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HomeMy WebLinkAbout14177 � _... � CTTY OF DIAMOND BAR '�� ...... .��-- �`� ,l � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES � � � �_� 21660 E.Copley Drive Suite 190 , (909)860-3195 Fax(909)861-3117 PRESS `'�'°�°�. BUILDIPTG PERMIT APPLICATION FIRMLY o DDRIESS��� ���� ��� �,,,/� �ATECATIO � ��! ���NUMBE(� � � #/C ISSUE TYPE OCC � APN LO TRACT DATE CONST. GROUP p OWNER �,�{,�•f� ��:��'l � "" ADDRESS� ZONING SETBACKS � O CITY y�• �j , ZIP�7 TEL:�I � FRONT RW LJ _ � APPLICANT TEI._ REAR - n � SIDE/SIDE STREET RW LJ � r� CONTRACTOR_ SIDE _ n_.___..__._,__ 3j O CDDRESS � Z�P TEL. PROPOSE�USE � � �� A � w ARCWENG/ 6' z DESIGNER NO.DWEL. � � ADDRESS UNITS STORIES BED`OOMS t � r � CITY ZIP TEL. — - � rn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION ,,,rJJJ,,, OWNER-BUIL�ER DECLARATION SFR/ADD/REM � �' O � � 1 HEREBY AfFIRM UNDEH PENPL7Y OF PERJURY THAT I AM EXEMPT FROM THE CONTRACTORS LI- G2fdJ0/CBI�IOfF . 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' _' ❑I,ASOWNEHOFTHEPROPERTI;AMEXCLU3IVELYCAMRACTINGWITHLICEN3EDCOMRACTORS � � �. TO CONSTPUCT TME PflQ1ECT(SEC,70N,BUSINESS ANO PROF[SSIONS CO�E TNE CONTRACTOfiS LI• 8II7811011 +.: _._.ADJ.ARFA____...__.,,,,.,__._____. W�� CENSEL0.WOOESNOTAPP�YTOAN04VNEROFAPROPEFTYWFIOBUILDSORIAIPFlUVESTHEREIXJ,AND ' �' V+FiOCOHTMCTSFORSUCHPHQIECTSWITHACONTRACTOR(S)LICENSEOPURSUANTTOTHECONTRAO QUANTITY DESCRIPTION FEE � iOflSLICENSELAW.). � u I AM EXEMPT UN�ER SEC. 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