HomeMy WebLinkAbout13-400 �� _ CITY OF DIAMOND BAR I
DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES /
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21A25 Copley Drive,Diamond Bar,CA 91765 � \/
(909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS
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I HEREBV AFFIRM UNDER PENALTY OF PERIURV THAT I AA1 E%EMPT FROM 7HE CANTRACTORS ll� G8f89B/CBfPOfI
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w TURE,VRIOR TO ITS ISSUANCE,AL50 RE�UIRES THE APPLICANT FOR SUCH PERMI7 TO FILE A SIGNED w Patio/Deck
� STATEMENT 7HA7 HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF 7HE CONTRACTORS LI� �
� CENSE LAW(CHAPTER 9(CAMMENCING WITH SEC710N 7000)OF DIVISION 3 OF 7HE BUSINESS AND PRO- POOVSpB
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WIIL DO THE WORK.AND THE S7RUC7URE IS NO7 INTENDED OR OFFEfiED FOR SALE(SEC.7a11,BU51- J
� NESS AND PROFESSIONS CADE:THE CANTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF �
— PROPERTV WHO BUILDS OR IMPROVES 7HEREON,AND WHO DOES SUCH WORN HIMSELF OR HERSELF OR
Q THROUGH HIS OR HER OWN EMPLOYEES,PROVIDED 7HA7 SUCH IMPROVEMENTS ARE NOT IN7ENDED OR m
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� I HEREBY AFFIRM UNDER PENPLTY OF PERJUPV 7HA7 I AM LICENSED UNDER PFOVISIONS OF CHAPTER �
� e(COMMENCING WITH SECTION 7000)OF DIVISION 3 Of THE BUSINESS AND PROFESSIONS CODE.AN� Z
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� I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: Z
ZIHAVEANDWILLMAINTAINACERTIFICA7EOFCONSEN7705ELF�INSUREFORWORKERS' _
¢ , COMPENSATION,AS PROVI�ED BY SECTION 37Uo OF 7HE LABOR CODE,FOR THE PERFORMANCE W
Q OFTHE WOFN FOR WHICH THIS PERMIT IS ISSUED. �
w �I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REOUIRED BV SECTION
Q 370o OF THE LABOR CODE,FOR THE PERFORMANCE OF 7HE WORK FOR WHICH 7HIS PERMIT IS
ISSUED.MY WO 6'CAMP NSATI N INSURAN CARRIER AND FOLICV NUMBER ARE: CONSTRUCTION
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Z I CERTIFY THAT IN THE PERFORMANCE OF THE WORN FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL
(.'} SHALL NOT EMPLOV ANV PERSON IN ANY MANNER SO AS TO BEGOME SUBJECT TO THE
� WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AGREE THAT IF I SHOULD BECOME INSPECTION FEE -
= SUBJECTTOTHEWORKERS'COMPENSATIONPROVISIONSO SECTION37000FTHELABOR �
CAD,I SH LL FOR7HWI7H COMPLY WITH 7H05 P I S. ISSUANCE Y
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p DATE: APPLICANT; SMIP
J WARNING:FAILUFE TO SECURE WORKERS'COM SATION C VERAGE IS UNLAWFUL,AND SHALL BE ENERGY P/C
� SU&lEC7AN EMPLOVER 70 CRIMINAL PENALTIE AND CIVIL FINES UP TOONE HUNDRED THOUSAND ENERGY PERMIT
DOLLARS(5100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN J�
� SECTION3708OFTHELABOHCODE,INTEREST,ANDATfORNEV'SFEES. RETENTIONFEE: � •`
a CONSTRUCTION LENDING AGENCY PRE-ALT FEE:
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� I HEREBY AFFIRM UNDER PENAL7V OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCY •
FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3087,CIV.CJ.
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� LENDER'S NAME
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� 1 CER7IFV THAT I HAVE READ THIS APPLICATION AND STA7E THAT THE ABOVE INFORMA710N IS CAHRECT.
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� CANSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE � � �: ���•�
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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 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
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 ____ _
FINAL PLUMBING -22-(3 _�k '' _ ENERGY _ ___
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