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HomeMy WebLinkAbout14415 • CITY OF DIAMOND BAR %r�"'� , w ----- "" DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES ` •'� /% , ' 21660 E.Copley Drive Suite 190 �`—'�✓ pRESS • �,w (909)860-3195 Fax(909)861-3117 '��' BUILDING PERMIT APPLICATION FIRMLY y JOBSITE �2/'1��� EI(�� �12 /�, APPLICATION�i "�,. i .{,., : PERMIT I L�- � P/C o ADDRESS��- _ ���> >T� �"" DATE 1 ` NUMBER #__ � ISSUE TYPE OCC APN LOT TRAC DATE_ CONST. GROUP _ � p OWNER � _ � ADDRESS� U'��' "P1`� G � G�� ZONING SETBACKS W � ZIP � TEL. U"' FRONT RW ❑___ ; g CITY��' ---- APPLICANT 7EL. `7 REAR ❑_____ � SIDEJSIDE STREET RW___ fl � CONTRACTOR � / SIDE __ L]_.._ � ADDRESS "C L � •� _ � CITY �- ` � � ZIP EL. ' PROPQSED USE o ARCH/ENG/ ---- -- z DESIGNER ADDRESS ` NO.DWEL. NO. NO. UNI7S_____._._ STORIES BEDROOMS � CITY __ ZIP TEL. �.. � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREA/VALUATION 1 Q OWNER-BUILDERDECLARATION SFFUADD/REM O - 0 I HEREBV AFFIAAI UtiD[R PENAI.TY OF PF.RJUFY THAT I AM EXEMPT�ROM THE CONTRqCTORS tl- � Garage/Carpor {8,I CENSEIAWFOR1FiEFOILOWINGREp50N(SEC.70J1.S�USINF.SSRNOPftOFF.SSION5CO0E:ANYCITYOR C�J CIXINTYWHICHREOt11RESAPEFMITTOCONSTRUCT,ALTEF,iMFFOVE,DEMOLISH,ORREPAIFANVSTRIJP W Pdt10/�BCI( ��� NRE,PRIOR TO ITS ISSUANCE,ALSO RfOUIPES THE APPI.ICANT FOR SUClf PEHMIT TO FILF.A SIGNEO W � STPTEMENT THAT NE OR SNE�5 I�CENSE()PUHSUANi TO THE YROVISIONS OF TI1E GON7HAC�ORS LI- CENSE LAW(CHAPTEP 9(CAMMENCIN6 V11TH SECTION 7Wa)O�i11V15!ON 30F THE BUSINES5 ANO PRO- � PoOVSpa FESSIONSCODE)ORTHATHEORSHEISEXEMPi7HEHEFROM/UDTHEE7ASISI�ORTHF:AILCGEUEXFMP- (� � TKKJ.ANVVIOLATIIXJOFSECTIOIJ7c31.58VAHYAP?LICANTFORAPEflMITSU&'ECTSTHEAPPLICANTTO Z Re-Roof r ACML PFNALN OF NOT MORE TtIAN FIVE HUNDRED DOLLARS(f5oo)J: � ❑I,ASOWNEROFTHEPRDPERTY,ORMYEA{P�OYEFSWITHWAGESASTHE�ASOLECOAIPFNSATION, Q COfflflt9fCidl ' .. 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