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�` CITY OF DIAMOND BAR
DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES
21825 Copley Drive,Diamond Bar,CA 91765 PRESS
'� (909)839-7020 Fax(909)861-3ll7 Building Inspection Hotline(909)839-7027
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� 1 MEREBY AFFlRM UNDER PENALTV OF PERIURY ONE OF THE FOLIOWING 9EClARHTIONS:
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� _1 HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF-INSURE FOR V/ORKERS' _
COMPENSATION,AS PROVIDED BV SECTION 3100 OF THE LABOR CODE.FOR THE PERFORMANCE W
OF THE WORK FOR WHICH THIS PERMIT IS ISSUE�. �
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_I HAVE AND WILL MAINTAIN WORNERS'CAMPENSATION INSURANCE,AS REQIJIPED BV SECTION
QQ 3700 OF THE UBOR CODE,FOR THE PERFOFMANCE OF THE WORK FOR WHICH THIS PERMIT IS
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� -.WORKERS'COMPENSATION LAWS OF CALIFORNI0.AND AGREE THAT IF I SHOULO BECOME INSPECTION FEE
SUBJECT TO THE WOHKERS'CONPENSATION PROVISIONS OF SECTION 3700 OF THE UBOR �S,�
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pOLLAFiS(5700,000),IN IDDITION 70 7HE CO57 OF COMPENSATION,DAAIAOES AS PROVIDED FOR IN I�.�
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� I CERTIFV THAT I HAVE FEAD THIS APPUCATION AND STATE THAY hIE ABOVE INFORMATION IS CqRRECT. TOTA� F E ES ��^�•�
w I AOREE TO CAMPLV WITH ALL CITY AND CAUNTV OPDINANCES AND STATE LAWS RELATWO TO BUILDINO
� CONSTqUCTIIXJ.AND HEREBV AUTNOR�ZE REPRESENTATIVES OF THIS CWN7Y TO ENTER UPON THE ,
Z ABOVE�MENTIONED PR07ERTV FOR INSPECTION PURPO5E5. .
COMMENTS
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RECPT.NO.b� PAID BY VALIDATION
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ELECTRIC GROUND UNDER FLOOR DUCT
GROUND PLUMBING UNDER FLOOR CONDUIT
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SLAB GRADE FIREPLACE FOUNDATION �
TEMP POWER FIREPLACE BOND BEAM
WATER SERVICE MID H'T. BOND BEAM
ROOF SHEATHING 8 FT. BOND BEAM �
FRAMINGNENTILATION FINAL BOND BEAM
ROOF COVER '` PRE-GRADING
ROUGH HEATING yJ,� BENCHING
:i%'r ROUGH GRADING
ROUGH ELECTRIC ,> ��
ROUGH PLUMBING ' ' FINISH GRADING
SHOWER/TUB TEST POOL ELECTRIC
EXT. LATH/SIDING POOL FENCING
WALL INSULATION POOL FINAL
CEILING INSULATION OFF SITE IMPS.
DRYWALL NAILING DEDICATIONS
SEWER FINAL ENG.
SEPTIC TANK LANDSCAPElIRRIG.
SEEP PIT/L.L. ON SITE IMPS.
GAS AIR TEST FINAL ZONING
FINAL CONST. FIRE DEPT. FINAL
FINAL HEATING � HEALTH DEPT. FINAL
FINAL ELECTRIC DEV. FEES PAID
FINAL PLUMBING ENERGY
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SEPTIC TANK SIZE
SEEP PIT/U SIZE
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