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HomeMy WebLinkAbout15412 (32) 4� � ._ // i . .. �\ CITY OF DIAMOND BAR � � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES , �,�� E 21660 E.Copley Drive Suite 190 (909)860-3195 Fax(909)861-3117 � PRESS ����� BUQ.DING PERMIT APPLICATION FIRMLY QJOBSfTE ,J� /I�A�I/�i p/' DATE CATION �O (�� NUMB R L'��I' N �� �/ 4 ADORESS� IC, � !�'�i $ ISSUE TYPE OCC APN OT TRA T DATE CONST. GROUP p OWNER �` p ADDR SS � ZONING SETBACKS • ' ' . � CITY � ZIP /•'jl�IkC�TE��•1��-�� FRONT RW ❑ APPLICANT TEL REAR ❑ � SIDFJSIDE STREEf RW ❑ CONTRACTOR SIDE ❑ � ADDRESS PROPOSED USE - � ►' ♦ CITY ZIP TEL. � ARCHIENG/ DESIGNER N0.OWEL. NO. NO. ADDRESS UNITS STORIES BEDROOMS � CfTY ZIP TEL. N DESCRIPTION SO.FT. 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CONSTRUCTION'����. ✓ � PLAN REVIEW � GARRIER � ptticrM;ueEn ELECTRIC 2 �O 0 (IFt55[CIpNF[�N7TBE071�itFTmCFhLFEfAifBia(iONEM.►�p7CJ00UA�t5Rta�ORLE55y PLUM6ING � ✓� Z 1 CERTIiYTHAT W h1f PEPFOA��NCE OF T1E M/ONK FOR K'NI(]I M6 PERMIT L:ISSIIED,I MECHANICAL '■' (•} S�Wl NOT EMPLOV/WY PERSON N M!V WNNCR SO I15 TO BECp.�E SUBJECT TO TME N YqR1lE0.5'COA�FENSATIONUW90FCALIFORNI/�IN'JACREETHATiISt�DULDB[CD1AE INSPECTIONFEE S SUBlECTTOTNEMbqRERS'C0IAPENS�TIONYHOVi5�ON40F5ECT10N7�DOOFiT+EUBOi1 �SSUANCE � COOE 1 SMAl1 fOffTHN9T/COUPLY WITX 1F105E PROVI5�ON5. � SMIP � � p DATE: APPLICANT: . � WMN:NQFALURETOSECUflEMORKERS'CO/.�PENSATpNCAVERAGEISUNLAWFUL,ANDSH�LLBE ENERGYP/C [� �y SVOJECTANEMPLOYERTOCRIMWAIPEWILTIESANOCN4FNESUPTOONEMUNDREDTTIOUSAND ENERGYPERMIT � •� � OOl1M5(f100.000).M ADD�TION TO THE COST OF COMPENSIRqN,DNAAGES�5 PHOVIDED FOR IN BU � SECTION77oeOFiHEU1BORCODE.M7ER[ST,ANDATTORNEY5FEE5. RETENT�ONFEE: OCONSTRUCTION LENDINO AGENCY PRE�-AI■�T�E:��� � 1 M[REBYAFFIRM UNDER PENALTY OF PERNRY THAT THERE IS A CONSTRUCT1oN LENDRw I1cENC`I ✓'i� �Z- FOR THE iERFORMANCE OF TNE WORK FOR N711CM THIS VENNIT IS ISSUED�SEG JOY7,GV.G). W � LEUDER'SNu.�E C IENDER'SADORE53 � IC£RTiFYTHATIMAVEPEA0TM�5APPLIGTIONANOS7ATETHATTIEABOVEWFOiiMAT10NI5CORRECT. TOTAL FEES ' , W IAGREElOCOA�iL�W�TNHLCT'ANDCOUNTYORDINANCESMlJSTATEUWSPEUTNGTOBUlDINO � CONSTRt1CT10N.AN�MEREBYAUT/qRREREPRESENTATNE50FTN15CDUNT'lTOENTERUPONTNf �- JA\ ��_JM�JV, �M/j � ABOYE�M HTIONEDVRO�ERfYFORPlSP rar+wnPoscs. COMMENTS,_ `� "� r �O _ __` �� � J � � 7ERMi E N E I1In - Q N _ ��'f� �/ ri/ � � N s, „�t OAiE � RECPT.NO. � PAID BY � _VALIDATION WHITE—Depertment Copy.YELLOW—Finence Copy,PINK--Assessa Copy.GOLDENROD—File Copy.GR[EN—ApplicanCs Copy CITY OF DIAfU�OND BAR .. . - . . If��PE�TIOt� FECORi� . . ;i!��-�'���''i'l'')►'4 � ���',��,F� '.li`�- :;1�d:-r.��1r1: ''�!! 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