HomeMy WebLinkAbout10-1193a
CITY OF DIAMON
DEPARTMENT OFCOMMUNITY&DEVELOPMENT SERVICES EXPIRED
21825 Copley Drive, Diamond Bar, CA 91765
(909) 839-7020 Fax (909) 861.3117 Budding Inspection Hotline (909) 839.7027
BUILDING PERMIT APPLICATION
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OWNER -BUILDER DECLARATION
I HEREBY AFFIRM ORDER PENALTY OF PERARY THAT i AM EXEMPT FORM THE CONTRACTORS U
CENSEUW FORTHEtWLWINO REASM (SEC 7015OUNIESSNfi PROFESSIONS COME ARE GTYOR
Q'UNIYWHICH REOWRESAPEFdE1TTO CONSTRICT ALTER MPREA E OEMOUSH OR RECOMMIT STRUG
MEESTATEMENT THATlt1E OR WE ISWILAINCE AOD LCOEFDEDUPUERWI.NTTUT THE FARM MOW OF TTHE CONTRACTWGU
DEMISElAW ICHMTERB (�MENCINO WITH SECTION ID9Dt OF WARREN D OF THE SJNNIHER PRO
'NCR eCORE)ORT T HE OR WE A EXEMPT THEREFROM .0 THE SARS FOR THE AIMED EXEMP
TOM ART VIOUTION OF METEOR OW 6 BYANV ANNUITANT AREA PERMIT MAJECTSTHE APPLICMAT TO
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HESBAHD PROFESSIONS GSOE THE OOMRACfORS UCENRE UW ONES HOT REPLY TO AN OWNER OF
PlIOPERIYWiD BUILDS OR IMPARRES THEHEON AND MMD ROSE WCH WORK HIMSELF OR HERSELFOR
m MORHEROWNEMPLOYEES PFIJNDEDTHATSUCHWP 5MENOTNiTEMEOM
OF}TRi@HMSMEIF HOWEVER ME811gDNODRIYPROVE#YENTAq SOICTMEHIM yEYEM OFCOIWRE
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DATE OWNER
LICENSED CONTRACTORS DECLARATION
HNEARST AFFIRM UNDER PRULTY OF PERURH TMTIAM=V,SW UNOER PROYI6KYi5ff CHAFER
F {O:MMGHCNO WIfi15ECTION RSM OF DIVISION AOPTHE BUSIkESSMU PWFESS ICHSCOOE AND
TAY LICENSE ISNRILL OMEARDEFFECT /
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WORKERS COMPENSATION DECLARATION
I MkRE FRM UNDER PERIALWOF PEMURYONEOF THE TO4LOWINGDECLARAYU115
I UPWARD Wl MXMAMACERITFICATE OF Gyi TMSELF POWER FOR WORKERS
PFNSATKW AS PROVIDED 9Y5ECi8J11 OTDD OFTHEJB�OCDE FORiHf PERWPMANCE
THE WO.
FOH W.B R THIS PERMIT IS KSUED
_I HASSAN) wai"WAN WORKERS COMPENSATION INSUFFER E AS REQUIRED BY SECTION
TIMI OF THE AMER CODE FOR THE PERFORMANCE DETER WpK HTR WHICH THE PERMIT IS
ISSUED MY WORKERS EOiWEN9ATbN A MAPAE CARRIER AND ROZY4WBER ARE
GRPoEA
Pq.tCY WAiBER ____
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I CERTIFY THAT NTHE PERF011MMCE OF THE THEM FOR WHICH THIS PERMIT IS PEACE i
RENAL ACT EMPLOY MET PERSON IN ANY MARKET SO AS M BEGONE 56WMI TO THE
WOAKERECOMPENSATAy1.AWS OF CAUM W A. ANO AGREE THAT IFI WOIAO BECOME
SUBJECT TO THE
IN
SUBJECT PROVISIONS OF SECTION 3) OF THE LAb3R
CODE ISHA'y FWirMHTHEOMPIYWITH'HOSEPAXPMWM4
DATE _.........._ APPLICANT
WARNED FAlLU0.E T9bECUAE WORKEPS COMPEHSA116NCOVERt6E'.SUNLAWFUL AND SHMLSE
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CONSTRUCTION LENDING AGENCY
IHEREHYAFFIFMUNDER PENXITYOF PERIURYTHAT THEACISACOXSTPAKTHNLENDNO AGENCY
FORTFE PEAFOPMANCE OF THE WORT WR WHCH TNIH PERMIT B 1560MISEC APR CIV C I
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QUANTITY DESCRIPTION FEE
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PLUMBING
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ENERGY PTC
ENERGY PERMIT
CY FE A .00
PRgE ALT FEE
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TOTAL FEES
COMMENTS
RECPT NO _ PAID BY _ VAUDATiON
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CITY OF DIAMOND BAR
INSPECTION RECORD
INSPECTION D ATE :INS
SETBACKI LETTER
PECTOR-, j"'iNSPECTIO N DATE INSPECTOR 1:
TRACT AND LEDGER
FOOTINGS FORMS
SWITCH GEAR
SLAB
COMMERCIAL HOOD
UG PLUMB_
T -BAR
UG ELECTRICAL
!INTERCEPTER
LIFER GROUND
! ! HOT MOPISHOWERPAN
SEWER LATERAL
SEPTIC/CESSPOOL
MAIN WATER UNE
HERS REPORT RECEIVED
SEWER CLEANOUT
DEMOLITION
ROOF SHEATHING
ROOF DRAINS
FLOOR SHEATHING
ROUGH CONDUIT
SHEAR WALLS EXTERIOR
POOUSPA
SHEAR WALLS INTERIOR
ROUGH PLUMBING_
FRAWNGIVENTING
ROUGH ELECTRICAL
ROUGH MECHANICALROUGH
MECHANICAL
jROUGH ELECTRICAL W( ) C ( )...................................'.,
GAS TEST
ROUGH PLUMBING
',. PRE GUNITE
INSULATION WALL
POOL PRE OECK BONGING
''...... INSULATION CEILING'...
'... P -TRAP
DRYWALL
i FENCE t GATE! ALARM
LATH (PRE)
FINAL POOL
LATH EXTERIOR
WALLS
LATH INTERIOR
WALL FOOTING/STEEL
GAS TEST
WALL STEEL lm( ) 2w( ) LIFT
,SCRATCH COAT
WALL BOND BEAM
ELECTRIC METER RELEASE
WALL DRAINISEAL
GAS METER RELEASE
WALL FINAL
'.. SPECIAL INSPECTION
RO FRAMINGILWMNGAPPROVAL
FINAL BUILDING
ROUGH FIREAPPROVAL
FINAL MECHANICAL
FINAL FIRE DEPARTMENT
FINAL ELECTRICAL
FINAL PLANNING
FINAL PLUMBING
FINAL ENGINEERING/ PW
TC of OCCUPANCY
FINAL COMMUNITY SERVICES
CERT Of OCCUPANCY
FINAL HEALTH DEPT
FINAL INDUSTRIAL WASTE
COMMENTS