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HomeMy WebLinkAbout11448 -�'�`�----- CITY OF D[Ah40IVD BAR I I i CO:vIMUNITY DEVELOPMENT DEP.4RT'v1ENT ��f ;,�-,.:�; 21660 E.Copley Drivc Suitc 790 (909)8(0-319.5 Fax l909)861-3117 PRESS �� �'""' BUILDING P�RA4ITAPPLICATiON FIRMLY � JOBSITE ���}� APPLICATION, PERMIT P/C o ADDRESS�=�W_i�2(G�� ' ; IDSSUE�� NUMBER I �� # ^° APN /L�OT _ TRACT DATE__ ONST_ GROUP p OWNER U6.�Q�1\ p ADDRESS �.f.I Ct+ i iw!;i''} L�,,-i'd:)�l'.0.;1�' ZONINC� SETBACKS z CITY�•.n>� e'��ccr'7 ZIP j--- TEL._ � FRONT ._ RW — ] O — REAR r- o APPLICANT __ ___ TEL.___ —� SIDFISIDESTREET RW _ ❑ ¢ CONTRACTOR�t�c,�� PY�C�S"I- � �1^':�_� SIDE ;� � ADDRESS� ��, �. f'i(�c,nxQ Cr20 �c n a a `� , �'IG � CITY �iV�!�:i ��t,i�� ZIP ��;TEL:�'��- PROPOSED USE ��' " o ARCHlENG/ � z DESIGNER w —' -- NO.DWEL. NO. NO. a ADDRESS � CITY ZIP TEL. UNITS_ STORIES BEDROOMS � - - cn DESCRIPTION SQ.FT. 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Z � ¢ � _�_!HAV,'_AN�Y11LL MA!N'AIN A CE9T'F:CA'F.OFCONSENTTO SELF�I.NSURE FOR WORKERS' _ ¢ Wl,iPEN50.T'ON,AS PROViDED 6V SEC�10^13i0�OF'HE LA20R CODL,FOR THE PER�ORMANCE U Q �OF THe WORK FOR Whl'CH?HIS PERPAiT IS ISSUED � � ,_�� IFAVEANOWIL•_N.A�N'AINWOWCE�S'CAMPENSATIO.•JINSI.'.iAhCE,ASR'cC�UIREDBvcECTpN � ¢ TS�OCOF?FIELA309GODE,FOHT4EP=FF07MA�' OF'HEWORKF03YlHICM�M!SP=_r7M1�15 y� �"�� � ISSUED.MVYJOR'ERS�COMPENS�IONINSURA� ECARRIE�AN�POLICYNL;419EP.A9E' � . STRUCTIO _____________„_ L !) , /' ¢ �—_1'�.'� ... � LC__ PLAN REVIEW =__— � CARFIER � . ZPOLk;Y NU•ne-a—��P_e?�_�i•.�TS ---_--.-�--- --- ELECTRIC ¢ � T.ISSEC�qNM1EEDNOTBECOMP.F.EDO�II{iPER'AITIS�-ORON=�U.tiJ�`_DDCi:AR5�5'CCjORLES51. 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