HomeMy WebLinkAbout11875 (5) �� _ CITY OF DIAMOND BAR x��
DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES �
� 21660 E.Copley Drive Suite 190
(909)860-3195 Fax(909)861-3117 PRESS
' ����A�'� BUILDING PERMIT APPLICATION FIRMLY
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� OWNER•BUILDER DECLARATION SFR/ADDlREM
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Z TURE,PRIOfl TO IT8 ISSUANCE,ALSO REOUIRES THE ACPLICANi FOR SUCH PERMIT TO FILE A SIGNED (
W STATEMENT THAT HE OR SNE I5 LICENSEO PIJFSUANT 70 THE PROYISIIXJS OF TME CONTRFCTORS LI- W [�
� CENSE lAW(CHIIPTER e(COMMENCING WITH SECTION 7000)OF DIYISION 30F THE BUSINESS AND Pfl0- � POOVSpB �
FESSION5 CO�E)OR THAT HE OR SHE 13 EXEMPT THEREKFiOM AN�THE BASI3 FOR THE AILEGE�EXEMV•
TION.AN`IYIOUTIONOFSECTION7031.58YANVAPPLICANTFORAPERMITSUBJECTSTHEAPPLICANTTO ' z Re-Roof ��
ACIVIL PENALN OF NOT MORETHAN FIVE HUNDRED oOLLpRs(35ao).J�. �
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NESiAND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NOi APPLY TO!uY OWNER OF
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CENSE LAW DOES NOT APPLY TOAN OWNEfl OF A PROPERTV WHO BUILDS OR IMPROVES THEFEON.AND
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._ ISSUE�.MYWOFKERS'COMPENSATIONINSURANCECARHIERIINDPOLICYNl1MBERARE: CONSTFIUCTION __.___,__,_____.._,_.____,_..,___ __ (�
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z ICERTIFVTHATINTHEPERFORMANCEOFTNEWORKFORWHICHTHISPERAAITISISSUED,I MECHANICAL __,_ __ ______,__ _ ____ r
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� WOftICERS'COMPENSATIONLAWSOFCAUFORNIA,ANDAGREETHATIFI LDBECAME INSPECTIONFEE ___.
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� SUBJECTANEMPLOYEflTOCFIMINALPENALTIESFNOCIVILFINESUPTOONEHIINUREDTkIOUSAN� ENER�YPERMIT �
DOLLARS(5700.000).M ADOITION TO THE COST OF COMPENSA710N,DAMAGES AS PROVIUE�FOR IN --"------"- �-'----
� SECTION 37080F THE Lq80R CODE,INTLREST,FN�ATTORNEY'S FEE3. HETENTION FEE: _ s
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OCONSTRUCTION LENDING AGENCV PHE-ALT FEE: .._„___ ___.._... �
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� I AGflEE TO COMPIY WI�N ALLCRV AND CAUNN OflDINqNCESAND STATE LAWS RELATING TO DUILDING py ,
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~ WHITE-Department Copy,YELLOW-Finance Copy,PINK-Assessor Copy,GOLDENROD-File Copy,GREEN-Applicant's Copy
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