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HomeMy WebLinkAbout14682 (17) �� CITY OF DIAMOND BAR � /� DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES � � � T� . 21660 E.Copley Drive Suitc 190 � (909)860-3195 Fax(909)861-3117 PRESS ''`•�'.. BUII.DING PERMIT APPLICATION . , FIRMLY � JOBSITE �- ,1 APPLICATION PERMR ��/C o ADDRESS _I��D O�I ES V� DATE �V � �_NUMBER��—11 � APN LOT �RACT ISSUE TYPE OCC DATE CONST. GROUP � OWNER L /Z�Z-_. • o ADD ESS L S ZONING SETBACKS "' CfTY / O r ZIP TEEfi��- .3� I FRONT RW ❑ � APPLICANT E►Q '►� TEl.9by-L2?-L•�!� SIDE/SIDESTREET RW ❑ r � CONTRACTO ��T � fi�L. I SIDE ❑ � ADD SS - ) O _ CITY ZIP 1 TEL O " 'lZ" y2 PROPOSED USE . � ; o ARCFUENG/ • . , � DESIGNER NO.DWEL NO. NO. ADORESS UNffS STORIES BEDROOMS � � CffY ZIP TEL ti � cn DESCFiIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLAAATION SFRIAD�IREM O p I HEREBY AfFtW LNDER OENALTY OF PERAIRY THAT 1 AA1 EXEMPT FNOM THE CONiMCTORS ll• G3�899/C91pOR ill CENSEUwFORMEWL101MNOREA50N(SEG76t1.6BU51NE55AN�DROFESSIONSCODE:ANYd7YOR (n , � COIMTYW/ACHRE0URE5APERMRTOCONS7RUCi.ALiERdPHOVEDEMOI'SH.ORREVA:RANYSTRUC W P8110/DBCk TUqE,Pitl01i 10 RS 68UANCE,KSO REOUtRE3 ME APPLMaWf FOR SUp1 PERAIIT TO FlLE�SICNED W B7ATEMEM 7FIA7 ME OR SHE IS LIGENSEO iURSUN(T TO 7NE PFpVI5�ON4OF THE CON7MCTORS LI• ss LENSE LAW(Q1AP7EX�(COMI�IENCBq WITH SEG710N 7000�OF DIYISION]OF iHE BUSINESS IW O PRO� � P�U$� - � FES9qN3COD�ORTW�THEOR5HE15E7(EAI7TTHEREFROMANDiHEBASISFOfiiMEA11EGEDE%EYP• . 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