HomeMy WebLinkAbout10-1175 ^
^ _���_ CITY OF DIAMOND BAR -
' DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES
21825 Copley Drive,Diamond Bar,CA 91765
(909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839- PRE$$
'�'°""� BUILDING PERMIT APPLICATION FIRMLY
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PqOPEHTY WIiO BUILOS OR IMPROVES THEREON,AND MMO DOES SUCH WORK HIMSELF OR HERSELF OR
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W CENSE LAW DOES NOTAPPLV TO AN OWNER OFA PROPERTV WHO BURDS OR IMPpOVES THEREON,M!D
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�¢ LICENSED CONTRACTORS DECLARATION w ( V!�
¢ 1 HEREBY AFFIRM UNDER PENALTY OF PERJURV THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER �
� 8(COMMENCINO WITH SECTION 7oa0)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CADE,AND Z 1
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� WORKERS'COMPENSATION DECLARATION � S - �
� I HEREBV AFFIRM UNDER PENALTV OF PERIURV ONE OF THE FOLLOWING DECURATIONS: �
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0 _I HAVE AND WILL MAINTAIN A CERTIFlCATE OF CONSENT TO SELF�INSURE FOR WORNERS' a /+'
� COIAPENSATION,AS PROVIDED BV SECTION 37o0OF 7HE U100R CODE,FOR THE PERFORMMICE U �' L�p
p�,THE WORK FOR WHICH THIS PERMIT IS ISSUED. W
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w �I HAVE AND WILL MAINTAW WORKENS'COMPENSATION INSURANCE,AS REOUIRED BY SECTION
Q J700 OF THE LABOR CADE,FOF THE PERFORMANCE OF iHE WORK FOR WHICH THIS PERMIT IS /'.�O
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Z �CEqTIFY THAT IN THE PEFFORMANCE OF THE WORK FOR WHlpl THIS PERMIT IS ISSUED,I ECHANIC � �
C�S SMALL NOT EMPLOY ANV PERSON IN ANV MANNEF ECT TO THE
(/� WORKERS'COMPENSATIONUWSOFCALIF ,ANDAGREETH1Id 5 DBECOME INSPEC EE
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�y SU&IECTANEMPLOVERTOCRIMWALPENALTIESANDCIVILFINESUPTOONEHUNDREDTHOUSAND E PERMIT ! 7 �O
DOLURS(5100.000).IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIOED FOR IN 1YA
w SECTION 37oe OF h1E LABOP CODE,INTEREST,AND ATTORNEV'S FEES. TION FE ' _ $��J v
O CONSTRUCTION LENDING AGENCY qF.vi T FFE� �
� I HEREBV AFFIRM UNDER PENALTV OF PERJURV THAT THERE IS A CANSTRUCTION LENDINO AGENCV r7�•r�—f ��' �
FOR THE PERFORMANCE OF iHE WORN FOP WHICH TNIS FERMIT IS ISSUED(SEC.3007,CIV.C.). Y
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� LENDER'S NAME
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w I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE T1iAT THE ABOVE INFORMATION IS CORRECT. TOTAL FE ES � 7
� I AQREE TO CAMPIV WITH ALL CfTY AND COUNTV ORDINANCES AND STATE LAWS RELATING TO BUIlDINO �
� CONSTRUCTION,AND HEREBV AUTFIORI2E REPRESENTATNES OF THIS CWNTV TO ENTER UPON THE .
Z ABOVE�MENTIONED PROPERTV FOR INSPECTqN 7URPOSES. COMMENTS '
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� ONANHE OF PE - DATE
� RECPT.NO. PAID BY VALIDATION
—Depertment Copy,YELLOW�inence Copy,PINK—Assessor Copy,(30LDENROD—File Copy,GREEN—Applicant's Copy
CBTV O� DIAMOND B�►R .
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� INSPECTION RECORD
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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 HT. BQND BEAM
ROOF SHEATHING 8 FT. BOND BEAM .
FRAMINGNENTILATION i� ( 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 FINAL ZONING
FINAL CONST. FIRE DEPT. FINAL
FINAL HEATING HEALTH DEPT. FINAL
FINAL ELECTRIC DEV. FEES PAID
FINAL PLUMBING ! � ENERGY
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COMMENTS
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SEEP PIT/U SIZE
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