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� CITY OF DIAMOND BAR
� --��`-- DEPARTMENT OF COMMUNITY&.DEVELOPMENT SERVICES
21825 E.Copley Drive pRESS
�` (909)860-3195 Fax(909)861-311'I
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(} SHHIL NOT EMPIOY ANV PERSON IN ANY MANNER SO AS TO BECOME$V&IECT TO THE I
� WORNERS'CAMPENSATION LAWS OF CALIFORN10.AND AGREE THAT IF I SHWLD BECOME INSPECTION FEE
SUBJECTTO THE N�ORKERS'COMPENSATtON PROVISIONS OF SECTION 370o OF THE IABOF U ^ `
~ CODE I SHALL FORTHYATM COMPLV WITH THA0.SE PROVISIONS. -�SSUANCE
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J SECTION 3708 OF THE LA60F CODE,INTEREST,ANO ATTORNEY'S FEES. RETENTION FEE: /
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� IHEREBVAFFIRMUNDERPENALTVOFPERJURYTHATTHEREISACONSTqUCTIONLENDINOACENCV
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� LENDER'S NAME
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� 1 AGREE TO COMPLY WITH ALL CITV AND COUNTV OPOINANCES AND STATE LAVJS RELATMG TO BUILDING
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ROOF SHEATHING ��o"L ��� 8 FT. BOND BEAM ,____ _
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ROOF COVER ��S %4 �� -1''���� �� PRE-GRADING
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CEILtNG IIV�ULATI�iV OFF SITE IMPS. �
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