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Home My WebLink AboutPR17-13059.. = CITY OF DIAMOND BAR I 6 i I'; DEPARTMENT OF COMMUNITY & DEVELOPMENT SERVICES 21810 Copley Drive, Diamond Bar, CA 91765 (909) 839-7020 Fax: (909) 861-3117 Building Inspection hotline (909) 839-7027 BUILDING PERMIT APPLICATION ww-mcityofdiamondbar.com liil a JOB SITE ADDRESS r, APN OT RACT n IJJ OWNER ADDR S a CITY CC l TEL. �p�� Ca — � a APPLICANT TEL. r Q 0 co 0 a 0 cc w z 0 a m¢ 0 Q O z d M u] CD 0 U LLE 0 U 0 2 O Cn 2 O 2 w 0 U m Cn 0 0 H a U. 0 7 I' Q G. z L U C c u 4L LL 0 c c Q `L e c L c C PRESS FIRMLY APPLICATION DATE: 1 t % P/C# ISSUE DATE: �1I PERMIT#: X�Z 13 QS TYPE CONST Scope of Work CONTRACTOR ADDRE r �� iZ # DWEL. UNITS CITY ilve,-- zip 2-5L'L. 95( — UIZ 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 reas)ns) 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, or repair, any structure, prior to its Issuance, also requires the appllcantfor the permitto file 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 exempt from Ilcensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civll penalty of not more than five hundred dollars (5560). L) I, as owner of the property, or my employees with wages as their sale compensation, will do (- 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 year of completer, the Owner -Builder will have the burden of proving that it was not built or improved for the purpose of sale,), () 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 properly who builds or improves thereon, and who contracleforthe projects with a licensed Contractor pursuantto the Contractors' State License Law.), (_) I am exemptfrom licensure under the Contractor's State License law for the following reason(s): By my signature below I acknowledge that, except for my personal residence in which I musl have resided far at least one year prior to completion of the improvements covered by this permO,I cannot legally sell a structure that I have built as an owner -builder if It has not beer 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 attire following Web site: httplwww.leginfo,ca,govlcalaw.html. 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 its In full force and effect il LICENSE CLAss'. LIC. NO.: f FXP. DATE: O /, CONTRACTOR; WORKER'S COMP NSATION DE LARATIGN I HEREBY AFFIRM UNDER PENALTY Of PERJURY ONE OF THE FOLLOWING DECtARATiON& Tand will malntain a Certificate of Consent to Sell -Insure for Worker's Compensation, as provided by ecton 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 of the Labor Code, for the performance att work for which this permltisissued MyWorker's Compensation insurance Camerand Policy Number are, . CARRIER POLICY NUMBER (THIS SECTION NEED NOT BE CDMPLETEC IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 6100 OR LESS). I earl that in the performance of the work for which this permit Is issued, l shall not employ any person in any manner so as to became subject to the Worker's Compensation Laws of CelNornla. And agree that If I should become subject to the Worker'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 degars (6100,000), in addition to the cost of the compensation, damages as provided for in section 3709 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. SOW, Civ. C.}, LENDER'S NAME: LENDER'S ADDRESS: I cel that I have read this application and state fhatthe above information is correct. I agree to comply with all city and county Ordin ces and state laws relating to building construction, and hereby authorize representatives of this county to enter upon a ove-mentioned property for inspection purposes, PERMITTEE NAME {PRINTJ� � ; y % � SIGNATURE DATE LL Lu LL O Z cc m OCC GROUP: k� # STORIES # BEDROOMS, DESCRIPTION SO, FT. FACTOR PSF ADJ. AREA/VALUATION SFRJADD/REM Garage/Carport PatWDeck Pocli Re -Roof Commercial Val"ua'�Fon: Adj. Area: QUANTITY I DESCRIPTION Cir` FEE CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: ®� MECHANICAL: SPECTION FEE: SUANCE: MIP: NERGY P/C: NERDY PERMIT: ETENTION FEE: RE -ALT FEE: ASF: LOT PLAN: DINING CLEARANCE: -OTAL FEES ;OM M ENTS: C; PAID BY: VALIDAT€ON: RECEIPT# _81CL. PAID VALIDATION: WHITE— Department Copy, YELLOW — Finance Copy, PINK— Assessor Copy CITY OF DIAMOND INSPECTION SETBACK/ LETTER FOOTINGS FORMS BLAS — UG. PLUMBING UG. ELECTRICAL LIFER GROUND .. SFWER LATFRAL MAIN WATER LINE _ — S['_WER CLEANGUT —. ROOF SI IEATHING— FL()OR SHEATHING — — — SHEAR WALLS EXTERIOR SHEAR WALLS INTERIOR FRAMING/VENTING ROUGH MECHANICAL ROUGH ELECTRICAL W( } C O �, ROUGH PLUMBING INS6LA7ON WAIL INSULATION CEIIING DRYWALL .—.. —.. — LATA (PRE) LATH FXFERlOR _ — LATH INTERIOR — GAS I EST SCRATCH COAT — ELECTRIC MEJER RELEASE GAS METER RELEASE SE'ECiAI_ INSPECTION FIN _ TRACT AND LEDGER SWITCH GEAR ROUGH FIRE APPROVAL _ FINAL FILE DEPARTMENT ,.. —,__.. _ COMMERCIAL HOOT)— L-BAH ELECTRICAL .— —..... INTERCEPTER �._ — .A� HOT MOP/5HOWFRPAN 5EPTICICFSSP001. —.,_.— HERS REPORT RECEIVED DEMOLITION ROOF DRAINS— ROUGH CONDUIT -POOL/SPA _... ROUGH PLUMBING— FINAL PLUMBING —_ - FINAL. EHMNEEIIING/ Pel T.C. of OCCUPANCY ROUGH ELECTRICAL FINAL COMMUNITY SERVICES CERT. of OCCUPANCY ROUGhI MECHANICAL FINAL HEALTH DEPT. GAS TEST _ FINAL. INDUSTRIAL WASTE m PRE GUNITE POOL PRE DECK BONDING P -TRAP FENCE I GATE/ ALARM FINAL POOL 1lVALLS:._ _. _..—..� WALL FOOTING/STEEL WALL STEEL "IS'( ) ?NC( ) LIFT WALL BOND BEAM WALL DRAIN/ SLAL WALL FINAL � — AL. . RO. FRAMING PLANNING APPROVAL AL BUILBING FINAL MECHANICAL _ ROUGH FIRE APPROVAL _ FINAL FILE DEPARTMENT ,.. —,__.. . SINAL ELECTRICAL .— —..... �._ — .A� FINAL. PLA NNII�(; FINAL PLUMBING —_ FINAL. EHMNEEIIING/ Pel T.C. of OCCUPANCY ..—._ FINAL COMMUNITY SERVICES CERT. of OCCUPANCY FINAL HEALTH DEPT. _ FINAL. INDUSTRIAL WASTE m CERTIFICATE OF VERIFICATION CF3R-MCH-23-H Space Conditioning System Airflow Rate (Page 4 of 4) Documentation Author's Declaration Statement 1. I certify that this Certificate of Verification documentation is accurate and complete. Documentation Author Name: Documentation Author Signature: Raymond Picazo Company: Date Signed: JC HERS Services, LLC 2017-08-31 Address: CEA/ HERS Certification Identification (if applicable): 11390 Doverwood Drive RCN13134 City/State/Zip: Phone; Riverside CA 92505 951-217-0805 Responsible Person's Declaration statement I certify the following under penalty of perjury, under the laws of the State of California: I. The information provided on this Certificate of Verification is true and correct. 2. 1 am the certified HERS Rater who performed the verification identified and reported on this Certificate of Verification (responsible rater). 3. The installed features, materials, components, manufactured devices, or system performance diagnostic results that require HERS verification identified on this Certificate of Verification comply with the applicable requirements in Reference Appendices RA2, RA3, and the requirements specified on the Certificate of Compliance for the building.approved by the enforcement agency. 4. The information reported on applicable sections of the Ce rtificate(s):of installation (CF213) signed and submitted by the person(s) responsible for the construction or installation conforms to the requirements specified, on the Certificate(s) of Compliance (MR) approved by the enforcement agency. S. I will ensure that a registered copy of this Certificate of Verification shallbe posted, or made available with the buWing permit(s) issued for the building, and made available to the enforcement agency for all:app(icable inspections. I understand that a registered copy of this Certificate of Verification is required to be included with the documentation the builder provides to the building owner at occupancy. Builder Or Installer Information As Shown On The Certificate Of Installation Company Name (Installing Subcontractor, General Contractor, or Builder/Owner): All Pro Air Responsible Builder or Installer Name: C51-3 License: Barry Palmer 934601 HERS Provider Data Registry Information Sample Group Number (if applicable): [swelling Test Status in Sample Group (if applicable) N/A PIERS Rater Information HERS Rater Company Name: JC HERS Services, LLC Responsible Rater Name: Responsible Rater Signature: Raymond Picazo Rayrv&n i' ic� Responsible Rater Certification Number w/ this HERS Provider: Date Signed: RCN 13134 2017-08-31 Digitally signed by CHEI=RSTM, This digital signature is provided in order to secure the content of this registered document, and in no way implies Registration Provider responsibility for the accuracy of the information. Registration Number: Registration Date/Time: 2017-08-31 11:40:32 HERS Provider, CHEERS 417-A020110388A-004-000-M 23000A -M 23A CA Building Energy Efficiency Standards Report Version: 2016.1.006 Report Generated: 2017-08-31 11:40:32 2016 Residential Compliance Schema Version: rev 10/16