HomeMy WebLinkAbout12-272� � _ '
I �`_ CITY OF DIAMOND BAR .�—�� i
DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES
T,;� , 21825 Copley Drive,Diamond Bar,CA 91765
(909)839-7020 Fax(909)861-3117 Building[nspection Hotline(909)839-7027 PRESS
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� STATEMENT THAT HE OR SHE IS LICENSED WRSUANT TO THE PROVISIONS OF-THE COMRACTORS LI�
� CENSE UW(CHAPTEH Y(COMMENCINO WITH SECTION 700a)OF DIVISqN 3 OF THE BUSINESS AND PRO� � POOUSPB
^ FESSIONS CODE)OR THAT HE OR SHE IS E%EMPT THEREFROM AND THE BASIS FOR THE ALLEOED EXEMP- (!i
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N7Ll DO THE WORIC,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.]oa1,8U51� J Commercial
� NESS AND PROFESSIONS CODE:THE CANTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF �
PROPER7Y WHO BUILDS OR IMPROVES h1EREON,AND NM1iO DOES SUG/WORK HIMSELF OR HERSELF OR
w THROU(L1 HIS OR HER ONM EMPLOVEES,PROVIDED THAT SUCF1 IMPROVEMENTS ARE NOT INTENDED OR m
Q OFFEREDWRSALEIF,HOWEVERTNEBUILDINOORIMPROVEMENTISSOLDWRHINONEVEAROFCOMPLE�
Z TqN,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR
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w ❑I,AS ON7JER OF THE PROPEHTY,AM E%CLUSIVELV CqNTRACTINO WfTH UCENSED CONTRACTORS
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LICENSED CONTFACTORS DECLARATION —�
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1 HEREBY AFFIRAI UNDER PENALTY OF PERIURV THAT 1 AM LICENSED UNDER PROVISKKJS OF CHAPTER �
� e(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF 7HE BUSINE55 AND PROFESSKKJS CODE,AND Z
�� IIY LICENSE IS M FULL FORCE AND EFFECT. m
� LICENSE CLASS LIC.NO.�/�// �
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� WOFKERS'COMPENSATION DECLARATI� �
N I HEREBV AFFIRM UNDER PENA�TY OF VERIUFV ONE OF THE FOLLOWING DECLARATION$: V
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� _INAVEANDWILLMAINTAINACERTIFICATEOFCONSENTTOSELF-INSUREFORWORKERS' _
� COMPENSATION,AS PROVIDED BV SECTION 370o OF THE IABOR CODE,FOR THE PER W RMANCE U
TNE WORK FOR WHICH THIS PERMIT IS ISSUED. W
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w � MAVEAND WILL MAINTAIN WOHI(ERS'COMPENSATION INSURANCE,AS REOUIRED BV SECTION
Q 37000F THE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHlp/THIS PERMIT IS
ISSUEO.MV WOFi�p�MPE�TION INSU CE CARRIER ANp�Pq.ICV NUMBERAAE: CONSTRUCTION
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dZ � ELECTRIC
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Z I CERTIFV THAT IN THE PERFORMAIJCE OF THE MlOHK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL
C} SHALL NO7 EMPLOV ANV PEFSON IN ANY MANNER SO AS 70 BECAME SU&IECT 70 THE
(n WORKERS'CAMPENSATbN LAWS OF CALIFORNI/�AND AGREE THAT�IF I SFIOULD BECAME INSPECTION FEE
= SU6IECT TO THE VJOqKERS'COMPENSATION PROVISIONS OF SECTION 9�0o OF THE LABOR �
CODE,I SH FO HWITH COMPLY WI/TH Ty'�OSE/��P�QV—I�SIO'NS/. / ISSUANCE
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� WARNINO:FAILURE TO SECURE WORKERS'COMPENSATION CAVEF7AGE IS UNLAWFUL,AND SHALL BE ENERGY P/C �
� SU&IECTANEMPLOVERTOCRIMINALPENALTIESANDCIVILFWESUPTOONEHUNOREDTHOUSAND ENERGYPERMIT
DOLLAHS(5100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMA�ES AS PROVIDED FOR IN
J SECTION 3708 OF THE LABOR CODE,INTEHEST,AND ATTORNEV'S FEES.
w RETENTION FEE:
O CONSTRUCTION LENDING AGENCY PRE-ALT FEE:
� 1 HEREBY AFFIRM UNDER PENALTY OF PERIURV THAT THERE IS A CANSTRUCTION LENDING AOENCV
FOR THE PERFORMANCE OF THE WORK FOR WHICH iH15 PERIAIT IS ISSUED(SEC.908�,CIV.C.).
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�Z LENDER'S NAME
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F— LENDER'SADDRESS �
W ICERTIFVTHATIHAVEHEADTHISAPPLICATIONANDSTATE7HATTHEABOVEINFORMATqNISCORRECT. TOTAL FEES y, ��
� I A6REE TO COMPLV WITH ALL GTY AND COUNTY ORDINANCES AND STATE UWS FELATING TO BUIlDINO l (
� CONSTFUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS COUNTV TO ENTER UPON THE
Z ABOVE-MENTIONED PROPERTV FOR INSPECTpN PURVOSES. COMMENTS
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m PERMITTEE NAME(PRINT) �
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� SIONATURE OF PE E DAT
� RECPT.NO. PAID B VALIDATION
WHITE—Depertment Copy,YELLOW--Finance Copy,PINK—Assessa Copy,GOLDENAOD--File Copy,(iRE —ApplicanYs Copy
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SET BACK FLOOR JOIST
FTGS/FORMS/STEEL FHA REQMTS
ELECTRIC GROUND UNDER FLOOR DUCT
GROUND PLUMBING UNDER FLOOR CONDUIT
SLAB GRADE FIREPLACE FOUNDATION
TEMP POWER FIREPLACE BOND BEAM
WATER SERVICE MID HT. 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 DEDICATfONS
SEWER FINAL ENG.
SEPTIC TANK LANDSCAPE/lRRIG.
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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COMIUIEfVTS
SEPTIC TANK SIZE
SEEP PIT/U SIZE
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