HomeMy WebLinkAbout26499CITY OF DIAMOND BAR f
DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES
21825 Copley Drive,Diamond Bar,CA 91765
909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS
BUILDING PERM T APPLICATiON FIRMLY
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JOBSITE / _ APPLICATION PERMIT p/C /p.GADDRESSDATENUMBERqV/
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I HEREBV AFFIRM UNDER PENALTV OF PERJURV THAT I AM E%EMPT FROM THE CANTfUCTORS LI G8l89B/Cef[1O11WCENSEUWFORTHEFOLLOWINQREASON(SEC.7031.5BUSINESSANDPROFESSION9COOE:ANVqTVOR (C1 COUNTVWHICHREOUIRESAPERMRTOCONSiAUCT,/LTER,IMPROVE,DEMOLISH,OFREPAIRANVSTRUG W P8I10/DBCKTURE,PRIOR TO ITS ISSUANCE.ALSO REOUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED wSTATEMENTTHATHEORSHEISLICENSEDPURSUANTTOTHEPROVISIONSOFiHECONTMCTOfiSLI-
CENSE LAW(pUPTER D(COMMENCING WITH SECTION 7000)OF DIVISION 3 0F THE BUSINE55 AND PRO- u' POOVSPB
FE9310NSCODE)OR7}UTHEORSHEISEXEMPTTHEREFROMANDTHEBASISFORTHEALlEOEDEXEMP C7 I
TION.ANV VqLAT10N OF SECTION 7031.5 BV ANV APPLICAM FOR A PERMIT SU&IECTS THE APPUCANT TO Z Re-RoofACMLPENALTVOFNOTMOFETHANFIVEHUNDREDDOLLARS(f5a0).):
I,ASOVMEROFTHEPROPERTV,ORIAVEMPLOVEESWITHWAGESASTHEIRSOLECOMPENSATION, 0 COrtIrtIBfC18IZWILIDOTHEWORK,AND THE STRUCTURE IS NOT IMENDED OR OFFERED FOR SALE(SEC.70l1,BUSI J
NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF
VROPERTY NM1iO BUILOS OR IMPROVES TIEREON,AND N170 OOES SUCH WORN HIMSELF OR HERSELF OR
wiHROUGHHISORHEROWNEMPLOVEES,PROVIDEDTHATSUCHIMPROVEMENTSARENOTINTENDEDOR m
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IMPROVE FOR THE W RPOSE OF SALE).
w O I,AS ONMER OF THE PROPEHTV,AM EXCIUSNELV COMMCTR70 WfTH LICENSED CONTMCTORS
TO CONSTRUCT THE PROJECT(SEC.7oH,BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS LI- V81U6fIOf1 qp.qqEqWCENSELAWDOESNOTAPVLVTOANOWNEROFAPROPERTVWNOBUIlD50RIMPROVESTHEREON,AND
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LICENSED CONTRACTORS DECLARATION w
I HEPEBV AFFIRM UNDER PENALTV OF PERJUtiY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER
9(COMMENGNO WITH SECTION 7000)OF DIVISKKJ 3 OF THE BUSINESS AND PROFESSIONS CADE D ZMYLICENSEISINFULLFOREANDEFFECT.
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WORKERS'COMPENSATION DEC RATION Q
U1HEREBVAFFIRMUNDEflPENALTVOFPERIURVONEOFTHEFOLLOWINGDECIONS: Z
I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF INSU F9R WORKERS' a2
Q COMPENSATION,AS PROVIDED BV SECTION 3700 OF THE LABOR CODE,FOR THE PERFORMANCE U
OF hIE WORK FOR WHICH THIS PERMIT IS ISSUED. w
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1 HAVE AND WILL MAIMAIN WOFNERS'CAMPENSATION INSURANCE,AS REOUIRED BV SECTION
Q3700 OF 7HE IABOR CADE,FOR THE PERFORMANCE OF THE WOR)(FOR WHIp1 THIS PERMIT IS 7ISSUED.MY WOR S'COMPENSATION INSURANCE CARRIER ANO 70LICV NUMBERARE: CONSTRUCTION
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WZ I CERTIFY THAT IN THE PERFORMANCE OF THE WO OR WHICH THIS P RMIT S ISSUED,I MECHANICAL
V'SHALL NOT EMPLOV ANV PERSON IN ANY MANNER 50 A TO BECAME S &lEC TO THE
WOPKERS'COMP NSATIONLAWSOFCALIFORNIA,AND REETHATIF SHO LDBECOME INSPECTIONFEE
SU&IECT THE RKERS'COMPENSATION P OV1510 S OF S T 370 OF THE UBOR
CADE.I ALL RTHWITHCOMPLVWITHTHO EPRO SION ISSUANCE
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p DATE APPLIC SMIP S
WJ WAPNIN .FA E TO SECURE WONCERS'CqMP SATION ERA I NUWFUL.ANO SHALL BE ENERGY P/CJ
SU&IECTAN EMPLOVER TO CRIMINAL PENALTIE PND CIVIL FI ES U T ONE HUNDRED THOUSAND
ENERGY PERMITDOLURS(5100.000),IN ADDITION TO THE COS F COMPENSATpN OES AS PROVIDED FOR INJSECTION3708OFhIELABOFCODE,IN7ERE .AND ATTORNEVS F
w RETENTION FEE:
O CONST CTION LENDING AGENCY PRE-ALT FEE:
I HEREBV AFFIRM UNDER PENALTV OF PERIURV THAT THERE IS A CONSTRUCTION LENDWG AOENCY
FOH TNE PERFORMANCE OF T1E WORK FOP WHICH THIS PERMIT IS ISSUED(SEC.30G7,CIV.CJ.
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LENDEFYS NAME
LENDER'SADDRESS
w I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE WFORMATKKJ IS CORRECT. TOTAL FE ES LC• • ' n
D I AGREE TO COMPLV N7TH ALL CfTV AND CAUNTY ORDINANCES AND STATE LAWS RELATINO TO BUILDINQ
CONSTRUCTION,AND HEREBY AUTHORIZE REPR F THIS COUNTV TO ENTER UPON THE
Z ABOVE-MENTIONED P ERTY FOR INS ECTION Es.
COMMENTS
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510 E OF ERMITT DAT
RECPT.NO. PAID BY ALIDATION
WHITE—Department Copy,YELLOW—Finence Copy,PINK—Aasessor Copy,GOLDENROD—File ,GREEN—Copy Applicant's Copy
ClTY CD DI iViOi AR
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1 pL C 4QOa ; G`t L `'` G].G.C r'OG3 Oa pC C'OOa . DGJ C OGYJ pC C 40a
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 GR,4DING
ROUGH PLUMBING FINISH GRADING
SHOWER TUB TEST POOL ELECTRIC
EXT. LATH/SIDING POOL FENCING
WALL INSULATION PQOL FINAL
CEILING INSULATION OFF SITE IMPS.
DRYWALL NAILING DEDICATIONS
SEWER FINAL ENG.
SEPTIC TANK LANDSCAPE/IRRIG.
SEEP PITIL.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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COMME lTS
SEPTIC TANK SIZE
SEEP PIT/U SIZE
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