HomeMy WebLinkAbout13-1422w,..,__ C1TY OF DIAMOND 13AR
I i ' DEPARTMENT OF COMMUNITY&DFVELOPMENT SERVICES b
p;-• — ' 21810 Coplcy Drivc,Diamond Bar,CA 91765 RESS
909)839-7020 Fax:(909)867-3117 13uilding Inspection Hotline(909)839-7027 FIRMLY
e°'. BUILDING PERMIT APPLICATION
APPUCATION DAT : P/C#
wJOB SITE ADDRESS pERMIT I r3- 1-42 2ISSUEDATE:
o qpN LOT TRAC7
o OWNER N TYPE CONST. OCC GROUP:
w
N ADDRESS W ZONING SEfBACKS
C Ty 21P 4 , TEL. S FRONT RW
a APPIICANT TEL. REAR a
o SIDE/SIDE STREEf RW
a CONTRACTOR SIDE
c ADDRESS I .,L 1 1 T/
pp PROPOSED USE
o cirY/ 1,./p,+•Q ziP TEL.H'/ S9 3 7 ti
ARCH/ENG/DESIGNER
0
o ADDRESS q DWEL.UNITS STORIES t BEDROOMS
Q C 7y ZIP TEL.
DESCRIPTION SO.Ff. FACTOR PSF ADJ.AREANA UATION
OWNER-BUILDEH DECLAHATION
I hereby attirm under penalty o(perjury that I am exempt hom the ContracWr's State Ucense Law fm the reasan(s)
SFR/ADD/REM
inaicated bebw try the checkmark(s),1 have D aced ne t ta the aDD ble item(s)(Section 70315,Business ando
Garage/Carport
w Professions Code:My c(ty ar couMy that requires a permlt to consWcl,alter,improve,demolhh,or repair,any
z struclure,prim W fts issuance,also requires the applkant for the permit to file a signed sWtemenl that he or she w Patio/Deck
a fs Iicensed Dursuant to the pravistons o1 the Contractor's State License Law(Chapter 9)Commertcing with Section w
7000 of Divisfon 3 of ihe Business anO Protessiom Cade or that he w she is ezempt trom licensure antl the basis(or LL Pool/Spa
N the alleged ezemD wn.My violation of Section 7031.5 by any aDD cant far a pertnit sub(ects the aODlicant to a civil penalty Z Re-Root
of nOt rtwre than frve hundrett tlollars(3500). p
o (,I,as owner of the property,or my employees with wages as Neir sole compensatlon,will do(.J all 01 w(„)poNons J Commercial
oi ihe work,arW the strucNre Is not interWed w ottered tor sale(Section 7044,Business and Professions Code:T e m
Contractors'Stata Ucense Law tloes nat apDN o o er of property who,ihrough employees'ar personal eflort,builds
w w impmves the property,provided that tha improvements are not Intendetl or afleretl lor sale.Ii however,the building or
improvement is sold wifhin one year of completlan,the Owner-Builder will have the burden ol proving Nat It was imt hullt
o a improvetl for Uie purpose of sale.).Ui
U I,as owner ot the properry,am exdusNely contracting wflh lYcensed Cantractors to canshuct Ihe projec[(Section
0 7pq4,gus7ness antl Professla s Cotle:The Contractas'Slate License Law does not appry ro an owncrc of property who
Valuation: Adj.fVea:
z
builds or improves tt ereon,and wtw contracts fa the projects witb a licensed Contracta pursuanl to the Contractors'State QUANTITY DESCRIPTION FEE
Y License law.).
o U exempt hom licensure under tAe ConVaclor's Sfale Llcense law lor ihe tollowing reasoMs):
i
By my signaWre below I acknowledqe that,except fm my personal residence In which I mus[have residetl tor at least one
z year prior ro wmpletion of Ne improvements covered by this permit,l cannot legally sell a structure that 1 have bultt as an ,,,
owner-buil0er iI it has irot been constructed In its entlrery by licensetl contractors.I understand that a copy of the applip le
law,Sectan 7044 of ihe Business and Professlons Code Is available upon request when this epplication is su6mitted ar at
a the following Web site:httphvvnv.leginio.ca.gov/plaw.ntrnl. z
w CO
DATE: SIGN:
11GENSEO CONTRACTOH'S DECLAHATION
V I hereby affirm unAer penatty M De ury ihal l am licensed under pmvisions ot Chapter 9(commencing with Sedion 7000)
w of Dlvision 3 of the Business and Prolessions Code,and my lice tte is In(ull lorce and eHecL
IICENSE CLASS:_ LI ND v a y
oZ DATE: CONTRACTOR: w
WOR 'S CIAFtATlON
I HEflEBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECIARATIONS:w
1 have and will malntain a CerlAtcate ol Consent to Self-Insure I r Worker's Compensation,as providetl by CONSTRUCTION:
Sec6on 3700 0l t e Labor Code,for the pertormance af the work for which ihis permit is issued. p(AN REVIEW:
j I have and will mainqin Worker's Compensation Insurance,as reqWretl by Section 3700 0!Ne Labor Code,tor ELECTRIC:
o the periormance of the work ror which this pertnit is issued.My Worker's Compensation liuurance Carrier antl
PolicyNumberare: PLUMBING:
o ppq Ep MECHANICAL'
Z POUCYlri1MBER INSPECTION FEE:c
f}AS SECTION NEED NOT BE COMPLEfED IFhiE PERMR IS FOR ONE MINDRED O011NCS(570 OR LESS. ISSUANCE:
oI certify iha in ihe pertorm;u ca ot ihe vrak ta vrhich thfs permit is issued,I shafl fmt empby any persai In arry maruier so as to
SM I P:
o becqne su ject to Ihe WorkerS Compeivatian L ws M California tl agree that If I shoukl6ecome subject m tlie Work.er's
Compensa prwis' sofSection3700olthe Code orltnvith ' v o`s«u_ ENERGYPJC:
J DATE: APPUCANT: ENERGY PERMIT:
WARNIN Fallur to secure worlcer satl is unlawlul,and shall sub}ed en employer to criminal RETENTION FEE:
OO
w penattles and civil fines uD to one hundred tlollars(5100.000),in addition to the cost ol the compensatlon,
a damages pra ided for in section 3708 01 ihe iabor code,intarest,antl attomey's tees. PRE-ALT FEE:
CONSTRUCTION LENDING AGENCY BSAF:
w I hereby a10rm uMer penaly of perjury that ihere is a Construction Lending Agen y for the pertormance ol ihe work for
which this permit is issued(Sec.3097,Clv.C.).
LENDER'S NAME
LENOER'SAD RESS:
TOTAL FEES
a I cerllfy ihat I have read ihis appllcation and state that the above inPormation is conect.I agree tn campty with all ciry antl 7 c
counry wtlinances and state taws relating to twilding construcfi n,and hereby authorize representatires ol mis caunty ro COMMENTS:
enter upan the above-mentioned properry far Inspection pu
m T e 7'S
Q PEAMRTEE NAA7E Nn
tn
DATE RECEIPT PAID BY VALIDATION:
NFIE Of
r
WHITE—Department Copy,YELLOW—Fnance Copy,PINK—Assessor Copy,GOLDENROD—Flle Copy,GREEN—Applicant's Copy
CITY OF DIAMOND BAR
INSPECTION RECORD
SETBAGKI LETTER ' TRACTAND LEDGER
FOOTiNGS FORMS t=. '
1 R';
SWffCH GEAR
S qg:. i: COMMERCIAL HOOD
UG.PLUMBING: T-BAR
UG:fLECTRICAL INTERCEPTER
UFER_GROUND,;_a,+';' HOT MOP/SHOWERPAN
e
SEWER LATERAL SEPTIC/CESSPO L
MAIN WATER IINE HERS REPORT RECEIVED
SEWER CLEANOUT DEMOLITION
HOOF SHEATHING ROOF DRAINS
FLOOR SHEATHING ROU6H CONDUIT
SHEAR'WALLS:EXTERfOR" POOL/SPA _t -
t . ;
R I UGWPL M81N6 's r SHEAR WALLS•INTERIOR ,,
FRAMINGNENTING " ''" r
RQUGH`ECEGTRICAL.'
k' ' r Y
r`'x
r
ROUGH MECHANICAL ..,'.;; ':', , . ROUGN MECHANICAL: f`
R{ r a Y'
ROUGH ELECTRICAL W(;:)C( 1 i GAS TEST ` h u C ,.
ROUGH PLUMBING ,:,. ;,'PRE GUNITE j' y
r C '
INSULATION WALL PQOL PRE_DECK BONDtN 7 d _;s 1, .
INSULATION CEILING
r
P:TFU P ,:
DRYWALL FENCE%GP,TE/ALARNI
Y"'- J ' ''
LATH(PRE}FINAL POOL ,,°; { :, r'-`h" ' -
LATH EXTERIOR WALLS:
LATH INTERIOR WALL FOOTING/STEEL
GAS TEST WALL STEEL 1( )2ND( )LIFT
SCRATCH COAT WALL BOND BEAM
ELECTRIC METER RELEASE WALL ORAIN/SEAL
GAS METER RELEASE WALL FINAL
SPECIAL INSPECTION RO FiiAMING P11 1PNNGAPP,ROVAL
i
x
Y, .
ROUGH FIREAPPROVAL rFINAL'BUILDING K Jj
FINAL MECHANICAL s FINAL FIRE DEPARTMENT 4 "
FINAL•ELECTRIC IL`
x
r
i FINALPLANNING ; : ,
N . FINAL EN INEERING/PW. . ;; 'h ' ''
FINAG PLUMBING
T,C.of OCCUPANCY_, ,= .
t
s F,INAL COMMUNITY;'SERVICES r
EINAL HEALTH DEP7
T;
CERT.of OCCUPANCY ;.
FINAL=INDUS7RIAL.WASTE -=. .* ''.5 ' =
COMMENTS:
CERTIFICATE OF FIELD VERIFICATION &DIAGNOSTIC TESTING CF-4R-MECH-25
efrigerant Charge Verification - Standard Measurement Procedure Page 1 of 6)
Site Address: Enforcement Agency: Permit Number:
21119 Silver Cloud dr, Diamond Bar CA 91765 City of Diamond Bar 13-01422
Note: If installatian of a Charge Indicator Display(CID) is utilized as an alternarive to refrigerant charge
verification for compliance, a MECH-24 Certifrcate (instead of this MECH-25 Certificate) shouid be used to
demonstrate compliance with the refrigerant charge verification requirement. TMAH and STMS are not
required for compliance, when a CID is utilized for compliance.
As many as 4 systems in the dwelling can be documented for compliance using thls fo m. Attach an
additional fo m(s) for any additional systems in the dweUing as applicable.
Temperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement
Sensors (STMS)
Procedu es for instal/ing TMAH are specified in Reference Residential Appendix RA3.2. If refrigerant charge
veriFcation is required for complfance, TMAH are also required for compliance, un/ess the TMAH Compliance
Option is chosen.
STMS are only required for completely new or replacement space-conditioning systems that utilize
prescriptive compliance method.
TMAH -Access Holes in Suppfy and Return Plenums of Air Handler
System Name or ldentification/Tag System 1
System Location or Area Served . Whole House
5/16 inch (8 mm) access hole
1
upstream of evaporative coil.in the Yes Yes Yes Yes
return plenum and labeled according No No No O No
to Figurefin'Section RA3.2.2.Z.2:
Return:side of the duct system is.r t ' f
I` ' '; Y` r.'Pr . „
located entirefy within'conditioned Yes.r Yes , "Yes ' " O Yes .
la
space and return:airflow temperature No'_,' } , ;No No #' No .
tojb`e;rr easured at_the return.grille. J °,_ -; , 5 f " `' '",'` '"
5/1'6 inchr(8 mm access hole` ir"`
K "(
f, -
f.9 A..?:-`'
2 downstream of evapocative,cal-in the Yes ! D Yes;Ye`s O Yes
supply plenum and labeled according 0 No No No No
to Figure in Sedion RA3.2.2.2.2.
The TMAH Compliance Option sFiould be checked only if the HERS Rater is able to confirm that it was
physically impossible for the HVQC Installer to drill the TMAH as required by Section RA3.2.2.2.2. Using this
Compliance Option requires the:HVAC installer to annotate on the HERS Provider's data registry an
explanation as to why the TMAH'cannot be installed on the system, and photographs of the equipment on
which the TMAH cannot be installed. Use of this Compliance Option also requires minimum airFiow
verification through the direct measurement of airtlow per RA3.3. For more information see
hrto•//www enerav ca as v/titfe24/2008standards/s ecial case anoliance/
TMAH Complia ce Option
Yes to 1 and 2, or Yes to la and 2,or
checking the TMAH Compliance Option, is Pass Pass Pass Pass
a pass. O Fail Fail O Fail Fail
Enter Pass or Fail
Reg: 213-A0056649A-M2500001A-M25A Regietration Date/Time: 2013/O8/15 03:34:22 HERS Provider: Ca10ERTS, Inc.
2008 Residential Compliance Foxma February 2013
INSTALLATION CERTIFICATE CF-6R-M ECH-2I-HERS
Duct Leakage Test— Existing Duct System Page 1 of 2)
Site Address:
Enforcement Agency: Permit Number:21119 Silver Cloud dr, Diamond Bar CA 91765 (System
City of Diamond Bar 13-014221)
Enter the Duct System Name or ldentiflcation/Tag: System 1
Enter the Duct System Location or Area Served: Whole House
Note: Submit one Installation Certificate for each duct system that must demonstrate compliance in the
d welling.
This installation certificate is required for compliance for alterations and additions in existing dwellings to
space condi[ioning systems and duct systems.
Note: For exfsting dwe/lings, a completely new or replacement duct system can a/so Tnclude existing parts of
the original duct system (e.g., register boots, a!r handler, coll, plenums, etc.) if those parts are accessible
and they can be sealed. For a completely new or replacement duct sysrem installed!n an existing dwelling,
use the Installation Certificate titled "Duct Leakage Test- Completely New or Replacement Duct System."
Duct Leakage Diagnostic Test-existing duct system
Select one compliance method from the following four choices.
1. Measured leakage less than 15%of fan flow
2. Measured leakage to outside less than 10%of Fan Flow
3. Reduce leakage by 60%and conduct smoke and fix all leaks
4. Fix all accessible leaks using smoke and HERS rater verify
Note: (One of Options 1, 2 or 3 must be attempted.,_before utilizing,Option 4.), ,ti,,, _e..._ ,, _u,,;;..
Determine nominal Fan'Flow using one o.tfie'following tRree calculatiori methods ' ' } '"t ''
Coo ng;`system rriethod Seze of condenser in Tons ' 4' 'x 400 = 1600. CFM ,<
e -j f ,_ i ; a
Heating system method 21 7 z Output Capacity in,Thousands of Btu/hr—_CFM F. .
i f y ?y
I y
1 h+ 'l /{ .
E-
t !f'... , .. •.' . f .. ,q. '.w
f'"
f. •
4'
O Measured system airfl,oiiv usmg;RA3.3 airtlow test procedures - CFM '' 9, ,,','
a;,,`"'.,r
Option i used then: t,.
1 Allowed leakage= Fan AirFlow 1600' x 0.15 = 240 CFM
Actual Leakage = 233 CFM,'
Pass if Actual Leakage is less than Allowed leakage Pass Fail
Option 2 used then:
Z Allowed leakage= Fan Airflow; ' x 0.10 =_CFM
Actual Leakage to outside.= CFM
Pass tt Actual leakage to outside is less than Allowed leakage Pass Fail
Option 3 used then:
Initial leakage prior to start of work=_CFM
Final leakage after sealing all accessible leaks using smoke test=_CFM
3 Initial leakage_- Final leakage_= Leakage reduction_CFM
Leakage redudion_/Initial leakage_)x 100% _Reduction
Pass If%Reduction >= 60aYo Pass Fail
Optlon 4 used then;
4 All accessible leaks repaired using smoke test. HERS rater must verify(No Sampling).
Pass if ail accessible leaks have been repaired using smoke Pass Fail
Reg: 213-A0056649A-M2100001A-0000 Regietration Date/Time: 2013/08/04 16:31:19 HERS Provider: Ca10ERTS, Inc.
2008 Reeidential Compliance Forma March 2010
IN$Tl4LLATION CERTIFICATE CF-6R-MECH-25-HERS
efri erant Char e Verification- Standard Measurement Procedure Pa e 1 of 6999
Site Address: Enforcement Agency: Permit Number:
21119 Silver Cloud dr, Diamond Bar CA 91765 City of Diamond Bar 13-01422
Note: If installation of a Charge Indlcator Display(CID) is utilized as an alternative to refrigerant charge
verif/cation for compliance, a MECH-24 Certificare (ins[ead of Chis MECH-25 Certificare)should be used to
demonstrate compliance with the refrigerant charge verificatlon requirement. TMAH and STMS are not
equired for compliance when a CID is utilized for compliance.
As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an
additional form(s) for any additional systems in the dwelling as applicable.
Temperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement
Sensors (STMS)
Procedures for installing TMAH are specified in Reference Residential Appendix RA3.2. If refrigerant charge
verlfication is requlred for comp/iance, TMAH are a/so required for comp/iance, un/ess the TMAH Compl/ance
Option is chosen.
STMS are only required for completely new or replacement space-condirioning systems that utllize
prescriptive compliance method.
TMAH -Access Holes in Supply and Return Plenums of Air Handler
System Name or ldentification/Tag System 1
System Location or Area Served Whole House
5/16 inch (8 mm) access hole
1
upstream of evaporative coil in the Yes Yes O Yes Yes
return plenum and labeled according No No No No
to Figure,in Section RA3.2.2.2.2.Y--..
r--,.
Returri side of the duct sysfem
ais'
F' • . , ' ' ", ; ` ' •: ,'
1a
located;entirely within conditioned Yes : `rYes'
7 ,Yes I x Yes
space and retum afrflow temperature 0 No„. . No' No- x No
to be;,measured,at the.retum_`grille. I
i if X
µ5/i`6 irieh (8fmm)access h'ole ; ._Y , a' ',f:
z
2 down$tream of eva'porative coil in the Yes O Yes , Yes :;' .-
s'' '- supply plenum and labeled according No No No
No to Figure in Section RA3.2.2'.2.
2.The TMAH Compliance Option should be checked only if it is physically impossible to drill the TMAH
as required by Section RA3.2.2.2.2:.Using this Compliance Option requires the HVAC installer to annotate
on the HERS Provider's data.registry an explanation as to why the TMAH cannot be installed on the
system,and photographs of the equipment on which the TMAH cannot be installed. Use of this Compliance
Option also requires minimum airtlow verification through the direct measurement of airflow per RA3.
3 For more information see htto•//www enerav ca nnvirit P 4/2008standards/snP iai a P
annlianrP/TMAH Compliance Option
p Yes to 1 and 2, or Yes to la and 2,
or checking the TMAH Compliance Option, is Pass 0 Pass Pass
Pass a pass. Fail 0 Fail Fail
Fail Enter Pass or
Fail Reg: 213-A0056649A-M2500001A-0000 Registration Date/Time: 2013/08/04 16:35:58 HERS Provider: Ca10ERTS,
Inc.2008 Residential Compliance Forma March
