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HomeMy WebLinkAbout15336 (8) „, CITY OF DIAMOND BAR ( .j�� --�-- DEPARTMENT OF COMMiJNITY&DEVEL�PMENT SERVICES �y� � ai�o E.c�i�y nri��s,�c�i90 PRESS '��� BUQ.DII�G PERMIT APPLICATION FIRMLY � JOBSITE � APPLICATION PERMR I P/C o ADDRESS 7n5�”I � 2(]SS"Z SH�+NNa oJ DATE � NUMBER`�33,� � $ ISSUE-�"'J 2 7YPE OCC APN�_ LOT TRA'�fT DATE � �7 CONST. GROUP p OWNER I A{(F_YIf1YY�I� It.�� ADDRESS ZONING SETBACKS CITY ZIP TEL. FRONT RW ❑ APPitCANT ��, REAR ❑ SIDE/SIQE STREET RW ❑ CONTRACT /AJ SIDE ❑ Q ADDRESS � PROPOSED USE � CRY � n ZIP r�1� TEL � nJ 8 ARCH/ENG! � DESIGNER NO.DWEL. � NO. NO. ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. y DESCRIPTION SQ.FT. 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ISSUANCE 0 /'' SMIP pATE: � APPLICAM: ` WARNM�:FAILURETOSECUREWORKERS'COMPENSATqNCOVERACiEISUNLAWFUL,ANDeHALLBE ENERGYP/C C'1'f'Y OF D /� ,"�� � BUBJECfANEMPLOYEHTOCRIMINALPENALTiESANOCIV�LFINESUPTOONEIRIDDREDT110USAND ENERGVPERMIT $U���V n+�r — } OOlLMS(i100,00�.W AD�ITION TOTHE COSTOF COMPENSATION.DAMM3ES AS PROVI�EO fOR IN � SECTION77oeOF7MEU160RCODE.INTEHEST.AND�TTORNEY'SFEE9. RETENlTIONFEE: CONSTRUCTION LENDING AGENCY PRE-ALT FEE: � 1 HEREBV AFFIIIM UNDER PENALTYOF PE(iJUFlY THAT THERE IS ACONSTRUCTION LENDINO ACiENGY FOR iHE GERFOHIAANCE OFTHE WORK FOR WHIpIT1115 VERMIT IS ISSUW(SEC.3an,PV.C.]. � � LENOERSNAME t LEIJ�ER'S/�DRESS q7 � I CERTIFY THAT I FMYE READ THIS APPLICA7ION AND SiAlE TUR TIE ABOVE MFOtiMATpN IS GORRECL TOTAL FE ES / � �/ d I A[3HEE TO COMPLY 4V7TH ALL GTY MD COUNTV GRDINANCES MA STATE UWS REU1TMJa TO BINLDwO CONS7qUCIlON,ANO NEREBYAUTTIORIZE PEPRESENTATNES OF THIS COVNiY TO ENTEA UPON TF1E S�, ABOVE•MENTqNE07ROVERTVFOFINSPECT10NPl1HPO5ES. 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