HomeMy WebLinkAbout12-2063 _ �
�� CITY OF DIAMOND BAR V'_ /
DEPARTMENT OF COM1yIUNITY&DEVELOPMENT SERVICES � V
. 21825 Copley Drive,Diamond Bar,CA 91765
(909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS
"°�", BUILDING PERMTT APPLICATION ��0,3 FIRMLY
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� I HEREBV AFFIRM UNDER PENALTV OF PERNRV THAT 1 AA1 E%EMPT FROM THE CONTRACTORS LI- GBfeJB/CBfPOfI
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� NRE,PRIOR TO ITS ISSUANCE.ALSO REW IRES THE APPUCANT FOR SUCM PERMIT TO FILE A SIONED w P8�10/DBCI(
STA7EMENT THAT HE OR SHE IS LICENSED PUHSUAN7 70 THE PROVISIONS OF THE CANTRACTORS lb
� CENSE LAW(CMAPTER o(COMMENCINO WITH SECTION]aoo)OF DIVISION 3 OF THE BUSINESS AND PRO� � POOUSpe
FESSIONS CODE)OR THAT HE OR SHE IS E%EMPT THEREFROM AND THE BASIS FOR THE ALLEOED E%EMP- �
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ACML PEN/�LTV OF NOT AqRE THAN FIVE HUNDRED DOlURS(5500).):
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Z WILL DO 7HE WORK,AND THE STRUCTURE IS NOT INTENOED OR OFFERED FOR SALE(SEC.7041,BU51� J
� NESS M1D PROFESSIONS CODE:THE CONTMCTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF ?
PROPEfRY NM110 BUILOS OR IMPROVES TMEREON,AND NM1IO DOES SUCH WORK HIMSELF OR HERSELF OR
CL TMROUGHHISORHEROWNEMPLOVEES,PROVIDEDTHATSUCHIMPROVEMEMSARENOTINTENDEDOR m
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Z TqN,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUIID OR
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� TO CONSTRUCT THE PRQIECT(SEC.70�1,BUSINESS AND PROFESSIONS CADE:TNE CONTRACTORS LI- V91U0SIOf1 �+' ADJ.AREA
CENSE LAW DOES NOTAPPLV TOAN OWNER OFA PROPERTY WHO BUII.DS Oq IMPROVES THEREON,AND
� NM1iOCONTRACTSFORSUCHPR0.IECTSWITHACONTRACTOR(S)LICENSEDPURSUANTTOTHECANTMC� QUANTITY DESCRIPTION
70RS UCENSE UW.). FEE
� ❑I AM E%EMPT UNDER SEC. B.8 P.C.FOR THIS REASON � � r
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� OATE OWNER �
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� LICENSED CONTRACTORS DECLARATION W �
� 1 HEREBV AFFIRM UNDER PENALTV OF PERIURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER �
� D(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE,AND Z
��� W LICENSE IS IN FULI FOFCE AND EFFECT, m
� LICENSE CLASS G� UC.NQ � ,�J' 'w 1 �
V DATE � L�' CONTRACTOR � d
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� WOFKERS'COMPENSATION DECLARATION �
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� I HEREBY AFFIRM UNDER 7ENAL7Y OF PERIURV ONE OF THE FOLLOWING DECUAATIONS: Z
0Z _I HAVE AND WILL MAMTAIN A CERTIFICATE OF CANSEM TO SELF-INSURE FOR MqRKERS' a •
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COIdPENSATION,AS PROVIDED BY SECTION 3700 OF TIiE LABOR CODE,FOR TME PERFORMANCE U
OF THE WORI(FOR WHICH THIS PERMIT IS ISSUED. W
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w _I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REOUIRED BV SECTION /'
Q 370o OF 7HE UBOR CODE.FOR THE PERFORMMJCE OF THE WORK f-0R WHICH THIS PERMIT IS /( ��
ISSUED.MY WORKERS'COA/PEN/$'ATION INSURANCE CARRIER AND PoLI V NUMBER ARE: CONSTRUCT�ON "f
� CARRIER ���'�i h'C– � ��' ` PLAN REVIEW � � � � O
� POLICV NUMBER �7 /Z� ELECTRIC ,
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Z I CERTIFY THAT IN THE PERFORMANCE OF THE WOPoC FOR WHICH THIS PERMIT 45ISSUED.I MECHANICAL
C�3 SHALL NOT EMPLOV ANY GERSON IN ANV MANNER 50 AS TO BECOME SU&IECT TO THE
(/� WORKERS'COMPENSATION LAWS OF CALIFORNIq AND AGREE THAT IF 1 SHWLD BECAME INSPECTION FEE
SU&IECT TO THE WOPKERS'COMPENSATION PROVISIONS OF SECTI 3700 OF THE LABOR t
S CODE,I SHALL FORTHWITH COMPLV WITH THO E PROV�IONS.� ISSUANCE —•�
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"'� WAPNINO:FAIL RE T SECUFE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALLBE
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� SU&IECTAN EMPLOVER TO CRIMINAL PENALTIES AND CNIL FINES UP TOONE HUNDRED THOUSAND ENERGY PERMIT
DOLURS({100,000),IN ADDITION TO THE COST OF CAMPENSATION,DAMAGES AS PROVIDED FOR IN
w SEC710N 37oe OF THE LABOF CODE,IN7EFEST,AND ATTORNEVS GEES. RETENTION FEE: '���
O CONSTRUCTION LENDING AGENCY PRE•ALT FEE:_ _
� I HERE9V AFFIRM UNDEi7 PENALTV OF PERJURY THAT THEFE IS A CONSTFUCTION LENOINO AOENCV }/��/��i;M� � ��
FOR THE PERFORMANCE OF THE WORK FOR WFIICH THIS PERMIT IS ISSUED(SEC.3087,CIV.C.). y`r`i��
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� LENDER'S NAME
F— LENDER'SADDRESS
W ICERTIFVTHATIHAVEREADTHISAPPLICATIONANDSTATETHATTHEABOVEINFOfUAAT10NISCOqRECT. TOTAL FEES �OC.iI �39
p IAGREETOCAMPLVWITHALLCITYANDCOUNTVORDWANCESANDSTATEUWSPEUTWGTOBUILDING � fr�
� CONSTRUCTION,AND HEFEBY AUTHORIZE REPRESENTATIVES OFTHIS CWN7YTO ENTEF U70N THE ' �
Z ABOVE-MENTIONED GROPERTV FOF INS EcraN auaaoses. COMMENTS '
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� RECPT.NO. PAID BY VAI.IDATION
WHITE—Department Copy,YELLOW�inence Copy,PINK—Assessor Copy,GOLDENRO�File Copy,GREEN—ApplicanYs Copy
CI?Y O� DIAMOI�D �AFi ,
II�SPECTIO� RECORD
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SET BACK FLOOR JOIST
FTGS/FORMS/STEEL FHA REQMTS
ELECTRIC GROUND UNDER FLOOR DUCT
GROUND PLUMBING UNDER FLOOR CONDUIT
SLAB GRADE FIREPLACE FOUNDATION
TEMP POWER FIREPLACE BOND BEAM
WATER SERVICE MID HT. BOND BEAM
ROOF SHEATHING 8 FT. BOND BEAM
FRAMINGNENTILATION FINAL BOND BEAM
ROOF COVER PRE-GRADING
ROUGH HEATING BENCHING
ROUGH ELECTRIC ROUGH GRADING
ROUGH PLUMBING FINISH GRADING
SHOWERlTUB TEST POOL ELECTRIC
EXT. LATH/SIDIfVG POOL FENCING
WALL INSULATION POOL FINAL
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 ; r` FINAL ZONING
' ''���''` � FIRE DEPT. FINAL
FINAL CONST. d '� •',;.
FINAL HEATING � �� " HEALTH DEPT. FINAL
FINAL ELECTRIC + t DEV. FEES PAID
FINAL PLUMBING I� ENERGY
C�OI�o�l..�
COMMENTS
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