HomeMy WebLinkAboutPR 12-463J _
CITY OF DIAMOND BAR
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 PRESS
BUILDING PERMIT APPLICATION FIRMLY
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JOBSITE APPLICATIO PERMIT p/
o ADDRESS _A--C-- `'\ 1 • DATE I (O \ NUMBER^ 3
p ISSUE TYPE OCCAPNLOTTRACTDATE4(
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o ADDRESS ZONING SETBACKS
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o APPLICANT _i r?]o..J?I TEL. REAR p
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Q CONTRAC OR G SIDE p
ADDRES
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CITY ZIP TEL.
UNITS STORIES BEDROOMS
DESCRIPTION Q.Ff. FACTOR PSF ADJ.AREANALUATION
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OWNER-BUILDER DECLARATION
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p I HEREBY AFFlRM UNDER PENALiY OF PERIURV THA7 I AM EXEMGT FROM THE CONTMCTORS LI- G0fee0/CefPOAWCENSEUWFORh1EFOlLOWINOREASON(SEC.7031.5BUSMESSANDVROFESSIONSCODE:ANYpTYOR (nC. COUHTYNRiICNREOUIRESAPERMI7TOCONSTRUCT,ALTER,iMPROVE,DEMOLISH,ORREPAIRANYSTRUG wwTURE.PRIOR TO RS ISSUANC ALSO REW IRES THE APPIICANf FOR SUCH PERMIT TO FlLE A SIGNEO w Patio/DeckSTATEMENTTHATHEOHSHEISLICENSEDPURSUANTTOTHE7ROVISIONSOFiHECOMRACTORSLI-
CENSE UW(CHAPTER v(COMMENCING WI7H SECTION 70D0)OF DIVISION 3 OF THE BUSINESS AND-PR6 POOUSPO
FESSIONS COD OR THAT HE OR SHE IS ExEMPT THEREFROM AND TME BASIS FOR THE ALLEGED EXEMP-
TION.ANVVIOLA710NOFSECTION7o31.5BYANVAPPLICANTFORAPERMITSU IECTS7HEA PLICANTTO R9- O
ACML PEN LiY OF NOT MOiiE THAN FNE HUNDFED DOLURS(f5ao).:
0 I,ASOWNEROFTHEPROPERTY,OPMVEMPLOVEESWITHI4AGESASTHEIRSOLECOMPENSATION, Commercial
z N7LL DO THE WORK,AND THE STRUCTURE IS NOT IMENDED OR OFFERED FOR SALE(SEC.7oai,BU51- J
NESS ANO PROFESSIONS CODE:THE CONTRACTORS IICENSE UW DOES NOT APPLY TO AN OWNEp OF
PROPEfffY N110 BUIL0.S OR IMPROVES THEREON,AND NMO DOES SUCH WORK HIAISEIF OR HERSELF OR
Q THROUGHHISORHEROWNEMVLOVEES,PROVIDEDTHATBUCHIMPROVEMENTSARENOitNTENDEDOR m
OFFERmFORSALEIF,HOWEVERTMEBUILDINOORIMPROVEMfMIS50LDWfTHINONEVEAROFCOMPLE
z TqN,7HE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BURD OR
IMPROVE FOR THE PURP0.SE OF SALE).
W 1,AS OWNER OF THE PROPERTY,AA1 EXQUSIVELY CON7RACTINO WfTH LICENSED CONTRACTOfiS
TO CONSTRUCT THE PRQIECT(SEC.7os1.BUSINESS AND PROFESSIONS CODE:THE CONTMCTORS LI- V81U2lIOIl ADJ.AREA.W CENSE LAW OOES NOTMVLY TO AN OWNER OFA PROPERTV WHO BUILDS OR IMPROVES THEREON,AND
W/iOCONTRACTSFORSUCHPR0.IECTSWITiACONTRACTOR(S)UCENSEDPURSUANTTOTHECONTRAP QUANTITY DESCRIP'fION FEE TORS 110ENSE UW..
J0 I AM EXEMPT UNDER SEC.' B.8 P.C.FOR THIS REASON QU
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DATE ONMER U
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LICENSED CONTRACTORS DECLARATION W
I HEREBYAFFIRM UNDER PENILTV OF PERJURY THAT I AMIICENSED UNDER PqOVISIONS OF CMAP7ER
9(COMMENCIMO WITH SECTION 7000)OF DIVISION J Oi THE BUSINESS AND PROFESSIONS CODE,M1D ZXL' IAY UCENSE IS IN FULL FORCE AND EFFECT.
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UCENSE C SS
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V DATE CONTRACTOR d
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WORKERS'COMPENSATION DECLARATION Q
I HEREBY AFFIHM UNDER PENALTY OF VERJURV ONE OF THE FOLIOWING DECURATIONS: Z
O _IHAVE ANDWILLMAINTAINACERTIFICATEOFdONSENTTOSELF-INSUREFORWORKERS'
Q COMPENSATION,AS PROVIDED BV SECTION 370o OF THE LABOR OODE,FOR THE PERFORMANCE U
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OF 7HE WORK FOR NRiICH THIS PERMIT IS ISSUED.
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1 HAVE AND WILL MAIN7AIN WORKERS`COMPENSA710N INSURANCE,AS REIXIIHED BY SECTION
37o00FTHElABORCODE,FORTiEPERf-0RMANCE OFTHEWORNFORWHICHTHISPERMRIS y SO
ISSUED.MY WORNEAS'COMPENSAT INSURlWCE CARq1ER AND POLICY NUMBER ARE: CONSTRUCTION Q ,.`
19CAflRIER PLAN REVIEW
0Z OLICV NUMBER E ELECTRIC
p (n+ssEcnonH rareEoo.FrmoFn Ea aMrswaor+Erura 000unASK aloa ss) PIUMBING
Z I CERTIFY THA71N THE PERFORMANCE OF THE WORK FOR WHICH THIS PERAIIT IS ISSUEO,1 MECHANICAL
CS SHALL NOT EMPLOY ANY 7ERSON IN ANV MANNER 50 AS TO BECAME SU&IECT TO THE
NKIRKERS'COMPENSATION LAWS OP CAIIFORNIti AND AGREE 7HAT IF I SH O @ECAME W SPECTION FEE
SU&IECT TO7HE WORKERS'COMPENSATION PROVISIONS OF S 0 O 1 UBOR
COO,I SFNLL FORTHWITH COMPLY WITH hiOSE PROVIS ISSUANCE 3 . \d
SMIPpDA1E: PPLICANi:
JENERGY P/C
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WARNINO:FAIWpETOSECUREWORKERS'COMPENSATI CAVE AGEISUNUWFUL,ANDSHALLBE
SU&IECTANEMPIOVERTOCRIMINALPENAL71E5ANOCIVI I UPTOONEHUNDREDTHOUSAND
ENERGY PERMITDOLURS.(5100,000),IN ADDITION TO THE COS70F COMPEN ION,DAMAGES AS PROVIDEDFOR INJSECTION37oeOF7HEIABORCODE,IHTEREST,AND ATTORNEY'S FEES.
p RETENTION FEE:
OCONSTRUCTION LENDING AGENCY PRE-ALwT FEE:J I
1 HEREBY AFfIRM UNDER PENAL7V OF PEfiIURY THAT THERE IS ACONSTRUC710N LENDINO AOENCY V y 1^'FOR THE PERFORMAtJCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3097,CIK C.).
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LENDER'S NM1E
F- IENDER'SAD RESS
wICERTIFYTHATIHAVEREADTHISAPPLICATIONANDSTATETHATTHEABOVEINGORAIATIONISCARRECT. TOTAL FEES 3, _I
d I AGREE TO CAMPIV WITH ALL CI7Y AND COUNTV ORDINANCES AND STATE UWS REUTING TO BUILDING
CONSTRUCTION,AND HEREBY AUTHOR2E REPRESENTATNES OF IS COUNTY 70 ENTER UVON THE
Z ABOVE-MENTIONED PROPERTY FOR INSGEC710N
COMMENTS '
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m 7ERMITTEE N E(PRl
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Vj -S ONANREOFPERM177EE DATE
RECPT.NO. ,D I 'J1 J pqlD BY , r VALJDATION
WHITE—DepaRment Copy,YELLOW—Finenca ,PINK—Assessor Copy,GOLDENROD--File Coq,GREE–ApplipnYs Copy
CITV CJF lAMOND AR
INSPECTI RECQRD
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SET BACK FLOORJOIST
FTGS/FORMS/STEEL FHRQMTS
ELECTRIC GROUND UNDER FLOOR OUCT
GROURD PLUMBING i UNDER FLOOR CONDUIT
SLAB GRADE FIREPLACE F UNDATION
TEMP POVJER FIREPLACE BOND BEAM
WATER SERVICE I MID HT.BOND BEAM
ROOF SHEATHING 8 FT.BOND BEAM
FRAMING/VENTILATION 1 Z..__ FINAL BOND BEAM
ROOF COVER PRE-GRADING
ROUGH HEATING BENCHING
ROUGH ELECTRIC ROUGH GRADING
ROUGH PLUMBING j fINISH GRADING
SHOWER/TUBTEST POOL ELECTRIC
EXT.LATH/SIDING POOL FENCING
WALL INSULATION POOL FINAL
CEILING If SULATION OFF SITE IMPS.
DRYWALL NAILING I DEDICATIONS
SEWER FINAL ENG.
SEPTICTANK LANDSCAPE/IRRIG.
SEEP PIT/L.L. ON SITE IMPS.
GAS AIRTEST FINAL ZONING
FINAL CONST. FIRE DEPT.FINAL
FINAL HEATING HEALTH DEPT.FINAL
FINAL ELECTRIC DEV.FEES PAID
FINAL PLUMBING ENERGY
FINALPLANING
FINAL ENGINEERING Z 0,:e
C MMENTS _
SEPTIC TANK 51ZE
SEEP PIT/U SIZE
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riptive Certificate of Compliance: Residen a e oofi-- — c.-=-rR--Rc,--
ct Ad ress:Glimate Zone Permit#
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OOFING PRODUC7S (CQdt ROOFS} §151(t}12
hen fhe area of exferior roaf surface fo be reptaced exceeds 50%of the exisfing raaf area,ar 1,Q00 ,whichever is less, the new
ofing area must meef fhe raaftng product"Caol Raat"requirements of§152{6)1HE, 152{b)9Hii,ar 152(b}?'Niii. '
eck applicable aifernative or exception beiow if the roo#alteration is exempt from the roofing product"Cooi Roaf° requirements::
Cool roafs not required in Climates Zones 1-12,14,and 16 with a iow sloped roof pitch({ess or 2:12 pi ch).
Cool roofs not requireci in Climafes Zanes i-9,and 16 with a steep-sfaped roofs(greater p'ktch than 2:12}and product weight iess#han 5/3bltt.
Itematives to§152{b}1 Hi and§152(b}N i,Steep-slope saof(pttch>2:12)
Insuiation with a thermai resistance af at least 0.85 hr•ftz°F/Stu or at{east a 3/4 inch air-space is added to the roof deck aver an at c;or
p E asting ducts in the atfic are'snsulated and sealed according to§151(f 10;or
In dirnate zanes 10,'!2 and 13,with 1 ft2 of free ventiletion area of attic ventilation for every 150 ff2 of attic floor area,and
where at least 30 percent of the ftee ventilation rea is within 2 feet vertical distance of the roaf ridge;or
Building has at least R-30 ceiling insulation;or
Building has radiant berrier in the attic meeting the requirements of§i 51{fl2;or
Bulding has na ducts in the attic;or
ln ciimate zones 10;11, 13 and 14,F2-3 or greater roof cSeck insutation above vented attic.
ccepfion to§152(b}1 Hiii LOW'SIO 3@!'QO't J JtCI1 52.12}
C] Suifding has no ducts in the attic.
Qther Exceptions
Roofing area is c4vered by building integrated,photovoltaic panels and solar therma(paneis are exempt frorn ff e Cooi Roof criteria.
C] Roaf canstructions tfiat have thermal mass over the mof inembrane with at least 25 ibfft2 are exempt fram#he Coat Raof criteria.
IOTE:!f any Qne of the altematives or exception is checked fhe Aged Sotar Reflecfance and Therma!Emiffance requir menfs for roofing
roducfs in§118(ij are nof applicable. Da nof fill table befow.
Roof Slope Product Weight Praduct Aged Solar Thermal
GRRC Product ID Number s 2:12 >2:12 { 5lblft >_51b/ft T e2 Ftefiectance3'4
Emittance SRI
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I p¢
p4
Yofe:If no CRRG1 labe!is available,fhis c mpliance meihad cannaf be used, use fhe Perfarmance Approach fo show comp/iance,
1.The CRfZC Product 1D Number can be obfained from fhe Cooi 1?oof f?ating Council's Rafed Producf Direcfary af www.eooJrc ofs.oralpmductsfsearch ht
2.Indicate the type of praduct is being used for the rtsof fop,i.e.sing7e-pty mof, asphalt roof,mefe!roof,efc.
tf fhe Aged Reflectance is nof avaifabfe in the fi,00!Roof Reting Caunci/'s Rated Producf Direcfory then use the Initial Reflectance value frtim the same
directory and use the equation{0.2+0.7(p,,ar—0.2)to o6tain a calculated aged value. Where p is the Initial Sofar Reflectance.
4. Check box if the Aged Reflectance is a calculated value using fhe equafion above.
5. Calculafe the SR!vatue by using fhe SR1-Worksheef at htfpllwin w.enervv.ca.qovf ifle241 and enfer the resufting vatue in the SRJ Cotumn above and aHach
acopy of fhe SRl-Warksheet fo fhe CF 1R.
o apply Liquid Field Apptied Caatings,he coating must be applied across the entire roof sur#ace and rneet the dry mil thickness ar caverage
recomsnended by the coatings manufact rer and meet minimum performance requirements listed in §118(i)4. Select the applicable coating:
Aluminum-Pigmented Asphalt Roofi Coafing L7 Cement-8ased Roo#Caating Other
NOTE: When a Cool Roaf is required, fhe installing contractor sha!!complete and submit fhe CF-6R-ENU-Oi for final inspection.
Declaratian Statement
I certify under penatty af perjury,under tt e laws af the State af Galitomia,fhe infacmation provided an this form is acc Jrate and comp4ete,
1 certify thaf fhe energy features and performance specifications identifisd an ihis Certificate of Campliance conform to the requirernents of TiUe 24,Parts
1 and 6 of the Califomia Cade of Regulations.
Name: Signature:
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Company: --J! J
Date:
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Address:
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License:
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City/Stete2ip:Phpne:
Gc/''.-' . 'p fd't! f s,--
For assistance ar quesfions regarding fhe Energy Standards, contacf fhe Energy Kotline af: 1-800-?72-3300.