HomeMy WebLinkAbout1155 DIAMOND BAR BL (30) ;.......,.._ =��;:.�,.,�,,,...,::: CITY OF DIAMOND BAR - o ����,
� DEPARTMENT OF COMMU1vITY&DEVELOPMENT SERVICES �
� , _,� ,. FINALI�,6�s
- — 21810 Copley Drive,Diamond Bar,CA 91765
`,,�,�$�� (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 FIRMLY
BUILDING PERMIT APPLICATION
i JOB SITE ADDRESS I �`� S �p�(� APPLICATION DATE: I��d-�cik/� P/C#
i ISSUEDATE: � ��/ �('J��PERMIT# �U -D `���
z APN LOT TRACT
� OWNER .�C` K: TYPE CONST. OCC GROUP:
� ADDRESc�� �, D�w1M�mI F3G�Ir � ZONING SEfBACKS
� CITY n�0.tYv�nrrrl Rn)- ZIP_9/�/(�TEL.�Cy—�JD,�'�UOZi FRONT RW ❑
a APPLICANT TEL. REAR �
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� SIDE/SIDE STREEf RW ❑
� Dd� �� S,� SIDE ❑
¢ CONTRACTOR Y
� ADDRESS ', W � 1- ��� �
� ZIP TEL — O " Q PROPOSED USE k�'�I -�j� ,,.. e. �s)
= ciry L. � G�� �, � s��('ToT�L�
� ARCH/ENG/DESIGNER
z ADDRESS I
� #DWEL.UNITS #STORIES #BEDROOMS
¢ CITY ZIP TEL. DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREA/VALUATION �
Q OWNEH-BUILDEH OECLAFIATION I
= I hereby affirm under penalty of perjury that I am ezempt from the Contractor's State License Law for the reason(s) SFR/ADD/REM
�
� indicated below by the checkmark(s),I have placed next to the applicable item(s)[Section 7037.5,Business and Garage/Carport
Professions Code:Any city or county that requires a permit to construct,alter,improve,demalish,or repair,any . I
z structure,prior ta its issuance,also requires the applicant for the permit ta Hle a signed sfatemerrt that he or she � Patio/Deck �
i is licensed pursuant to the provisians of fhe Contractor's State License Law(Chapffir 9)Commencing with Section W I
j 7000 of Division 3 af the Business and Professions Code]or that he or she is exempt hom licensure and the basis for LL Pool/Spa
� the alleged exemption.Any violation of Section 7031.5 by any applirant for a permit subjects the applicant to a civil penalTy � I
� of not more than five hundred dollars(5500). Z Re-Roof
s �
� (�I,as owner of the property,or my employees with wages as their sole compensation,will do U all of or(_.)portions � Commercial I
y of the work,and the structure is notintended or offered for sale(Section 7044,Business and Professions Code:The m I
� Contractors'State License Law does not apply to an owner of property who,through employees'or personal effort,builds
� or improves the pmperty,provided that the improvements are not intended or offered for sale.If however,the building or I
improvement is sold within one year of completion,the Owner-Builder will have the burden of proving that it was not built
jor improved for the purpose of sale.). I
�
L)I,as owner of the property,am exclusively cont2cting with licensed Contractors to construct the projed(Section
� 7044,Business and Professions Code:The Contrac�rs'State License Law does not apply to an owner of property who V81U2tion. Adj.Area: I.
Z buildsorimprovesthereon,andwhocontractsfortheprojeclswithalicensedContradorpursuanttotheContractors'State QUANTIIY DESCRIPTION FEE I
:n
,� License Law.). 1 t �
� �)I am exempt from licensure under the Contrac[or's State License law for the foilowing reason(s): � �
� � I
1 By my signature below I acknowledge that,except for my personal residence in which I must have resided for at least one w I
� year pnor to completion of the improvements covered by this permit,l cannot legally sell a structure that I have built as an .w I
owner-builder if it has not been constructed in its entirety by licensed contradors.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
1 the following Web site:http/www.leginfo.ca.go/ aw ml. Z
y � I
DATE:6�-�L�_�� SIGN: �
� I
— LICEN CONTHACT S DECLAfiATION �
y I hereby affirm under penalry of perjury that am licensed under provisions of Chapter 9(commencing with Sedion 7000) I
� of Division 3 of the Business and Professions Code,and my license is in full force and effect. J I
= ^ (�� �'�� �j 2 U
n LICENSE CLASS: `— ' "' LIC.NO.: [l_ /"/ J�> Q I
� I
� ATE:���� CONTRACTOR: �
Q WOHKEH'S COMPENSATION OECLAflATION � � I
y I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: �j"��
� I have and will maintain a Certificate of Consent to Self-Insure for Worker's Compensation,as provided by CONSTRUCTION: d°7�
� Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. p�,qN REVI EW: 7�� /�
� I have and will maintain Worker's Compensation Insurance,as required 6y Section 3700 of tl�e Labor Code,for ELECTRIC: �•��
� the performance of the work for which this permit is issued.My Worker's Compensation Insurance Carrier and �—
¢ PolicyNumberare: PLUMBING:
� CARRIER MECHANICAL•
�
� POLICY NUMBER INSPECTION FEE: /�
n (IHIS SECTION NEED NOT BE CAMPLEfED IF1HE PEFiMfT IS FOR ONE HUNDRFD DOLLARS($100)OR LESS�. ISSUANCE: �J.�7
� I certify that in the pertortnance of the work for which this permi�is issued,I shall not employ any person in any manner so as to 'y
= become subject to me Worker's Compensation Laws of Califomia.And agree that'rf I should become subject to the Worker's SMIP: e.1 (�
JCompensaUon pmvisions of Section 3700 of the Labor Code,I shall(orthwitl�comply with those provisions. ENERGY P/C:
i DATE: APPLICANT: ENERGY PERMIT: M
= WARNING:Failure to secure Worker's Compensation coverage is unlawful,and shall subject an employer to criminal RETENTION FEE: ��W
y penalties and civil fines up to one hundred thousand dollars($100,000),in addition to the cast of the compensation,
� damages as provided for in section 3708 of the labor code,interest,and attorney's fees. PRE-ALT FEE:
i CONSTHUCTION LENDING AGENCY BSAF: �• D
y I hereby affirm under penalty of perjury that there is a Construdion Lending Agency for the performance of the work for �
� which this permit is issued(Sec.3097,Civ.C.).
LENDER'S NAME:
� LENDER'SADDRESS:
i I certfy that I have read this application and state that ihe a6ove information is correct.I agree to comply with all ciTy and TOTAL FEES �/�/'�`,��
=� county ordinances and sTate laws relating to 6uilding construction,and hereby authorize representatives of this county to COMMENTS: V�'
� enter upon the above-mentioned property for inspection purposes.
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¢ PERMI E NAM PRINn
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= SIGNA R PERMf1T DATE RECEIPT# 1�� PAID BY:' � Q� VALIDATION:
WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy
CITY OF DIAMOND BAR
INSPECTION RECORD � �
a � � � - • � � � . � .
£SETBACIU LETTER �, ,, � � � , �,, : � � •• TRACTAND LEDGER
FOQTINGS FQRMS � �� �: �,, ,� � � � �� SWITCH GEAR �
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;UFER GROUN[� ���° _ _ _
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SEWER LATERAL SEPTIC/CESSPOOL
MAIN WATER LINE 'HERS REPORT RECEIVED
SEWER CLEANOUT DEMOLITION
ROOF SHEATHING ROOF DRAINS
FLOOR SHEATNING ROUGH CONDUIT
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RQUGH MECHANICAL�_� � � , �, �� ROUGH MECHANICAL � � � � -
ROUGH ELECTi�ICA� W( ��C( } � �� GAS TEST � � � � � _ � � r
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RQUGH PLUMBING � � � �� � � „ PRE GUNITE� � � � ��
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INSULATION WAL� POOL PRE DECK BONDING A � i � � ,
INSULATION CEILING P-TRAP
DRYWALL FENCE I GATE/ALARM
LATN(PRE) FINAL POOL
LATH EXTERIOR WALLS:
LATH INTERIOR WALL FOOTING/STEEL
GAS TEST WALL STEEL 1 sr� �2r+e� )LIFT
SCRATCH COAT WALL BOND BEAM
ELECTRIC METER RELEASE WALL DRAINi SEAL
GAS METER RELEASE WALL FINAL
SPECIALINSPECTION RO.FRAMINGPItWNINGAPPROVAL � � <:
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FINAL�BUILDING , � � / a� J , ROUGH FIRE APPROVAL
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FINA€:ELECTR!ICAL � q � , e FINAl.FIRE DfPARTMENT $
FINAI MECHAN
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CAI��� � i`"�,� e ���'� �� � FINAL PLANNING
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=T.G;:of�OGCUPaNGY�'��'��� '`` - � '� �"", �° , � -�� � ' � FINAL COMMUNITY SERVICES � .� � �
,CERT'of'BCCUPANCY � � ''� ; , � , �` ' � � FINAL NEALTH D'EPL , . .
FINAL INDUSTRIAI WASTE �
COMMENTS:
STATE OF CALIFORNIA '
' SIGN LIGHTING
CEC-NRCC-LTS-01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE NRCC-LTS-OI-E
, Sign Lighting (Page 5 of 5)
Project Name: �'
- � ,�^ Date Prepared:
�r �
DOCUMENTATION AUTHOR'S DECLARATION STATEMENT
1. I certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name: � �m t � Documentation Author Signature: �
Company: �6 ^\ � Signature Date: D(��� '�
S
Address: r�� � �{..� CEA/HERS Certification Identification(if applicable):
J , � �C � �1't � ��
CitY/State/Zip: � � , � n OQ !� Phone: ��r ��^ ��
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RESPONSIBLE PERSON'S DECLARATION STATEMENT
I certify the following under penalty of perjury,under the laws of the State of California:
1. The information provided on this Certificate of Compliance is true and correct.
2. I am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design
identified on this Certificate of Compliance(responsible designer).
3. The energy features and performance specifications,materials,components,and manufactured devices for the building design or system
design identified on this Certificate of Compliance conform to the requirements of Title 24,Part 1 and Part 6 of the California Code of
Regulations.
4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information
provided on other applicable compliance documents,worksheets,calculations,plans and specifications submitted to the enforcement
agency for approval with this building permit application.
5. I will ensure that a completed signed copy of this Certificate of Compliance shall be made available with the building permit(s)issued for the
building,and made available to the enforcement agency for all applicable inspections.I understand that a completed signed copy of this
Certificate of Compliance is required to be included with the documentation the builder provides to the buildin owner at occupancy.
Responsible Designer Name: � ,A� � � Responsible Designer Signature: �
V�
Company: �� DateSigned: � �� yD 1
♦ �
Address: License: ��
(`�/0 1� � �c e1_� 11�Q
City/State/Zip: Phone: �
l— . �. �� oo i� �-I 3-- 03—�o�`
CA Building Energy Efficiency Standards-2013 Nonresidential Compliance June 2014
STATE OF CALIFORNIA
' SIGN LIGHTING
CEC-NRCC-LTS-01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION�
CERTIFICATE OF COMPLIANCE NRCGLTS-01-E
Sign Lighting (Page 1 of 5)
ProjectName: ���;QM DatePrepared:
I ' � � � ��
Project Address:
�/.�,� S ���.��( (3�.r B� � �
Location of Sign Outdoor Signs ❑Indoor Signs
Phase of Sign Construction ew Signs ❑Sign Alterations
Type of Lighting Control ❑New Lighting Controls Replaced Lighting Controls ❑Not Installing Lighting Controls
This Certificate of Compliance includes the following components(check all that apply)
❑Mandatory Measures(Lighting Controls) ❑Maximum Allowed Lighting Power ❑Specific Lighting Sources
1.Mandatory Sign Lighting Controls
NOTES:
1. The same responsible person may install both the sign lighting power and the sign lighting contro/s, or a different responsible
person may install the sign lighting controls than the responsible person installing the sign lighting power.
2. The Mandatory Measures (sign lighting controlsJ are required for compliance with the sign lighting Standards. If the person
responsible for installing the sign lighting power is not also responsible for the sign lighting controls, then the owner of the sign,
general concractor,or architect shall be responsible to have the sign lighting contro/s installed.
3. If more than one person has responsibility for compliance, each responsible person shall prepare and sign a Certificote of
Compliance and an Installation Certificate applicable to the portion of construction for which they are responsible;alternative/y,
the person with chief responsibility for construction shall prepare and sign the Certificate of Compliance Declaration Statement
for the entire construction.
la. Statements of Responsibility:Any person signing the Certificate of Compliance Declaration Statement on this NRCC-LTS-01-E
shall complete Part la.Check Yes or No for all of the following statements:
1 I have responsibility for installing the sign lighting controls
❑Yes,complete parts la and 1b of this form No,complete part la of this form
Z There are no existing sign lighting controls and.l will be installing compliant sign lighting controls
❑Yes �No
3 There are no existing sign lighting controls and someone else will be responsible to install compliant sign lighting controls
❑Yes �No
There are existing sign lighting controls that do not comply with the applicable provision of§110.9 and§130.3 and I will be
4 installing compliant sign lighting controls
Yes O No
There are existing sign lighting controls that do not comply with the applicable provision of§110.9 and§130.3 and someone
5 else will be responsible to install compliant sign lighting controls
❑Yes (�No
,
CA Building Energy Efficiency Standards-2013 Nonresidential Compliance June 2014
STATE OF CALIFORNIA
SIGN LIGHTING
CEC-NRCC-lTS-01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE NRCGLTS-01-E I
� ' Sign Lighting (Page 2 of S)
Project Name: � ,0�1 Date Prepared:� 0(�1Z -� /'� � •
/ vV �
ib.Mandatory Sign Lighting Controls
If the person signing the Certificate of Compliance Declaration Statement on this NRCC-LTS-01-E is responsible for complying with
the sign lighting control requirements,that person shall answer all of the following questions:
If there are construction documents,indicate where on the building plans the
mandatory measures(sign lighting control)note block can be located:
1 §130.3(a)1.All indoor sign lighting is controlled with an automatic time-switch control or astronomical time- Y N NA
switch control. ❑ ❑
§130.3(a)2A. All outdoor sign lighting is controlled with a photocontrol in addition to an automatic time- Y N NA
2 switch control,or an astronomical time-switch control. ❑ ❑
EXCEPTION to Section 1303(a)2A:Outdoor signs in tunnels,and signs in large permanently covered outdoor Y NA
areas that are intended to be continuously lit,24 hours per day and 365 days per year. ❑ �
§130.3(a)26. All outdoor sign lighting that is ON both day and night is controlled with a dimmer that provides
the ability to automatically reduce sign lighting power by a minimum of 65 percent during nighttime hours. Y N NA
3 Signs that are illuminated at night and for more than 1 hour during daylight hours shall be considered ON both ❑ ❑ �
day and night.
EXCEPTION to Section 130.3(a)2B:Outdoor signs in tunnels and large covered areas that are intended to be Y NA
illuminated both day and night. ❑
§130.3(a)3. Demand Responsive Electronic Message Center Control.An Electronic Message Center(EMC) Y N N/A I
having a new connected lighting power load greater than 15 kW has a control installed that is capable of � � �
4 reducing the lighting power by a minimum of 30 percent when receiving a demand response signal.
EXCEPTION to Section 130.3(a)3: Lighting for EMCs that is not permitted by a health or life safety statute, Y NA
ordinance,or regulation to be reduced by 30 percent. ❑
Field Inspector Notes:
CA Building Energy Efficiency Standards-2013 Nonresidential Compliance June 2014
STATF OF CALIFORNIA I
� SIGN LIGHTING
CEC-NRCC-LTS-01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION
_ CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E
Sign Lighting (Page 3 of 5)
Project Name: � Date Prepared:
S � o -�-z- � 1
2.Maximum Allowed Li¢htine Power Method of Compliance
Certificate of Compliance and Field Inspection Energy Checklist
Complete this part if there are signs using the maximum allowed lighting power method of compliance.(Complete part 3 of
this Certificate of Compliance if there are signs using the Specific lighting sources method of compliance)
A B C D E F G H I J
Symbol OPTIONAL—Energy Complies Filedlnspector
Or Code Description of the Sign Verified Label(see Allotted Watts Design Watts Y N Check that sign
instructions below) � complies
N �
Q w� Q ry"y.r � � � V�
� = y d � � 1O _ •N = \
J � �
`° �'�' m � 3 3 �i " N `o
v '° c N m � c � v
L � i . OJ '� X N
Q
� N
C y ��,, 7 O � N O Y �+ � �.
in c W = a �. w a F 3 0
✓ U ✓
VV TSII S� /"� ❑ � � � 5�F" �U(J t� �
❑ ❑
❑ ❑
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❑ ❑
❑ ❑
❑ ❑
❑ ❑
❑ ❑
❑ ❑
❑ ❑
A Symbol or code used on the plans(when plans are required)and other documents.
B A description of the sign,or location of sign on the building;and the location of sign on construction documents.
OPTIONAL-Check this box only if this sign has a permanent,pre-printed,factory-installed,ENERGY VERIFIED label,confirming that the
sign complies with the Section 140.8 of the California 2013 Title 24,Part 6 Standards,using the Maximum Allowed Lighting Power
method of compliance. The only labels that will be recognized for this purpose are ENERGY VERIFIED Certification Marks authorized by
� Underwriters Laboratories(UL)or other Product Certification Body accredited to ISO/IEC Guide 65 by the American National Standards
Institute in accordance with ISO/IEC 17011.Surveillance by the Accredited Certification Body shall be an ongoing annual inspection
program carried out by a Type A Inspection body in accordance with I50/IEC 17020.For signs with such an ENERGY VERIFIED label,
columns'D'through`I'are not required to be filled out.Note:Using an ENERGY VERIFIED label is an optional method to validate
compliance.An ENERGY VERIFIED label is not needed for compliance.
D The sign area in square feet.
E List"I"if the sign is internally illuminated. List"E"if the sign is externally illuminated.
F Allowed.watts per square foot. Enter 12 if the sign is listed as"I"in column E.Enter 2.3 if sign is listed as"E"in column E.
G Multiply the square footage in column D times the allowed Lighting Power Density(LPD=watts)in column F.
H Show the total installed watts in the sign,as determined according to the applicable provisions of§130(c).
I Enter Y if the number in column H is less than or equal to the number in column G. Otherwise,the sign does not comply.
J This page doubles as a field inspection checklist.
Field Inspector Notes:
CA Building Energy Efficiency Standards-2013 Nonresidential Compliance June 2014
STATE OF CALIFORNIA
� ' SIGN LIGHTING
CEC-NRCC-LTS-01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E
�� Sign Lighting (Page 4 of 5)
Project Name: � � Date Prepared: r�1�/
� M
3.Saecific lishtine Source Method of Compliance
Certificate of Compliance and Field Inspection Energy Checklist
Complete this part if there are signs using the Specific lighting source method of compliance. (Complete part 2 of this Certificate
of Compliance if there are signs using the maximum allowed lighting power method of compliance)
A B � p E
OPTIONAL Specific light source used for Field Inspector
Symbol ENER6Y VERIFIED compliance Check that Sign
or Description label Shall include only lighting Complies
Code (see instructions technologies listed below �
below} List ail that apply
❑ �
❑ �
p ❑
O �
❑ �
A Symbol or code used on the plans(when plans are required)and other documents.
B A narrative description of the sign,or location of sign on the building;and the location of sign on construction documents
C OPTIONAL-Check this box only if this sign has a permanent,pre-printed,factory-installed ENERGY VERIFIED label,confirming that this sign
complies with the Section 140.8 of the California 2013 Title 24,Part 6 Standards,using the Specific Lighting Source Method of Compliance. The
only labels that will be recognized for this purpose are ENERGY VERIFIED Certification Marks authorized by Underwriters Laboratories(UL)or
other Product Certification Body accredited to ISO/IEC Guide 65 by the American National Standards Institute in accordance with ISO/IEC
17011.Surveillance by the Accredited Certification Body shall be an ongoing annual inspection program carried out by a Type A Inspection body
in accordance with I50/IEC 17Q20.For signs with such an ENERGY VERIFIED label,column'D'is not required to be filled out.Note:Using an
ENERGY VERIFIED label is an optional method to validate compliance.An ENERGY VERIFIED label is not needed for compliance.
Specific Light Source Compliance Method. The sign(s)identified above use only the following lighting technologies:
List all applicable numbers(1 through 9)that apply in column D above for each row.
1 High pressure sodium lamps
Metal halide lamps that are pulse start or ceramic served by a ballast that has a minimum efficiency of 88 percent or
2 greater. Ballast efficiency is the measured output wattage to the lamp divided by the measured operating input wattage
when tested according to ANSI C82.6-2005.
Metal halide lamps that are pulse start that are 320 watts or smaller,are not 250 watt or 175 watt lamps,and are served by
3 a ballast that has a minimum efficiency of 80 percent.
Ballast efficiency is the measured output,wattage to the lamp divided by the measured operating input wattage when tested
according to ANSI C82.6-2005.
Neon or cold cathode lamps with transformer or power supply efficiency greater than or equal to a minimum efficiency of 75 percent
� 4 when the transformer or power supply rated output current is less than 50 mA.The ratio of the output wattage to the input wattage is at
100 percent tubing load.
Neon or cold cathode lamps with transformer or power supply efficiency greater than or equal to a minimum efficiency of 68 percent
5 when the transformer or power supply rated output current is 50 mA or greater.The ratio of the output wattage to the input wattage is at
100 percent tubing load.
6 Fluorescent lighting systems meeting one of the following requirements:A.Use only lamps with a minimum color rendering index(CRI)of
80;or B.Use only electronic ballasts with a fundamental output frequency not less than 20 kHz.
7 Light emitting diodes(LEDs�with a power supply having an efficiency of 80 percent or greater;
Single voltage external power supplies that are designed to convert 120 volt AC input into lower voltage DC or AC output,and have a
8 nameplate output power less than or equal to 250 watts,shall comply with the applicable requirements of the Appliance Efficiency
Regulations(Title 20).
I 9 Compact fluorescent lamps that do not contain a medium screw base sockets(E24/E26).
E This page doubles as a field inspection checklist.
Field Inspector Notes:
CA Building Energy Efficiency Standards-2013 Nonresidential Compliance June 2014