HomeMy WebLinkAbout12-516 CITY OF DIAMOND BAR �
---��— DEPARTMENT OF COMMUNITY&DEV7�LOPMENT SERVICES
21810 Copley Drive,Diamond-Bar,CA 91765
(909)839-7020 Eax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS
�'•^'� BUILDING PERMIT APPLICATION FIRMLY
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� STA7EMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS�OF THE�CANiRACTOR3 L4 ,
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� 1 HEREBV AFFIRN UNDER PENALTY OF PER1UFiV ONE OF THE FOLLOW W(i DECLARATIONS: Z - .
� _� ANDWILLMAINTAWACERTIFICATEOFCqN5ENT70SELF•INSUREFORMqHNERS' � � - � I
PENSATION.AS PROVIDED BV SECTION 3700 OF THE LABOR CODE,FOR THE PERFOFlAIANCE W.
OF THE WOR1C FOR NM1iICH TNIS PEAMIT IS ISSUED. �
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w I HAVEAND WILLMAINTAW.WORKEA3'COAAPENSATON WSURANCE,AS qEOUIREO BY 5ECTION
Q 37000FTHELABORCODE,FORTHE�PERFORMANCE'OFTHEWOfiKFORWHip1THI5PERM1T15 � ./�(G�.�/A �
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� WDRKERS'COMPENSATqNlAW50FCAL A,ANDAGREETHA7IFISHOULDBECOME INSPECTIONFEE
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^ � WAHNINO:FAR.URE TO SEGURE WORKERS'COMPENSATION COVERAOE IS UNLAWFUL,AND fiMALL BE ENERGY P/C
� SU&IECT AN EMPLOYER TO CRIMPULL PENALTIES AND CJVIL FlNES UP TOONE HUNDRED 7YIOUSMID �ERGY PERMIT
DOLURS(St00,00D),IN ADD�710N TOTHE COST OF COMPENSATpN,DAMA6E5 AS PROVIDED FOH W
J SECTION 370!OF THE LABOFi CODE.INTERE3T,AND ATfORNEY'g FEES. � � ' ' '
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Q 1 HERE6Y AFFIRM UNDER PENALTY OF PERIURV THAT TNERE IS A CONSTRUCTION LEN�WO AAENCV �jS�� �
�Z� �FOR h1E PERFORMANCE OFTHE WOR)(FOR NM1i1CH THIS PERMR IS ISSUED(SEC:�30D7,qV.G).
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�Z'. LENDEftS NAME . . . ,
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� IENDER'SADDRESS
W I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THATTHE ABOVE INFORMATIDN IS COiiRECL TOTAL FE ES `�
� I A(3REE TO COMRV N7TH'ALL CfTV AND COUNTV ORDINANCES AND STATE LAWS REIATINO TO BURDWO
� CONS7RULTION,AND HEREBV AUTHORRE REPRESENTATNES OF 7HIS COUN7Y 70 ENTER UPON THE �
Z ABOVE-MEMI�NEOPROPER7YFORINSPECTqNWRPOSES. COMMENTS ` �
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� SIONATURE OF P E DATE
� RECPT..NO. PAID B VAUDATiON
WHITE-Depertment Copy,YELLOW—Finence Copy,PINK—Assessor Copy,GOLDENROD—Flle Copy;6REEN—HpplicanCe Copy
CITY OF DIAMOND BAR
� INSPECTIO� RECOFtD �
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SET BACK FLOOR JOIST
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GR�UND PLUMBING UNCER FLOOR CONDUIT
SLAB GRADE FIREPLACE FOUNDATION
TEMP POWER FIREPLACE 80M11D�EAM _
WATER SERVICE � ' MID HT.BOND BEAM,
ROOF SHEATHING � �y 8 FT.BOND BEAM
FRAMING/VENTILATION FIIdAL BOND BEAM
ROOF COVER PRE-GRADING
ROUGH HEATING BENCHING
ROUGN ELECTRIC ROUGH GRADING
ROUGH PLUMBING FINISH GRADING
SHOWER/TUB TEST POOL ELECTRIC
EXT.LP;(N/SIDING POOL FENCING
WALL INSULATION POOL FINAL
CEILING I(JSULATION OFF SITE IMPS.
ORYWALL NAILING DEDICAT�ONS
SEWER FINAL ENG. "
SEPTIC TANK ' LANDSCAPE/IRRIG.
SEEP PIT/L.L. ON 51TE IMPS.
GAS AIR TEST FINAL ZONING
FINAL CONST. -,5� FIRE DEPT.FINAL
FINAL HEATING HEALTH DEPT.FINAL
FINAL ELECTRIC DEV.FEES PAID
FINAL PLUMBING ENERGY
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SEPTIC TANK 51ZE
SEEP PIT/U SIZE
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