HomeMy WebLinkAbout10-1000 CITY OF DIAMOND BAR '�
-"-��`— DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES �
21825 Copley Drive,Diamond Bar,CA 91765
(909)839-7020 Fax(909)861-3ll7 Building Inspection Hotline(909)839-7027 Pf�E$$
'°^' BUILDING PERMIT APPLICATION FIRMLY
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W TURE.PRqR TO ITS ISSUANCE.ALSO REOUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIONED W Petio/Deck
� STATEMENT TFUT HE OF SHE IS LICENSED WRSUANT TO THE PROVISIONS OF THE CANTRACTORS LI-
� CENSE UW(CHAPTER Y(COMMENqN6 WITH SECTION�000)OF DIVISqN 3 OF THE BUSINESS AND PRO� � POOVSPB
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A CIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS(f5oo)J:
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� NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF �
VROPEHTV NRiO BUILDS OR IMPROVES THEREON,AND VhiO DOES SUCH WORK HIMSELF OR HERSELF OR
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� 1 HEREBY AFFIRM UNDER PENALTV OF PERIURV THAT I AM UCENSED UNDER PROVISIONS OF CHAGTER �
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Q PENSATqN,AS PPOVI�ED BV SECTION 3700 OF THE LABOR CODE.FOR THE PERFORMANCE U
OF THE WORK FOR NM171CH THIS PERMIT IS ISSUED. W
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w _1 HAVE MID WILL MAINTAIN WORKERS'CAMPENSATION INSURANCE,AS REOl11RED BV SECTION
Q 3700 OF THE LFBOR CADE,FOR THE PERFORMANCE OF THE WOqK FOR WHICH THIS PEFMIT IS
ISSUED.MV NqRKERS' PEN ATION NSU��RqIERnN�P 1LNUMBER ARE: CONSTRUCTION
� CARRIER X'�� � PLAN REVIEW
� POLICV NUMBER � - �— ELECTRIC
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Z I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL
C.�} SHALL NOT EMPLOV ANV PERSON IN ANV MANNER SO AS TO BECOME SU&IECT TO THE
(�j WORKERS'CAMPENSATION LAWS OF CALIFORNIA,AND AOREE THAT IF I 5 D BECO INSPECTION FEE
SUBJECT TO THE WORKERS'COA/PENSATION PROVIS 5 F ECTION o0 F R �j�
� E,I SHALL FORTHWITH COA/PLV WITH THOSE PR ISSUA ac Q O
p DAT���D qPPLICANT: G SMIP
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OOLLAAS(5100,000),IN�DDITION TO THE COST OF COMPENSATION,DAMAOES AS PROVIDED FOR IN
� SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATTORNEV'S FEES. RETE TI
OCONSTRUCTION LENDING AGENCY PRE-ALT FEE:
� I HEREBV AFFIRM UNDER PENALTY OF PERJURV THAT THERE IS A CANSTRUCTION LENDING AOENCV
� FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.30G7,CIV.C.).
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' � LENDERS NAME
F— LENDER'SADDRESS
W I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFOWAATION IS CORRECT. TOTAL FE ES ��
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� CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS CWNTV TO ENTER UPON THE '
Z ABOVE�MFj1TIONED PROPERTV FOR INSPECTION PURGOSES. COMMENTS '
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� 51 OF PERMITTEE DA7E
RECPT.NO. PAID BY ' VALIDATION
WHITE—Depanment Copy,YELLOW�Inance Copy,PINK—Assessor Copy,GOLDENROD—Rle Copy,GREEN—Appitcant's Copy
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INS��C�EOI� RECOFiD
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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 POWER FIREPLACE BOND BEAM
WATER SERVICE MID H'T. 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 POQL 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 ENERGY
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