HomeMy WebLinkAbout10002CITY OF DIAMOND BAR
COMMUNITY DEVELOPMENT DEPARTMENT
21660 F- Copley Drive Suite 190
(909) 860-3195 Fax (909) 861.3117
BUILDING PERMITAPPLICATION ®r
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OWNER -BUILDER DECLARATION
I HEREBY AFFIRM UNDER PENALTY OF PERAIRY TMT I AM EXEMPT FROM THE CONTRACTORS LF
GENSE UW FORME FOLLOWNG REASON (SEC ]0]I.SBUSNESSANO PROFESSIONS CODE. MY CITY OR
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TORE, PRIOR TO RS MWANOE, ALSO RECUNES THE APPLICANT FOR SUGH PERMIT TO FILE A SIGNED
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TORS LICENSE LA.).
O 1 AA EXEMPT UNDER SEC. B. a PC FOR THIS REASON
DATE OWNER
LICENSED CONTRACTORS DECLARATION
1 NEREBYAFFIRM UNDER PENAW OF PERAIRYTMT I M LICENSED NAER PMWSMS OF CHAPTER
S (COMM ENCWG MTM SECTION TUG) OF DIVISION ] OF THE BUSINESS AN FACIE SSONS CODE, AND
MY LICENSE IS N HAL/ FORCE AND EFFECT. )
LICENSECYASS C -I G UC. NO.
DATE CONTRACTOR
WORKEFIT COMPENSATION DECLARATION
IHEREBYWFIIIMUTAERPENALTYOFPC0. WONEOFTIE FOLLOWWGDECUAT,0NS:
_I HAVE AND RAILMANTAPN A CERTIFICATE OFCONSENTM SELFWSURE FORIPOI $'
COMPENSATION,AS PROVOED BY SECTION —OFTHE LABOR GOOF. FOR THE PERFORMANCE
W ME WORK FOR W WOI THIS PERMIT IS ISiI1ED.
_I RAVE AND ANLL MA WAW WOAERS' CW PENSATION NSUANCE M REWIRED BY SECTION
]TPG OF THE LIBOR CODE. FOR THE PERFORMANCE OF TME WORK FOR NMIM MLS PERMRIS
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I CERT FT THAT N THE PERFORMANCE OF THE PARK FOR WHICH THIS PERMIT IS ISSUED, I
SHALL NOT EMPLOY ANY PERSON N ANY MANNER SORA TO BECOME SUBJECT TO THE
WORKERS' COMPENSATICN LAWS OF Cµ1FORNU.-D AGREE THAT IFI SHOULD BECOME
SUSLIECT M TIE MMERT COMPENSATION PPIOWSIONS OF SECTION ]TPP OF THE LIBOR
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DATE: - '7APPLIOANM
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CONSTRUCTION LENDING AGENCY
1 HEREDY FFFIRM UNDER PENALTY a PERAIRY TUTTHEnE M A CONSMNUCTM LENOWG AGENCY
FOR THE PERFORMANCE OF THE WORK FOR MIC H THIS PERMIT IS RSUED (SEC —, Ov. G).
LENDERS NAME
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TOTAL FEES y(J
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WHITE—oPINULY nl COPY, YELLOW—FnBnce Copy, PINK—ASaanGr Wpy, GOLDENROD --Rb Copy, GREEN—ApPlow'. Copy
CITY. OF, DIAMOND BAR
INSPECTION RECORD
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SET BACK
lJD Xo !1.00p§0,to�:t+++�- ��6i�aS_. J
1 FLOOR JOIST
FIGS/FORMS/STEEL -
FHA REOMTS -
ELECTRIC GROUND
UNDER FLOOR DUCT
GROUND PLUMBING
-
UNDER FLOOR CONDUIT -
SLAB GRADE -
FIREPLACE FOUNDATION
TEMP -POWER - _.:_ .._
_ __ ._ ...
FIREPLACE BOND BEAM - -
WATER -SERVICE-.'-
MID HL BOND BEAM
ROOF SHEATHING
8 FT. BOND BEAM
FRAMING/VENTILIATION
FINAL 80ND BEAM -- -' -
-ROOF COVER -
PRE -GRADING
ROUGH HEATING
BENCHING
ROUGH ELECTRIC
- - ' -
ROUGH GRADING .
ROUGH PLUMBING
-
GRADING
-SHOWER/TUB TEST'
_ -
—FINISH
POOL'ELECTRIC
EXT. LATH/SIDING- !
POOL FENCING
WALL INSULATION
POOL FINAL
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OFF SITE IMPS.
DRYWALL NAILING
DEDICATIONS
SEWER _. .....
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FINAL ENG.
SEPTIC TANK.
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ON SITE IMPS.
GAS AIR TEST---- -
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FINAL ZONING
FINAL CONST.
FINAL HEATING---
_
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FIRE DEPT. FINAL
HEALTH DEPT. FINAL ., -
FINAL ELECTRIC -_: ...
DEV. FEES PAID -
FINAL PLUMBING
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ENERGY _
COMMENTS-
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