HomeMy WebLinkAboutPR17-15847 (13)CITY OF DIAMOND BAR
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Tel DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES
21810 Copley Drive, Diamond Bar, CA 91765 PRESS
l<1(909) 839-7020 Fax. (909) 861-3117 Building Inspection Hotline (909) 839-7027 FIRMLY
BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@diamondbarca.gov
JOB SITE ADDRESS `A U(A ,:' ` lana �t'
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APPLICANT v: L °. TEL.
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CONTRACTOR o4Lvge -°ems
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CITYi g: e .. g n� ZIP `' 1 - S<"J TEL.
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DESIGNER
ADDRESS
CITY ZIP TEL.
OWNER -BUILDER DECLARATION
I hereby afflrm under penally 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 701 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 permit to file a signed statement that he or she
Is licensed pursuant to the provisions of 1he Contractor's State License Law (Chapter 9) Commencing with Section
7DO0 of Division 3 of the Business and Pfofessions Cade] or that he or she Is exemptfrom Ilconsure and the basis for
the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant io a civil penalty
of not more than five hundred dollars ($500).
U 1, as owner of the property, or my employees with wages as their sole compensation, will do (-) all of or Ca 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 cr offered for sale. If however, the building or
improvement is sold within one year of completion, the Owner -Builder wi11 have the burden of proving that it was not bullt
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 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 Contractor pursuant to the Contractors` State
License taw.).
Li I am exemptfrom I€censure 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 l must have resided for at least one
year prior to completion ofthe improvements covered by lhls 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 Professions Code is available upon request when this application is
submitted or at the following Web site: http/www.leglnfo.ca.govlcalaw.html.
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that 1 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 farce and effect
LICENSE Cl LIC. NO.: f 2 Z' _f °
EXP. DATE: ''� d� <.% CONTRACTOR:�""�"
WORKER'S SATION 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 ofthe Labor Code, for the performance of the work for which this perm€t 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 work for which this permit is issued. My Worker's Compensafion Insurance Carrier and
Policy Number rare:
CARRIER
POLICY NUMBER
{THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS $100 OR LESS)
Iceriifgthat in the performance of the workforwhich this permit is issued, I shall cot employ any person in any manner so asto
become subject to the Worker's Compensation Laws of California. And agree that if I should become subject to the Warker's
Compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
DATE: APPLICANT:
WARNING: Failure 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 cost of the compensation,
damages as provided for in section 37GB 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
whlch this permit Is issued (Soo, 3097, Clu C.),
LENDER'S NAME:
LENDER'S ADDRESS:
1 certify that ! have read th€s 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 abovo-mentioned property for Inspection purposes,
,.F ix.. 1v
PERMITTEENAME�-
SIGJJWUEE- DATE
APPLICATION DATE: -7/0r? P/C# M I — 6 5 y d
ISSUE DATE: �r S i"I PERMIT#: r%g 0-1— I's%
TYPE CONST. OCC GROUP:
Scope of Work
i's 'Aa�+��d.r.:; � 3 a�T:�.f1� mss'.
# DWEL. UNITS # STORIES It BEDROOMS
DESCRIPTION SQ. FT. FACTOR PSF
ADJ. AREA/VALUATION
SF7VADD/REM
Garage/Carport
LO
PatiolDeck
[Li
Pool/Spa
ZRe
-Roof
Commercial
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{ aimaition: ad f--'
Adj. Area:
QUANTITY DESCRIPTION
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CONSTRUCTION:
PLAN REVIEW:
ELECTRIC:
PLUMBING:
MECHANICAL:
INSPECTION FEE:
ISSUANCE:-
SMIP:
t -
ENERGY P/C:
ENERGY PERMIT:
RETENTION FEE:
PRE -ALT FEE:
BASF:
- t
PLOT PLAN:
ZONING CLEARANCE:
TOTAL FEES
COMMENTS:
!S
P/CZ,CIL PAID BY: -""'f "? j/ VALIDATION:
RECEIPT# (&9 2-5 PAID BY: € VALIDATION: '"` n
WHITE—Department Copy, YELLOW —Finance Copy, PINK—Assessor Copy
CITY OF DIAMOND
INSPECTION C
SETBACK/ LETTER
TRACT AND LEDGER
FOOTINGS FORMS
SNITCH GEAR
SLAB
COMMERCIAL HOOD
UG. PLUMBING
T -BAR
UG. ELECTRICAL
INTERCEPTER
UFER GROUND
HOT MOP/SHOWERPAN
SEWER LATERAL
SEPTIC/CFSSPOOL
MAIN WATER I INF
SEWER CLI ANOW'
ROOF SHFNI lING
FLOOR Sl IFA FI IING
SHEAR WAILS EXTERIOR
SHEAR WALLS INTERIOR
....... ......... .
FRAMING/VENTING
ROUGH MECHANICAL
ROUGH ELECTRICAL W( ) C ()
_ ........
ROUGH PLUMBING
INSIII ATION WALT_
INSULATION CFILING
DRYWALL
HERS REPORT RECEIVED
DEMOLfTION
ROOF DRAINS
ROUGH CONDUIT
......._._...
PODUSPA
- ._.
-.......
ROUGH PLUMBING
ROUGH ELECTRICAL
ROUGH MECHANICAL
GAS TEST
-
PRE GUNITE
_------
.. .-_..---
POOL PRE DECK BONDING
P -TRAP
FENCE / GATE/ ALARM
FINAL.. POOL
WALLS: 1.
WAIL FOOTING/STF.A.
WAI I. STLLI. 1;u( ) 7Nu( ) I IFT
VITAL!_. BOND BEAM
WALL DRAIN/ SIAL
WAIL. FINAI
RO FRAMING PLANNINGAPPn(.)VAL
FIRE APPROVAL
FINAL FIRE DEPARTMENT
FINAL PLANNING
FINAL ENGINE RING/ PW
FINAL COMMUNITY SERVICES
LATH (PRE)
LATH EXTERIOR
LATH INTERIOR
GAS TEST
... .........
SCRATCH COAT
ELECTRIC METER RELEASE
GAS METER RELEASE
SPECIAL INSPECTION
FINAL BUILDINGROUGH
FINAL MECHANICAL
--
FINAL ELECTRICAL
FINAL PLUMBING
- _ --
IT. 0. of OCCUPANCY
CERT, of OCCUPANCY
_._
FINAL HEALTH DEPT.
COMMENTS:
FINAL INDUSTRIAL WASTE
::�.. Assembly Bill 2188 applies only to residential rooftop solar energy systems
that are no larger than 10 kilowatts or 30 kilowatts thermal.
This form conforms to Assembly Bill 2188.
\-
.��g Residential Photovoltaic Power Systems
Permit Issuance Checklist
Please complete the following information to submit for Building & Safety plan check.
APPLICANT completes this box.
Address: I° i G; 2cc .q�_ Q'�2. APN: Zone:
Lot Size: S.F. Average Slope: %
Technology: (check one): Building Integrated Roof -Mounted Panel Ground -Mounted Panel
System size and power: Number of panels: 1 �-, Total square feet: 2.7 sq.ft. , - kW (if electric)
Are the property lines correctly dimensioned on the plans? (circle one) es, No
If Ground -Mounted: Max. height of system, (i.e. distance from top of pan oo natural or finished grade):
If Roof -Mounted: Max. height above roof, (max.distance from top of roof to top of panel):
If framing is over eight inches (8") off roof or ground, is it screened? (circle one) Yes No
Are the panels proposed on a permitted structure? (circle one) � No NIA
r
Panel directional orientation, (check one): West V Southwest South Southeast Last
System visibility from nearby public streets, parks, or trails, (circle one): Not Visible, Low, Medi Higli,
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)?
Oyes ❑No
Page 1 of 3
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.
Dyes ❑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&Splans)
❑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 11"x17", attach all manufacturer's specification sheets,
m allation instructions, and listings.
❑Yes ❑No
2. All 'posed conduits painted to match the roof is noted on the plans.
[ es ❑No
3. In submittal, provided electrical single -line diagram clearly identifying all devices installed in the PV system and
indi ting total M rating of system.
Yes ❑No
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
clafication C-46 or C-10.
❑Yes ❑No
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
o�r� alifornia licensed contractor classification C-46 or C-10.
[Byes 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
rooD,framing members on plans.
es ❑No
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
Caljifornia Building Code based on the type of construction of the building Effective January 1, 2015.
Dyes ❑No
Page 2 of 3
8. Applicant acknowledges installation of the photovoltaic system shall be in compliance based off 2016 California
electrical Code Article 690.
El'yes ❑No
9. Applicant acknowledges installation of the interconnected electric power production source shall be in
compliance based off 2016 California electrical Code Article 705.
MYes ❑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 ofessions Code Section 7031.5.
es ❑No
It. Applicant acknowledges that the photovoltaic system may only be installed on a permitted structure.
®Yes ❑No
12. Applicant acknowledges that the photovoltaic system meets the "California Solar Permitting Guidebook":
http://opr.ca.gov/docs/California Solar Permitting Guidebook.pdf
Eyes ❑No
13. Proposed project meets state fire marshal set -backs for roof mounted photovoltaic system requirements and code
sect' n R908 CRC 2016.
`es ❑No
Signature of Applicant: Viµ., Date:
Print Name: 0_��
Page 3 of 3