HomeMy WebLinkAbout14438 �� CITY OF DIAMOND BAR f—�
DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES /
2]660 E.Copley Drive Suite 190
(909)860-3195 Fax(909)861-3117 PRESS
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W CENSELAWFORTHEFOLLOWINGREASON(SEC.]031..BVSINESSAN�PHOFESSIONSCODE:ANYCITVOii
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W 7UHE,PRIOR TO ITS ISSUANCE,pL50 REOl11RES THE APPLICANT FOR SUCN PERMIT YO FILE A SIGNE� W PetiO/08Ck
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� I HEREBYAFFIRM UNDF.R PEHAITV OF PERIl1RV ONE OFTHE FOLLOWING DECLARATIDNS:
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� I CERTIFY THAT IN THE PFFiFOqMPIrCE OF THE WORK FOR WHICH hi15 PER T IS ISSUEL�,I MECHANICAL �y}y`'.q�
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y WORKFFlS'COMPENSATION LAWSOf CALIFORWA,AND AGPEf THAT IF I SHUUL� ��WreF INSPFCTION FEE _____ � '• _____ _
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FOR THE PERFORMANc:E OF THF\YOPK FOFI W HICH THIS PERMIT IS ISSUEO(SEC.3ov7,CIV.C.).
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Z. ABOVE�MENTIONED PROPERTY FOR INSPLCTION VURPOSC:S.
� CObliMENTS.._._.__.. _.__..___
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