HomeMy WebLinkAbout12-1171 G-o r�YG�.�� �-N��7- ',
��_ CITY OF DIAMOND-BAR ��
�� ' � DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES
21825 Copley Drive,Diamond Bar,CA 91765
(909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-702
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w TURE,PRIOR TO ITS ISSUANCE,AL50 REW IFES THE APPLICANT FOR SUCH PERMIT TO FILE A 516NE0 w Patlo/Deck
� STATEMENT THAT HE OR SME IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTOqS LI-
CENSE LAW(CHAPTER G(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND Pq0- � POOUSF78
� FESSIONSCOD�OR7}1ATHEORSHEISE%EMPTTHEREFROMANDTHEBASISFORTHEALLEGEDEXEMP� C7
V 7pN.ANY VIOLATION OF SECTION 703t.5 BV ANV APPLICAM FOR A PEFiM1T SU&lECTS iHE APPLICANT TO Z Re-Roof
A CML PENALTV OF NOT MORE THAN FIVE HUNDRED DOLLAflS(f500)J:
� ❑4�OWNEROFTHEPROPERTY,ORMVEMPLOVEESWITHWAGESASTHEIRSOLECOMPENSATION, � COmfTIBfCi81
Z WILL DO TiE WORI(,AND THE S7RUCTURE IS NO7 INTENDED OR OFFERED FOR SALE(SEC.7al,BUSI- J
� NESS AND PROFESSIONS CODE:THE CANTRACTORS LICENSE UW DOES NOT APPLY TO AN OWNER OF �
PROPEHTY WFIO BUILOS OR IMPROVES hIEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR
w THfKJUGH HIS OR HER OWN EMPLOVEES,PROVIDED 7}NT SUCM IMPROVEMENTS ARE NOT INTENDED OR m
� OFFEREDWRSALEIF,HOWEVERTNEBUIIDINGORIMPROVEMENTISSOLDWITHINONEVEAROFCOMPLE-
Z TION.THE OWNEF�BUILDER WILL HAVE THE BUFDEN OF PROVIN6 TFIAT HE OR SHE DID NOT BUIIA OR
� WPROVEF-0RTHEPURPOSEOFSALE).
w ❑I.ASONMEROFTHEPROPERTY,AME%CLUSIVELYCONTRACTINOWfTHUCEN5EDC0l1TRACTORS
[[ TO CANSTRUCT THE 7RQIECT(SEC.]WI,BUSINESS AND PROFESSIONS CODE THE CON7MCTORS LI- V81U2t{Ofl A0.1.AREA
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� W/iOCANTRACTSFORSUCHPRQIECTSWITHACONTRACTOfl(5)LICENSEDPURSUANTTOTHECONTRAG QUANTITY DESCRIPTION
Y TORS LICENSE IAW.). FEE �
� ❑I AM E%EMPT UNDER SEC. B.8 P.C.FOR THIS REASON JQ
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� DATE OWNER �
� LICENSED CONTRACTORS DECLARATION � w
� I HEREBY AFFIRM UNDER PENALTV OF PERIURY THAT 1 AM UCENSED UNDER PROVISIONS OF CHAPTER �
� Y(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE,AND Z
��� MY UCENSE IS IN FULI FORCE� D EFFECT. �� m
� LICENS CLASS LIC.NO. � �
V DATE ��`��'�^� CONTRACTOFi d
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� WORKERS'COMPENSATION DECLAR TI � ,� �
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� I HEREBV AFFIRM UNDER PENALTV OF PERIUilY ONE OF TFIE FOLLOWING'DECLARATIONS: Z
� _IHAVEANDWILLMAINTAWACERTIFICATEOFCONSENTTOSELF-INSUREFORWORKERS' a
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Q COMPENSATION,AS PROVIDED BV SECTION 370o OF 7HE LABOR CODE,FOR THE PERFORMANCE U
OF hIE WORN FOR WHICH THIS PERMIT IS ISSUED. W
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VEAND WILL MAINTAIN WOFKERS'COMPENSATION INSURANCE,AS REWIRED BV SECTION
Q 370o OF THE LABOR COOE,FOR THE PERFORMMICE OF THE WORK FOR WMCH THIS PERMIT IS �
SUED.MY WORKE COMPENSATqN INSURANCE CARRIER AND POLICY NUMBERARE: CONSTRUCTION
jARRIER��� PLAN REVIEW
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W 'Z 1 CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHIp1 THIS PERMIT IS ISSUED,I MECHANICAL
U' SHALL NOT EMPLOV ANV PERSON IN ANV MANNER SO AS TO BECOME SU&IECT TO THE • •
(n WOPKERS'COMPENSATION UWS Of CALIFORN10.AND AGREE THAT IF I SHOULD BECOME INSPECTION FEE
= SUAIECT TO THE WORKERS'COMPENSATqN PROVISqNS OF SECTION 37000F TNE LABOR ��
CADE,I SHALL FORTHWITH COMPLY TH 5 PROVISIONS. ISSUANCE
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p DATE: APPLICANT:� SMIP
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� WARNINO:FPJLURE TO SECURE WORKERS'CAMPENSAT VERAGE IS UNUWFUL,AND SH�LLBE ENERGY P/C �
� SU&IECTMIEMPLOYERTOCRIMINALPENALTIESANDCI ILFI ESUPTOONEHUNDREDTHWSAtJD ENERGYPERMIT
DOILARS(f100,000).IN ADDITION TO THE COST OF COMP NS ION,DAMAGES AS PROVIDED FOR IN
� SECTION 3708 OF TiE LABOR CODE,INTEREST,AND ATTO ceEs. RETENTION FEE:
OCONSTRUCTION LENDING AGENCY ' PRE-ALT FEE:
� I HEREBV AFFIRM UNDER PENALTY OF PERIURV THAT THEfiE IS A CONSTRUCTION LENDINO AGENCY
FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMfT IS ISSUED(SEC.3087,CIV.C.�.
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� LENDEIYS NAME �
H LENDERSADDRESS
� I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATpN IS CARAECT. TOTAL FE ES `
� I AGREE TO COMPLV WITH ALL CITV AND COUNTV ORDINANCES AND STATE LAWS REUTIN6 TO BUILDING �f
� CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS COUNTV TO EN7ER UPON THE �
Z ABOVE�MENTIONED GROPERTV FOR INSPECTION PUR705E5. COMMENTS �
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SET BACK ' FLOOR JOIST �• •••
FTGS/FORMS/STEEL FHA REQMTS
ELECTRIC GROUND UNDER FLOOR DUCT
GROUND PLUMBING UNDER FLOOR CONQUIT
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
SHOWERlfUB TEST POOL ELECTRIC '
EXT. LATH/SIDING POOL FENCING
WALL INSULATION POOL FINAL
CEILING 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
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SEPTIC TANK SIZE
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� Sim lified Prescri tive Certificate of Com liance:2008 Residential HTjACAlteralions CF-IR-ALT-HVAC
Climate Zones 10 to 15
I Site Address: orceneent Ag Date: Permd#: '
�o ��o�. �r . �� °1-��-�a
E ui ment T e List Minimum Efficienc Duct insulation r ' ement Conditioned Floor Area Thermostat
O Packaged Unit Over 40 ft of ducts added or ' �Setback
�FI Fumace ❑AFLTE �COP replaced in uncondirioned
❑Indoor Coil �SEER�_ ❑HSPF_ space Serv�ed�b-y�system (Ijnoi already
'�Condensing Unit O EER ❑Rcsistance ❑R 6 (CZ 10-13) -���' . Sf Presenr,nwsr be
installe�
❑Other O R 8 .�Z 14-1 S
1.Equipmen[Type:Choose the eguipment being irutalled,•if more than one system,use mrother.CF-1 R-ALT-HYAC for each system.
, 2.Minunrun Equipment Eff,tciencies:13 SEEI�, 78%.4F.UE,7.7HSPFfor rypica!residerstia!systems. '• .
HERS VERIFICATION SUMMARY Listed 6elow are four HVAC altezation Options. The installer decides what work is being done and
picks one of the appropriate Options. Each Option lists the HERS measures that must be wnducted.A copy of the forms shall tie left on site for final
inspection and a copy�ven to the homeowner. At final,the inspector verifies that the work listed on this form was in fact thc work completed by the
installer. Thc inspxtor also vcrifies that qch approgriate CF-6R aud reg�stered C�'�R fo�s(no haud filled CF-4Rsallowed)are filled out aad
si ed. B ' nin Uctober 1,2010 a r red eo of the CF-1R d CF-6R ahaIl also be on site[or final ins ectioa
� 1. HVAC Changeout $,eqpired;�'Qc7ns; ,
• All HVAC Equipment replaced �-��D�` ���, *21=HER$'au (for splii systems)Iv1ECH-25-HERS i
CF-4R forms: -21 a�� foS lit tems MECH-25
• Condenser Coi]and/or CF-6R forms: MECH-2I-HERS and(for split systems)MECH-ZS-I�RS . I
• Indoor Coil and/or �'�R forms: MECfi-21 and for Lt MECH-25
• Fumace � � ��)
For Split Systems:Duct leakage<15 percent; RC,CCA>300 CFM/ton(Minimum Air Fiow Requirement),TMAH
For Packaged Units: Duct leakage<15 percent '
Exempted from duct leakage tesring i�
❑ 1.Duct system was documented to have been previously sealed and confirmed through HERS verification,or
j ❑2.Duct systems witb]ess than 401iaear feet in tmconditioned space,or
0 3.Existin duct stems are construcied,insulaud or sealed with asbestos
� ❑2.New HVAC Sysfem Reqnu�ed For�s:
i '
• Cut in or Changeout with new CF-6R forms: MECH-04,MECH-20.HERS,sud(for s�lit systems)MECFI-22-FIERS,and MECH-25-FIERS
ducu:(all new ducting and all �����: MECH 2O-;and(fqr sp�t systems�IECFb-22,and ME�H 25
new ui �nent
For Split SysEems:Duct leakage<6 percent;Ft,C,CCA>350 CFIv1/ton,FWD,1ZvIA�i,STMS,and either HSPP or PSPP.
For Packaged Units:Duct leakage<6 percent
i ❑3.New Ducts with ReplacecRent Required Forms:
, • Includes replacing or installing aD aew dueting CF-6R Potmst MFEFI-04,MECH-20�RS,and(for spiit systems)MECFI-25-F�EERS
and/or outdoor condcnsing unit a�d/or mdoor CF�4R forms;MECH-20 and(for splat systems)MECFI-25
coil and/or furnace. Not all equxpment changed.
For Split Systems:Ducf leakage<6,pe<rc��,R�,.CCA>_300 CFM/ton,'I'M�+.H ,
For Packa ed Units:Duct 1. e<6 ercent
� O 4.New Ductin �over 40 feet . Re_uir.ed Form,s:
� • Includes adding or replacing more tfian 40
I linear feet of duct in unconditioned . CF-6R forms: MECH-04,MECI�-2I-HERS CF-4R fonns: MECH-21
i For split system or packaged n ts: Duct lealcage< 15 percent
O EXCEP'TION:Existin duct . stems consttucted,insulated or sealed with asbestos.
Contractor(Documentation Anttior's/�esponsible Designer's Declaration Statement)
• I ccrtify chat this Certificate of Compliance documentation is accurate and complete.
i • I am eligible under Division 3 of the Califomia Business and Professions Code to accept responsibility for thc design idendfied on this Ccrtificate
of Compliance.
• i certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the
requircments of Title 24,Parts I and 6 of the Califomia Code of Regulations.
• The design features ideurified on this Certificate of Compliance are consistent with the informarion documented on other applicable compliance
iorms,worksheets,calculations, lans and ecificarions submitted to the enfo�+cement a enc for a roval with the ermit licabon.
Name: �� l � Signature: _
Company: Date:
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Address: �aa5 h�� ��v� License: �p `$Z�
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Ciry/State/Zip: � �+�` � Phone: Q�eJ� Zt�,p,.�