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4 ' . ' � �� CITY OF DIAMOND BAR � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21660 E.Copley Lhive Suite 190 (909)860-3195 Fax(909)861-3117 PR E$$ �T��^� BUII.DING PERM[T APPLICATION FIRMLY o DDRESS���C7 ����'�� �!'t�� DATECATION �-1�.�� NUMB R � "�'`� Y� � ISSUE TYPE OCC APN LOT TRACT DATE CONST. GROUP °C OWNER O ' � p ADDRESS�_ � -- C .=f/>'-/-� -�' 20NING SETBACKS W CITY ZIP TEL. '�O- � FRONT RW O � APPUCANT • TEL. REAR ❑ " SIDE/SIDESTAEET RW ❑ � CONTRACTOR � �.�_ c ' SIDE ❑ ADDRESS���� ��„� �r^ ���_1� � CfTY Z�p c�c_�u i ,E r � PROPOSED USE T�� iGG�� _ � ARCH/ENG/ r-� � 1/1L-/SL-�- T�!_t%_ -"' 7�-,�y, '�"�6,c--r DESIGNER NO.DWEL. �--- - -- ��NO. ' NO. ADDRESS UNITS STORIES r ��BEDROOMS � C17Y 21P TEL. � DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION � Q OWNER•BUILDER DECLARATION SFR/ADD/FiEM OQ 1 MEREBY AFFli�I UNDER VENALT'OF�ERR111Y TMAT 1 AM EXEMPT ii10M iME CONTfUCiORS lb GdfdgB/C01pOR ill CENSEUWFOf11HEFOLLOVlINaR[ASd/f5EC.70.t1.SBU5WES5ANDPROFE55iON5CODE:ANYpTYOR (n U COUrfTYNM�REOURESAVEfLATTOCONSTRUCT.ALTE0.WPR0YE,�EA10U511.OHREPNRANYSTRUC- W Peti01D0Ck �� TURE,VRqR TO RS tSSUINCE.ILLSO REWiRES TNE APCLICANT fOR SUCH PEHUIT TO FILE A SIGNEO W STATEIAEM TUT HE OR SME IS LICENSED PVRSUANT TO TME VROVISIONS OL TME CONTRACTORS L6 � CENSEUW(CHAVTERY(COMMENCINOWITHSECf10N70o0�OFDIVI510N10FiNEBV51NE5SANDPRO� LL PoaUSpa FESSqN5CO0E)ORTMATMEORSHEI9EXEUPTMEREFHOA�hNOTHE8A5i5FOFiTHEALLECEDE%E1AP� C7 TION.ANYVIOLIITIONOFSECTION7o71.68YANYMPLILAf1TFORAPERMi75U&1ECTST/+E�PPLICANT70 Z RB-R001 �„_ ACMLiENALTYO�NOTMO(IETMNFIVENUNDRE�DOLUWS(t5aa).k ' � ❑I,1�SONNEROFTHEPRDPERtY,ORMYEMPLOYCESVATHWAGE5A5THEIH50LECOMPCNS�TpN. 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