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CITY OF DIAMOND BAR
- ---��` ---- DEPARTMENT OF COMMUNTI'1'&DEVELOPMENT SERVICES
21825 E.Copley Drive
- (909)860-3195 Fax(909)861-3117 PRESS
, ��'<�»��� BUILDING PERMIT APPLICATION FIRMLY
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� I HEREBV AFFIRM UNDER PENALTV OF PERIURY THAT I AM EXEMPT FROM THE CONTRACTORS LI� G2f890/Cd(POfI
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w TUFiE,PFIOR TO ITS ISSUANCE,ALSO REOUIRES THE APPLICAN7 FOR SUCH PERMIT TO FILE A SIGNED w
� STATEMENT THA7 HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF 7HE CONTMCTORS LI- �
� CENSE LAW(CHAP7ER 9(COMMENCING WI7H SECTION 7000)OF DIVISION 3 0F THE BUSINESS AND PRO� POOUSp2
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V TION.ANY VIOLATION OF SECTION 7031.5 BY ANV APPLICANT FOR A PERMIT SU&lECTS THE APPLICANT TO Z RB-ROOf
A CIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS(f5oo).):
ZOI,ASOWNEROFTHEPROPEFiTV,ORMVEMPLOVEESWITHWAGESASTHEIRSOLECOMPENSATION, 0 COrtIrtl8fCi81 -
WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.70�d,BUSI� J
� NESS AN�PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF �
PROPERTV WHO BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR
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� OFFEREDFORSALE.IF,HOWEVERTMEBUILDINGORIMPROVEMENTISSOLDWITHINONEVEAROFCAMPLE�
Z 710N,7HE OWNER�BUILDER WILL HAVE THE BURDEN OF PROVING THA7 HE OR SHE DID NOT BUILD OR
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� TO CANSTRUCT THE PRQIECT(SEC.7ou,BUSINESS AND PROFESSIONS CODE:THE CONTHACTORS LI- VdIU0t1011 ADJ.AREA
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� ❑I AM EXEMPT UNDER SEC. B.6 P.C.FOR THIS REASON Q
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� LICENSED CONTRACTORS DECLARATION W
� I HEREBV AFFIRM UNDER PENALTV OF PEFUURV THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER �
� 6(COMMENCING WITH SECTION 7000)OF DIVISION 3 0F THE BUSINESS AND PROFESSIONS CODE,AND Z
X MY LICENSE IS IN�E7U L CE AND EFFECT.
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� WORKERS'COMPENSATION DE L ATION a
NI HEREBV AFFIRM UNDER PENALTV OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: Z
Z _IHAVEANDWILLMAINTAINACERTIFICATEOFCONSENTTOSELF-INSUREFORWORKERS' _
Q CAMPENSATION,AS PROVIDED BY SECTION 3700 OF THE LABOR CODE.FOR THE PERF-0RMANCE w
OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. �
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W I HAVEAND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REOUIRED BY SEC710N ���
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� (�FiL55EC110NNEmNOTBE E�EDOFTHE ISFORONE UPDREDDOLLPFiS(f100)ORLESS). PLUMBING
Z I CERTIFY THAT IN THE PERFOHMANCE OF THE WORK FOq WHICH THIS PERMIT IS ISSUED,I MECHANICAL
(} SHALL NOT EMPLOY ANY PERSON IN ANY MANNER 50 AS TO BECOME SUBJECT TO THE
� WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AGREE THAT IF I SHOULD BECOME INSPECTION FEE
, j SUBJECT TO THE WORKEFS'COMPENSATION PROVISIONS OF SECTION 3700 OF THE LABOR
CO�E.I SHALL FORTHWITH COMPLV WITH THOSE PROVISIONS. ISSUANCE
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p DATE: APPLICANT:
J WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL BE ENERGY P/C
� SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND ENERGY PERMIT
DOLLARS(f100.000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PHOVIDED FOR IN
� SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATfORNEV'S FEES. RETENTION FEE:
� CONSTRUCTION LENDING AGENCY PRE-ALT FEE:
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� I HEREBV AFFIRM UNDER PENALTY OF PERIURV THAT THERE IS A CONSTRUCTION LENDING AGENCV
FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PEFMIT IS ISSUED(SEC.3087,CIV.C.).
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� LENDER'S NAME
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� ICERTIFVTHATIHAVEREADTHISAPPUCATIONANDSTATETHATTHEABOVEINFORMATIONISCORRECT. TOTAL FEES �
w I AGREE TO COMPLV WITH ALL CITV AND COUNTV ORDINANCES AND STATE LAWS RELATWG TO BUILDING ��,C�
� CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS COUNTV TO ENTER UPON THE �
� ABOVE��ENTIO ED PR RTY FO INSP TION Pjl POSES.
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FTGS/FORMS/STEEt ; FHA REGMTS
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ELECTRIC GROU�ID _ � ; UNDER F�OQR DUCT
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GROUND PLUMBING : UNQER FLOOR CUf��D�iT ; ______
SLAB GRADE __. _I_FIREPLACE FOUNDATION __ I __
TEMP POWER ; �_�FIREPLAGE BUND BEAM
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W,4TER SERVICE ' -__. ; MID HT. B�7(�D BEAM
ROOF SHEATHING -_ -- � ; 8 FT. BOND BEAM ---� ---- � ------
FRAMIiVGNENTILiATION ; FINAL BOND BEAM
— --- ------- ---
ROOF COVER PRE-GRADING
— ---- - --, - ---
ROUGH HEATING � BENGHIN� _ � ( ___�__
ROUGH E�ECTRIC � ROUGH GRADING
ROUGH PLUMBING � FINISH GRADING
SHOWER�TUB TEST i POOL ELECTRIC
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EXT. lJ1TH/SIDING � i ; POOL FE�lCING
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WAL�INSULATION j ; POOL FlNAL
CEILI�lG INSULATION —r i OFF SITE IMPS.
DRYWALL i�AILII�G � DEDICATIOiVS
SEWER FINAL EtVG.-_-- ---- ----
SEPTIC TANK LANDSCAPE/IRRIG. � �
SEEP PIT/L.L. ! OPV SITE IMPS.
GAS AIR TEST � FINAL ZONING
FINAL CONST. � , FIRE DEPT. FINA�
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FINAL HEATING ! ! HEALTH DEPT. FINAL
FINAL ELECTRIC ; DEV. FEES PAID
FIfVAL PLUMBING ; i ENERGY ,
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