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�---� CITY OF DIAMOND BAR { I I COMMUNII'Y llEVEL01'MENT DEPARTMr�T i ' �`'�Q '►__.W . 21((i0 H.Coplcy Drivc Suite 190 PRESo� (909)8fi0-3195 Fax(909)8C1-3117 li UILDING PBRMII'AI'PLICATION FI R M LY � JOBSITE / .y �.. APPLICATION 'J� .r 1�,.-. ERMIT P/C o ADDRESS_._.�=1��.=5���.V,RJ.f/�'C��.E.tI /1 d�/.) L, �� �Z. ---- DATE_��_r_�_ NUMBER .�----- - N--- __— � --- ISSUE TYPE OCC APN___.__._,___�iLCJT_____.,__ TRACT . ,___ _______ DATE CONST. GROUP p OWNER --�--IS Cl1_�:--��� -- - ---------- --- --...--�--- - LL "___ _''_"' ADDRESS�' _.�-✓%'r�/= t' L' L)✓?J✓' / �/ ZONING SETBACKS z CITY�`/!/Z'R/'TdS _ ZIP.Qd��i61�TE �Z_�G�"' I� FRONT RW--,.----- C7---.------.. ..-- � APPLICANT --------- TEL.-------------- REAR ------------ �-� ---... � SIDE/SIDE STREET__, RW_____._ •!-1__.___... __ Z ---- --�- a CONTRACTOR__l✓�YrA� 1� .- � � SIDE _ ,____ ' _ � A�DRESS���'' /G �d`' /�/✓!�.._ � � � CITY�L/f.C.G/<sL ZIP7:�TELr/�. " �tS PROPOSED USE____ � ♦ � oARCH/ENG/ ----- ---�._---------- .� z DESIGNER Z___['"��✓'/� .�ir�'__ I�/1_'��. .._ NO.DWEL. NO. NO. d AD�RESS��f t:.c_-X-�E��-/ ✓�- � - � --- --- � � CITY�'�_�',�j .��%� ZIP� 7� TEL / .],S"� UNITS _____.,_.._____ STORIES BEDROOMS � � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION Q OWN[R-BI;ILDER DECLARATION SFR/ADD/REM � O -- � p I HEflEBY�FFIRM UNDFH VENALTY O.'PFR,IUf1Y I HAT I AM EXiN,f'1'fROM TH[CUNTRACTORS LI- Gaf�QO/CafaOfl # W CENSf:IAWFOflTMEFOLLOWINGREASON�5EC.7031.6[3USINt55ANC1PR()fE5510Y5COD[:ANYGITVDH (n U C(:'JNfYWHICI{HEOUIRESAPI�riMll'TOCONSiHUCT,AlTC17,IMPROVC,�FMOLISH,ORREPAiRANYSTRl1C- uJ py�10/DBCk � Z TUHE,PflIOR TO 1T9 ISSUANCE,AL50 HEOUIHES THF APVLICANf f ON SUC!1 I'ERMIT TO FILF.A tiIGNEl1 � STATtMC-NT THA7 H!:OR SHE IS LICENSED PURSUANT TO THE PflOVI510N5 OF THE GONTRAGTORS LI� W � Cf:NSE LAW(CHAPTER R(COMMENCINL'VlITI I SECTIO�lOOC)UF UIVISIOY 3 OF I NE dUSINESS FND Pfl�- � POO�Sp2 FESSI�YSCODF)DRTHATHEORSHEISEXEMPTTHEHEFHO.MANUffILUA51.5FORTHEALLEGEUEXLMV- � -'--'— i � TION.ANYVI(riATIOfvOfSCCiiONio31513YANYAPPLICANTFORAPEFlM1T5UdJEGTSiHEA�PLICANTTO z Re-Roof _ . 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