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HomeMy WebLinkAbout10297 (5) i CITY OF DIAMOND BAR �" `� COMMUNiTY DEVELOPMENT DEPARTMENf• �C 21660 E.Copley Drive Suite 190 PRESS (909)860-3195 Faz(909)861-3117 �'""'� BUILDING PERMIT APPLICATION FI RM LY N JOBSfTE APPUCATION � � PERMIT ! �C� p/C o ADDRESS��IC� �CCI'�1E�/4/L� L�v DATE NUMBER� � : � ISSUE NPE OCC APN LOT TR[�CT � DATE CONST. GROUP p OWNE��NTC' f� �� �. � ADDRESS C I�`� Yd0 20NING SETt3ACKS w CITY J.�itS�u..--1 ZIP�� TEL.°�G.=�S�3L FRONT RW ❑ � APPLICANT TEL flEAR 0 � SIDFJSIDE STREET RW O � CONTRACTOR CX"��' SIDE ❑ ADDRESS � CIN ZIP TEL PROPOSED USE �-v•t���'— o ARCWENGJ z DESIGNER N0.DWEL � NO. NO. a ADDAESS UNITS STOFIES BEDROOMS � CITY ZIP TEL N DESCRIPTIOM SO.FT: FACTOR PSF ADJ.AREANALUATiON c� OOWNER-BI:ILDER DECLARATION SFR/ADDlREM p t HEREBV AFFIRM UNDER PEN►LTY OF iEiWR1 TNA7I A!A E%EMPT FROIA THE CONTMCTORS LI• Ge�lq6/C8ry01S . 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