HomeMy WebLinkAbout11-1459 �„`_ CITY OF DIAMOND BAR �
DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES
21825 Copley Drive,Diamond Bar,CA 91765
(909)839-7020 Fax(909)8fi1-3117 Building Inspection Hotline(909)839-7027 PRESS
I �'°w"� BUILDING PERMIT APPLICATION FIRMLY
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DATE CONST. GROUP
p OWNER ERiC SmiTH
p ADDRESS 2079/ /�/SS/ON/4�QY R�D(rE RO. ZONING SEfBACKS
Z CITY D• Bf}Q ZIP �II789 TEL. 3I- SOe�O FRONT qyy �
� APPLICANT BLfIKE MAQTI%V TEL. $/� REAR �
SIDE/SIDE STREET RW ❑
� CONTRACTOR REXWAY ROOF/N� SIDE �
� ADDRESS 5�7 N• 2USR REMOVE T/iES FQOn�► yqt1S�3
� CITY LA PUEN7'F ZIP Q17y4 TEL. 333 SG/S PROPOSED USE _ .� �ARA6F•
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� CENSE UW(CHMTER B(COMMENCWO WIiH SECTION 7000)OF DMSION 3 OF THE BUSINESS AND PRO� POOVSPB 1
^ FESSIONS CODE)OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED E%EMP- (�
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X AIY LICENSE IS IN FULL FOflCE AND EFFECT.
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� WORKERS'COMPENSATION DECLARATION Q
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� I HERFBYAFFIRM UNDER PENALTY OF 7ERIURY ONE OFTHE FOILOWING DECLAHATIONS: Z
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'dT- �SATION,AS PROVIDE�BV SECTION 370a OF THE LABOR CODE.FOR THE PERFORMMICE U
HE WORK FOR WHICH THIS PERMIT IS ISSUED. W
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� _I HAVE AND WILL MAMTAW WORKERS'COMPENSATION INSUFlANCE,AS REOUIqED BV SECTION
Q 3700 OF THE UBOR CADE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PEqM1T IS
ISSUED.MV WOqKERS'COMPENSATION INSUHANCE CARRIER AND POIICV NUMBERAAE: CONSTRUCTION �� �
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Z I CERTIFV iHAT INTHE PERFORMANCE OF THE WORN FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL
� SHALL NOT EMPLOV ANV PERSON IN ANY MANNER 50 AS TO BECOME SU&IECT TO THE
(/� WORKERS'COMPENSATION LAWS OF CALIFORN10.AND AGREE THAT IF I SHOULD BECOME INSPECTION FEE
SU&IECT TO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 370o OF THE LABOR �
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p OATE:���ay��, APPLICANT: / SMIP �, '� �
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DOIURS(5100,000).IN ADDITION TO THE CQST OF COMPENSATqN,DAMAGES AS PROVIDED FOR IN
J SECTIDN 3�08 OF 7HE LABOR COOE,MTEREST,AND ATTORNEV'S FEES.
w RETENTION FEE: •
O CONSTFUCTION LENDING AGENCY PRE-ALT FEE:
� I HEREBV AFFIRM UNDEF PENALTV OF PERJURV THAT THERE IS A CONSTRUCTION LENDINO AGENCY _
FOR THE PERFORMANCE OF TFIE WORN FOR WHICH THIS PERMIT IS ISSUED(SEC.30G7,CIV.CJ.
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� LENDEF7'S NAME
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w I AGREE TO CAMPLY WITH?LL CITY AND COUNTV ORDINANCES AND STATE LAWS REUTINa TO BUILDINO S� � �/
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� CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS COUNTV TO ENTER UPON THE '
Z ABOVE-MENTIONED VROPER7V FOR INSPECTION PURGOSES. '�"t'
� COMMENTS '
� Bc�vicE /►'raRT7�/
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� ATURE OF PERMfTTEE DATE
� RECPT.NO. PAID B VALIDATION
, WHITE—Department Copy,YELLOW—Finance Capy,PINK—Assessor Copy,GOLDENNOD—File Copy,GREEN—ApplicanPs Copy
CITV O� DIAfViOND ��►R
� INSPECTIOt� RECORD
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SET BACK FLOOR JOIST
FTGS/FORMS/STEEL FHA REQMTS
ELECTRIC GROUND UNDER F�OOR DUCT
GROUND PLUMBING UNDER FLOOR CONDUIT
SLAB GRADE FIREPLACE FOUNDATION
TEMP POWER FIREPLACE BOND BEAM
WATER SERVICE MID H'T. BOND BEAM
ROOF SHEATHING ' �� -" 8 FT. BOND BEAM
FRAMING/VENTILATION 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 FINA�
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
FINALCONST. �� FIRE DEPT. FINAL
FINAL HEATING HEALTH DEPT. FINAL
FINAL ELECTRIC DEV. FEES PAID
FINAL PLUMBING ENERGY
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COMMEfVTS
SEPTIC TANK SIZE
SEEP PITlU SIZE
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