HomeMy WebLinkAbout11-1457 1-�
^ 1��,,`_ CITY OF DIAMOND BAR
� DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES
�, 21825 Copley Drive,Diamond Bar,CA 91765
(909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-70 7 PRESS
"�^'��w BUILDING PERMIT APPLICATION FIRMLY
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I HEREBV AFFIqM UNDER PENAL7V OF PERJURV THAT I AM EXEMPT FROM THE CONTRACTORS LI� Gef890/C8lpOR
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w iURE,PRIOR TO ITS ISSUANCE,PLSO REOUIRES THE APPLICAN7 FOR SUCH PERMIT TO FILE A SIGNED w Patio/Deck
� STATEMENT 7HAT HE OR SHE IS LICENSE�PURSUANT TO THE PROVISIONS OF 7HE CONTRACTORS LI�
CENSE LAW(CHAP7ER e(COMMENCING WITH SEC710N 7000)OF DIVISION 3 Of 7HE BUSINESS AND PRO- � PooUSpa
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N NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF �
PROPER7Y NMO BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR
� THROUGH HIS OR HER OWN EMPLOYEES,PROVIDED 7HAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m
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�Q LICENSED CONTRACTORS DECLARATION W
2 1 HEREBY AFFIRM UNDER PENALTY OF PERJURV THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER �
� 9(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE,AND Z
�� MY LICENSE IS IN FULL FORCE AND EFFECT. m
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� WORKERS'COMPENSATION DECLARATION Q
� I HEREBV AFFIRM UNDER PENALTV OF PERJURY ONE OF 7HE FOILOWING DECURATIONS: Z
� _I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF-INSURE FOR WORKERS' a
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COMPENSATION,AS PROVIDED BV SECTION 370o OF THE LABOR CODE,FOR THE PERFORMANCE U
Q OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. � ,.
w _I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REQUIRED BY SECTION
Q 3700 OF THE LABOH CODE,FOR THE PERFORMANCE OF THE WOHK fOR WHICH THIS PERMIT IS
0 ISSUED.MY WORKERS'CAMPENSATION INSURANCE CARRIER AND POLICV NUMBER ARE: CONSTRUCTION '��• �
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Z I CERTIFV 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 BECOME SUBJECT TO THE
(n WORNERS'COMPENSATION LAWS Of CAUFORNIA,AND AGREE THAT IF I SHOULD BECOME INSPECTION FEE
= SU&IECTTO7HEWORKERS'COMPENSATIONPROVISIONSOFSECTION37000FTHEUBOR
CADE.I SHALL FOHTHWI7H COMPLV WITH osE aaovisioNs. ISSUANCE �� ` C�
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p DATE: V APPLICANT: CI �+l�p, SMIP �
J WARNING:FAILUqE 70 SECURE WORKERS'COMPENSATION COVEFAGE IS UNUWFUL,AND SHALL BE ENERGY P/C
� SU&IECTANEMPLOVERTOCRIMINALPENALTIESANDCIVILFINESUPTOONEHUNDREDTHOUSAND ENEAGYPERMIT
DOLURS(f100.000).IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PPOVIDED FOR IN
� SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATfORNEV'S FEES. RETENTION FEE: �. ��
OCONSTRUCTION LENDING AGENCY P{R�E•ALT FEE:
� 1 HEREBV AFFIRM UNDER PENALTV OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCY p�� 1. �
FOR THE PERf-0flMANCE OF THE WORK FOF WHICH THIS PERMIT IS ISSUED(SEC.7087,CIV.CJ.
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� LENDER'S NAME
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� TOTAL FEES ��1-•�3
� I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CARRECT.
w I AGREE TO COMPIV WITH ALL GTV AND COUNTY ORDINANCES AND STATE UWS flEUTING TO BUILDINC
� CANSTRUCTION,AND HEREBV AUTHORIZE REPRESEN7ATIVES OF 7HI5 COUN7Y 70 EN7ER UPON 7HE
� ABOVE-MEN710NED PROPERTV FOR INSPEC710N PURPOSES.
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~ WHITE—DepaAment Copy,YELLOW—Finance Capy,PINK—Assessor Copy,GOLDENRO�File Copy,GAEEN—ApplicanYs Copy
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SET BACK FLOOR JOIST �
FTGS/F�RMS/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 CQVER PRE-GRAOING
ROUGH HEATING BENCHING
ROUGH ELECTRIC RQUGH GRADING
ROUGH PLUMBING FINISH GRADING
SHOWER/TUB TEST POOL ELECTRIC
EXT. LATH/SIDIMG �� � ��; � '�_ POOL FENCING
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WALL INSULATION ��.n/�i PQOL FINAL
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CEILING INSULATION �_� OFF SITE IMPS.
DRYWA�L NAILING DEDICATIONS
SEWER FINAL ENG.
SEPTIC TANK LANDSCAPElIRRIG.
SEEP PIT/L.L. ON SITE IMPS.
GAS AIR TEST . FINAL ZONING
FINAL CONST.�j�Dl�t/G �� �..1?j FIRE DEPT. FINAL
FINAL HEATING HEALTH DEPT. FINAL
------ - - — -___.__.___-----------_ __..._----.____ _..__._.-------- -__.__.__._.
FINAL ELECTRIC DEV. FEES PAID
FINAL PLUMBING ENERGY
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COMMENTS _
SEPTIC TANK SIZE
SEEP PIT/U SIZE
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