HomeMy WebLinkAbout10-366 CITY OF DIAMOND BAR � /
' -"�-��' — DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES � / /
21825 Copley Drive,Diamond Bar,CA 91765 V
(909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS
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� STATEMENT 7HA7 HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI- �
� CENSE UW(CHAPTEF e(CAMMENCING WI7H SEC710N 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- POOVSPB
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WILL DO THE WORK,AND THE STRUCTURE IS NOT INTEN�ED OR OFFERED FOR SALE(SEC.70��,BUSI� J
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� WORKERS'COMPENSATION DECLARATION � Q �
� I HEREBY AFFIRM UNDER PENALTV OF PERJURY ONE OF THE FOLLOWING DECLARA710NS: Z � � �
0 I HAVE AND WILL MAIN7AIN A CERTIFICATE OF CANSENT TO SELF-INSURE FOR WORKERS' a
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QCAMFENSATION,AS PROVIDED BY SECTION 37000F TME UBOR CODE,FOR THE PERFORMANCE W V C'✓I'
Q OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. �
QW _I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REOUIRED BV SECTION �
370o OF THE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOfi WHICH 7HIS PERMIT IS �] ",p
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Z I CERTIFV THAT IN THE PERFOPMANCE OF THE WORK FOR WHICH 7HIS PERAl1T IS ISSUED.1 HANICAL
�J SHALL NOT EMPLOY ANV PERSON IN ANV MANNER 50 AS TO BECAME SUBJECT TO THE
(/) WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AGREE THAT IF I SHOULD BECOME INS dON FEE
= SU&IECT TO THE WOfiKERS'COMPENSA710N PROVISIONS OF SECTION 3700 OF THE LABOR J
CODE,I SHALL FORTHWITH COMPLY WITH THOSE PROVISIONS. SUANCE / D���
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'J WARNING:FAIIURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL BE ENERGY P/C �¢
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DOLLARS(f100.000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOH IN
� SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. RETENTION FEE: ���
a CONSTRUCTION LENDING AGENCY PRE-ALT FEE:
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� I HEREBYAFFIRM UNDER PENALTY OF PERJURV THAT THERE IS ACONSTRUCTION LENDING AGENCY
FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED�SEC.3oD7,CIV.CJ, � � ' � .
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� LENDER'S NAME
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� TOTAL FEES � y as�_32 � �//. ��
� I CERTIFV THAT 1 HAVE READ THIS APPLICATION AND S7ATE 7HAT THE ABOVE INFOHMA710N IS CORRECT.
w I AGREE TO CAMPIV WITH ALL CITV AND COUNTV ORDINANCES ANO STATE UWS FEUTING TO BUILDING
� CANSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS COIINTV TO ENTEH UPON THE C cK 3`-1-1 L� -
� ABOVE-MENTIONED GROPERTV FOR INSPEC710N PURPOSES. �
Z COMMENTS
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FTGS/FORMS/STEEL � - FHA RE(QMTS
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 �fl FINISH GRADING
SHOWER/TUB TEST P�OL ELECTRIC
EXT. LATH/SIDING � POOL FENCING
WALL INSULATION POOL FINAL
CEILING INSULATION �! OFF SITE IMPS.
DRYWALL NAILING �� DEDICATIONS
SEWER /< <o FINAL 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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