HomeMy WebLinkAbout12-387 _�`_ CI'I'Y OF DIAMOND BAR ✓
DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES
21810 Copley Drive,Diamond Bar,CA 91765 " I
(909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 � PRESS !
"'"', BUILDING PERMIT APPLICATION FIRMLY
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� WORKEFS'COMPENSATIONDECLARAT70N �� � � � � � � �
� 1 HEREBV AFFIRM UHDER PENALTV OF PERIUHY ONE OF THE FOLLON7N(3 DECIARATION3: V
� �� _1 HAVE AND WILL MAINTAW A CERTIFICATE OF COPJgENT TO SELF-INSURE FOq NqRNERS• � ' �-
COMPENSATION,AS PROVIDED BY SECTION 37000F THE UBOR CODE,FOR THE PERfORM�NCE U��
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Q 37000F�THE IABOR CODE.FOR THE PERFORMM10E�pF THE WOPo(FOR WHK]i THIS PERNIT IS
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Z I CERTIFY THAT IN THE PERFORMANGE OF TNE WORK FOR WMCM T/119 PEHMIT IS ISSUED,1 �MECHANICAL 5� `�j��
CJ SHAII NO7 QdPLOY ANY PERSON IN ANY lAANNER SO AS TO BECOME SU&IECT 70 THE' �
(n WORNERS COMPENSAT1q1 LAWS OF CAIIFORNIA,AND AGREE THAT IF I SHqriD BECAME INSPECTION FEE�
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� WARNINO:�FAILURETOSECUREWORKERSCOMPENSATqNCOVEM(3EISUNUWFUI.ANDSFULLBE ENERGYP/C �
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DOLLARS�f10o,o00),W ADDI710N TO THE�COST OF COMPENSATION,DAMAOES AS PROVIDC-0 FDR IN
J SECTqN 370E OF 7HE LABOR COO�W7EREST,AND ATfORNEY'g FEES. � ' � ��
� RETENTION FEE:
oCONSTRUCTION LENDING AGENCY PRE•ALT FEE
� 1 HEREBYAFFIRM UNOER PENALTY OF PERri1RV THAT TiERE IS ACONSTqUCTION LENDW6 AOQJCY • �
�Z� FOR TME PERFOWAANCE OF�h1E WORI(FOR N7ilC117H75 PEHMR IS ISSUED(SEC:3087,qV.C.).
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� I A(iREE 70 COMVLY N7TH ALL CfTV AND COUNTV ORDWANCE3 AND STA7E UWS RELATYKI TO BURDINO
.�. CONSTRUCTION,ANp HEREBY AUTHORIZE qEPRESENTATIVES OF TMS COUNTY TO ENTER UPON 1HE ' .
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CI'T"Y QF DIAMOND B,4R
INSPECTION RECORD
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SET BACK FLOOR JO(ST
FTGS/FORMS/STEEL FHA REQMTS
ELKTRIC GROUND UNDER FLQOR DUCT
GROUND PLUMBING UNDER FlOOR CONDUIT
SLAB GRADE FIREPLACE FOUNDATION
TEMP POWER FIREPLACE BOND BEAM
WATER SERVICE MID HT.BOND BEAP/1
ROOF SHEATHItJG 8 FT.BOND BEAM
FRAMING/VENTILATION FltdAl BOND BEAM
- ROOF COVER PRE-GRADING .
ROUGH HEA7ING BENCHING
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ROUGH ELECTRIC ' %" ROUGH GRADING
ROUGH PLUMBING �� FINISH GRADING
SHOWER/TUB TEST POOL ELECTRIC
EXT.LATH/SIDING POOL FENClNG
WALI INSULATIOPI POOL FINAL
CEILING IfJSULATION OFF SITE IMPS.
DRYWALL NAILING DEDICATIONS
SEWER FINAL ENG.
SEPTICTANK LANDSCAPE/IRRIG.
5EEP PIT/L.L. Ofd SITE IMPS.
GAS AIRTEST FINAL ZONING
FINAL CONST. FIRE DEPT.FINAL
FINAL HEATiNG HEALTH DEPT.FINAL
FINAL ELECTRIC DEV.FEES PAID
FINAL PLUMBING ' ENERGY
FINAL PLANING _�
FINAL ENGINEERING� . � p
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COMMENTS
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