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HomeMy WebLinkAbout12269 (11) � �� CiTY OF DIAMOND BAR DEPARTMENT OF COMMi7NITY&DEVELOPMENT SERVICES ,�" _ � 21660 E.Copley Drive Suite 19p (909)86(}-3195 Fax(909)861-3117 � PRESS ��'�' BUII,DING PERMIT APPLICATION FIRMLY A� JOBSITE 10� ' DATE��N� NUMBER I�!�� g�C �t3 r��� ADDRESS $ , ISSUE � /G ��TYPE OCC APN_T._ LOT ,TRACT DATE "�!C1 ` y CONST. GROUP p OWNER Q ADDR SS/ ZONING SETBACKS � FRONT CITY ZIP TEL. � � REAR Rw u APPUCANT TEL. SIDE/SIQE STREET Ryy ❑ �' CONTRACT R �?7 SIDE ❑ ADDR � C�TY ZIP, ��� TEL.����`�-�-q PROPOSED USE u�i ARCHIENG/ , � z DESIGN�ER � W NO.pWEL. NO. la a,: ADDRESS • v� UNITS STORIES BEDROOMS �: CITY ZIP TEL. � DESCRIPTION S�.FL FACTOR PSF ADJ.AREANALUATION O:: . OWNEfl•BUIL�ER DECLARA710N SFR/ADD/REM � p. I HEREBY AFFlRM UNDEH PENALTY OP PERA1qY iHAT i AM E%EMPT FAOM TNE CONTFiqCTORS U- ' G8f0 8/CafpOrt W� CENSEUWFOR7HEf'Ot10WINGqEASON(SEC.7037.SBUSINESSANDPROFESSIONSCODEp1JYCITYOR (n 9 Z�.. 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