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Home My WebLink About15098 - 21015 PATH FINDER RDCITY OF DIAMOND BAR DEPART?BENT OF COMMUNITY &DEVELOPMENT SERVICES 21660 E. COplcy Drive Suite 190 (909)860 3195 Fax (909)651-3117 BUILDING PERMIT APPLICATION JOBSITE (� . ADDRESS "t APN LOT TRAqT OWNER ADD SS • i• CITY M P 1TEL- APPLICANT TEL CONTRACTOR' at'r- ADDRESS CITY ZIP TEL ARCWENG/ DESIGNER ADDRESS CITY ZIP TEL, OWNER -BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT 1 AM EXEMPT FROM THE CONTRAC70RS LI- CENSE LAW FORTHE FOLLOWING REASON ISEC. 7031.5 BUSNESS AND PROFESSIONS CODE ANY CRY OR COUNTYWHICH(REOUIRESA PERMIT TOCONSTRUCT,ALTEIL IAPROVE. DEMDUSK OR REPAIR ANY STRU(, TUBE, PRIOR TO ITS ISSUANCE. ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI- CENSE LAW (CHAPTER F (COMMENCING WITH SECTION 7DOO) OF DIVISION 3 OF THE BUSINESS AND PRO- FESSIONS CODE) OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THEALLEGED EXEMP- TION. ANY VIOLATION OF SECTION ?WI.5 BY ANY APPLICANT FORA PERMIT SUBJECTS THE APPLICANT TO A CIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS 13600).): O L AsOWNER OF THE PROPERTY. OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION. MALL 00 THE WORK. AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (SEC. 7044, aLISI- MSSAND PROFESSIONS CODE: THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF PROPERTY VINO BUILDS OR IMPROVES THEREON, AND WHO DOES SUCH WORK MIMSELF OR HERSELF OR THROUGH HIS OR HER OWN EMPLOYEES, PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR OFFERED FOR SALE IF.HON'EVER THE BUILDING ON IMPROVEMENT IS SOLD WITHIN ONE YEAR OFCOMPLE- TION. THE OMMER4BURDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE). O L AS OHFMER OFTHE PROPERTY. AM EXCLUSIVELY MNTRACTNG WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEC. 70U. BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS U. CEASE UAW DOES NOTAPPLY TORN OWNER OF A PROPERTY WHO BUILDS OR IMPROVES THEREON, AND WHO CONTRACTS FOR SUCH PROJECTS WITHACONTRACTORIS) LICENSED PURSUANT TO THE CONTRA(, TORE LICENSE LAW.), D 1 AM EXEMPT UNDER SEC. B. 5 P.C. FOR THIS REASON DATE OWNER LICENSED CONTRACTORS DECLARATION 1 HEREBYAFF1iM UNDER PENALTY OF PERJURY THAT IAM LICENSED UNDER PROVISIONS OF CHAPTER I (COMMENCING WITH SECTION 7000) OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE AND MY LICENSE IS N FULL FORCE AND EFFECT. LICENSE CLASS LIC. NO. DATE CONTRACTOR WORKERS' COMPENSATION DECLARATION 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: _I HAVE AND WALL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS COMPENSATION, AS PROVIDED BY SECTION 3700 CF THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR W1OCH THUS PERMIT IS ISSUED. _I HAVE AND WILL MAINTAIN WORKERS' COMPENSATION INSURANCE. AS REQUIRED BY SECTION 37D0 OF THE LABOR CODE. FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. MY WORKERS COMPENSATION INSURANCE CARRIER AND POLICY NUMBER ARE: CARRIER POLICY NUMBER PHIS SECTION NEW NDT BECDNRETIDOFTHE PEWATISFOR ONE HUNDRED COUAR5 RIOO) OnLEs4 I CERTIFY THAT N THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.1 SMALL NOT EMPLOY ANY PERSON N ANY MANNER SO AS TO BECOME SUBJECT TO THE WORKERS' COMPENSATION LAWS OF CALIFORNIA. AND AGREE THAT IF 1 SHIOULD BECOME SUBJECT TO THE WORKERS' COMPENSATION PROVISIONS OF SECTION 3700 OF THE LABOR CODE.I SMALL FORTHWITH COMPLY WITH THOSE PROVISIONS. DATE: - APPLICANT. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL BE SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS IS 100.000). IN ADDITION TO THE COST OF COMPEN SATION• DAMAGES AS PROVIDED FOR IN SECTION 370e OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. CONSTRUCTION LENDING AGENCY 1 HEREBY AFFIRM UNDER PENALTY OF PENURY THAT THERE 15 A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED (SEC. 3007. LIV. C.). I LENDERS NAME LENDERS ADDRESS I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. I AGREE TO COMPLY WITH ALL CITY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUDDING CONSTRUCTION. AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER �I(NN TIME, A ABOVEJAENTIONED PROPERTY FOR INSPECTION PURPOSES /WI `A,M•- 1�� `JVL 1 ICan&A vQzn - I ! PE ENAME 0" 31(WTURC OF E DATE PRESS FIRMLY APPLICATIO PERMIT P/C DATE NUMBER M ISSUE TYPE OCC DATE CONST, GROUP ZONING SETBACKS FRONT RW ❑ - REAR ❑ SIDE/SIDESTREET RVf ❑ SIDE ❑ PROPOSED USE Y' Sy S-W—M I.t NO. DWEL NO. NO. UNITS STORIES BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ_ AREAIVALUATION SFRIADD/REM Garage/Carport W Patio/Deck U- PooUSpa Zno -Roof 0 Commercial - 5 to Valuation ADJ.AREA QUANTITY DESCRIPTION FEE U H slia elo s DWI W z ,I m ` a.Iay,C.f J a UN' 14 LULL U (�1 C) I31 ITI T)TTTrr A N TT, C' A T-.-- , 2 U W CONSTRUCTION PLjAXf1ENfIEW+� ELECTRIC PLUMBING MECHANICAL P� v E�CFNFEE ENERGY P/C ENERGY PERMIT RETENTION FEE: PRE-ALT FEE: TOTAL FEES "�eNTsCIV, c , RECPT. NO. PAID BY VALIDATION I '— WHITE —Department Copy. YELLOW —finance Copy, PINK—Aseeeaor Copy, GOLDENROD —File copy, GF E COPY - A CITY OF DIAMOND BAR ; ;•,. ;•-. INSPECTION RECORD Y SET BACK \ f � } FLOOR JOIST "f ; J FTGS/FORMS/STEEL FHA REQMTS ELECTRIC GROUND 'UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CONDUIT + SLAB GRADE -- _ FIREPLACE'1=OUNDATION TEMP POWER - - FIREPLACE BOND BEAM WATER SERVICE ' :.... -..: - . -MID HT BOND BEAM ROOF SHEATHING ', ' r "'-` 8 FT BOND BEAM FRAMINGNENTILIATION _ :.i `; + .' FINAL BOND BEAM ROOF COVER.' PRE -GRADING - -ROUGH HEATING - - -- - - -- - BENCHING ROUGH ELECTRIC - --- ROUGH GRADING -ROUGH PLUMBING - - - FINISH GRADING SHOWERITUB TEST., _ ___ _ _ .__ POOL ELECTRIC EXT.LATH/SIDING . r- POOL FENCING WALL INSULATION POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS' SEWER .._ _ _ - ! FINAL ENG -SEPTIC TANK _..._- L_ _ LANDSCAPE/IRRIG, SEEP PIT/L.L. -- _ -- :_- - ON SITE IMPS. GAS AIR TEST, - - :, -- - - FINALZONING FINAL CONST: - - '- `, - ; : FIRE DEPT. FINAL FINAL -HEATING '' ` "` `' HEALTH DEPT. FINAL FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING ENERGY COMMENTS..__ SEPTIC TANK SIZE SEEP PIPLI SIZE Ap