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HomeMy WebLinkAboutPR17-16450CITY OF DIAMOND BAR I I I s DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 PRESS (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-7027 FIRMLY BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@diamondbarea.gov JOB SITE ADDRESS' r,&yirr° APN LOT TRACT OWNER 'K' f) iR v Y4 III 3 ADDRESS 2 i * 1 nm'ou n,", CITY C.s. rZIP €. 7f, APPLICANT '')a� 6t TEL. i°sem) 4 0 4 CONTRACTOR C w f's ADDRESS f' 6 rC I$ CITY fC✓.i ZIP " TEL - it yC re,r4. ARCH/ENG/ DESIGNER ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the rsaacri indicated below by the checkmark(s), I have piaced next to the applicable Item(sj [Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, atter, Improve, demolish, or repair, any structure, prior to its issuance, also requires the applicant for the permit to ilia a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9) Commencing with Section 7000 of Division 3 of the Business and Professions Code] or that he or she Is exemptfrom licensure and the basis for the alleged exemption. Any violation of Section 1031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). U I, as owner of the properly, or my employees with wages as their sole compensation, will do I all of or U portions of the work, and the structure Is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or Improves the property, provided that the improvements are not intended or offered for sale. If however, the building or improvement Is sold within one yeaf of completion, the Owner -Builder will have the burden of proving that it was not built or improved for the purpose of sale.). LU I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project {Section 7044, Si and Professions Code: The Contractors' State License Law does not apply to an owner of properly who builds or improves thereon, and who contracts forthe. projects with a licensed Contractor pursuant to the Contractors' State License Law.}. U I am exemptfrom licensure under the Contractor's State License law for the following reason(s): Date: Slgr: By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit,l cannot legally sell a structure that I have built as an owner-bullder if It has net been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Cade is available upon request when this application Is submitted or at the following Web site: httpMrww logirfo.ca,gov/aalawhtml. LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty, of perjury that I am licensed under provisions of Chapter 9 (Commencing with Section 7000) of Division 3 of the Business and Professions ,aCode,andmy license is in full farce and effect. ICENSE CLASS:' `-" LIC, NC.: "$ yid 0 �"� XP. DATE: 13 " CONTRACTOR: 42. t 'L WORKER'S COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: I have and will maintain a Certificate of Consent to Self -Insure for Worker's Compensation, as provided by Section 3700 of the labor Code, for the performance of the workfor which this permit is issued. I have and will maintain Worker's Compensation Insurance, as required by Sectlon 3700 ofthe Labor Code, far the performance afthe work for which this permit is issued: My Worker's Compensation Insurance Carrier and Policy Number are: CARRIERAP POLICY NUMBER n THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS $100 CR LESS) I cedify that in the performance of the work for which this permit is issued, I shall not employ any person In any manner sum to become subject fa the Worker's Compensation Laws of California. And agree that if I should become subject 10 the Worker's Compensaflon provisions Df Section 5700 of the Labor Code, I shall forthwith complywith those provisions. DATE: APPLICANT: WARNING: Failure to secure Worker's Compensation coverage Is unlawful and shall Subject an employer to criminal I and civil fines up to one hundred thousand dollars ($100,901 In addition to the cost of the compensation, damages as provided for in section 3708 of the labor code, interest, and attorney's fees CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a Construction Lending Agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). LENDER'S NAME: LENDER'S 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 building construction, and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection purposes PERMITTEE E (PRIN _ V Volu SIGNATURE OF PERMITTEE DATE APPLICATION DATE: 0 N i \ -=ir PIC# ISSUE DATE: PERM€T#: 'e '» '- \,I. - 4 TYPE CONST- OCC GROUP: Scope of Work # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. Fes. FACTOR PSE ADJ. AREA/VALUATION SFR/ADDYREM Garage/Carport w Patio/Deck LU LL Pool/Spa ZRe -Roof In Commercial 02 m Valuation: Ad]. Area: QUANTITY DESCRIPTION FEE v s r U w imam an ammi w z m J rL @@ x - CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: MECHAN#CAL: '� -:N- INSPECTION FEE: ISSUANCE: Si ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: "J BASF: PLOT PLAN: ZONING CLLARANCE: TOTAL FEES COMMENTS: 1 P/C: PAID BY: J j VALIDATION: RECEIPT# PAID BY: VALIDATION: WHITE Department Copy, YELLOW — Finance Copy, PINK— Assessor Copy SETBAM LETTER FOOTINGS FORMS SLAB UG. PLUMBING UG. ELE(,TFiICAL LIFER GROUND - SEWk`li LATERAL MAIN WATER LINE SEWER CLEANOUT ROC[ SHEATHING FLOOR SHEATHING SHEAR WALLS EXTERIOR SHEAR WALLS INTERIOR FRAMINGNENTING ROUGH MECHANICAL ROUGH ELECTRICAL W( ) C ( ) ROUGH PLUMBING INYRATION WALL INSW ATICN GFILING DRYWALL LATH (PRE) I ATH EXTERIOR I ATH INTERIOR GAS TEST SCRATCH COAT ELECTRIC METER RELEASE GAS METER RELEASE SPECIAL INSPECTION FINAL BUILDING TRACT AND LEDGER SWITCH GEAR COMMERCIAL HOOD T -EAR INTERCEPTER HOT MOP/SHOWERPAN SEPTIC/CESSPOOL HERS REPORT RECEIVED DEMOLITON ROOF DRAINS ROUGH CONDUIT POOL/SPA ROUGH PLUMBING ROUGH ELECTRICAL ROUGH MECHANICAL GAS TEST __ _....... ...............-- PRE GUNITE POOL PRE DECK BONDING P -TRAP — ....... FENCE / GATE/ ALARM FINAL POOL WALLS: WALL FOOTING/STEF.1_ WALL STEEL 1sT( } ?NQ( ) LIFT WALL BOND BEAM WALL DRAIN/ SEAL WALL FINAL R0. FRAMING PLANNING APPROVAL ROUGH FIRE APPROVAL FINAL MECHANICAL FINAL FIRE DEPARTMENT FINAL ELECTRICAL FINAL PLANNING FINAL PLUMBING FINAL ENGINEERING/ PW T.C. of OCCUPANCY FINAL COMMUNITY SERVICES CENT; of OCCUPANCY FINAL HEALTH DEPT, FINAL INDUSTRIAL WASTE STATE: O� CALIFORNIA ALTERATIONS - HVAC CFC-GFIR-ALT 04-E (Revised 06/14) _ - CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF111-ALT-04-E -Alterations - HVAC CZ 2, and 8-15 (formerly CF -1R -ALT -HVAC) (Page 1 of 1) Site Address-. / / - Enforcement Agelicy: Date Pr"spared: Permit#: ui men(Type Equipment Efcienty New Ducting, Plenums, Lineset: ConditionedE Thermostat Required R -value Floor Area (sq ft) ❑ Packaged System ❑ Evaporator Coil AFUE COP 11R-6 (CZ 2, 81 Ducting Served by system 153) Setback 0 Spilt System El Condensing Unit ❑ R -g' (C7 11 14,15) Ducting sqft (if not already ❑ Mini Split ❑ Compressor SEER HSPF p R-6 (all CZ's) Plenums present, must I? Furnace ❑ Linesetinstall EER © R -S or R7.5) Lineset 4 be ed) ❑ TXV HERS VERIFICATION SUMMARY Installer determines work to be completed and matches to one of the options below. At permit application this form is allowed to be filled out by hand. For final inspection all forms are to he registered (no hand filled forms allowed) and a copy left on site. ftri HVAC Changeout/Repair Required Compliance Documents to be left on site for Final: All Equipment, CF11R-ALT.02-E Condenser Unit, Evaporator Coil, CF2R: MECH-01, MECH-20-HERS, MECH-(23or24)z-HERS, MECH-25-HERS' Compressor, TXV, Lineset, CF3R: MECH-20-HERS, MECH-(23 or 24) -HERS', MECH-25-HERS= Air Handler/Furnace' (Can include new ducting) Installer Requirement: Duct leakageL15510, or c 10% to outside, or seal all accessible_ leaks), Air Flow > 300 CFM/ton, Refrigerant Charge. Exempted from duct leakage testing if: ❑ 1, Duct system registered with HERS provider as previously sealed, or ❑ 2. There is less than 40 linear feet of duct in unconditioned space, or ❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos'(11st mariutacture date of building } EJ 2. New HVAC System Required Compliance Documents to be left on site for Final: All new equipment and All New Ducts' CF1.R ALT -02-E including Mini Split CF2R: MECH-01, MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24) -HERS', MECH-25-HERS' CF3R. MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24) -HERS, MECH-25-HFRS, Mini Splits require CF1R-ALT-02-E, CF2R-MECH-01, and (CF2R-CF3R) MECH-25-HERS Installer Requirement: Duct leakage <6Y., Fan Efficacy (.581N/CFM), Air Flow_ 350'CFM/tan (or alternative)., Refrigerant Charge ❑ 3. All New Ducts with Replacement Required Compliance Documents to be left on site for Final: All New.Ducts' and one or more of the following CF1R-ALT-02-E replaced: Condenser Unit, Evaporator Coil, CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS Compressor, TXV, Lineset, Furnace CF313: MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS Installer Requirement: Duct leakage < 6%, Air Flaw >_ 350 CFM/ton (or alternative), Refrigerant Charge Exempted from duct leakage testing if: 1111. Existing duct systems are constructed, insulated orsealed with asbestos 114. New Ducting over 40 feet Required Compliance Documents to be left on site for Final: New ducting but less than All New Ducts CFiR-ALT-02-E, CF2R: MECH-20-HtR5, CF3R: MECH-20-HERS Installer Required to: Duct leakage (<,15% or, c 10%to outside or, or seal all accessible leaks) ❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos. 'All new ducting R-8 required when more than 40 ftinstalled and R-6 when less than 40 ft installed. This includes in walls, between floors etc. I Heating only systems and Air Handler/Furnace changes do not require Air Flow MECH-(23 or 24), or Refrigerant Charge verification MECH-25 9 All New Ducts is when at least 75 percent of the duct system is new duct material, and up to 25 percent may consist of reused parts from the dwelling unit's existing duct system (e.g., registers, grilles, boots, air handler, coil, plenurils, duct material) 4 R-5 (1" thick insulation) for linesets 1" and less. R-7.5 (1.5" thick insulation) for linesets over 1 inch. Most mfg will require suction line Diameter with insulation as the following 1.5 -2T -2V8", 2.5 -3T -2%V, 3.5 to 4T-2%", 5T-47." Contractor {Documentation Author's /Responsible Designer's Declaration Statement) I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. . 2. 1 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the information on this document. 3. That the energy features and performance specifications forthe design identified on this Certificate of Compliance conform to the requirements of Title 24, Parts 1 and 6 of the California Code of Regulations (CCR), 4. That the energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the CCR. 5. The building design features or system design features identified on this Certificate of Compliance are consistentwith the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. Reskponsible0esignerilatne:_ Res/po�n�si le Designer signature: DayteSigned:( ucce°nse: -7 Uri Company: Addrew City/state/Zip: Phone; C! ii`tP+�: -�' 1✓ 4 i✓'til L p ( b Uhf $'4u i.R.-- Ci P,"3 (ey�i i. 6. 's �.:.L.. &Z i'� b oma) For assistance or questions regarding the Energy Standards, contact the Energy Hotline at:1-800-772-3300.. x, r