HomeMy WebLinkAbout10-1077 i �—
�`_ CITY OF DIAMOND BAR I�
DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES t
_," 21825 Copley Drive,Diamond Bar,CA 91765
(909)839-7020 Fax(909)861-3117 Building Inspect o�3i(�„�1�({9Q�L'�-7$� PRESS
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W TURE,PRqR TO ITS ISSUANCE,AL50 REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w
jv STATEMENT THAT HE OR SHE IS LICENSED PUHSUANT TO THE PROVISIONS OF THE CONTRACTORS LI� �'
� CENSE LAW(CHAPTER Y(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINE55 AND PRO� � Pool/Spa
, O FESSIONS CODE)OR 7HA7 HE OR SHE IS E%EMP7 THEREFROM AND THE BASIS FOR 7HEALLEGED E%EMP- (�
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Z WILL�h1E WORN,AN�THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7ou,BUSI- �J
N NESS AND PqOFE5510N5 ODDE:THE CONTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF j
PROPEfRV WFIO BUILOS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR
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Z TpN,THE OWNEF-BUIIAER WILL HAVE THE BUHDEN OF PROVWG THAT HE OR SHE DID NOT BUILD OR
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W ❑I,AS ONRJER OF THE PROPEHTY,AM EXq.L1SIVELV CANTRACTINO WRN LICENSEO CONTRACTORS
� TO CONSTRUCT THE PR0.IECT(SEC.76U,BUSINESS AND PqOFESSIONS CODE:THE COMRACTORS LI- V0IU8flOf1 ADJ.AREA
= CENSEUWDOESNOTAPPLVTOANONTJEROFAPROPERTYWHOBUIlA50RIMPROVESTHEREON,AND
� WHOCOMMCTSFORSUCHPP0.IECTSWITHACONTRACTOR(S)LICENSEDPURSUANTTOTHECONTRAG QUANTITY DESCRIPTION
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� ❑I AM EXEMPT UNDER SEC. 8.8 P.C.FOR THIS REASON �
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F LICENSED CONTFACTORS DECLARATION –�
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I HEREBY AFFIRM UNOER PENALTV OF PERIURV THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER �
� Y(COMMENCINO WfTH SECTION 7000)OF DNISION 3 OF THE BUSINESS AND PROFESSIONS CODE,AND Z
��� MV LICENSE IS IN FULL FORCE AND EFFECT. m
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� WORKERS'COMPENSATION DECLARATION �
� I HERFBY AFFIRM UNDER PENALTV OF PER1UqY ONE OF THE FOLLOWING DECUHATpNS: �
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� _I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF�INSURE FOR WORNERS' _
� COMPENSATqN,AS PROVI�ED BY SECTION 37000F THE LABOR CODE,FOR THE PERFORMANCE U
OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. W
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Qw _I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REOUIRED 9V SECTION
37oa OF THE LAHOR CODE,FOR THE PERf-0RMANCE OF THE WOPK FOR WHICH 7HI5 PERMIT IS
� ISSUED.MV WOR)(ERS'COMPENSATION INSURMICE CARRIER AND POLICV NUMBER AAE: CONSTRUCTION
] CARRIER PLAN REVIEW
� POLICV NUMBER ELECTRIC
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Z I CEFTIFV THA7 IN THE PERFORMANCE OF THE WOR)(FOR WHICH THIS PERMIT IS ISSUED,1 MECHANICAL
C,�S SHAIL NOT EMPLOV ANY PERSON IN ANV MANNER 50 AS TO BECOME SU&IECT TO THE
(n WORKERS'COMPENSATION LAWS OF CAUFORNIq AND AOREE THAT IF I SHOULO BECOME INSPECTION FEE
SUBJECTTO THE WORNERS'COMPENSATION PROVISIONS OF SECTION 37n00f THE LABOR ��
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p DATE: APPLICANT: SMIP
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� WARNING:FAILURE TO SECURE WORKERS'CAMPENSATION CAVEi7AQE IS UNLAWFUL,AND SHALL BE ENERGY P/C �
� SU&IECTANEMPLOVERTOCRIMW�IPENALTIESANDCIVILFWESUPTOONEHUNDREDTHOU5MID ENERGYPER
DOLURS(i100,000),IN ADDITION TO THE COST OF COMPENSATIDN,DAMAGES AS PROVIDED FOR IN
� SECTION 3708 OF THE LABOR CODE,MTEREST,M!D ATTORNEV'S FEES. N FEE:
�
O CONSTRUCTION LENDING AGENCV PRE-ALT FEE:
� I HEREBV AFFIRM UNDER PENALTV OF PERJURV THAT THERE IS A CONSTRUCTION LENDINO AGENCY
f-0R THE PERFOFIAANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.30Y7,CIV.CJ.
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� LENDER'S NAME
� LENDERSADDRESS
w I CERTIFV THAT I HAVE FEAD THIS APPLICATION AND STATE THAT THE ABOVE INFORAIATION IS CORRECT. TOTAL F E ES � ( ��
� 1 AGREE TO COMPLV WITH ALL CfTV AND COUNTY OFDINANCES AND STATE LAWS REUTWG TO BUILDING
� CONSTRUCTION,AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTV TO ENTER UPON THE -
Z ABOVE-MEMIONED GROPERTV FOR I SPECTION PURPOSES. COMMENTS '
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� RECPT.NO. PAID BY VALIDATION
WHITE—Department Copy,YELLOW—Finence Copy,PINK—Assessor Copy,GOLDENROD—Flle Copy,GREEN—Applicant's Copy
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GROUND PLUMBING UNDER FLOOR CONDUIT
SLAB GRADE FIREPLACE FOUNDATION •
TEMP POWER FIREPLACE BOND BEAM
WATER SERVICE MID HT. BOND BEAM
RO�F SHEATHING 8 FT. BOND BEAM
FRAMINGNENTILATION FINAL BOND BEAM
ROOF COVER PRE-GRADING
ROUGH HEATING BENCHING
ROUGH ELEC7RIC ROUGH GRADING
ROUGH PLUMBING FINISH GRADING
SHOWER/TUB TEST POOL ELECTRIC
EXT. LATH/SIDING POOL FENGING
WALL INSULATION POOL FINAL
CEIUNG INSULATION OFF S(TE iMPS. '
DRYWALL NAILING DEDICATIONS
SEWER FINAL ENG.
SEPTlC TANK LANDSCAPE/IRRlG.
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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