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HomeMy WebLinkAbout14142 �� C1TY OP DIAMOND BAR �X� ��� � DEPARTMENT OF COMMUNITY&DEVELCRMENT SERVICES 21660 G.Copley Drive Suite l90 � (909)860-3195 Fax(909)861-3117 PRESS � �e�'� BUQ.DING PERMTT APPLICA'Y ION FIRMLY y JOBSITE ��y �" q � � � APPLICATION� �� '��f�"� , PERMIT ��/I�„1;' P/C o ADDRESS I [ ���y,�i V , DATE � I_NUMBER � ` �'- N � ISSUE ` TYPE OCC APN_ LOT TRACT� DATE� CONST. GROUP p OWNER _ o ADDRESS ') , . �� ZONING SETBACKS z CITY � • ZIP�ZSTEL.�� FRONT —_ RW ❑-- g APPLICANT - TEL.. REAR _ rl__ SIDE/SIDE STREET RW ` ❑ CONTRACTOR,. G� � �i`�� � i '"a SIDE _ _. ❑_ � ADDRESS �/�-(L j�+'�i�?t�� r � _ � CITY ��,�• ZIP_C�TEL.�C' ' PROPOSED USE „_ o ARCWENG/ __ � --- � DESIGNER__ NO.DWEL. NO. NO. d ADDR�SS — UNITS STORIES BEDROOMS �' C{TY ZIP_ TEL. __ — � - DESCRIPTION SC1.FT. FACTOR PSF ADJ.AREAJVALUATION � OWNER-BUILDER DECIARATION SFR/ADD/REM O [] 1 HEREBY AFFIPoA UNDER PENALTY OF PERIURY THAT I AM EX�MPT FROM THE CCNTRACTOAS LI- Ge�dJ@/CB�pOfS W CEkSEIAWFOR7h1EFOLLOWINGqEA50N�SEC'lo315BU51NES5AN�PROFESSIONSCODE•ANYCITYOfl (n U. 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' ' , Z •�,.. •r�. � •;• • � C.���" , .., . COMMENTS--_ - --- �--�- --- n � 1 � � +i} � ---- --- - ��J�. a PERMITTEEN FiINi) � --- / �j���_�{�1�'__-�!?�i�����' _'_' - � `�� -%� --��----�`� ----- -- --- --- . ----- � SIONATUREOFF�HHMIREE �A � RECPT.NO.__ PAIDBY _____ VALIDATION_________� � � '___ WHI1'E-Depaflmant Copy,YEU_OW-Finance Copy,PINK-Assessor Copy,GOLDENROD-Fle Copy,GREEN-ApplicanPs Copy i , t � 4 ' � " 1 ���, - , i� 3 a ' � � � s � i ; �