HomeMy WebLinkAbout11-1131 __��_ CITY OF DIAMOND BAR , ���� ���� //
DEPARTMGNT OF COMMUNITY&DEVELOPMENT SERVICES �
21825 Copley Drive,Diamond Bar,CA 91765 S
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Z NRE,PRqR TO I75 IS9UANCE,ALSO REDUIRES THE APPLICANT FOR SUCH PERMI7 70 FILE A SIONED
w STATEMENT THAT HE OR SHE IS IICENSED PURSUANT TO THE�ROVISIONS OF THE CONTMCTORS LI�
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1 MEREBV AFFIRAI UNDER PENALTV OF PERIURV THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER �
d B(COMMENCINO WITH SECTION 7000)OF DNISION 3 0F THE BUSINESS AND OROFESSIONS CODE,AND z
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� I HEREBY�FFIRM UNDER PENALT'OF PE0.IURY ONE Of TNE FOLLOWING DECURATIONS:
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� 1 NAVE AND W�LL MAWTAW A CERTIFlCATE OF CONSENT TO SELF�INSURE FOR WORNERS' 2
� COMPENSATION,AS FROVIDED BV SECTION 37000FTHE LABOR CODE,FOR THE PERFORMANCE w
OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. r2
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I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE.h`+REOUIREO BV SECTION
Q 3700 OF TNE UBOF7 COOE,FOR THE PERFORIAANCE OF THE WORK FOR WHlpi THIS PERMIT IS
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Z I CERTIFV TMAT IN THE PERFORMANCE Of THE WOHK FOR WHICH TNIS PERMIT IS ISSUED,I
� SHALL NOT EMPLO�ANV PERSON IN ANV MANNER 50 AS TO BECOME SU&IECT TO THE INSPECTiON FEE
� 4VORNERS'COMPENSATION LAWS OF CALIFORNIA,AND AGREE THAT IF I SHOULD BECOME
S SU&IECTTOTHEWORKERS'COMPENSATIONPROVISKKJSOFSECTION97o0OFTHEUBO �SSUANCE � /
fAD 1 SH�LL FORTHWITH COMPIV WITH THOSE P VIS10N5.
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---� WARNINO:FAILURE TO SECURE N�ORKERS'COMPENSATION CO AOE IS UNUWFUL,AND SHALL
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� SU0.IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNORED Tl10USAN ENERGY PERMIT
DOIURS(5700.000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN �Y
J SECTION 3�OB OF THE LA00R COOE,INTEREST,AND ATTO�iNE�"5 FEES. � RETENTION FEE: .
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� I HEREBV AFFIRM UNDER VENALTV OF PERIURV THAT THEFE IS A CONSTRUC710N LENDING AOENCY
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� LENDER'S NAME
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� I CERTIFY THAT I HAVE fiEAD THIS AP7LICATION AND STATE THAT THE ABOVE INFORMATqN IS CORAECT. TOTAL FE ES /�/^/O
w I AGREE TO COMPLV WITH ALL CITV ANO COUNTY ORDINANCES AND STATE UWS REU7ING TO 0U0.01N0
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� ABOVE�MENTIONED VROPERTV FOR INSPECTION PURPOSES. .
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WHITE—Department Copy,YELLOW--Finence Copy.PINK—Aasessor Copy,GOLDENROD—File Copy.GREEN—Applicant's 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 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 RQUGH GRADING
ROUGH PLUMBING FINISH GRADING
SHOWER/TUB TEST POOL ELECTRIC
EXT. LATH/SIDING POOL FENC�NG
WALL INSULATION P�OL 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 _�.e2 ' ' HEALTH DEPT. FINAL
FINAL ELECTRIC DEV. FEES PAID
FINAL PLUMBING ENERGY
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