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HomeMy WebLinkAbout10096 (5) �; � : ; . ; M�, �� -• CffY OF DIAMOND BAR � /� `r �',�� ,. COMMUNITY DEVELOPMENT DEPARTMENT ( • _,.e z��oE.c�P►�rnri��s�«�»o PRESS (909)SGO-3195 Fax(909)861-3117 �'M"� BUILDING PER�IIT APPLICATION ! � FI RM LY � JOBSITE � � � /L 'A?PUCATION �' PERMIT, C D P� D o ADDRESS DATE NUMBER R � ISSUE TYPE OCC APN LOT T CT ' DATE �'�CONST. GROUP p OWNER I7�� ���= _ . , � ADDRESS ZONING SETBACKS Z CI7Y ZI TEL,P FFONT " RW O g APPLI ANT T� REAR � � SIDEJSIDE STREET RW O CONTRACTOR ' SIDE ❑ � ADDRESS y��� PROPOSED USE � � 0 CITY IP� TE Z o ARCH/E �LrJ(/� � DESIGNER NO.DWEL NO. NO. ADDRESS UNITS' STORIES BEDflOOMS � CITY ZIP TEL N DESCRIPTION Sa.F7: FACTOR PSF ADJ.AREANALUATION � � OWNER•BI:ILDER DECLARATION SFRJADD/REM O p 1 HEREBV AFFIR/A W�ER PENALTY OF PEfiR1RY 711AT I AAA C.%EMPT FRO11 TNE CONTRAC700.411� G9f9pB/L81pOR W CEHSEUWFOqiHEFOLLOWINGRE�SON(SEG70.11.68USWESShNDPROFE55qN5CODEFNYCRYOR . 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