HomeMy WebLinkAbout10-1007 ^ _��_ CITY OF DIAMOND BAR �
DEPARTMENT OF COMMUNITY& -1fS�I�iVIC S �(�� : ���
^ 21825 Copley Drive,Diamond Bar,CA ����� �f��
� (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-70{�� $
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� DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
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ZCOUNTVNMICHREOUIRESAPEFMITTOCONSTRUCT,ALTERIAIPROVE,DEMOLISH,ORREPAIRANVSTRUC- W Petlo/Deck
w 7URE,VRqR TO ITS ISSUANCE.ALSO HEOUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIONED W .
� STATEMENT THAT HE OR SHE IS LICENSED FURSUANT TO hIE PROVISIONS OF 7HE CONTRACTORS LI�
� CENSE UW(CHMTER Y(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO• � POOUSPB
� FESSIONS CODE�OR THAT HE OR SHE IS EXEA/PT THEREFROM AND THE BA515 FOR THE ALLE6ED EXEMP- �
TKKJ.ANV VIOLATION OF SECTION 7031.6 BY ANV APPLICANT FOR A PERMIT SU&lECTS THE APPLICANT T0 Z Re-Roof
A GVIL PENALTY OF NOT MORE THAN FIVE HUNOREO DOLURS(f5a0).):
� ❑lASOWNEROFTHEPROPERTV,ORMVEMPLOVEESWITHWA0ESA5THEIRSOLECOMPENSATION, � COR1rtI0fC18I
Z WILL DO THE WORI(,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.70{I,BUSI� J '
N NE3S AND PROFESSIONS CODE:THE CONTRACTORS 110ENSE UW DOES NOT APPLV TO AN OWNER OF �
VHOPEfiTV WHO BUILDS OR IMPROVES THEREON,AND VhlO DOES SUCH WORK HIMSELF OR HEHSELF OR
Q THROUGH HIS OR HER OWN EMPLOVEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m
Q OFFEREDFORSALEIF,HOWEVERTMEBUILDINQOHIMPROVEMENTISSOLDWfTHINONEVEAROFCOMPLE-
Z TION,THE OWNER�BUILDER WILL HAVE THE BUfiDEN OF PqOVINO THAT HE OR SHE DID NOT BUILD OR
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❑I.AS OWNER OF THE PROPEHTV,AM E%CIUSIVELY CANTRACTIN4 WfTH LICENSED CONTRACTORS
� TO CONSTRUCT TME PRQIECT(SEC.7611,BUSINESS AND 7ROFESSIONS CODE:THE CANTRACTORS LI- V91UflllOfl ADJ.AREA
W CENSELAWDOESNOTAPPLYTOANON?JEROFAPROPERTVWHOBUILDSORIMPqOVESTHEREON,AND
� WFiOCONTRACTSFORSUqiPR0.1ECTSWITHACANTRACTOR(5)LICENSEDPURSUANTTOTHECONTRAC- QUANTITY DESCRIPTION FEE
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0 ❑I AM E%EMPT UNDER SEC. B.8 P.C.FOF THIS REASON Q
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LL DATE ONTJEF �
� LICENSED CONTqACTORS DECLARATION W
� I HEREBV AfFIRM UNDER PENALTV OF PERJURV THAT I AM LICENSED UNDER FROVISIONS OF CHAPTER �
� �(COMMENCWCi WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CADE,AND Z
��� W UCENSE IS IN FULL FORCE AND EFFECT. (��(
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� WORKEFS'COMPENSATION DECLARATION Q
� I HEREBV AFFIRM UNDER VENALTV OF PERIURV ONE OF THE FOLLOWING DECURATIONS: �
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�Z _I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF-INSURE FOR WORKERS' a
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COMPENSATION,AS PROVIOED BV SECTION 3700 OF THE LABOH CODE,FOR THE 7ERFORMPNCE U
OF THE WORK FOR WHICH THIS 7ERMIT IS ISSUED. W
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� � I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REWIqED BV SECTION
Q 370o OF THE LABOR CADE.F9R THE PERFORMANCE OF THE WORK FOP WHICH THIS PERMIT IS
ISSUED.MV WORKERS' OMPENSATION INSURANCE CARRIER D POLICV NUMBER ARE: CONSTRUCTION
jCARRIER �� r— �Arf PLAN REVIEW
Z0 POLICYNUMBER ���j ELECTRIC
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Z I CEFTIFY THAT IN THE PERf-0RMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I A CA
CS SHALL NOT EMPLOV ANV PERSON IN ANV MANNER SO AS TO BECAME SU&IECT TO THE
(/� WORNERS'COMPENSATION LAWS OF CALIFORNIA,AND AaREE THAT IF I SHOULD BECOME INSPECTION FEE
S SUBJECTTOTHEWORKERS'COMPENSATIONPROVISIONSOFSECTION37o00FTHELABOR `�r� �
CODE, SHA FORTHWITHCOMPLYWI THOS ROVISI NS. SS
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p DATE: O � qPPLICANT.
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� WARNING FMLURE TO SECURE WORKERS'COMPENSATION COVERA6E IS UNLA ,AND SHALL BE ENERGY P/C �
� SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIC FINES UP TOONE HUNDRED THOUSAND ENERGY PERMIT
DOLLARS(f10o,000),IN ADDITION TO THE COST OF CAMPENSATION,DAMAGES AS PROVIDEO FOR IN
� SECTION 37oe OF THE UBOR CODE.INTEREST,AND ATTORNEV'S FEES. ENTION `�
OCONSTi7UCTION LENDING AGENCY PRE-ALT FEE: �
� I HEREBV AFFIqM UNDER PENALN OF PERJURY THAT THERE IS ACONSTRUCTION LENDINO AGENCV
� FOR THE PEFFOFiMANCE OF THE WORK FOR WHICH TMIS PERMIT IS ISSUED(SEC.7087,CIV.C.�.
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� LENOEF'S NAME
� LENDER'SADDRESS
w ICERTIFVTHATIHAVEREADTHISAPPLICATIONANDSTATETHATTHEABOVEINFORMATqNISCARRECT. TOTAL FEES � "
� I AaREE TO COMPLV WITH ALl CITV AND COUNTY ORDINANCES AND STATE IAWS RELATING TO BUIlDINO
� CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS COUNTV TO ENTEH UPON THE
Z ABOVE-MENTIONED PROPE FO INSPECTION PUqPOSES.
p 1a� h COMMENTS �
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v� S�� DATE RECPT.NO. � PAID BYC.K�.�p /�VAUDATION
� \ WHITE—Department Copy,YELLOW—Finence Copy,PINK—Aasessor Copy,GOLDENRO ile Copy,GREEN—Applicant's Copy
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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 BENCHIfVG
ROUGH ELECTRIC ROUGH GRADING
ROUGH PLUMBING FINISH GRADING
SHOWER/TUB TEST POOL EL.ECTRIC
EXT. LATH/SIDING POOL FENCING
WALL INSULATION POOL FINAL
CEILING INSULATION OFF SITE fMPS.
DRYWALL NAILING DEDICATIONS
SEWER FINAL ENG.
SEPTIC TANK LANDSCAPElIRRIG.
SEEP PIT/L.L. ON SITE IMPS.
GAS AIR TEST FINAL ZONING -
FINAL CONST. ro FIRE DEPT. FINAL
FINAL HEATING HEALTH DEPT. FINAL
FINAL ELECTRIC DEV. FEES PAID
FINAL PLUMBING ENERGY
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COMMEiVTS � a
SEPTIC TANK SIZE
SEEP PIT/U SIZE
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