HomeMy WebLinkAbout10-1155 (5) CITY OF DIAMOND BAR ��, n�
----��— 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
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w NRE,VRIOR 70 I7S ISSUANCE,AL50 REOUIqES THE APPLICANT FOR SUCH PERMIT 70 FILE A SIGNED w Patia/Deck
� STATEMENT THAT HE OR SHE IS LJCENSED PURSUANT TO THE PROVISIONS OF THE CANTRACTORS LI�
� CENSE UW(CHAPTER 9(COMMENCWO WITH SECTION 7000)OF DIVISION 3 OF h/E BUSINESS AND PHO� � PooUSpe
� FESSIONSCODE)OR7HA7HEORSHEISE7(EMP7TNEREFROMANDTHEBASISFORTHEALlEOEDEXEMP� C7
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� A CIVIL PENALTY OF NOT AqRE TMAN FIVE HUNDRED DOLLAHS(f500).):
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V.7LL DO THE WORK,M1D THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7M�,BUSI- J
� NESS AND PROFESSIONS CODE THE CONTMCTORS LICENSE UW DOES NOT APPLV TO AN OWNER OF j
PROPERTY VJI10 BUILDS OR IMPROVES TMEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR
CL THROU(3H HIS OR HER OWN EMPLOVEES,PROVIDED THAT SUCN IMPROVEMENTS ARE NOT WTENDED OR ' m
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Z TION,THE OWNEF-BUIIDER WILL HAVE THE BURDEN OF FROVINO THAT HE OR SHE DID NOT BUILD OR
� IMPROVE F-0R 7HE PURPOSE OF SALE).
W ❑I,AS OWNER OF THE PROPERTV,AM E%CLUSNELV CANTRACTIN(3 WfTH LICENSED CONTRACTORS
Q TO CONSTRUCT THE PRQIECT(SEC.7011,BUSINE55 AND PROFESSIONS CODE THE CONTRACTORS LI- V8N91IOf1 qp�,qqE,q
W CENSE LAW DOES NOTAPPLV TO AN ONTJEF OF A PROPERTY WHO BUI�DS OR IMPROVES THERE-0N,AND
� WFIOCONTRACTSFORSUq1PRQ1ECTSWITHACONTRACTOR(5)LICENSEDPURSUANTTOTHECONTqAG QUANTITY DESCRIPTION
70RS UCENSE LAW.�. FEE
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� LICENSED CONTRACTORS DECLARATION W ,
� I HEREBY AFFIRM UNDER PENALTV OF PERJURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER ����
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� WORKERS'COMPENSATION DECLARATION �
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� 1 HEREBV AFFIRM UNDER PENALTV OF PERIURV ONE OF THE FOLLOWING DECUAATIONS: Z
� _I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF�INSURE FOR WOHI(ERS' ¢
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CAMPENSATION,AS PROVIDED BV SECTION 37000F THE LABOR CODE,FOP THE PERFORMANCE U
OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. W
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Qw �I MAVE AND WILL MNNTAIN WOH)(ERS'COMPENSATION INSURANCE,AS FEWIRED BV SECTION
� 3700 OF THE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOq WHICN THIS PERMIT IS
� ISSUED.MY W(ORKERS'COMPENSATION INSURANCE CARRIER AND POLICV NUMBERARE: CONSTRUCTION
�j CARRIER �+����� PLAN REVIEW
� POI.ICVNUMBER �.a��no�-135 ( r fl /
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Z. I CEFTIFV hIAT INTHE PERFORMANCE OF THE WOFK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL
C3 SMALL NOT EMPLOY ANV PERSON IN ANV AIANNEH SO AS TO BECOME SU&IECT TO THE
(/) WORKERS'COMPENSATqN LAWS OF CALIFORNIA,AND AOREE THAT IF I SHOULD BECOME INSPECTION FEE
SU&IECT TO THE WORKERS'COMPENSATION PROVISqNS OF SECTION 37000F THE UBOR ,� `
s CODE,1 SHALL FORTHWITH COMPLV WITH THOSE PROVISIONS.
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p DATE: APPLICANT;
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� WARNIN(i:FAILURE TO SECUHE WORKERS'COMPENSATION CAVERAGE IS IJNLAWFUL.AND SHALL BE ENERGY P/C
� SU&IECTANEMPLOVERTOCRIMINALPENALTIESANDCIVILFINESUPTOONEHUNDREDTHOUSAND ENERGY
DOLLARS(flao,oao),IN ADDITION TO THE COST OF CAMPENSATKKJ,DAMAQES AS PROVIOED FOR IN
� SECTqN 3708 OF THE IABOR CODE,INTEREST,AND ATTORNEV'S FEES. ION FEE'
OCONSTRUCTION LENDING AGENCY PRE-ALT FEE:
� I HEREBV AFFIRM UNDER PENALTV OF PERIURV THAT THERE IS A CONSTRUCTION LENDINO AOENCV
FOR THE PERFORMANCE OF THE WOFU(FOR WHICN THIS PERMIT IS ISSUED(SEC.�ao7,CIV.C.).
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� LENDEF'S NAME
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w 1 CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT TNE ABOVE INFORMATION IS CORqECT. TOTAL FE ES ��
� I AGREE TO CAMPLV WITH ALL CfTV AND CIXINTY ORDINANCES AND STATE IAWS REUTINO TO BULLAINO
� CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO EMER UPON THE
Z ABOVE�MENTIONED PROPERTV FOR INSPECTION PURPOSES. COMMENTS '
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m FERMITTEE NAME(PR117T) ' �
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� RECPT.NO. PAID BY VALIDATION
WHITE—Depertment Copy,YELLOW—Finence Copy,PINK—Assesaor Copy,GOLDENROD—File Copy,GREEN—Appl(canYs Copy
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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 B�ND BEAM
WATER SERVICE MID HT. 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 POOL 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 FtNAL ZONING
FINAL CONST. FIRE DEPT. FINAL
FINAL HEATING HEALTH DEPT. FINAL
FINAL ELECTRIC DEV. FEES PAID
FINAL PLUMBING ENERGY
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COMMEIVTS
SEPTIC TANK SIZE
SEEP PIT/U SIZE
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