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1,r,� CITY OF DIAMOND BAR �
DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES
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(909)860-3195 Fax(909)861-3117
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� iHROUGH MS OR HER ONN EMPLOYEES,PROVIDED THAT SUCH IMPROVEMQJTS AFE NOT INTENDED OR m �
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� � I HEREBY AFFIiW UNOER PENALTV OF PERWRY TNAT I AM LICENSED UNDER PROVISqN9 OF CHAPTER . �
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� _I HAVE M1D WILL MAINTAPJ WOFiI(ER4'COMPENSATION INSURANCE,AS RE4UIRED BY SECTION � �- �
Q3700 OF TiE LABOR CODE.FOR THE PERFOMUNCE OF THE WORK FOR WHICFI 7HI5 PERMR 19 .
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� SHALL NOT EMPLOV ANV PERSON IN MIV MANNER SO AS TO BECOME SU&IECT TO THE ��
y WOPoCERS COMPENSATION UW3 0F CALIFORNI^MID AOREE THAT IF I SHOULD BECOME INSPECTION FEE
S SU&IECTTOTHENqRKERS'COM7ENSATpNPROVISION50FSECTpN370oOFTHELABOR .
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� WAANINO:FALURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL,AND SMALL BE
LL SUBJECTAN B.IPLOVEH TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND ENERGY PERMIT
DOLLMS(5700,000),W ADDITION TO THE COS70F COIAPENSATION,DAMAOES AS PROVIDED FOR IN
J SECTqN 370!OF THE UBOR COUE.INTEREST,iVID ATTORNEVS FEES. ' RETENTION FEE: �
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, d CONSTRUCTION LENDING AGENCY PRE-ALT FEE: � �
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� LEPIDERS NAME - -
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� ICERTIFYTHATIHAVEREADTIISMPLICATIONMI�STATETHATTiEABOVEWFORA1ATqNISCORRECT. TOTAL FEES � • . �
W I AOREE TO COMPLY N7TM ALL CT'AND COUNTY ORDINANCES AND STATE UWS RELATINO TO BU�DINO
� CONSTRUCTION,AND HEREBY AUTHORI2E REPRESENTATIVES OF THIS COUNTY 70 ENTER UPON THE � rf�'� �/\
� /�BOVE�AIE ONED PROPER7V FOR I PEC7KIN PU�roses. � COMMENTS 'Y Ili-� /i � ,I/�/1 /• L
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� � RECPT.NO. PAID BY VAUDATION �
WHITE—Department Copy,VELLOW—F'mence Copy,PINK—Assessa Copy,GOLDENFOD--File Copy,GREEN—Applkant's Copy
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CITY OF D1�11VIOND BAi� �
IIVSPECTIOiV RECOFiD � � �
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SET BACK � ` ` ' FLOOR JOIST � ,
FTGS/FORMS/STEEL � ' FHA RE(�MTS � �
ELECTRIC GROUND UNDER FLOOR DUCT -' �
GROUND PLUMBING UNDER F�OOF�CU�IDUIT -
SLAB GRADE ' FtREI�L`AGE�FOUNDATION- � '� - • � - _ -
TEMP POWER FIREPLACE BOND'BE�AM. . _ � - " ' ' '
WATER SERVICE =M!D HT. BOND BEAM ;- � .
ROOF SHEATH WG � • 8 FT. BOND BEAM , ;a. - �'. ` ,�.. ' ' �
r �FRAMINGNEN7ILIATION: . � FINAL BOND BEAM
ROOF COVER ' PRE-GRADING
ROUGH HEATING � BENCHiNG
ROUGH ELECTRIC ROUGH GRADING �
ROUGH PLUNIBING � FINISH GRADING
SHOWERlTUB TEST - POOL ELECTRIC
EXT. LATH/SIDING ,r„ POOL FENCING
WALL INSUTATION,�;.,gV�<s�(�-�,`<' POOL FINAL ' ,
CEILING W5ULA�ION" � , OFF StTE IMPS.
DRYWALL NAI�INGf,.,, ��, � '•%��� DEDICATIONS .
SEWER '���''" FINAL ENG.
SEPTlC TANK LANDSCAPE/IRRIG.
SEEP PIT/L..L. _ ON SITE IMPS.
GA$A�IF�TEST . FINAL ZONING
FINAL Cl7NST. •• - ' � FIRE DEPT. FINAL �
FINAr HE4TING ' � - • •-- � � - � HEA�TH DEPT. FINAL
FINAL ELECTRIC ' ' ` J " ` � ' DEV. FEES PAID
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