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Home My WebLink About15-102711) B�1P. - dry j a 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 BUILDING PERMIT APPLICATION JOB SITE ADDRESS 1 ` APN LOT I TRACT OWNER it AD ESS U CIZIP 7 TEL. a1 APPLICANT TEL. 1 CONTRACTOR AD SS I AaviTAW CITY rb ZIP s� D TEL. -7 _ 1 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 fora permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). (J I, as owner of the property, or my employees with wages as their sole compensation, will do CJ all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: 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 Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law.). (J 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 permit,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.html. 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 in full force Mand effect. LICENSE CLA S: �./ U , . NO.: l6' DATE: CONTRACTOR: WORKER'S NATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: I have and will maintain a Certificate of Consent to Self -Insure for Worker's Compensation, as provided by Section 3700 of the Labor Code, far 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 76— the performance of the work for which this permit is issued. My Worker's Compensation Insurance Carrier and Policy Number are: 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 for which this permit is issued, I shall not employ any person in any manner so as to become subjec to tie Worker's Compensation Laws of California. And agree that 91 should become subject to the Worker's Comp en 'on islons Section 3700 of the Labor Code, I al orthwi ly witi those provisions. DATE: APPLICANT: WARNING: Failure to secure Worker's Compensation coverage is unlawful, and shall su-b'jeb4n employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,000), in addition m the cc 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 the 's 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 mad 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 constru ion, and hereby authorize representatives of this county to en upon the above- n ' ned property for inspection pur see, N l �� MITT N E (PRI j y SIGNATURE OF PER DATE PRESS FIRMLY APPLICATION DATE: 'P/C# ISSUE DATE: J �f PERMIT# 1P— �. TYPE CONST. OCC GROUP: 7 ZONING SETBACKS FRONT RW REAR SIDE/SIDE STREET RW SIDE ❑ ❑ ❑ ❑ PROPOSED USE # DWEL. UNITS If STORIES # BEDROOMS DESCRIPTION SQ. FT FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM Garage/Carport rnPatio/Deck w LL Pool/Spa ZRe J 7 -Roof Commercial ILU MEW m Valuation: Adj. Area: QUANTITY DESCRIPTION FEE a U 2 U J w z IL a 5'F7� U a U CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: MECHANICAL: INSPECTION FEE: ISSUANCE: SMTP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE:_ PRE -ALT FEE: eow BSAF: TOTAL FEES COMMENTS: RECEIPT # PAID BY. VALIDATION: WHITE — Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy, GOLDENROD — File Copy, GREEN — Applicant's Copy SETBACK/ LETTER >. FOOTINGS FORMS. `SL'Ag�'w"a AUG. PLUMBING UG. ELECTRICAL ' UFER41101.141) MAIN WATER LINE SEWER CLEANOUT ROOF SHEATHING FLOOR SHEATHING SHFAR WALLS EXTERIOR SHEAR WALLS INTERIOR TRAMINGNENTING ROUGH MffA, RgUGti'E Ct ALS :ROUGH>PLUM " INSULATION At -14 INSULATION CEILING DRYWALL LATH (PRE) LATH EXTERIOR LATH INTERIOR GAS TEST SCRATCH COAT ELECTRIC METER RELEASE GAS METER RELEASE SPECIAL INSPECTION FINALBUILDING FINAL. MECHANICAL. $V1 VVVY l COMMENTS: CITY OF DIAMOND BAR INSPECTION RECORD TRACT AND LEDGER SWITCH GEAR COMMERCIAL HOOD T -BAR INTERCEPTER HOT MOP/SHOWERPAN SEPTIC/CESSPOOL HERS REPORT RECEIVED DEMOLITION ROOF DRAINS ROUGH CONDUIT POOL/SPA r ROUGH PLUMBING ROUGH ELECTRICAL .m m. ROUGH MECHANICAL _ GAS TEST PRE GUNITE POOL PRE DECK BONDING P -TRAP FENCE / GATE/ ALARM FINAL POOL WALLS: WALL FOOTING/STEEL WALL STEEL 1S'( ) 2ND( ) LIFT WALL BOND BEAM WALL DRAIN/ SEAL WALL FINAL RO:FRAMING 'PLANNING APPROVAL ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT FINAL PLANNING FINAL ENGINEERING/ PW FINAL COMMUNITY SERVICES FINAL HEALTH DEPT. Ate_ - FINAL INDUSTRIAL WASTE 71 I STATE OF CALIFORNIA "'ALTERATIONS - HVAC Wry CEC-CFIR-ALT-04-E (Revised 06/14) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CFIR-ALT-04-E Alterations - HVAC CZ 2, and 8-15 (formerly CF -IR -ALT -HVAC) (Page 1 of 1) Sit:ldf tle�s:4�R_ llNew Enforcement Agency: Date Prepared: Permitil: Ducting, Plenums, Lineset: Conditioned Equipment Type Equipment Efficiency Re uired R -value Floor Area (sq ft) Thermostat ❑ Packaged System ❑ Evaporator Coil AFUE COP R- ,(CZ2, 8-13) Ducting Served by system, 11 Setback ❑ Split System ❑,Condensing Unit R-8' (CZ 11, 14, 15) Ducting _ 0 sqft (!f not already ❑ Mini Split ❑ Compressor SEER H ❑ R-6 (all CZ's) Plenums present, must ❑ Furnace 'N 4 ❑ Lineset EER ❑ R-5 or R7.5) Lineset' be installed) ) ❑ TXV HERS VER-IFICATION 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. ❑ 1. HVAC Changeout/Repair Required Compliance Documents to be left on site for Final: All Equipment, CFIR-ALT-02-E Condenser Unit, Evaporator Coil, CF2R: MECH-Ol; MECH-20-HERS, MECH-(23 or 24)' -HERS, MECH-25-HERS' Compressor, TXV, Lineset, CF3R: MECH-20-HERS, MECH-(23 or 24) -HERS', MECH-25-HERS' Air Handler/Furnace' (Can include new ducting) Installer Requirement: Duct leakage (L15%, or < 10% to outside, or seal all accessible leaks), Air Flow 2 300 CFM/ton, Refrigerant Charge. Exempted from duct leakage testing if: ❑ 1. 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' CFIR-ALT-02-E including Mini Split CF2R: MECH-01, MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24)-HERS2, MECH-25-HERS' CF3R: MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24) -HERS', MECH-25-HERS' Mini Splits require CFIR-ALT-02-E, CF2R-MECH-01, and (CF2R-CF3R) MECH-25-HERS Inst er Requirement: Duct leakage < 6%, Fan Efficacy (.58W/CFM), Air Flow >_ 350 CFM/ton (or alternative), Refrigerant Charge 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 CF1R-ALT-02-E replaced: Condenser Unit, Evaporator Coil, CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS 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 Ex pted from duct leakage testing if: ❑ 1. Existing duct systems are constructed, insulated or sealed with asbestos >ZL4. New Ducting over 40 feet Required Compliance Documents to be left on site for Final: New ducting but less than All New Ducts' CFIR-ALT-02-E, CF2R: MECH-20-HERS, CF3R: MECH-20-HERS Installer Required to: Duct leakage (< 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. ' Heating only systems and Air Handler/Furnace changes do not require Air Flow MECH-(23 or 24), or Refrigerant Charge verification MECH-25 ' All New Duets is when at Ieast.75 percent bf 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 -2W',-3.5 to 4T-2'/.", ST -4Y." 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 1 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. 5. The building design features or system design features identified on this Ce "ficate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets, calculate s, plans and specifications submitted to the enforcement agency for approval with this building permit application. Respogyhl�e-pe9'gpe.LName: Responsible Des a ignature: Date SigVdI Licens Co � 6 Add r s� I ) a/>p1S Ci /State/Zi u bl �� Pho e: For assistance or quest ns regarding the E rgy Standards, contact the Energy lHotline at: 1-800-772-330