HomeMy WebLinkAbout14757 (19) �
, _ *di � CITY OF DIAMOND BAR ��(���E�
DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES
� 21660 E.Copley Drive Suite 190 �U N 1 S 2OOZ PRESS
(909)86Q3195 Fau(909)861-3117
��=���. BUILDING PERMTT APPLICATION . FIRMLY
� JOBSITE ' ' . APPLICATION PERMIT �L,� P/C
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w TUqE,PRIOR TO ITS ISSUANCE,ALSO REW IRES THE APPLICANT FOR SUCH PEPMIT TO FILE A SIGNED W
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F LICENSED CONTRACTORS DECLARATION W
� 1 HEHEBY AFFIRM UNOER PENALN OF PEfiIURV THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER �
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iL� MY LICENSE IS IN FULL FORCE AND EFFECT. m
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� 1 HEREBY AFFIRM UNDER PENPL7Y,OF PERIURY ONE OF THE FOLIAWING DECLAMTIONS:
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� �Q.I HAVE AND WILL MAINTAIN ACERTIFlCATE OF CONSEHT TO SELF-INSURE FOR VIOHKERS' 2 � , '
K� COMPENSATION,AS PROVIDED BY SEC710N 370o Of THE LABOR CODE,FOR THE PERFORAUNCE U
Q �OF THE WORK FOR NMICH THIS PERMIT IS ISSUED. �
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W _IHAVEANDWILLMAINTAINWORKERS'COMPENSATIONINSURANCE,ASREOUIREDBYSEC710N /''� /��
Q 3700 OF THE UBOR CODE.FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS �•/ �(•)
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Z I CEHTIFY THAT IN THE PERFORMANCE OF 7HE M/ORK FOR WHICH 7HIS PERMIT IS ISSUED,I
(� SHALL NOT EMPLOY ANY PERSON IN ANY MANNER SOAS TO BECAME SU&IECT TO THE
� WORKERS'COMPENSATION UWS OF CALIFORN10.AND AGHEE THAT IF I SHOULD BECOME INSPECTION FEE
S SUBJECT TO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 37o00F THE LABOR
CODE,I HALL FORhIWITH COMPLY WIh1TH05 OVI51 NS. ISSUANCE
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LL SUBIECT MPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDHED THOUSPND ENERGY PERMIT
DOLLARS(i W.000).IN ADDITION TO7HE COST OF COMPENSA710N,DM/AGcS AS PROVIDED FOR IN
� SECTION 37oB OF TIE LABOR CODE.INTEREST,AND ATTORNEV'S FEES. RETENTION FEE:�y�p
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� I HEREBV AFFIpM UNDER PENALTV OF PERIURV THAT 7HERE IS A CONS7RUCTION LENDINO AGENCV
FOR THE PERFORMANCE OF?HE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3oW,CIV.C.).
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� ICERTIFVTHATIHAVEREADTHISAPPLICATIONANDS7A7ETHATTIEABOVEMFORMATIONISCOHRECi TOTAL FEES � I A--� /
w 1 AGREE TO CAMPLV WI7H ALL CT'AND COUN7Y ORDINANCES AND STATE LAWS REUTINO TO BUILOING V <
� CONSTRUCTION.PNDHEREBYAUTHORIZEREPRESENTATIVESOF7HISCOUNTYTOEN7ERUPONTHE � �
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SLAB GRADE � FIREPLACE FOUNDATION
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WATER SERVICE MID HT. BOND BEAM -
ROOF SHEATHING �ZR� - 8 Fi'. BOND BEAM � � � � � �
FRAMINGNENTIUATIDN. � � FINAL.BOND BEAM
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ROUGH HEATING ' BENCHING �
ROUGH ELECTRIC ROUGH GRADING
R�UGH PLUNIBING FINISH GRADING
SHOWER/TUB TEST POOI.ELECTRIC
EXT. LATH/SIDING POOL FENCING
WALL INSIJIATION POOL FINAL
CEILING INSULATION OFF SITE IMPS.
DRYWALL NAILING DEDICATIONS ' �
SEWER FINAL ENG.
SEPTIC TANK LANDSCAPElIRRIG.
SEEP PIT/L.L. ON SITE IMPS.
GAS AIR TEST ' FINAL ZONING
FINAL CONST, FIRE DEPT. FINA�
FINAL HEATING HEALTH DEPT. FINAL
FINAL ELECTRIC DEV. FEES PAID
FINAL PLUMBING ENERGY
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