HomeMy WebLinkAbout10-1062 (5) CITY OF DIAMOND BAR � I
--�-1�`— DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES
21825 Copley Drive,Diamond Bar,CA 91765 I
(909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS
'��' BUILDING PERMIT APPLICATION FIRMLY
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w TURE,PRIOR TO ITS ISSUANCE,AL50 RE�UIRES THE APPLICAN7 FOH SUCH PERMIT TO FILE A SIGNED w Patio/Deck
� STATEMENT 7HAT HE OR SHE IS LICENSEO PURSUAN7 TO THE PROVISIONS OF THE CONTRACTORS LI- �
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WIIL�fIb THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.70�/,BUSI� J
� NE55 AND PROFESSIONS CADE:THE CONTPACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF �
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Q THROUGH HIS OR HER OWN EMPLOYEES,PROVIDED 7HAT SUCH IMPRWEMENTS ARE NO7INTENDED OR m
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Q TO CONSTqUCT THE PRQIECT(SEC.70��,BUSINESS AND PROFESSIONS CODE:THE CANTRACTORS LI- V01UetlOfl ADJ.AREA I
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� 1 HEREBY AFFIFM UNDER PENALTV OF PERJURV THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER �
d e(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE,AND Z
X MY LICENSE IS IN FULL FORCE AND EFFEC7.
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� WORKERS'COMPENSATION DECLARATION Q
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Z I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF-INSUPE FOR WORKERS' a
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Q CAMPENSATION,AS 7ROVI�ED BV SEC710N 370o OF TFIE LABOR CADE,FOR THE PERFORMANCE U
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W _I HAVE AND WILL MAIN7AIN WORKERS'COMPENSATION INSURANCE,AS REOUIRED BY SECTION J��,
Q3700 OF THE LABOR CODE.FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ()�/
ISSUED.MY WOPNERS'CAMPENSATION INSUFANCE CARRIER AND POLICY NUMBER ARE: CONSTRU �� "'`�
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Z I CER7IFY THAT IN THE PERFORMANCE OF THE WORN FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL .
C'} SHALL NOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBJECT TO THE
� WORKERS'COMPENSATION LAWS OF CAUFORNIA,AND AGREE THAT IF I SHOULD BECOME INSPECTION FEE
� SU&IECTTOTHEWORKERS'COMPENSATIONPROVISIONSOFSECTION37000FTHELABOR
� CADE,I SHALL FORTHWITH COMPLV WITH THOSE PROVISIONS. NC
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p DATE: APPLICANT:
J WARNING:FAILUFiE TO SECURE WORNERS'COMPENSATION COVERAGE IS UNUWFUL.AND SHALL BE ENERGY P/C
� SU&IECTANEMPLOYEfi70CRIMINALPENALTIESANDCIVILFINESUPTOONEHUNDRED7HOUSAND ENERG� .
DOLURS(i10o.000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVI�ED FOR IN
J SECTION 3708 OF THE LABOR CODE,MTEREST,AND ATTORNEV'S FEES. E I /�
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� � CONSTRUCTION LENDING AGENCY P ALT F
O J �� I HEREBV AFFIRM UNDER PENALTV OF PERJURV THATTHERE IS A CONSTRUCTION LENDING ACENCV �� /�_
FOR THE PERf-0RIdANCE OF THE WORN FOR WHICH THIS PERMIT IS ISSUED(SEC.3087,CIV.4�. �U f
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� LENDER'S NAME
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� I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT.
w I AGREE TO COMPLY WITH ALL CITY AND CAUN7V ORDINANCES AND STATE LAWS REUTING TO BUILDING
� CANSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATNES OF THIS COUNTV TO ENTER UPON THE
� ABOVE�MENTIONED PROPERTY FOR INSPECTION PURPOSES.
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~ WHITE—Department Copy,YELLOW�inance Copy,PINK—Assessor Copy,GOLDENROD--File Copy,GREEN—Applicant's Copy
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SET BACK FLOOR JOIST
FTGS/FORMS/STEEL FHA REQMTS
ELECTRIC GROUNQ UNDER FLOOR DUCT
GROUND PLUMBING UNDER FLOOR CONDUIT
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 BENCHING
ROUGH ELECTRIC ROUGH GRADING
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 FtNAL ENG.
SEPTIC TANK LANDSCAPE/IRRIG.
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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