�
swuv�a t�dc,� M�n r.
WHITE—Department Copy,YELIOW—Finanee Copy.PINK—Assessor Copy,GOLDENROD--Fite Copy,GREEN—Appticanq Copy
BS10Gtt189
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