HomeMy WebLinkAbout8869APPLICATIONDEPARTMENT • .- COUNTY
DIVISIONBUILDING PERMIT BUILDING AND SAFETY
FOR APPLICANT TO FILL IN
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 IBLOCK I LOT NO. 44
DISTRICT GROUP CONST. ZONE PROCESSED BY
Ty E FIRE E
L.
OWNER PRESLEY OF SO. CALIF. No 540-0500
STATISTICAL CLASSIFICATION
SEWER MAP
ADDRESS P.O• BOX 2200
CLASS NO.
DWELL. UNITS BK PG
CITY Newport Beach, CA. ZIP 92663
USE ZONE MAP
"
chitectural ConcernNo979-0451
NO.AlC
SPECIAL
ENGIiN E
CONDITIONS
ADDRESS77 BrookholloW Dr. , Santa Ana,CA.
ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑
TEL.
CONTRACTOR Same as Owner NO.
BLDG. SETBACK FROM
(STREETI
LIC.
FRONT PROP. LINE OF
ADDRESS No.289274
HIGHWAY + YARD =
TOTAL SETBACK FROM TYPE OF EXISTING
LIC.
FRONT PROP. LINE HIGHWAY WIDTH
CITY CLASS B-1
CONSTRUCTION LENDER
Unknown
+
NAME AND BRANCH
BLDG, SETBACK FROM
SIDE PROP, LINE OF
(STREET)
ADDRESS CITY
TOTAL SETBACK FROM TYPEOF EXISTING
SQ.FT.1518 NO. OF 1 NO, OF 1 CHECK
HIGHWAY + YARD =
SIDE PROP. LINE HIGHWAY WIDTH
SIZE STORIES FAMILIES ONE
DESCRIPTION OF WORK Plan 17—A NEW
+
ADD ❑
Sin le Family Dwelling
CORNER CUTOFF
YES ❑ NO ❑
Gar. - 461 sq.ALTER ❑'. ft.
❑
IN OPEN SPACE
YES ❑ NO ❑
REPAIR
USE OF
❑
IN COASTAL PERMIT ZONE
YES ❑ NO ❑
EXISTING BLDG. EMOL
APPLICANT TEL
(PRINT)Kenneth D Stark No. 540-0500
p
1
r
j `IV
BY (SIGNATURE)
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
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�4-•-�
WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF
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THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM-
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PENSATION INSURANCE.
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SIGNATURE OF (>
FINAL
BY
PERMITTEE
DATE
����
ADDRESS cc- pus Drive
Xe
5
New Beach, CA. TEL
540-050
P.C. Fee $
Permit Fee
CITY
-'
Issuance Fee
VALUATION $ �
� � 3 g�1
a
�f
Total Fee
r'
PLAN CHECK VALIDATION
LA Co 122977 23
CK. M.O. CASH
16 8.E0
PERMIT VALIDATION CK. M.O. CASH
'P)S 76A638A CE #803A 6/76