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HomeMy WebLinkAboutPR17-10966CITY OF DIAMOND BAR 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 ww-mcityofdiamondbar.com building@diamondbarea.gov JOB SITE ADDRESS OL D -, APN LOT TRACT OWNER ! wi ADDRESS d 16 C i ":_;;/-, J;,_7 _ CITY ZIP Al :- TEL. -7 /'1' � APPLICANT TEL - CONTRACTOR C .. 8'^4 �. �V ADDRESSa. CITY �/ ZIPCTEL. %. ARCH/Et/ 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 reasons) indicated below by the checkmark(s), I have placed next to the applicable Item(s) [Section 7931.5, Business and Professions Code: Any city or county that requires a permit to construct, after, improve, demolish, or repair, any structure, prior to its Issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License law (Chapter 9) Cammencing with Section 7900 of Division 3 of the Business and Professions Cool or that he or she Is exemptfrom licensure and the basis for the alleged exemption Any vielailon of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). CJ I, as ownerof the property, or my employees with wages as their sole compensation, will do U a€I of orU portions of the work, and the structure is not Intended or offered fur sale (Section 7044, Business and Professions Code, The Contracters' Slate License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the Improvements are not intended or offered for sale, If however, the building or Improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that a was not bullt or Improved for the purpose of sale.). (-) I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Seciion 7044, Business and Professions Cade: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed ContracSor pursuant fa the Contractors' State License Law.), U I am exemptfrom licensure under the Contractor's State License law for the following reason(s): Date: Sign: By my signature below I acknowledge that, except for my personal residence In which I must have resleled for at least one year prior to completion of the Improvements covered by this permit,l cannot legally sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors I understand that a copy of the applicable law, Section 7044 of the Business and Profess€ons Coda is available upon request when this application is sutrmitted or at the following Web slte: http/vvww.leginfo.ca.gov/ca€aw.htmi. LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions o1 Chapter 9 (commencing with Section 7000) of Division 3 of the Business Id Professlons Code, and my license, is in full force and effect. f - G - LICENSE CLASS: LIC. NO.: FXP. DATE: '"�x+r B°^$ CONTRACTOR ¢xn�`�! -_ - j WORKER'S COMPENSATION DECLARATION € HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: I have and will maintain a Certificate of Consent to Self -Insure tot Worker's Compensation, as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as required by Section 3700 ofihe Labor Code, for the performance ofthe work for which this permit is issued, My Worker's Compensation Insurance Carrier and Policy Number are:,, CARRIER POLICY NUMBER (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HJNDREO DOLLARS 5100 OR LESS). I certify that in the performance of the work for which this permit is issued, I shall not employ any person In any manner so as to I subject to the Worker's Compensation Laws of California. And agree that if I should became subject to the Worker's Compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these prevlslens. DATE: APPLICANT: WARNING: Fallure to secure Worker's Compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,000), in addition to the cosi V the compensation, damages as provided for in section 3708 ofthe 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 at this county to enter upon the above- entloned proper¢y for ipspection purposes. PERMITTEE NAME (PRINT) -t � SIGNATURE OF PERMITTEE DATE APPLICATION DATE: 2-1 , �jP/jC�# EE ISSUE DATE: PERMIT# TYPE CONST. OCC GROUP: Scope of Work # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport LL PatiolDeck LL LL Pool/Spa ZRe -Roof ©_ Commercial M M Valuation: Adj. Area: QUANTITY DESCRIPTION FEE EEEE v w c� m ri w U Z 4 x U CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEL: ISSUANCE: SMTP: ENERGY A/C: LNERGY PERMIT: RETENTION FEE: PRE -ALT FEE: BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES�- COMMENTS: P/C: PAID BY: VALIDATION: RECEIPTPAID BY: VALIDATION: WHITE: Department Copy, YELLOW — Finance Copy, PINK— Assessor Copy CITY OF DIAMOND BAR INSPECTION RECORD SETBACK/ LETTER TRACT AND LEDGER SWITCH GEAR COMMERCIAL HOOD T -BAR INTERCEPTER HOT MOP/SHOWERPAN ................ SEPTIC/CESSPOOL HERS REPORT RECEIVED DEMOLITION ROOF DRAINS CONDUIT _.. -- POI USPA ROUGH PLUMBING ROUGH ELECTRICAL FOOTINGS FORMS SLAB UG, PLUMBING UG ELECTRICAL LIFER GROUND SEWFII LATERAL MAIN WATER LINE SEWER CLEANOUT HOOF SHEATHING hI OOR SHEATHINGROUGH - .... SHEAR WALLS EXTERIOR SHEAR WALLS INTERIOR FRAMING/VENTING ......... ..... ... ._-_ ROUGH MECHANICAL ROUGH MECHANICAL ROUGH ELECTRICAL W( ) C O GAS TEST PRE GUNITE 13OUGH PLUMBING INSULATION WALL POOL PRE DECK BONDING INSULATION CEILING P -TRAP FENCE / GATE/ ALARM FINAL POOL WALLS: WALL FOOTIWIVSTFEL WALL STEEL 1N'( ) PN0( ) LIFT WALL BOND 81AM WALL DRAIN/ SEAL WALL FINAL DRYWALL LATH (PRE) LATH EXTERIOR LATH INTERIOR GAS TEST SCRATCH COAT ELECTRIC MEl Eli RELEASE GAS METER RLLIASE SPECIAL INSPI C1ION R0. FRAMING I'LANNING APPROVAL ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT FINAL BUILDING FINAL MECHANICAL FINAL ELECTRICAL FINAL PLANNING FINAL ENGINEERING/ PW FINAL PLUMBING T.C, of OCCUPANCYF€NAL - .........._.. COMMUMTY SERVICES _ - _.................. FINAL HEALTH DEPT. .._.......... _ y... _ CERT. of C U ANCY FINAL INDUSTRIAL WASTE COMMENTS c LU 0 z DLAN01TD BAR' I � m CITY OF DIAMOND BAR 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 JOR SITE ADDRESS - VCf2-1 "A) L_,\, '0' APN LOT TRACT OWNER ADDRESS ZYL)e"8 CITY §)iC+,,Vric _64 -- ZIP5/$C6 TEL. 714 (ES-1 aiG ' APPLICANT rek TEL. CONTRACTOR .1 EN_ .L Ie" r i r :)' �+ ADDRESS L S r "3 c rpt i AI e to _. trY°Qi;;1;f 11 5 CITY 91 56-J V�, l� ZIP TrilSS TEL. Vj'8IE 'fl C 110 ARCH/ENG/ DESIGNER ADDRESS '� S�r.r` {}�;� it CITY ZIPS TEL. S95r 4A Zr 4' OWNER -BUILDER DECLARATION I hereby affirm under penally of perjury chat I am exempt from the Contractor's State License Law for the reason(s) Indicated below by the checkmark(s), I have placed next to the applicable Item(s) [Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, Improve, demolish, of repair, any structure, prior to its fSaaaRGe, also requires the applicant for the permitto file a signed statementthat 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 Codej or that he or she Is exempt from licensure and the basis for the alleged exemption, Any violation of Section 7031.5 Ovary applicant fora permit subjects the applicant to a civil penally of not more than five hundred dollars (5500). U I, as owner of the property, or my employees with wages astheir sole compensation, will do L1 all of or (-) portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Cada: 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 improvemant Is sold within One year of complei the Owner -Builder will have the burden of proving that It was not built or Improved for the purpose of sale.). U I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professlons Code: The Contractors' State License Law does net apply to an owner of property who builds or improves thereon, and who contracts for the projectswith a licensed Contractor pursuantto the Contractors' State License Law.). iJ I am exempt from licensure under the Contractor's State License law for the following reason(s): Date: Sign: By my signature below I acknowledge that, excoptfor my personal residence In which I must have resided for at least one year prior to completion of the Improvements covered by this permiLl cannot legahy sell a structure that 1 have built as an owner -builder if It has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable taw, Section 7044 of the Business and Professions Code Is available upon request when thls application is submitted or at the following Web slte: http/www. loginfo.ca.govlcalaw.html. 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 Code, and my license is in full force and effect. LICENSE CLASS: C1 LIC. NO.: EXP. DATE, ' >�_9 ci_....-.-_ CONTRACTOR: 11d,,,e Urfa 'iil2. �- `�i .3 � 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 ty Section 3700 ofthe 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 Section 3700 of the Labor Code, for the performance of the workfor which this permit is issued. My Worker's Compensation Insurance Carrier and Policy Number are: M CARRIER 4 cc �? POLICY NUMBER-d.�1(;7 LI (THIS SECTION NEED NOT BE COMPLETED IFTHE PERMIT IS FOR ONE HUNDRED DOLLARS 5100 OR LESS). I cerffythat in the performance of the workfor which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation Laws of Califomia. And agree that if I should become subject to the Worker's ii Compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. r DATE: APPLICANT: i WARNING: Failure to secure Worker's Compensation coverage is unlawful, and shall subject an employer to criminal i penalties and civil tines up to one hundred thousand dollars ($160,000), in addition to the cost of the compensation, damages as provided for in section 5708 of the labor code, interest, and attorney's fees CONSTRUCTION LENDING AGENCY i 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 I certify that I have read this appllcatlon and state that the above information Is correct, l agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to j enter upon the above-mentloned property for inspection purposes. i PERMITTEE NNAMEE IN SIGNATURE OF PERMITTEE DA71 1 E APPLICATION DATE:: 0. Jr}1 ! P/C## l Ri r — 109 ISSUE DATE: �d ! PERM€T# : PR +T — 10916040 TYPE CONST. OCC GROUP: Scope of Work 5c, I 1� 1 p� - J, I ! IV.-ee'"4 - # DWEL. UNITS # STORIES .2- 15 C r -,,r # BEDROOMS_ -57 DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFFVADD/AE.fv1 Garage/Carport CO Lu Patio/Deck LU LL Pool/Spa Re -Roof Commercial CO Valuatte": 1 d,c7�p. `r Adj. Area: QUANTITY DESCRIPTION FEE w z m J a U Z 4 x U CONSTRUCTION: PLAN REVIEW: . 89 ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: y• SMTP: + ENERGY P/C: ENERGY PERMIT: RETENTION FEE: PRE -ALT FEE: d6 BASF: PLOT PLAN: ZONING CLEARANCE: TOTAL FEES COMMENTS: ®/ P/C: PAID BY: ✓ `4 -'D RFCFIAT # _ O 7 ��^°' PAID BYZ i VALIDATION: L_ C" —VALIDATION: WHITE — Department Copy, YELLOW — Finance Copy, PINK—Assessor Copy SETBAX LETTER FOOTINGS FORMS SLAB UG. PLUMBING UG. ELECTRICAL UFER GROUND SEWER LATERAL MAIN WATER LINE SEWER CLEANOUT _ ROOF SHEATHING _ FLOOR SHFATHING — SHEAR WALLS EXTERIOR m SHEAR WALLS INTERIOR FRAMING/VENTING _ ROUGH MECHANICAL ROUGH ELECTRICAL W( } C ( ) ROUGH PLUMBING INSULATION WALL INSULATION (.FILING DRYWAI 1. LATH (PRC) LATH EXTERIOR LATH INTERIOR GAS IF.) i SCRATCH COAT ELECTRIC METER RELEASE GAS METER RELEASE SPECIAL INSPECTION FINAL BUILD[NG, FINAL MECHANICAL FINAL ELECTRICAL _ _ 1 - FINAL PLUMBING T.C. of OCCUPANCY CERT. of OCCUPANCY COMMENTS: CITY OF Dl INSPECTION TRACT AND LEDGER SWITCH GEAR COMMERCIAL HOOD T -BAR - INTERCEPTER HOT MOP/SHOWERPAN SEPTIC/CESSPOOL HERS REPORT RECEIVED DEMOLITION ROOF DRAINS ROUGH CONDUIT POOL/SPA ROUGH PLUMBING ROUGH ELECTRICAL ROUGH MECHANICAL _ GAS TEST PRE GUNITE POOL PRE DECK BONDING P-.1 RAP FENCE / GATE/ ALARM FIN& POOL MALLS' WA.I FOOTING/STFf'1_ WAIL 51 -FF 11'" ( ) ? of )LIFT WALL 130ND BEAM — WALL DRAIN/ SLAL WALL. FINAL RO FRAMING PLANNING APPROVAL ROUGH EIRE APPROVAL FINAL FIDE DEPARTMENT FINAL PLANNING FINAL ENGINEER] NC/ PFS! FINAL COMMUNITY SERVICES FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE Assembly Bill 2188 applies only to residential rooftop solar energy systems 'Ni I W that are no larger than 10 kilowatts or 30 kilowatts thermal. This form conforms to Assembly Bill 2188. Residential Photovoltaic Power Systems Permit Issuance Checklist Please complete the following information to submit for Building & Safety plan check. APPLICANT completes this box. Address: --t of Lt, , l( APN: Zone: Lot Size: S.F. Average Slope: % Technology: (check one): Building Integrated Roof -Mounted Panel )C: Ground -Mounted Panel System size and power: Number of panels: � 3 Total square feet: sq.ft., Z kW (if electric) Are the property lines correctly dimensioned on the plans? (circle one) Yes No If Ground -Mounted: Max. height of system, (i.e. distance from top of panel to natural or finished grade): If Roof -Mounted: Max. height above roof, (max.distance from top of roof to top of panel): S _ If framing is over eight inches (8") off roof or ground, is it screened? (circle one) Yes No N/A) Are the panels proposed on a permitted structure? (circle one) (Yes No NIA Panel directional orientation, (check one): West 7� Southwest South_ )C Southeast East System visibility from nearby public streets, parks, or trails, (circle one)(Not VisVis b e Low, Medium, High If "no" to any of the above, see the Planning Division. COUNTER PLAAWER completes the remaining form. 1. Zoning ,Yes ❑No a. Does the proposed project meet the setback requirements (or is it an allowed encroachment)? Front setback ft. interior setbacks ft. WN/A ❑Yes ❑No b. If Qround-mounted: Does the project comply with setbacks and lot coverage requirements? Yes ONO C. Are the panels proposed on a permitted structure? KYes ❑No d. Are the property lines correctly dimensioned on the plans? 2. Design ❑Yes 5§.No a. Is there an open/pending project for the property? ❑Yes Mo b. Will the system be obscured from public view, i.e. as viewed from a public street, sidewalk, park, beach or trail, is it completely hidden by a parapet, located behind a residence, down a private driveway not visible off site, etc.? Consider cell potential public views of the site, especially on hillside properties. If "yes", then skip to item No.6 below. If "no", continue to item 3. 3. Is the proposed project affiliated with a historic resource (Check historic resource list)? ❑Yes MNo Page 1 of 3 4. Is the proposed project on a site which includes a potentially sensitive visual resource, such as: Dyes ONO a. Hillside property (regardless of slope)? 5. Is the proposed project located in a restricted use area? Oyes jBNo 6. The plans cannot be approved over the counter and must be routed to staff for further review. If there are Zoning concerns ("no" to question No. 1), indicate those in the zoning activity. Oyes ❑No 7. Applicant proceeds to Building & Safety Counter to continue the review (add approval notes in Zoning Clearance file, stamp and initial three (3) sets of B&S plans) ❑Yes ❑No Building and Safety requirements. Applicant shall complete the remaining form. (Please check the correct answer for each question) 1. Applicant submitted (3) sets of plans minimum I I"x17", attach all manufacturer's specification sheets, installation instructions, and listings. Yes ❑No 2. All exposed conduits painted to.match the roof is noted on the plans. PYes ONO 3. In submittal, provided electrical single -line diagram clearly identifying all devices installed in the PV system and indicating total kW rating of system. .Yes ONO 4. Applicant acknowledges correct circuit sizing and current calculations based off 2016 California electrical Code Article 690.8 on plans from California state licensed electrical engineer or a California licensed contractor classification C-46 or C-10. OYes ONO 5. Applicant acknowledges photovoltaic source and output circuits have a maximum photovoltaic of up to 600 volts based off 2016 California electrical Code Article 690.7 on plans from California state licensed electrical engineer or a California licensed contractor classification C-46 or C-10. ]Yes ❑No 6. Applicant acknowledges wet -stamped and signed submittal of structural calculations for wind uplift based of ASCE 7-10 from State license civil or structural engineer. All Structural Elements shall be identified on existing roof framing members on plans. PYes ONO 7. Applicant acknowledges rooftop mounted photovoltaic systems shall be tested, listed and identified with a fire classification in accordance with UL 1703. The fire classification shall comply with Table 1505.1 of the California Building Code based on the type of construction of the building Effective January 1, 2015. ]Yes ONO Page 2 of 3 9. Applicant acknowledges installation of the interconnected electric power production source shall be in compliance based off 2016 California electrical Code Article 705. 7Yes []No 10. Applicant plans are to be signed by a California licensed contractor classification C-46 or C-10. Provide signature and license number on each sheets. Contractor who signs the document must be the one doing the work, Business and Professions Code Section 7031.5. Yes ❑No IPIIJ 11. Applicant acknowledges that the photovoltaic system may only be installed on a permitted structure. Fes ❑No 12. Applicant acknowledges that the photovoltaic system meets the "California Solar Permitting Guidebook": http://opr.ca.gov/docs/California Solar Permittin Guidebook. df Yes ❑No 13. Proposed project racets state fire marshal set -backs for roof mounted photovoltaic system requirements and code section 8908 CRC 2016. [;Yes C]No Signature of Applicant: ' r. " t! -� Date: 1�Llll Print Name: A l t cL -P I' �—y c C f Page 3 of 3