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Home My WebLink AboutPR17-7150CITY OF DIAMOND BAR t DEPARTMENT OF COMNfUNITY & DEVELOPMENT SERVICES V 21810 Copley Drive, Diamona Bar, CA 91765 -, PRESS (909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 839-702 FIRMLY BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@diamondbajrca.gov JOB SITE ADDRESS j `' Ai LOT TRACT. OWNER ?, ADDRESS f' 1' CITY N'4 ZIP:21 . C JP TEL APPLICANT TEL. .. i g CONTRACTOR fay" ADDRESS Y -/;' CITY<"g ZIP 11`�TEL. ARCH/ENG/ DESIGNER ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION J hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the reason(s) indicated below by the checkmark(s), l 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, 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 at the Contractor's State License Law (Chapter 9) Commending with Section 7000 of Division 3 of the Business and Professions Code] or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation 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). U I, as owner of the property, or my employees with wages as their sole compensation, will do U 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 properly who, through employees' or personal effort, builds or improves tide property, provided that the improvements are not intended or offered for sale. li however, the building or improvement is sold 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 I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 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.) O € am exempt from licensure under the Contractor's State License law for the following reasori Date Sign: 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 penal cannot legally sell a sttuoture that I have built as an owner-bullder If it has not been constructed in Its entirety by licensed contractors. 1 understand that a copy of the applicable law, Section 7044 of the Business and Professions Code is avallahlo upon request when this application is submitted or at the following Web site'. httpAvww.Ieginfo.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 7099) of Division 3 of the Business and Professlons Code, and my license is in full force and effect. LICENSE CLASS- c e"'- LIC NO.. p EXP, DATE4 CONTRACTOR:',- WORKER'S COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: 1 have and will maintain a Certificate of Consent to Se11-Insuro for Worker's Compensation, as provided by Section 3700 ofthe Labor Code, forthe performance of the work for which this permit Is Issued. I have and will maintain Worker's Compensation Insurance, as required by Section 3700 of the tabor Code, for the performance of the work for which this permit is issued. My Worker's Compensation Insurance Carrier and Policy Number are: r CARRIER 2- Ll,, -V' POLICY NUMBER P '2' C (THIS SECIION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS $400 OR LESS). I cartfythat in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to hecome subject to the Worker's Compensation Laws of California, And agree that if I should hecome subject to the Worker's Compensation provisions of Secilon 5700 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 6vII fines up to one hundred thousand dollars ($100,0001, In addltlon 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 represcntafives of this county to enter upon the above-mentioned property for inspection purposes, PERMITTEE NAME (PFIN] { SIGNATURE OF PERM17FE DATE APPLICATION DATE: -� ' -,,— �i . 1' P/C# PR l-+- T1W ISSUE DATE: T�Z�� i _+ PERMIT# : PR I + TYPE CONST, OCC GROUP: Scope of Work # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/RFM Garage/Carport LJ Patio/Deck Liu LL Pool/Spa zRe -Roof Commercial m Valuation: `: � Adj. Area: QUANTITY DESCRIPTION FEE c� s V J w z in a r� 2 a x v 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 — Flnance Copy, PINK Assessor Copy CATY OF DIAMOND BAR INSPECTION RECORD r 6 SETBACK/ LETTER GLR ()OD 7T -BAR '7 INTERCEPTER HOT MOP/SHOWERPAN FOOTINGS FORMS SLAB UG. PLUMBING UG ELECTRICAL UFFR GHOUNU SFINI=II I ATFRAI. MAIN WATER IJNF SEWER CLEANOUT ROOF SHEATHING FLOOR SHEATHING SHEAR WALLS EXTERIOR SHEAR WALLS INTERIOR FRAMINGNENTING SEPTIC/CESSPOOL HERS REPORT RECEIVED DEMOLITION ROOF DRAINS ROUGH CONDUIT POOIUSPA ROUGH PLUMBING ROUGH ELECTRICAL ROUGH MECHANICAL ROUGH ELECTRICAL W( ) C ( ) ROUGH MECHANICAL 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: WALL FOOTING/STEEL LATH INTERIOR GAS TEST WALL STEEL IST( ) 2N`( ) LIFT WALL BOND BEAM SCRATCH COAT EI.FGTWC METER RELEASE GAS METER RELEASE ,Y'Ei;iAL INSPECTION FINAL BUILDING FINAL. MECHANICAL FINAL ELECTRICAL FINAL PLUMBING T.C. of OCCUPANCY CERT of OCCUPANCY _......... ......... WALL DRAIN/ SEAL WALL FINAL RO FRAMING PLANNING APPROVAL ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT FINAL PLANNING FINAL ENGINEERING/ PW FINAL COMMUNITY SERVICES FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE - =' .. _ _ CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 PRESS (909) 839.7020 Fait: (909) 861-3117 Building Inspection Hotline (909) 839-7027 FIRMLY BUILDING PERMIT APPLICATION www.cityofdiamondbar.com building@diamondbarca.gov JOB SITE ADDRESS- APN L T g _ TRACT OWNER -PZI— +AA_ p �e cif i ADDRESS `� Z CITY VF ZIPL s`� TEL. APPLICANT TEL. ijL r CONTRACTOR ADDRESS __i 11( iG CITY ZIP I; TEL. ARCH/ENG/ r DESIGNER ADDRESS o CITY ZIP TEL. = OWNER -BUILDER DECLARATION c nI hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the reasan(s) � indicated below by the checkmark(s), I have placed next to the applicable item(s) ISection 7031A Business and a Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair, any L structure, prior to its Issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuantto the provisions of the Contractor's State License Law (Chapter 9) Commencing with Section 700 of Division 3 of the Business and Professions Code] or that he or she is exempt from licensure and the basis for Q the alleged exemption. Any violation of Section 7031.5 by any applicantfor a permit subjects the applicant to a civil penalty I-- of not more than five hundred dollars ($5001 D U 1, as owner of the property, or my employees with wages as theirsole compensation, will do U all of or(, 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' ar 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 it was not built or improved for the purpose of sale.). z (_) I, as owner of the property, am exclusively contracting with I€cersad Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who y auildS or improves thereon, and who contracts lorthe projects witil licensed Contractor pursuartto t1re Contracters'Stato x License Law,). U I am exemptfrom licensure under the Contractor's State License law for the following reason(sj: LL n Si a Date: 9 By my signature below i acknowledge that exceptfor 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 legally sell a structure that I have built as an E: owner -builder if it has not been censtrucled in its entirety by licensed contractors. I understand that a copy of the X applicable law, Section 7044 of the Business and Professions Code is available upon request when th€s application is W CD submitted or at the following Web site: http/www.leginfo.ca.govlcalaw.html. v LICENSED CONTRACTOR'S DECLARATION ml hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7GOO) of Division 3 of the Business and Professions Code, and my license is in iull force and eiiect. LICENSE CLASS: Z3 r1p LIC. NO.: ¢ EXP. DATE: CONTRACTOR: - o WORKER'S COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: o I have and will maintain a Carlificate of Consent to Self -Insure for Worker's Compensation, as provided by J Section 3700 otthe Labor Code, for the performance of the work for which this permit Is Issued. k have and wild maintain Worker's Compensation Insurance, as required by Sec on 3700 of the Labor Code, for the performance of the wcrkior which this permit is issued. My Worker's Compensation Insurance Carrier and Policy Number are: oLU CARRIER`r POLICY NUMBER THIS SECTIDN NEED NOT BE COMPLETED IF TRE PERMIT IS FOR ONE HUNDRED DOLLARS $100 OR LESS). cD 1 cerIlythat in the performance ofthe work for which this permit is issued, I shall not employ any person in any manner so as to p become subject to the Worker's Compensation Laws of California. And agree that if 1 should become subject to the Worker's LU Compensation provisions of Section 3700 ofthe labor Cade, I shall forthwith comply with those provisions, S DATE: APPLICANT: WARNING: Failure to secure Worker's Compensation coverage is unlawful, and shall subject an employer to criminal Lu penalties and civil fines up to one hundred thousand dollars ($100,000), in addition to the cost of the compensation, p damages as provided for in section 3708 of the labor code, interest, and attorney's fees. a 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: 2 LU �- I certify that €have read this application and slate 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 ofthis county to ES enter upon the above-menlionedproperty forinspection purposes. J PERMITTEE NAME (PRI co EE SIGNATURE OF PERMITTER DATE l— APPLICATION DATE: -;L - 5—, / P/C# P9 I i — 71 ISSUE DATE: PERMIT# TYPE CONST OCC GROUP: Scope of Work d +�` "' - V V S�_- 6 s-AlF it DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREAlVALUATION SFR/ADD/REM Garage/Carport Patio/Beck Pool/Spa Re -Roof Commercial Valuation: Adj. Area: CONSTRUCTION: PLAN REVIEW: f- ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE• ISSUANCE: QUANTITY DESCRIPTION FEE J ' ENERGY P/C: V _ J w PLOT PLAN: z Do a �d VALIDATION: VALIDATION: U CONSTRUCTION: PLAN REVIEW: f- 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: PIC: e,f�g,,PAID6Y:'� '� .� RECEIPT#� 6_1 y 19 PAEDBY: ® VALIDATION: VALIDATION: WHITE — Department Copy, YELLOW Finance Copy, PINK—Assessor Copy CGIONT UFAI nof .. _ 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. Residential Photovoltaic Power Systems Permit Issuance Checklist Please complete the following information to submit for Building & Safety plan check. APPLICANT completes this box. Address: 5'�� + "� v°e°^- 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:.. Total square feet: sq.ft. kW (if electric) Are the property lines correctly dimensioned on the plans? (circle one) 6�;) 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): 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) Ye No NIA Panel directional orientation, (check one): West Southwest South Southeast East System visibility from nearby public streets, parks, or trails, (circle one): Not Visible Lo , Medium, High If "no" to any of the above, see the Planning Division. COUNTER PLANNER completes the remaining form. 1. Zoning �es ❑No a. Does the proposed project meet the setback requirements (or is it an allowed �? encroachment)? Front setback ft. interior setbacks ft. 'ON/A Dyes ❑No b. If ground -mounted: Does the project comply with setbacks and lot coverage requirements? AYes ❑No c. Are the panels proposed on a permitted structure? '[Yes ❑No d. Are the property lines correctly dimensioned on the plans? 2. Design FYes ❑No a. Is there an open/pending project for the property? ❑Yes'�To b. Will the system be obscured from public view, i.e. as viewed from a public 11 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.6 below. If "no", continue to item 3. 3. Is the proposed project affiliated with a historic resource (Check historic resource list)? Dyes WO I Page 1 of 3 4. Is the proposed project on a site which includes a potentially sensitive visual resource, such as: Dyes FN a. Hillside property (regardless of slope)? 5. Is the proposed70C t located in a restricted use area? ❑Yes 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. ryes ❑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 and add a review fee.) PYes ❑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, installation instructions, and listings. `Yes ❑No 2. All exposed conduits painted to match the roof is noted on the plans. F, es ❑No 3. In submittal, provided electrical single -line diagram clearly identifying all devices installed in the PV system and indicating total kW rating of system. es ❑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 classification C-46 or C-10. ll ` KOS ❑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 or a California licensed contractor classification C-46 or C-10. Pkes ❑No 6. ?tApplicant 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 f framing members on plans. ['es ❑No 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 ❑No Page 2 of 3 S. Applicant acknowledges installation of the photovoltaic system shall be in compliance based off 2016 California electrical Code Article 690. es ❑No 9. Applicant acknowledges installation of the interconnected electric power production source shall be in compliance based off 2016 California electrical Code Article 705. pYes ❑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. Oyes ❑No 11. A plicant acknowledges that the photovoltaic system may only be installed on a permitted structure. es ❑No 12. Applicant acknowledges that the photovoltaic system meets the "California Solar Permitting Guidebook": bq://Mr.ca.gov/docs/Califomia Solar Permitting Guidebook.pdf riYes ❑No 13. Proposed project meets state fire marshal set -backs for roof mounted photovoltaic system requirements and code section R908 CRC 2016. ayes ❑No Signature of Applicant: �� Date: I _, , f ?- Print Name: o"C_ 4 e, -f Page 3 of 3