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D�FART:4tENT OF CO'.N'.NUNITY CcrJF,VELt'1PME;YT SEItVICES
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CITY OF DIAMOND BAR �
INSPECTIOAi�iECORD
• e • a • e � � s -
SETBACH!LEffER TRACTANO LEOGER
FOOTINGS FORMS SWITCH GEAR
SLAB COMMERCIAL HOOD
UG PLUMBING T-BAR
UG ELECTRICAL INTEHCEPTER
UFERGROUN� HOT MOP/SHOWERPAN
SEWER LATERAL SEPTIClCESSPOOL
MAIN WATEfl LINE HERS REPORT RECEIVED
SEWER CLEANOUT DEMOLITION
ROOF SHEATHING J ROOF DRAINS
FLOOR SHEATHING ROUGH CDNDUIT
SHEAR WALLS EkTERIOR POOUSPA
SHEAR WALLS IMEPoOR flOUGH PLUMBING
FRAMINGNENIING flOUGH ELECTRICAL
ROUGH MECHANICAL ROUGH MECHANICkL
ROUGH ELECTRICAL W� )C( � GAS TEST
ROUGH PLUMBING PRE GUNITE
INSULATION WALL PODL PflE DECK BONDING
INSULATION CEILJNG P-TRAP
ORYWALL fENCE/GATE/ALARM
LATH(PR� FINAL POOL
LATH EXTERIOR WALLS
LATH INTERIOR WALL fODTING/STEEL
GAS TEST WALL STEEL 1�'( )2N°( �LIfT
SCRATCH COAT WALL BOND BEAM
ELECTRIC METER RELEASE WALL DHAIN/SEAL
GAS METER RELEASE WALL FINAL
SPECIAL INSPECTION RO FRAMMGPLANMN�APPROVAL
FINAL BUILOING ROUGH FIRE APPROVAL
FINAL MECHANICAL FINAL FIRE DEPAfiTMENT
FINAL ELECTRICAL FINAL PLANNING
FINAL PLUMBING FINAL ENGINEENING(PW
T.C,of OCCUPAPJCY FINAL COMMUNITY SERYICES
CERT.of OCCUPANCY FINAL HEALTH�EPT
RNAL IN�USiRIAL WASTE
COMMENTS
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�HB'�
Building&Safety I)iv'ssion
21$10 Copley Driv�
Diamond Bar,Catifarnia 91765
(909}839-7020 Fau{�l9)861-3117
Job Address �Qt��.� �G�Nv��� �`�i
Dear Property Owner
An apphcatron for a buildmg gerrrut has been subnukted yn your name statrng yourself as the
bu�ider of the property rmprovements spec�hed
For your protechon,yott should be aware that as"owner-bu�lder" you are the respt3nsible pazty of
record on such a pernut Bu�ldmg pertruts are nc�t requued ta be signed by praperty owners unless they are
personally performiitg theu cswn work If your work is beutg performed by sameone other than youzself,
you may protect yourself from gassible habiliky�f khat person appl�es for the proper permxk m tus or her
nan�e
Contractors are requued by law to be hcensed and bonded by the State of Catiforrua and ta have a
busin�ss hcense fram the City of Caunty They are alsa requued by Iaw to put theu i�cense number an all
permits ft�r wtuch they apply
If you employ ar otherwise engage any persons other than yaur xmmed�ate family,and the work
{includang matenals and o#her cosks) �s$2Q4 00 or more for the enhre praaect,and such persons are not
hcensed as cantractors or subcon#rartors, then yoa utay be an employer
If you are an eznployer,you must register wsth the state and federal government as an ernployer and
yau are sul�ect to several abligahons utclud�ng skate and federal rncome tax withholdu�g,federal sarial
secixnty taxes,workers compensahon u�surance,c3ssabilzty msurance casts, and unempIoyment
cornpensahon contribuhons.
There may be fin�ncial nsks for you if qou do nak carry out these obligatrons,and these nsks are
especially senaus with respect to workers compensahon uisurance
For more specific utformat�on about your abhgahons under the federaI]aw,contact the Intemal
Revxew�ervice (and�f you wrsh,the U S SmalI Busmess Admtmstrahon) For mare specific uzformahon
about your obl�gatrons under 8tate law,contact the I7eparkmenk of Benefxk-Paysnents and the Division of
Industnal Acadents
If the structure is intended for sale,the praperty owners who are not hcenseci contractars are
allowed to perform theu work personally or through therr awn employees,without a hcensed contractor or
subcontrackox,only under lusuted conditrons
A frequent practrce of unlzcensed persons profess�ng to be contrackors�s to secure an"awner-
bu�ider" budding permit, errt�neonsly implymg that the property awner xs providing}us or her awn labor
and materials personally Buildmg pernvts are nc�t required ta be signed by the property owners uniess
they are performu�g their own work personally
Tnforrnahon about hcensed eontractors rnay be obtained by cantachng the Cantractors State Lacense
Boazd at 4821 Bus�ness Park L7rive,Sacramento, CA 4582?,www cslb ca �t�v or at(SDO)321-CSLH{2?52}
PIease complete and retvm khe enctoseti"Qwner-Btulder" verifzc�hon form so that we can confum
that you are aware of these matters The bu�ldutg perrruk will nok be issaed unhl the venhcahan�s
retttmed
,
,
�
• ., �?�
,
�
Building E�x SafeEy Divisian
21825 Copley Drive
Diamond Bar, California 91765
{9oq} ss�-7ozo F��9og)ssl-sii�
Attenhon Property Owner
An"C?cvner-Bwider"builci�ng pez�ut has been apphed for ui your name and bearuig your signature
Please complete and return tFus uiformatran at yaur earl�est opportuiuty to avoid unnecessary delay u7
processu5g and vssuulg your builduYg peruuk No bix�lci�ng pernvt will be�ued untrl this ver�ftcahan ts
recerved by as.
2 I personally p}�y��provide #he ma�or labor and matenais far canstruchon of khe praposed praperty
innprovementt(ye or na}
2 I av /have not) signed an appl�cahon for a buildutg peruut€Qr the proposed work.
3 I have contracted with the Eollowuig person (hrm) ta provide the groposed constructron
Name Addre�s Crty
Phone Contractars Luense No
4. I plan to provide parhans of the work,but I have hired the following person ko coordmake,
snpervise and prov�de the ma�or work
IVame Address C.�ky
Phone Contractors Lacense No
5 I will pravide sorne oE the work but I have contracted {hued)the follawing persons to provide the
work ulciicated�
Name Address Phone Type of Work
Signed � ,�,
—��,��e��—
L?ate , � � �} 1 1�