HomeMy WebLinkAbout10-1019 �`_ CITY OF DIAMOND BAR � ���� (�,�„ /�� ' �
• � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVI E U U (/�„U��j ��
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w TURE,PRIOR TO ITS ISSUANCE,ALSO RE�UIRES 7HE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED W Patio/Deck
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WILI DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7o4I,BU51- J
� NESS AND PROFESSIONS CADE:7HE CANTRAC70RS LICENSE lAW DOES NOT APPLV TO AN OWNER OF �
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CC THROUGH HIS OR HER OMM EMPLOVEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m
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� 1 HEREBY AFFIRM UNDER PENALTY OF PERJURV THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER �
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� WORKERS'COMPENSATION DECLARATION Q L — 9S. t�
� I HEREBV AFFIRM UNOEH PENALTV OF PERJURV ONE OF 7HE FOILOW WG DECURATIONS: Z n_ �1� i-1 �
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Q COMPENSATION,AS PROVIDED BY SEC710N 370o OF 7HE LABOR CADE,FOR THE PERFORMANCE U I Z 11',K�
Q OF THE WORK FOR WHICH THIS PEiiM1T IS ISSUED. �
w _I HAVE AND WILI MAINTAIN WORKERS'COMPENSATION INSURANCE.AS REaUtRED BY SECTION
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Z I CER7IFV THAT IN THE PE{iFORMANCE OF THE WORN FOR WHICH 7HI5 PERMIT IS ISSUED,I �
(,�J SHALL NOT EMPLOV ANV PERSON IN ANY MANNER 50 AS TO BECOME SUBJEC7 70 THE
� WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AGREE 7HA71F I SHOULD BECOME INSPECTION FEE
= SUBJECT TO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 370o OF THE LABOR ^�`�'
CADE,I SHALL FORTHWITH COMPLV WITH THOSE PROVISIONS. SSUANCE (�7 r
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p DATE: APPLICANT:
J WARNING:FAILUFE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNIAWFUL,AND SHALLBE ENERGY P/C
� SUBJECTANEMPLOVERTOCRIMINALPENALTIESANDCIVILFINESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT
DOLtARS(=100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN
� SECTION3700OFTHELABORCODE,INTEREST,ANDATfORNEV'SFEES. ETENTIONFE ' Ia ,��
OCONSTRUCTION LENDING AGENCY PRE-ALT FEE:
� I HEREBYAFFIRM UNDER PENALN OF PERJURY THAT THERE IS ACONSTRUCTION LENDINCa AGENCY
FOR THE PERFORMANCE OF THE WORK FOR WHICH 7HI5 PERMIT IS ISSUED�SEC.3097,CIV.C.).
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� LENDER'S NAME
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� I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CARRECT.
w I AGREE 70 COMPLY WITH ALL CITV AND COUNTY ORDINANCES AND STATE UWS REU7ING TO BUILDING
� CANSTRUCTION,AND HEREBV AU7HORIZE REPRESENTATIVES OF 7HIS COUN7V TO ENTER UVON THE
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� COMMENTS
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= RECPT.NO. PAIDBY ���✓�G7�ALIDATION
~ WHITE—Department Copy,YELLOW--Finance 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 GROUND UNDER FLOOR DUCT
GROUND PLUMBING UNDER FLOOR CONDUIT
SLAB GRADE FIREPLACE FOUNDATION
TEMP P�WER FIREPLACE BOND BEAM
WATER SERVICE MID H'L 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 i
EXT. LATH/SIDING POOL FENCING
WALL INSULATION POOL FINAL
CEILING INSULATION OFF SITE IMPS.
DRYWALL NAILING DEDICATIONS
SEWER 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
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