HomeMy WebLinkAboutPR17-9110CITY 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(a,-Wiamundbarea.gov
JOB SITE ADDRESS
APIN g LOT TRACT
OWNER
ADDRESS,: 7�&s'/,6 A 1"41
CITY ZIP TEL
APPLICANT TE
CONTRACTOR
S
ADDRESS-'fff — k&f ZaL
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ARCH/ENG/
DESIGNER
ADDRESS
CITY ZIP TEL.
OWNER -BUILDER DECLARATION
hereby affirm order penalty of perjury that 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 Items) [Section 7031.5, Business and
Professions Code: Any city or county that requires a permit to construct, alter, Improve, demolish, or repair, any
structure, prior to its issuance, also requires the applicant for the pormitta file a signed statementilhat 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 all the Business and Professions Code] or that he or she is exempt from 11censure and the basis for
the alleged exemption. Any violator of 7031.5 by any applicant for a permit subjects the applicaritto a civil penalty
of not more than five hundred dollars ($l
U 1, as owner afthe property, or my employees with wages as their sale compensation, will do W all of or U portions
at the work, and the structure is not intended or offered for sale (Section 7044. Business and Professions Code: The
Contractors' State License Law does rat apply to an owner of property who, through emi personal effort, builds
or Improves the property, provided thatthe improvements are not intended or offered for sale. If however, the building or
improvement is said within one year of completion, the Owner -Builder will have the burden of proving that it was not built
or improved for the purpose of sale.).
U 1, as owner of the property, am exclusively contracting with 11cersed Contractors to construct the project (Scotian
7044, Business and Professions Code! 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 Contractor pursuant to the Contractors' State
License Law.):
I I am exemptfrom licensors under the Contractors State License law forthe folicwhig reasorl
Date: Sign.
By my signature below I acknowledge that, exceptfor my p6mrm; residence In which I must have resided for at least one
year prior to completion of the Improvements covered by this pnrmft,l cannot legally sell a structure that I have built as ap
owner -builder If It has not been constructed In Its entirety by licensed contracilms, I understand that a copy of the
applicable law, Sector 7044 of the Business and Professions Carlo is available upon request when this application is
submitted or atthe following WO site: hdplwww,lDginfo,ca,gDvlcalaw,htmi,
LICENSED CONTRAGTORIS DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions Of Chapter 9 (commending with Section 7000)
of Divislofi 3 of the Business and Professions Code, and my license is in full force and effect.
LICENSE CLASS - LIC NO,:
EXP. DATE:.'CONTRACTOR:
WORKER'S COMPENSATION PEL4iMIRON
I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWIN3 OVOLARATIONS:
I have and will maintain a Certificate of Consent tc Self -Insure for 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 efthe Labor Code, for
the performance of the workiorwIblch this permit Is issued My Worker's Compensation insurance Carrier and
Policy Number
CARRIER
POLICY NUMBER
(THISSFUION NEED NOT 3FCOMPLFTFD IFTHE PERMIT IS FOR CNFH[)NDRFD DOLLARS $100 OR LESS),
I codify that Inthe performance of the work for which this permit Is Issued, I shall draft employ any person In any manner soasta
become subject to the Worker's Compensation Laws Of Call And agree that If I should become subject to the Workers
Compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those brovislons
DATE— APPLICANT:
WARNING: Failure to secure Worker's Compensation coverage is unlawful, and shall subject an employer to criminal
penalties and civil tries up to one hundred thousand dollars (3100,0010), in addition to the not of the compensation,
damages as provided for in section 3708 of the labor code, interest, and attorney's ises.
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, GIv. 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 cry and
CDLrtY ordinances andstatelaws relating to building construction, and hereby ami representatives of this county to
enter upon the above-ifierfloneid prcI for inspection p0poses
, .'," 4
PERMr7EF NAME (PRINT) 2
SIGNATURE OF PFRM17EE DATE
APPLICATION DATE: P/09
ISSUE DATE:. Q? 3pERMIT# it 6
TYPE CONST. OCC GROUP:
Scope of Work
1A, zr,
i7:
# DWEL. UNITS "# STORIES
# BEDROOMS
DESCRIPTION SQ. FT, FACTOR PSIF
ADJ. AREA/VALUATION
SFR/ADD/REM
Garage/Carport
Patio/Deck
LL
Pool/Spa
Fe -Root
Commercial
valuafil
Adj. Area:
QUANTITY DESCRIPTION
FEE
U
cb
CONSTRUCTION:
PLAN REVIEW:
ELECTRIC:
PLUMBING:
MECHANICAL:
INSPECTION FEE:
ISSUANCE:
SMTP:
ENERGY P/C:
ENERGY PERMIT:
RETENTION FEE
PRE -ALT FEE:
BASF:
PLOT PLAN:
ZONING CLEARANCE:
TOTAL FEES
COMMENTS:
P/C: PAID BY:
RECEIPT PAID BY:
VALIDATION:
VALIDATION:
WHITE — Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy
CITY OF DIAMOND BAR
INSPECTION EO;r'D
SETBACK/ LETTER
TRACT AND LEDGER
FOOTINGS FORMS
SWITCH GEAR
SLAB
COMMERCIAL HOOD
UG, PLUMBING
T -BAR
UG. ELECTRICAL
INTERCEPTER
UFER GROUND
HOT MOP/SHOWERPAN
SEWER LATERAL
SEPTIC/CESSPOOL
MAIN WATER LINE
HERS REPORT RECEIVED
SEWER CLEANOUT
DEMOLITION
ROOF SHEATHING
ROOF DRAINS
FLOOR SHEATHINGIF
ROUGH CONDUIT
SHEAR WALLS EXTEBI0R
POWSPA
SHEAR WALLS INTERIOR
ROUGH PLUMBING
FRAMINGNENTING
ROUGH ELECTRICAL
ROUGH MECHANICAL
ROUGH MECHANICAL
ROUGH ELECTRICAL W( j C (
GAS TEST
ROUGH PLUMBING
PRE GUNITE
INSULATION WALL
POOL PRE DECK BONDING
INSULATION CEILING
P -TRAP
DRYWALL
FENCE / GATE/ ALARM
LATH (PRE)
FINAL POOL
LATH EXTERIOR
WALLS:
LATH INTERIOR
WALL FOOTING/STEEL
GAS TEST
WALL STFFL 1a'( ) 2N°( ) LIFT
SCRATCH COAT
WALL BOND BEAM
ELECTRIC METER RELEASE
WALL DRAIN/ SEAL
GAS METER RELEASE
WALL FINAL
SPECIAL INSPECTION
R0, FRAMING PLANNING APPRCVAL
F114AL BUILDING
ROUGH FIRE APPROVAL
FINAL MECHANICAL
FINAL FIRE DEPARTMENT
FINAL ELECTRICAL
FINAL PLANNING
FINAL PLUMBING
FINAL ENGINEEMNG/ PW
T.G. of OCCUPANCY
FINAL COMMUNITY SERVICES
CERT. ®f OCCUPANCY
FINAL HEALTH DEPT.
FINAL INDUSTRIAL WASTE
COMMENTS:
..i_..,.._._ Assembly Bill 2188 applies only to residential rooftop solar energy systems
I that are no larger than 10 kilowatts or 30 kilowatts thermal.
This form conforms to Assembly Bill 2488.
Residential Photovoltaic Power Systems
Permit Issuance Checklist
Please complete the following information to submit for Building & Safety plan check.
APPLICANT completes this box.
Address: 9r APN: Zone:
Lot Size: S.F. Average Slope: %
Technology: (check one): Building Integrated Roof -Mounted Panel Ground-Munted Panel
System size and ower: Number of panels Totals square feet: s ft �` y�" kW of electric
Y p p q q• a� C )
Are the property lines correctly dimensioned on the plans? (circle one) 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): , ' C
If framing is over eight inches (8") off roof or ground, is it screened? ircle one) Yes No
Are the panels proposed on a permitted structure? (circle one e No NIA
Panel directional orientation, (check one): West Southwest,: South Sout ast East
�_ _�-
System visibility from nearby public streets, parks, or trails, (circle one): Not Visibl L o : %'Medium, High
If "no" to any of the above, see the Planning Division.
COUNTER PLANNER 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.
❑NIA ❑Yes ❑No b. If ground -mounted: Does the project comply with setbacks and lot coverage
requirements?
❑Yes ❑No C. Are the panels proposed on a permitted structure?
❑Yes ❑No d. Are the property lines correctly dimensioned on the plans?
2. Design
❑Yes ❑No a. Is there an open/pending project for the property?
❑Yes ❑No 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
all potential public views of the site, especially on hillside properties.
If "yes", then skip to item No.b below.
If "no", continue to item 3.
3. Is the proposed project affiliated with a historic resource (Check historic resource list)?
❑Yes ❑No
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4. Is the proposed project on a site which includes a potentially sensitive visual resource, such as.
❑Yes ❑No a. Hillside property (regardless of slope)?
5. Is the proposed project located in a restricted use area?
❑Yes ❑No
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.
❑Yes ❑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. Appli t submitted (3) sets of plans minimum 11"x17", attach all manufacturer's specification sheets,
i lation instructions, and listings.
Yes ❑No
11
2. A exposed conduits painted to match the roof is noted on the plans.
Yes ❑No
3. In sub ittal, provided electrical single -line diagram clearly identifying all devices installed in the PV system and
in ' ating total M rating of system.
Yes ❑No
4. Applicant acknowledges correct circuit sizing and current calculations based off 2016 California electrical Code
Antic 690.8 on plans from California state licensed electrical engineer or a California licensed contractor
rsification C-46 or C-10.
es ❑No
5. Applicant acknowledges photovoltaic source and output circuits have a maximum photovoltaic of up to 600 volts
based,.based,pff 2016 California electrical Code Article 690.7 on plans from California state licensed electrical engineer
or aXalifornia licensed contractor classification C-46 or C-10.
es ❑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
ro framing members on plans.
Yes []No
7. Appli t acknowledges rooftop mounted photovoltaic systems shall be tested, listed and identified with a fire
clas 'fication in accordance with UL 1703. The fire classification shall comply with Table 1505.1 of the
C fornia Building Code based on the type of construction of the building Effective January 1, 2015.
Yes ❑No
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8. Applic ht acknowledges installation of the photovoltaic system shall be in compliance based off 2016 California
ele ical Code Article 690.
es ❑No
9.Appl' ' t acknowledges installation of the interconnected electric power production source shall be in
co liance based off 2016 California electrical Code Article 705.
Yes ❑No
10. Applicant plans are to be signed by a California licensed contractor classification C-46 or C-10. Provide signature
and " ii
se number on each sheets. Contractor who signs the document must be the one doing the work, Business
an rofessions Code Section 7031.5.
Yes []No
11.icant acknowledges that the photovoltaic system may only be installed on a permitted structure.
Yes ❑No
12. Applic rat acknowledges that the photovoltaic system meets the "California Solar Permitting Guidebook":
htt • o r.ca. ov/docs/California Solar Permitting Guidebook. df
KYes ❑No
13. Prop'99ed project meets state fire marshal set -backs for roof mounted photovoltaic system requirements and code
se
on R908 CRC 2016.
Yes ❑No
Signature of Applicant: !" J - bate:
Print Name:. / r22�
a
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