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Home My WebLink About11-1228� � � _ � -�-� ��G�� _ CITY OF DIAMOND BAR �• DEPARTMENT OF COMMUNITY&DEVELOPM�NT RVICES D n 21825 Copley Drive,Diamond Bar,CA 91765 �Q��I(�}�� (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 P $ ��'�^' BUILDING PERMIT APPLICATION FIRMLY QJOBSITE � /' `�4T��s DATEICATION G�,�� // NUMBER #/C ¢ ADDRESS I �� V iA L� 4� � / � l��Z� � ISSUE TYPE OCC APN LOT TRACT DATE — CONST. GROUP p OWNER �N/L(/�tiwt'� o� o�/Cr� o ADDRESS �O�'/o /�Sy-_� S 7Y�.r7(� � ZONING SETBACKS z CITY �j7�/�..a-/Vlr'y,:.C7 ZIP 92�LL TEL.,7��- 1 FRONT q�y p � APPLICANT TEL. REAR p � SIDE/SIDE STREET RW ❑ z m CONTRACTOR (p SIDE ❑ ¢ ADDRESS 't. o CITY ��P �ix�67U TEL.S6Z'�/�/ri 'lJ PROPOSED USE w ARCWENG/ z DESIGNER w NO.DWEL. NO. NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS � �n DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM � Q� O O p I HEREBY AFFIRM UNDER PENALTV OF PERIURV THA7 I AM EXEMPT FROM THE CONTRACTORS LI� GdfegO/CefPOA W CENSE UW FOR 7HE FOLLOWMG REASON(SEC.7031.5 BUSINESS AND PROFESSIONS CADE:ANV qTV OR (n U COUNTVWHICHRE�UIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE.DEMOLISH,ORREPAIRANYSTRUC- W py�i0/DBCk w TURE,PHIOR TO ITS ISSUMlCE,/�LSO REOUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED W � STATEMENT THAT HE OR SHE IS LICENSE�PURSUANT TO THE PROVISIONS OF THE CONTMCTORS LI� � � CENSE LAW(CHAPTER e(COMMENCING WITH SECTION 7000)OF DIVISION 3 Of THE BUSINESS AND PRO- POOVSPe O FESSIONSCODE)OR7HATHEORSHEISEXEMPT7HEREFROMANDTHEBASISFORTHEALLEGEDEXEMP� (� V TION.ANVVIOLATIONOFSECTION7o31.58YANYAPPLICAN7FORAPERMITSUBJECT57HEAPPLICANTTO Z Re-Roof � A CIVIL PENALTV OF NO7 MORE THAN FIVE HUNDRED DOLLARS(SSoo).J: Z ❑I,ASOWNEROFTHEPROPERTY,ORMYEMPLOVEESWITHWAGESASTHEIRSOLECOMPENSATION, 0 COrtIrtlBfClal WILL DO 7HE WORK,AND THE STRUCTURE IS NOT INTENOED OR OFFERED FOR SAIE(SEC.704{,BU51- J � NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE lAW DOES NO7 APPLY TO AN OWNER OF � PROPERTV WHO BUILOS OR IMPROVES THEREON,AND WHO DOES SUCH wORK HIMSELF OR HERSELF OR � TMROUGH HIS OR HER OMM EMPLOVEES,PROVIDED 7HAT SUCH IMPROVEMEN75 ARE NOT INTENDED OR m w OFFEREDFORSALEIF,HOWEVER7HEBUIIDINGORIMPROVEMENTI550LDWITHINONEYEAROFCAMPLE- � TION,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR Z IMPROVE FOR THE PURPOSE OF SALE). �_ ❑I,AS ONRJER OF THE PROPER7V,AM EXCLUSIVELV CONTMCTING WITH LICENSED CONTRACTORS 7 TO CANS7RUCT THE PRQIECT(SEC.7011,BUSINESS AND PROFESSIONS CODE:THE CANTRACTORS LI- ValUet1011 ` �� ADJ.AREA W CENSE LAW DOES NOTAPPLV TO AN OWNER OF A PROPERTV WHO BUILDS OR IMPROVES 7HEREON,AND � WHOCON7RACTSFORSUCHPROJECTSWITHACANTRACTOR(S)LICENSEDPURSUANTTOTHECAN7fUC- QUANTI DESCRIPTION FEE Y TORS UCENSE LAW.). � ❑I AM EXEMPT UNDER SEC. B.6 P.C.FOR THIS REASON J O U s� � o[ Cr I/LC.... DATE OWNER U Z W ' � LICENSED CONTRACTORS DECLARATION � I HEREBV AFFIRM UNDER PENALTV OF PERJURY THAT I AM LICENSED UNDER PROVISIONS OF CHAP7ER � d B(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CADE,AND Z X MV L�CENSE IS IN FULL FORCE AND EFFECT. � LICENSE CLASS ,� V LIC.N0. `� U ��,� �+' 1 j V DATE CONTRACTOR ��ti 1"iv� d W � WORKERS'COMPENSATION DECLARATION Q C �w v� `N � J � I HEREBY FFIRM UNDER PENALTY OF PERJURV ONE OFTHE FOLLOWING DECU(iATIONS: Z Z I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF�INSURE FOR WORKERS' Q 2 Q CAMPENSATION,AS PROVIDED BV SECTION 37000F THE UBOR CODE.FOR THE PERFORMANCE U OF THE WORN FOR WHICH THIS PERMIT IS ISSUED. � � _I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REOUIRED BV SECTION Q 370o OF THE LABOR CODE.FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMI715 ISSUED.MY W (ERS'CA,�pMP,E�NSA/TION INSURANCE CARRIER AND POLICV NUMBER ARE: CONSTRUCTION ¢ CAHRIER �-/V V� I PLAN REVIEW QPOLICYNUMBER V 0��6 �� L� U ELECTRIC , 'Y�, ` � (fHU^SECfK7NNEmNOTBE00MPLE7EDOFTHEPERMfTISFORONEHU1�DitEDDOIUAS�f10D)ORLESS? PLUMBING Z I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I ECHANICAL l �_.i � U' SHALL NOT EMPLOV ANV PERSON IN ANV MANNER SO AS TO BECOME SUBJECT TO THE ' N WORNERS'COMPENSATION LAWS Of CALIFORNIA,AND AGREE THAT IF I SHOUID BECOME INSPECT�ON FEE = SU&IECTTO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 37o00F THE IABOR . CADE.I SHALL FORTHWITH COMPLV WITH THOSE PROVISIONS. ISSUANCE � � � SMIP p DATE: � APPLICANT: J WARNING:FAILURE TO SECURE WORNEfiS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL BE ENERGY P/C � SU&IECTAN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND ENERGY PERMIT DOLLARS(S10o,o00),IN ADDITION TO THE COST OF COMPENSA710N,DAMAGES AS PROVIDED FOR IN � SECTION 3�ae OF THE LABOH CODE.INTEREST,AND ATTORNEV'S FEES. RETENTION FE ' �� . � CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O � I HEREBYAFFIFM UNDER PENALTY OF PERJURY THATTHERE IS ACONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WOFK FOF WHICH THIS PERMIT IS ISSUED(SEC.3097,CIV.C.). . Z W � LENDER'S NAME I-- LENDER'SADDRE55 � TOTAL FEES 6� � � I CERTIFV THAT I HAVE READ THIS APPLICA710N AND STATE THAT THE ABOVE INFORMATION IS CqRRECT. w I AGREE TO COMPLY WITH AlL CITY AND COUNTV ORDINANCES AND STATE LAWS PELATING TO BUILDING � CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS COUNTV TO ENTER UPON THE � � ABOVE-MENTIONED PROPERTY FOR INSPECTION PURVOSES. Z COMMENTS - 0 J � m PERMITTEE NAME(PHINT) � Q � N SIGNATUREOFPERMITTEE DATE = RECPT.NO. PAID BY VALIDATION ~ WHITE—Department Copy,YELLOW--Finance Copy,PINK—Assessor Copy,GOLDENROD--File Copy,GREEN—AppliranPs Copy . � :: . . ._ _., ,.z^�r.,,� , � i� , �?� �' . . , . - � � '*; `'-� �� i�z��%�� I,'��4�, � . . �U�_. :�.a u��f 1� ��t� U� ll�� 0�'V OI� ��li�61�� ff� ,�--,�.-;��r�., > `��.-'�(�uu'�}�.-Vj,=_��' @�S4�f��'00� �1��6�� Oa�3pCC�400a DQ4(� ` Oa�3pL�40G3 �a�3pGC�400a DGJ4C� Oa�3pCC��GJ SET BACK FLOOR JOIST FTGS/FORMS/STEEL FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CONDUIT SLAB GRADE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID HT. BOND BEAM ROOF SHEATHING 8 FT. BOND BEAM FRAMINGNENTILATION FINAL BOND BEAM ROOF COVER PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWER/TUB TEST POOL ELECTRIC EXT. LATH/SIDING POOL FENCING WALL INSULATION POOL FINAL CEI�ING INSULATION OFF SITE.IMPS. DRYWALL NAILING DEDICATIONS __ SEWER FINAL ENG. SEPTIC TANK LANDSCAPE/IRRIG. SEEP PIT/L.L. ON SITE IMPS. GAS AIR TEST FINAL ZONING FINAL CONST. FIRE DEPT. FINAL FINAL HEATING � HEALTH DEPT. FINAL FINAL ELECTRIC � DEV. FEES PAID FINAL PLUMBING ENERGY ��o � COMMEfVTS SEPTIC TANK SIZE SEEP PIT/U SIZE a c� � — � � �. � Prescri tive Certificate of Com liance: �2esidential CF-IR-ALT Residential Alterations (Pa e 5 of 5) Project Name• — Climate 7.one# #of Stories �3 7 o v'� �/1,�-- �i�� . HERS VERIFICATION SUMMARY The enfnrcenrent agency shozdd pa��specia!atte�7liorr to dre HERS Measures specified in tlzis checklist below. A completed and signed CF-4R Forrn for nll�he measin•es specifed sholl be su6milted!o the building ii7spector before final i�rs ection. D�u�Sealing&Testing HERS verificntion is r•equrred,jor this measure. LfdYES ❑NO YES:In Climate Zones 2 and 9-16,if more than 40 linear feet of new or replaczment ducts are installed in unconditioned space,the ducts are to be sealed per§l52(b)1Dii and the newly installed ducts are to be insulated per§]51(fl10. ❑ EXCEPTION:Existing duct systems that are extended,which are constructed,insu]ated or sealed with asbestos. 0 YES ❑NO YES:Tn Climate Zones 2 and 9-16,if the existing space-conditioning system(HVAC equipment and ducting)is replaced,the ducts are tobe sealed per§152(b)1Di. �YES ❑NO YES:In Climate Zones 2 and 9-]6,if the existing HVAC equipment is replaced(including the replacement of tl�e air handler, outdoor condensing unit of a split sqstem,cooling or heating coil,or the fumace heat exchanger)the ducts are to be sealed per§152(b)lE. 0 EXCEPTION:Duct systems that are documented to have been p►•eviously sealed confirmed through HERS verification in accordance with procedures in the Reference Residential Appendix Ii.A3. � EXCEPTION:Duct systems with less than 401inear feet in unconditioned space. ❑ EXC�PTION:Existing duct systems constructed,insulated or sealed with asbestos. Refrigerant Charge-Split System NERS verification is reqvir•ed for this meosw•e. ❑YES ❑NO YES:In Climate Zones 2 and 8-]5,when the exis[ing HVAC equipment is replaced(including tl�e replacement of the air handler,outdoor condensing unit of a split system A/C or heat pump,cooling or heating coil,or the fumace heat exchanger)a refrigerant charge measurement shall be verified per§152(b)1F. Central Fan Integrated(CFI)Ventilation System and Fan Watt Draw The ventilation re uirements of§150(0)do not a ly to existing residential homes. Ducted Split Systems-Air Conditioners and I�eat Pumps:Airflow HERS verifrcatio�r is required for this meQstn•e. ❑YES ❑NO YES:ln Climate Zones 10 through 15,when the existing space-conditioning system(HVAC equipment and ducting)is replaced,the airflow and fan watt draw shall be verified per§152(b)1Ci to meet tl�e requirements of§151(�7B. Documentation Author's Declaration Statement • I certif that this Certificate of Com liance documentation is accurate and com lete. Name: ` Signature: � Company: Date: �7 vv ...�✓'._!"' riC. • 1// Address: lf Appl cable�CEA or 0 CEPE �2 ' (, (Certification#): City/State/Zip: ` Phone: .�F- �l.!�^-� � �—7�'�! � —( 2. Responsible Building Designer's Declaration Statement o I am eligible under Division 3 of the Califomia Business and Professions Code to accept responsibility for the building design identified on this Certificate of Compliance. • I certify that the energy features and performance specifications for the building design identified on this Certificate of Compliance conform to the requirements of Title 24,Parts] and 6 of the California Code of Regulations. s The building design features identified on this Certificate of Compliance are consistent with the information provided to document this building design on the other applicable compliance forms,worlcsheets,calculations,plans and specifications submitted to the enforcement agency for a roval with this building ermit a plication. Name: Signature: Company: Date: Address: License: City/State/Zip: Phone: / For assisiarrce or questions regarding the Ener��Sta�rdards,co�7tact the Energy Hotline at:1-800-772-3300. Registratio�r Number: Regisd•ation Date/1'ime.' HERS Pr•ovider: 2008 Residential Cnmpliance Forms August 1009