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Home My WebLink About15-0683ND BAP. CITY OF DIAMOND BAR DEPARTMENT OF COMMUN14TY &-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 JOB SITE ADDRE D 49V1W APN LOT TRACT OWNER ADD S S+r` CITY_ aC ZIP EL. y APPLICANT [�PC . TEL.n`.5kili`01 q CONTRACT Y\ ` ��✓ ADDR SS •0` ookk ff --G CITY NJA\ ZIP � .LAA TEORD- 3 ARCH/ENG/DESIGNER 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 reason(s) 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 applicant for the permit to file a signed statement that he or she is licensed pursuard 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 licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). U I, as owner of the property, or my employees with wages as their sole 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 Gods: 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 completion, the Owner -Builder will have the burden of proving that it was not built or improved for the purpose of sale.). U I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Cade: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts far the projects with a licensed Contractor pursuant to the Contractors' State License Law.). U I am exempt from 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 must have resided for at least one year prior to completion of the improvements covered by this pennit,l cannot legally sell a structure that I have built as an owner -builder if it has not been 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 at the following Web site: http/www.leginfo.ca.gov/calaw.htmi. DATE: SIGN: LICENSED CONTRACTOR'S DECLARATION 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 is iinnfull force and effect. LICEN P LASS: LIC. NO.: Am Lin DATE: - CONTRACTOR: i WORKER'S COMPENS N DECLARATION I HEREBYAFFIRM UNDER PENALTY OF PERJURY ONE OFTHE FOLLOWING DECLARATIONS: I have and will maintain a Certificate of Consent to Self -Insure for Worker's Compensation, as provided by ASection 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 of the work for which this permit is issued. My Worker's Compensation Insurance Garner and Policy Num are: 1 t CARRIER POLICY NUMBER (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS). I certify that in the performance of the work far which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation Laws of California. And agree that if I should become subject to the Worker's Compensations �P�visions of Section 3700 of a Labor Code, I sl�uuorthwith comp ith those provisions. DATE: % S APPLICANT: 1 WARNING: Failure to secure Worker's Compensation coverage i unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,000), in addition to the cost of the compensation, damages as provided for in section 3708 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. 3097, Civ. C.). LENDER'S NAME: LENDER'S ADDRESS: I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to enter the above-mentioned property for inspects purposes. 'I , ERMI EN�A � /� GNATURE ATE FINALIM9 RESS FIRMLY APPLICATION AT a P/C# j ISSUE DATE:� �1 V�� PERMIT# TYPE CONST. OCC GROUP: ZONING SETBACKS FRONT RW ❑ REAR ❑ SIDE/SIDE STREET RW ❑ SIDE ❑ PROPOSED USE # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. Fr. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport rA W Patio/Deck LL Pool/Spa 2 Re -Roof � Commercial Q] 1 Valuation: Adj. Area: QUANTITY DESCRIPTION FEE a U cc U J w cv z cc i a U Q y� coy U W CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMIP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: L/ pty PRE -ALT FEE: �— BSAF: TOTAL FEES 1 ov, 0 / COMMENTS: i RECEIPT # _�� PAID BY. :�.�yf ! VALIDATION: WHITE — Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy, GOLDENROD — File Copy, GREEN — Applicant's Copy Cl -TY Or DI4m' OND" BAR INS PECTION, R-EICORD SETBACKi LETTER- , fi .; ° : e - > > TRACT AND LEDGER EOQTINGS FORMS' ) a SWITCH GEAR SLAB COMMERCIAL HOOD ,UG.'PLUMBING ` ` ° ` ' ` T -BAR AUG. ELECTRICAL ° P:: , ' a ^ INTERCEPTER ;UFER°G,ROUND_ . �.7 HOT MOP/SHOWERPAN SEWER LATERAL SEPTIC/CESSPOOL MAIN WATER LINE HERS REPORT RECEIVED SEWER CLEANOUT DEMOLITION ROOF SHEATHING ROOF DRAINS FLOOR SHEATHING ROUGH CONDUIT SHEAR.WALLS EXTERIOR: - S EAR WALLS INTERIOR �FRAMINGVENTING° ° ° a °ROUGH,MECHANICAL �. ROUGH ELECTRICAL W(° )�G (') ROUGH PLUMBIING INSULATION WALL INSULATION CEILING DRYWALL LATH (PRE) LATH EXTERIOR LATH INTERIOR GAS TEST SCRATCH COAT ELECTRIC METER RELEASE GAS METER RELEASE SPECIAL INSPECTION FINALS BUILDING FINAL MECHANICAL ; j AI- /f FINAL ELECTRICAL FINAL�PLUMBING=� T:C.'of OCCUPANCY COMMENTS: POOL/SPA ROUGH PLUMBING ROUGH ELECTRICAL ° ROUGH MECHANICAL GAS TEST PRE GUNITE POOL PRE DECK BONDING .P -TRAP FENCE / GATE/ ALARM FINAL POOL WALLS: WALL FOOTING/STEEL WALL STEEL 1sT( ) 2ND( ) LIFT WALL BOND BEAM WALL DRAIN/ SEAL WALL FINAL R0. FRAMING PLANNING APPROVAL ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT FINAL PLANNING FINAL ENGINEERING/ PW FINAL COMMUNITY SERVICES FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE STATE OF CALIFORNIA 1 ALTERATIONS - HVAC CEC-CF1 R -ALT -04-E (Revised 08/14) { CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ALT-04-E Alterations - HVAC CZ 2, and 8-15 (formerly CF -IR -ALT -HVAC) (Page 1 of 1) Site Addrreesss: �� ^ forcemen Agency: Date Prepared: Permit#: (moi %t ti✓ Equipment Type Equipment Efficiency New Ducting, Plenums, Lineset: Conditioned Thermostat Required R -value Floor Area (sq ft) ❑ Packaged System ❑ Evaporator Coil *Split System :Condensing Unit F0AFUE COP A*B-6 (CZ 2, 8-13) Ducting Served b stem etback ❑ Mini Split ❑ Compressor N%17SEER HSPF ❑ R-81 (CZ 11, 14, 15) Ducting sgft (If not already present must Ca Furnace ❑ Linesetbe ❑ R-6 (all CZ's) Plenums ❑ R-5 or R7.5) Lineset` installed) 13 TXV _EER HERS VERIFICATION SUMMARY Installer determines work to be completed and matches to one of the options below. At permit application this form is allowed to be filled out by hand. For final inspection all forms are to be registered (no hand filled forms allowed) and a copy left on site. i. HVAC Changeout/Repair Required Compliance Documents to be left on site for Final: All Equipment, CF111-ALT-02-E Condenser Unit, Evaporator Coil, CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24)2 -HERS, MECH-25-HERS2 Compressor, TXV, Lineset, CF3R: MECH-20-HERS, MECH-(23 or 24)-HERS2, MECH-25-HERS2 Air Handler/Furnace2 Can Include new ducting) Installer Requirement: Duct leakage (:S.15%, or < 10% to outside, or seal all accessible leaks), Air Flow 2 300 CFM/ton, Refrigerant Charge. Exempted from duct leakage testing if: 111. Duct system registered with HERS provider as previously sealed, or ❑ 2. There is less than 40 linear feet of duct in unconditioned space, or ❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos (list manufacture date of building ❑ 2. New HVAC System Required Compliance Documents to be left on site for Final: All new equipment and All New Ducts' CF111-ALT-02-E including Mini Split CF2R: MECH-01, MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24)-HERS2, MECH-25-HERS2 CF3R: MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24)-HERS2, MECH-25-HERS2 Mini Splits require CF111-ALT-02-E, CF2R-MECH-01, and (CF2R-CF3R) MECH-25-HERS Installer Requirement: Duct leakage :< 6%, Fan Efficacy (.58W/CFM), Air Flow 2 350 CFM/ton or alternative), Refrigerant Charge ❑ 3. All New Ducts with Replacement Required Compliance Documents to be left on site for Final: All New Ducts' and one or more of the following CF111-ALT-02-E replaced: Condenser Unit, Evaporator Coil, CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS I Compressor, TXV, Lineset, Furnace' CF3R: MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS Installer Requirement: Duct leakage <6%, Air Flow 2 350 CFM/ton (or alternative), Refrigerant Charge Exempted from duct leakage testing if: ❑ 1. Exi ing duct systems are constructed, insulated or sealed with asbestos ❑ 4. New Ducting over 40 feet I Required Compliance Documents to be left on site for Final: New ducting but less than All New Duds' I CF111-ALT-02-E, CF2R: MECH-20-HERS, CF3R: MECH-20-HERS Installer Required to: Duct leakage (:S_15% or, < 10% to outside or, or seal all accessible leaks) ❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos. ' All new ducting R-8 required when more than 40 ft installed and R-6 when less than 40 ft installed. This includes in walls, between floors etc. 2 Heating only systems and Air Handler/Furnace changes do not require Air Flow MECH-(23 or 24), or Refrigerant Charge verification MECH-25 3 All New Ducts is when at least 75 percent of the duct system is new duct material, and up to 25 percent may consist of reused parts from the dwelling unit's existing duct system (e.g., registers, grilles, boots, air handler, coil, plenums, duct material) ' R-5 (1" thick insulation) for linesets 1" and less. R-7.5 (1.5" thick insulation) for linesets over 1 inch. Most mfg will require Suction line Diameter with insulation as the following 1.5-2T-2%", 2.5-3T-2%", 3.5 to 4T-2%", 5T -4K" Contractor (Documentation Author's /Responsible Designer'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. 1 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the information on this document. 3. That the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the requirements of Title 24, Parts'l and 6 of the California Code of Regulations (CCR). 4. That 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 CCR. S. 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,ans and Pi specifications submitted to the enforcement en for agency g approval with this building permit application. Respnsible Designer N po Desig tures Da a Signed: License: 1 803433 Company: Address: City/State/Zip: Phone: Design Air, Inc. P.O. ox 10014 Moreno Valley, Ca 92552 951-369-0943 W d—tante Or gvesztons regaromg the Energy Standards, contact the Energy Hotffne at: 1-800-772-3300