HomeMy WebLinkAbout11642 - CTfY�F DIAMOND BAR '�t�
COMMUNCfY DEVELOPMENT DEPARTMENT �� �
;.,.,� . 21660 E.Copley Drive Suite 190 PRESS
(909)860.3195 Fax(909)861-3]17
""""� BUILDING PERMIT APPLICATION FIRMLY
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STATEMEN7 THAY NE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTPACTOpS LI.
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Z WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDE�OR OFFEREO FOP SALE(SEC.7�14.BU56 J
� NESS ANO PROFESSIONS COOE:THE CONTflACTORS LICENSE LAW DOES NOT APpLY TO AN OWNER OF ?
PROPERTV NMO BUILOS OR IMPROVES?HEREON ANO WHO DOES SUCH VJORK HIMSELF Dii HERSELf OR
� THROUGH HIS OR HER OWN EMPLOVEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTEN�ED OR m
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� LICENSE�CONTRACTORS D CLARAT ON W . . � �-
� �HEREB�AFFIRM UNDER PENAL7V OF PERJURV THAT 1 AM LICENSED UNDER PROVISIDNS OFCHAPTER �
d B(WMMENCING WITH SECT�ON 7000)OF�IYISION 30F THE BUSINESS AND PROFESSqNS CODE,AND Z
`X MY UCENSE IS IN FULL FORCE AND EFFECT. m
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� WORKERS'COMPENSATION DECLARATION ¢
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� I HEREBV AFG'IRM UNDER DENALiY OF PERJURY ONE OF TNE FOLLOWIN��ECIARATIONS: Z
0 _I HAYE RN�WILL MAINTAIN A CERTIFICATE OF CONSENTTO SELF�INSUFE FOR WORKERS' _
Z COMPENSA710N,ASPROVIDE�BYSECTION37000FTHElA90RCODE,FORTHEPERFORMANCE U
¢ OF TME WORK FOR WHICH TMIS PERMIT IS ISSUED. �
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QW I HAVE AND WILL MAMTAIN WORKERS'COMPENSATION INSUqRNGE,AS RE�UIRED BY SECTION �
3]OOOFTNELABORCO�E,FORTHEPERFORMANCEOFTHEWORKfORWHICHTHISPERMITIS � � -
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Z I CERTIFY THAT M THE PERFORMANCE OF THE WORK FOH WHICH THIS PERMIT IS ISSUED,I MECHANICAL
(� SHALLNOTEMPLOYANYPERSONINANVM/WNERSOASTOBECOMESUBJECTTOTHE
Uj WOPKEflS'COMPENSATION LAWS OF CALIFORNIA,ANDAQREETHAT IF I SHOULDBECOME INSPECTION FEE �
? SU&IECTTOTHEWOFiKERS'COMPENSATIONPROVISIDNSOFSECilON37000FTHELABOR
COOE,I SHALL FOflTHWITH fAMPLY WITH THOSE PROVISIONS. ISSUANCE k
� SMIP
p DATE: APPLICANT.
� WARNIN�:FAILURETOSECUPEWOPo(ERS'COMPENSATIONCOVERAGEISUNLAWRJI.ANOSHALL9E ENERGYP/C
� SU&IEC7ANEMPLOVERTOCRIMINAIPENALTIESANpCIVILFMESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT
�OLLARS�5100.000�.IN A�ITION TO THE COST OF COMPENSATION.DAMAGES AS PROVIDE�FOR IN
� SECTION 3708 OF THE LABOR CADE,MTEREST,AND ATTORNEV'S FEES. RETENTION FEE: �
d CONSTRUCTION LENDING AGENCY pRE-ALT FEE:
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� I HEREBV AFFlRM UNDER FENALTY OF PERIURV THATTHERE IS A CONSTRUCTION LENDING AGENCY ,
FOR THE PERFORMANCE Of THE WORK WR WNICH THIS PERMIT IS ISSUED(SEC.3087,CIV,C.�.
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� LENOER'S NAME
H LENDER'SADDRESS �-���� � ���
� ICEFTIFViHAT�HAVEREA�TNISAPPUCATIONANDSiATETH�TiHEABOVE1NFOqMATIONISCORRECT. TOTAL FEES x+� rjV
� I AGREE TO COMPLY WITH ALl CITY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILOING .
� CONSTRUCTION,AND NEREBYAUTHOR2E REPRESENTATNES OG THIS CWNTV TO ENTER UPON THE '
z ABOVE�MENTIONEDPROPEflTYFORMSPECTIONPURPO5E5. COMMENTS
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= RECPT,NO. PAID BY V/1LIDl(TION
~ WHITE—Department Copy,YELLOW—Finance C � � '� � " �
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SET BACK ,..._, : ._� _ � FLOOR JOIS7 � . „
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GROUND PLUMBING UNDER.FLO(?R C'C)�IDUtT `
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SLAB GRADE - - : '' ' ' ' ! FIREPLACE FOUNDATION '
TEMP P�WER - FIREPLAGE BCJND BEAM F��' a ' � '
WATER SERVICE . ', . :' I MID HT. BC�ND BEAM • . :
ROOF SHEATHING 8 FT. BOND BEAM �-�
FRAMINGNENTILIATION `,.:` ,, �INAL BOND BEAM __.___ _ _ _ ,
ROOF'COVER _ -_. PRE-GRADING '
ROUCaH HEATING :, , : BENCHING _ •_ _... .. --
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ROUGH ELECTRIC _ _ ROUGH GRAaING . . , „ .,. ,-. _,,,,,,,
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