HomeMy WebLinkAbout12-793 _�� CITY OF DIAMOND BAR
DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICFS
21810 Copley Drive,Diamond Bar,CA 91765
(909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS
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� 1 HEREBY AFFlRAI UNOER PENALTY OF PER0.IRV 7HAT I AM�LICENSED UNDER FROVISIONS OF G7APTER � - �
d, D�COMMENCINO WITH SECTION 7000)OF OMSIOIJ 30F THE BUSINESS AND PROFESSIONS CppE,ANO Z � �
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� WORKERS'COMPENSATION DECLARATION � - � � - � � � -
� 1 HEREBV AFFUiM UNDER PENALTV OF PERJURY ONE Of THE FOLLOW W6 OECIARATIONS: V - ' �
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� _1 HAVE AND WILL MAMITAW A CERTIFICATE OF CqJSENTTO SELFINSURE FOii NORKEq8• � - �
Q COMPENSA710N,AS PROVIDm BV SECTION 370o OF 7HE LABOR CODE,FOR 7HE PERFOFlMANCE W�
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Q 370o OF�THE LABOR CODE,FOR THE PERFORMMICE�OF THE WORK WR WMICH TH15 7EHMIT 13
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ry SUBJECTANEMPLOYERTOCAfMWALPENALTIESlWDpVILFWESUPTOONEHUNDREDTHOUSMID ENEROY�PERMIT
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w SECTION 3'loE OF 7HE LABOR CODE,INTERE57;AND ATfORNEV'S FEES. ' RETENTION FEE:
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� 1 HEREBYAFFlRM UNDER PEN�L7Y OF PEFWRV THAT THERE IS ACONSTRUCTION LED7pW(i A6ENCY
� �FOR T17E PERFORMANCE OF THE WORK FOR N711CF17HI5�PERMR IS ISSUED(SEC.3047,qV.G}
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CONSTRUCf10N,ANp HEREBV AUfHO{i12E REPRESENTATIVES OF iH15 COlu7TY 70 ENTER UPON 7HE
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CITY OF DIAMOND BAR
INSPECTIOPV REC4RD
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GROUND PLUMBING UNDER FLOOR CONDUIT
SLAB GRADE FIREPLACE FOUNDATION '
TEMP POWER FIREPLACE BOND BEAM
WATER SERVICE MID HT.BOND BEAM
ROOF SHEATHItVG 8 FT.BOND BEAM
FRAMING/VENTILATION FIldAL BOND BEAM
ROOF COVER PRE-GRADING
ROUGH HEATING BENCHI(dG
ROUGH ELECTRIC ROUGH GRADING i
ROUGH PLtJMBING FINISH GRADING
SHOWERffUB TEST POOL ELECTRIC
EXT.LATH/SIDING POOL FENCING
WALL INSULATION POOL FINAL .
CEILING INSULATION OFF SITE IMPS.
DRYWALL NAIIING DEQICATIONS
SEWER FINAL ENG.
SEPTICTANK LANDSCAPEIIRRIG.
SEEP PIT/L.L. ON SITE IMPS
GAS AIR TEST �FINAL ZONING
FINAL CONST. j fIRE DEPT.FINAL
FINAL HEATING HEALTH DEPT.FINAL
FINAL ELECTRIC DEV.FEES PAlD
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FINAL PLANING
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SEEP PIT/U SIZE
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