HomeMy WebLinkAbout17100 (25) ^ _��` _ CITY OF DIAMOND BAR
DEPARTIvfENT OF COTRvIUNTI'1'8c DEVELOPMENT SERVICES
21825 E.Copley Drive
(909)860-3195 Fax(909)861-3117 PRE$S
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Z WILI DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.70�a,BUSI- J
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Z I CERTIFV THAT IN 7HE PERf-0RMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL e1 1
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(/� WORKERS'COMPENSATqN LAWS OF CALIFORNIq AND AGREE TMAT IF I SHOULD BECOME INSPECTION FEE � �
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� SECTqN 3)oe OF THE LABOR COOE,INTEREST,AND ATfOHtJEV'S FEES. RETENTION FEE: �1
OCONSTRUCTION LENDING AGENCY PRE-ALT FEE: V
� 1 HEREBV AFFIRM UNDER PENALTV OF PERJUiiV THAT THERE IS A CONSTRUCTION LENDINO ADENCV
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� ICERTIFVTHAT HAVEREADTHISAPPLICATIONANDSTATETFIATTHEABOVEINFOPMATIONISCARRECT. ��.��`//� '- .
I AGREE TO CO �LV WITH ALL CITV AND COUNTY ORDINANCES AND STATE UWS RELATING TO BUILDING 1
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