HomeMy WebLinkAbout8877• - - • NJ
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COUNTYDEPART.. 1BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN
BUILDING
ADDRESS
BUILDING
ADDRESS
LOCALITY
NEAREST
CITY Diamond Bar ZIP
CROSS ST.
NO. OF BLDGS.
SIZE OF LOT NOW ON LOT None
ASSESSOR
MAP BOOK
PAGE
PARCEL
TRACT 31152-A I BLOCK LOT NO. 43
TYPE FIRE
DISTRICT GROUP CONST. ZONE
PROCESSED BY
TEL.
OWNER PREST,F7y OF SO. CALIF.No.540-0500
STATISTICAL CLASSIFICATION
SEWER MAP
ADDRESS P.0• BOX 2200
CLASS NO. DWELL. UNITS
BK PG
CITY Newport Beach, CA. zip 92663
USE ZONE MAP
ARCHITECj OR TEL.
concernNo.979-0451
NO.
SPECIAL
EN Architectural
CONDITIONS
ADDRESS77 Brookhollow Dr., Santa Ana CA.
ROAD DEPARTMENT APPROVAL REQUIRED
YES ❑ NO ❑
TEL.
CONTRACTOR Same as Owner NO.
BLDG. SETBACK FROM
Lic. 289274
FRONT PROP. LINE OF
(STREET)
ADDRESS NO.
HIGHWAY + YARD = TOTAL SETBACK FROM
FRONT PROP. LINE
TYPEOF EXISTING
HIGHWAY WIDTH
LIC.
CLASS B-1
CITY
_
+
CONSTRUCTION LENDER
Unknown
NAME AND BRANCH
BLDG. SETBACK FROM
SIDE PROP. LINE OF
(STREET)
ADDRESS CITY
SQ. FT. NO. OF NO OF CHECK
1388 1
HIGHWAY + YARD = TOTAL SETBACK FROM
SIDE PROP. LINE
TYPE A EXISTING
HIGHWAY WIDTH
SIZE STORIES FAMILIES ONE
DESCRIPTION OF WORK Plan 97-B NEW
Single Family Dwellin ADD ❑
CORNER CUTOFF YES ❑
NO ❑
— 470 sq. ft. ALTER ❑
❑
IN OPEN SPACE YES ❑
NO ❑
pear.
USE'OFrc —42 SCE. tt. REPAIR
❑
IN COASTAL PERMIT ZONE YES ❑
NO ❑
EXISTING BLDG. DEMOL
APPLICANT Kenneth D. Stark TEL 540-0500
(PRINT)
BY )SIGNATURE) d �
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES
AND LAWS REGULATING BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE
/
WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF-�
THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COW
PENSATION INSURANCE.
UY
SIGNATURE OF
FINAL ; BY
2.
PERMITTEE
DATE
ADDRESS 4600 Camus Drive
Newport Beach, CA. No 540-0500
y
P.C. Fee $ ,o
Permit Fee
CITY
a-
Issuance Fee
7
VALUATION 7,a C.
"�
Total
r t%,
Fee
fam k, [41'.1*CWT'"IIBYAI[e]\i
c 8$1.7 122.9,-n 2
0" 76A638A CE #803A 6/76
CK. M.O. CASH
IF) 6.80
NtKMI1 VALIUAIIUN CK. M.O. CASH