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HomeMy WebLinkAbout10542 . i — CITY OF DIAMOND BAR � �^ COMMUNITY DEVELOPMENC DEPARTMENT �� 21660 H Copley Drive Suite 190 (909)860-3195 Fax(909)861•3117 PRESS �''"'� BUILDINGPERMITAP TION FIRMLY o D RESS �� "-� ~ DATECATION/I•-2( •�� PERMIT � /C � ( NUMBER x � APN LOT �TR T ISSUE 7yPE pCC DATE CONST. GROUP p OWNER � � ADD � / 20NING SEBACKS , • CI ZIP �J/ TEL. - FROhlT pyy � � APPLICANT TEL� - - � SIDE/SIDE STREET qµ/ p � CONTRACTp /N f SIOE p ADD �P . • � C ZIP TEL ' - PROPOSED USE o ARCH/ENG! � DESIGNER NO.DWEL NO. NO. n. ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS � N DESCRIPTION S0.Fi: FACTOR PSF ADJ.AREANALUATION p� OWNER-BI:IL�ER OECLARATION SFR/ADD/REM O p 1 NEREBY AFFlRM UNDER FEN�LTY OF VEMIRY THAT 1 MI EXEMPT FAOM iHE COMMCTORS LI� G�lB�dCotpOR W CENSEUWFORTHEFqlOWHUNEASON(SEG70.t1.6BU51NES5ANOPROFE551Q45000E:ANYdTYOR (n � V COUMYWHICHREOURESAVERYITTOCDNSTRUCi.ALTEf�MPROVE.DEMOLISH,ORREPMIRANY4TpUC. 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PRE•ALT FEE: � INEREBYAFFUiAIUNDERPENAITYOFOEIWRYTMATTMEREISACONSTNUCTIONLENOPlOAGENCY ' fOR TNE PER W RAIANCE OF T/1E WORK FOR WMICH iN15 PERW T IS ISSUED(SEG�oY7,CN.G� � � LENOER'S NAME C IENDER'SADDRESS w ICEH7IFYTHAT114WEREAOT115MPLIWTqNANDSTATET1ATiHEABOYEWFORNATqNISCOflRECL TOTAL FEES f � IAOREETOCOMPL�WITMALLCITTANDLOUNTYOROWIWCESAImSTATEUNSPEUTNOi06UILD1lW � CONSiRUCiION,MIDNEREBYAUT1q1i1ZEREPRESENTATNESOFTIYSCOUNTYTOEMERUPONTHE ABOVE� ED PROVEHTY FOR WSPECTION VURPOSES. ^ COMMENTS � ,c1,R/ � .. ,��i� m PERwTTEE ��ZI Q N � (� PE E � DATE � - ' - � RECPT.NO. PAIO 8Y VALIDATIO � WHITE-Op�rtment Capy.YELLOW-Fnance Copy,PINK-Asa�uor Copy,GOLDENROD-Flk Copy,GREEN-AppIM.aM's Copy � �y. . .V�.��....� wr ♦ vi. wi ..b. '.�.✓�K,' . .0 Y�+ Y �t... ..�N�:.7.?Y�" h1'7�' M" �}.T'i.C.w�v�..a��� I" 4 ' Hr N�R f•;�'�' i . ...y,. . . .. .. , �C�� , ..-w.a� �. . . . , i<'��r :':.. .}.':� ..,: . �.�. 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