HomeMy WebLinkAbout1009 Paloma DriveCOD Z O
CERTIFICATE OF DEMOLITION
�Z
ARCAniA
PLEASE COMPLETE THE FOLLOWING INFORMATION (REQUIRED):
PROJECT ADDRESS
DATE STRUCTURE BUILT ZONE CLASSIFICATION i
APPLICANT(S) NAME SQV1 y G1.0 �,n�i er 11,�-i I m� �� -:T-Mc- -
MAILING ADDRESS ass �t CIS �� ZT ZOO
CITY /°�V C/`G�\� STATE CA ZIP 91004
E-MAIL ADDRESS 50.v�k/a-�O GAS 0 A0 L •C&M
TELEPHONE NO. (6;af'J146 - 90q -h
PROPERTY OWNER(S) NAME fiA'
MAILINGADDRESS t01-+ P,11-omc,, �r
CITY AVrMJ 1 % STATE nt� ZIP �O
E-MAIL ADDRESS N
TELEPHONENO. Y.Z°Ir ;?L-? 0111A
THE APPLICANT AND PROPERTY OWNER HEREBY DECLARE UNDER PENALTY OF PERJURY THAT ALL
THE INFORMATION SUBMITTED FOR THIS APPLIC TION IS TR�ANDORRECT.
;?
APPLICANT'S SIGNATURE DATE
7
Z&2—
PROPERTY OWNER'S SIGNATURE DATE
ACTION TAKEN
�l CONDITIONALLY APPROVED
1. The subject structure(s) shall notbe dre� lished until the City's Building Services Division has
issued a building permit for a new S 1on the property.
❑ DENIED
BY: DATE:. O ✓ I EXPIRATION:
THERE IS ATEN (10) CALENDAR DAY APPEAL PERIOD FOR THIS APPLICATION. APPEALS MUST BE SUBMITTED IN WRITING TO THE
COMMUNITY DEVELOPMENT DIVISION WITH A $600.00 APPEAL FEE BY 'JU P.M. ON
DATE FILED -71Z-2-(" RECEIPT NO. 5 O 0 77 PAID -4 1 RECEIVED BY L
7 T
COD -1- 2/17
qa