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HomeMy WebLinkAbout13683 �,� CITYOFDIAMONDBAR ' Eh,Pf�Ep DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21660 E.Copley Drive Suite 190 M • (909)860-3195Faa(909)861-3117 JUC 31 �001 PRESS ���'� BUII.DING PERMIT APPLICATION FlRMLY � JOBSITE � 3 �� �/�� �-/� APPUCATIO PERMIT /_ A/C o ADDRES �� ��� DATE �n'�_�NUMBER �v $ ISSUE TYPE OCC APN � LOT TRAC DATE CONST. GROUP � OWNER�-GY�i'N f/O�/NC� L�/1/Bt�1 ADDRESS ZONING SEfBACKS � CITY ZIP TEL. R�R RW � APPLICANT TEL SIOE/SIDESTREEf RW ❑ � CONTRACTOR O�/� SIDE p � ADDRESS PROPOSED USE � � , CfTY ZIP TEL � ARCH/ENG/ , DESIGNER NO.DWEL NO. O. ADDRESS UNITS STORIES BEDROOMS � CITY ZIP TEL. � DESCRIPTION S�.FT. 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W ENERGYPlC U� I i ry, ,��1 � WARNINO:FAM1URE TO SECURE WOPKERS'COIAPENS�TION COVEMGE IS UNUWFU�AND SH/LL18E r SU[iIECTAt1EMPLOYERTOqiIMiNALPENALTES/�NOGVILfWESUPTOONEFNNOREDT/qU51W0 ENERGYPERMIT LI 1��(lr r�-. , r� OOl1ARS(f tOD.000),N ADORION TO THE CAST OF GOMPErySATIDN,DAMAOES AS VROVIDEO FOR IN _. - � 8ECTION770lOFi/1EU00FCWE,WTEREST,ANOATTORNEYSFEES. RETEMIONFEE: �JTlT� ' J •, ' a CONSTRUCTION LENDINGAGENCY pRE-ALT FEE: � 1 MEREBY�ii1fUA UHOER PENALTY OF iEfLURY iMA7TNENE IS ACOHSTRUCTION LENONfl AGENCY Z iOH TNE VERFORAIANCE OF 7HE WORK FOR WMICH MIS VE WAIT IS ISSUEO(SEC.70Y7,CfV.C.). W ,_,Z IENDER'SrIM�E ! � LENDER'SADDRESS � ICER7IFYTHA7IHMEREADTHIS/�VLIGTIONANOSTATETHATTIEABOVENFO(wATqNISCORRECT. TOTAL FEES t W IA(iREETOCOM7LYN7TlIILLICITYI�NOCOUNTYORDIWWLE5�ND5TATEUWSRELATIN6TOBUM1DINO . �' CONSTRUCTION,AND HEREBYAUTHORIZE RE7RESENTAlIVES OF 7HI5 COUNtt TO ENTER UPON iHE � � ABOVE•MEMIOpEDPROGERiYFORINSPECT10NVURPO5E5. 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