HomeMy WebLinkAbout14-5003 �
r =,,,,.;.:,,�=.":-��__ .,,". CITY OF DIAMOND BAR
� I r ; DEPARTMENT OF COMMUMTY&DEVELOPMENT SERVICES �5
`- Sc� 21810 Copley Drive,Diamond Bar,CA 91765 � ,Q I''�RESS
`\`2 ��,� (9 0 9)8 3 9-7 0 2 0 F a x:(9 0 9)8 6 1-3 1 1 7 B u i l d i n g I n s p e c t i o n H o t l i n e(9 0 9)8 3 9-7 0 2 7 - "�( FIRMLY
'�" BUILDING PERMIT APPLICATION
= JOB SITE ADDRESS ���� `� dV � APPLICATION DATE: ��Z���� P/C# I
i ISSUE DATE: II,�..HL e�LG�Y PERMIT# l y-r�-G�
z APN LOT TRACT �
�
y OWNER �SOiO�1 A. � �O TYPE CONST. OCC GROUP:
n ADDRESS 'Q� t✓
aCITY D• FJ�-� ZIP R( `�TEL. ' Z ,$�,T ZONING F ONTCKS RW ❑
r APPLICANT TEL. REAR ❑
�
n �O�' /���� ,L SIDE/SIDESTREEf RW ❑
� CONTRACTOR � '�T SIDE
I ' ❑
� ADDRESS 3�I D G�• /"�a'�✓IS o h S�
= CITY [ o✓bN4 ZIP PROPOSEDUSE
� �l�'19 TEL. R�e�0I4G2, PGLG�R4� �/►�►.—f -�-0 t�
� ARCH/ENG/DESIGNER
�
z ADDRESS
� #DWEL.UNITS #STORIES #BEDROOMS
¢ CITY ZIP TEL. I
� DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
OWNFA-BUILDEfl DECLAHATION I
¢ SFR/ADD/REM
= I hereby affrm under penalty of perjury that I am ezempt from the Contractor's State License Law for the reason(s)
� indicated below by the checkmark(s),I have placed ne#to the applicable item(s)[Section 7031.5,Business and Garage/Carport
I
Professlons Code:Any city or county that requires a permit to construct,alter,improve,demolish,or repair,any
z structure,prior to its issuance,also requires the applicant for the permit to file a signed sfatement Nat he or she � Patio/Deck I
i is Iicensed pursuant to the provisions of the Co�actor's STate License Law(Chapter 9)Commencing with Section W
n7000 of Division 3 af the Business and Professions Code]or that he or she is exempt from licensure and the basis for � Pool/Spa ` I
the alleged exemption.Any violation of Section 7031.5 6y any applicant for a permit subjects the applicant to a civil penalty C7
= of not more than five hundred dollars($500�. • ZQ Re-Roof �- I
� U I,as owner of the property,or my employees with wages as their sole compensation,will do(�all of or(�portians � Commercial I
y of the work,and the structure is not intended or offered for sale(Section 7044,Business and Professions Code:The m I
Z 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 I
� 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.). I
�
U I,as owner oi the property,am exclusively contracting with licensed Contractors to construct the project(Section Valuati0n: �
' Z 7044,Business and Professions Code:The Contractnrs'State License Law does not apply to an owner of property who � Z Adj.Area: I ,
� buildsorimprovesthereon,andwhocontraclsforlheprojeclswithalicensedContracrorpursuanttotheContractors'State QUANTIIY DESCRIPTION FEE �
Y License Law.). I
� (�I am exempt trom licensure under the Contractor's State License law for the following reason(s): a I
� �
ZBy my signature below I acknowledge that,except for my personal residence in which I must have resided for at least one w I
� year prior to completion of the improvements covered by this permit,l cannot legally sell a structure that I have built as an w
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 I
� I
X the following Web site:http/www.leginfo.ca.gov/calaw.html. Z I
� DATE: SIGN: �
— LICENSED CONTHACTOH'S DECLAHATION � I
n_ Iy I hereby aftirm under penally 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 and effect. J I
�j � •�� .
�j LICENSE SS: �� LIC.NO.: ��S�3" Q 4G � I
� DATE: CONTRACTOR:T�Iw' d�M., ✓L = I
U
¢ WOHI�H'S COMPENSATION OECLAl1ATI0N � I
y I HEREBY AFFIRM UNOER 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 CONSTRUCTION:
� Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. p�qN REVI EW:
> �I have and will maintain Worker's Compensation Insurance,as required by Section 3700 of the Labor Code,for ELECTRIC:
� the peAormance of the work for which this permit is issued.My Worker's Compensation Insurance Carrier and
¢ PolicyNumberare: PLUMBING:
� CARRiER MECHANICAL: D.�I�
y
� POLICY NUMBER INSPECTION FEE: —�
� (THIS SECTION NEED NOT BE COMPLEfED IFTHE PEAMfT IS FOH ONE HUNDRED DOLLARS($100)OR IFSS�.
ISSUANCE: f•,r�
� I certity that in the performance of the work for which tt�is permit is issued,I shall not employ any person in any manner so as to
� become subject to ihe Worker's Compensation Laws of � mia.And agree that if I should become subjecY to the Worker's SMI P: I
� Compen tion p sio of Sec6on 3700 af tl�e Labor d,I sh forthwith comply with ihose provisions. ENERGY P/C:
J
i DATE: APPLICANT: ENERGY PERMIT: /�
� WARNING:Failure to secure Worker's Compensation cove is unlawful,and shall subject an employer to criminal RETENTION FEE: l^�
y penalties and civil fines up to one hundred thousand dollars(5100,000),in addition fi the cost of the compensation,
1 damages as provided for in section 3706 of the labor code,interest,and attorney's fees. PRE-ALT FEE:
�
i CONSTHUCTION LENDING AGENCY BSAF:
y I hereby affirm under penalry ot perjury that there is a Construction Lending Agenc.y for the performance of the work for
= which this permit is issued(Sec.3097,Civ.C.�.
�
LENDER'S NAME:
r LENDER'SADDHESS:
i I certify that I have read this application and state that the above information is correct.I agree to comply with all city and TOTAL FEES fl;h (a�
� county ordinances and state laws relatin to buildin construction,and hereb authorize 2 resenta[ives of this coun to VV�V
z 9 g Y P �' COMMENTS:
� enter upon the a6ove-mentioned property for inspection purposes.
J
n v
a PERMITTEE NAME I /
� /��l �j
= SIGNATURE OF PERMITf DATE RECEIPT# �"/ PAID BY:�VALIDATION: �
WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—ApplicanYs Copy
CITY OF DIAMOND BAR . r
INSPECTI4N RECORD '
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SEWER LATERAL SEPTICiCE5SP00L
MAIN WATER LINE � HERS REPORT RECEIVED
SEWER CLEANOUT DEMOLITION
ROQF SHEATHING ROOF DRAINS ;
FLOOR SHEATHING ROUGH CONDUIT
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ROUGH PLUfV161NG ��;� #�"�'�?,'���,���� � ;, �` ,:. ._:�.- � .���� xq;� �„� �P�E�GUNiT€�.�.��W�.... _�_� ��.� �. _ �
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INSULATION VVALL �Pt�OL;PRE QECK BbNDING� =�� ,, �` "; ���, ,�
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LATH INTERIOR WALL FOOTINGiSTEEL
GAS TEST_ INALL STEEL 1S�( )2"0( )LIFT � _ �
SCRATCH COAT WALL BOND 6EAM I
ELECTRIC METER RELEASE WALL DRAIN/SEAL j
GAS MET'tR RELEASE WALL FINAL
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COMMENTS:
- ,
CERTIFICATE OF VERIFICATION CF3R-MCH-20-H
Duct Leakage Diagnostic Test (Page 1 of 3)
Project Name: SOPHIA DAARQ Enforcement Agency: City of Permit Number:
Diamond Bar PR20140005203
Dwelling Address: 1124 cleghorn B City: Diamond Bar Zip Code: 91765
A.System Information �
01 Space Conditioning System Identification or Name System 1
02 Space Conditioning System Location or Area Served Location 1
03 Building Type from CF-1R Single family
04 Verified Low Leakage Ducts in Conditioned Space No,credit is not taken
(VLLDCS)Credit from CF1R?
OS Verified Low Leakage Air Handling Unit Credit from No,credit is not taken
�.;.
CF1R?
06 Duct System Compliance Category - � . � �., Alter,ation - ..
- '� '� �� _4� .. ��
�- . ��.',..��::. � ,�`;:
4. a � k�`�rs,` ��.r�.� �Z ���1"'�'i' a,
�� s�` �,�,v ' �¢�_ �����',� , �� .�
MCH-20d-Complete�Replac�emen or Altered Duct S�ystem � r��� � ^ 5�� �R�� i�`fy��:� ,�;.
-- •_ :
.,,�
��:�,. . ,, � � ; � �� .,,�� � �k rs a� n��I�f�k` �..."W.,a� ���d�^ .i �r��t ,.
�_ �. 9. �-..., r� n�_.�..�-��;.,.�...,,...' "�''� t� ..._ . .c W , � ����'Er„m
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._ . __• - v,.�tfi,a.�,d�,,�n�aF .na..�c;��,. .
B. Duct Leakage Diagnostic,Test ��
,����.�,�;x:�,
� ,: - ��s:
01 Condenser Nominal Cooling Capaaty`.(ton) 5
02 Heating Capacity(k6tu/h) 60
03 Conditioned Floor Area served by this HVAC system(ft2) 1385
04 Duct Leakage Test Condition Test final
05 Duct Leakage Test Method Total leakage
• 06 Leakage Factor- - - ' 0.15 ���� �
�� Air Handling Unit Airflow(AHUAirflow)Determination Cooling system method
Method
08 Measured AHUAirflow This field or section is not applicable
09 Calculated Target Allowable Duct Leakage Rate(cfm) 300
10 Actual duct leakage rate from leakage test measurement 290
(cfm)
11 Compliance Statement:System passes leakage test
12 Notes:
Registration Number.214-A0146838A-M2000002A-M20A Registration Date/Time: 2015-01-06 15:04:14 HERS Provider.CaICERTS I
CA Building Energy Efficiency Standards Report Version:2014-05-08 Report Generated:2015-01-06 13:40:07
2013 Residential Compliance Schema Version:0.515DD I
I
_ ;
CERTIFICATE OF VERIFICATION CF3R-MCH-20-H
Dud Leakage Diagnostic Test (Page 2 of 3)
. C.Additional Requirements for Compliance •
Ol System was tested in its normal operation condition.No temporary taping allowed.
Outside air(OA)ducts for Central Fan Integrated(CFI)ventilation systems,shall not be sealed/taped off during duct leakage
02 testing.CFI OA ducts that utilize controlled motorized dampers,that open only when OA ventilation is required to meet
ASHRAE Standard 62.2,and close when OA ventilation is not required,may be configured to the closed position during duct
leakage testing.
03 All supply and return register boots were sealed to the drywall.
04 Building cavities were not used as plenums or platform returns in lieu of ducts.
05 If cloth backed tape was used it was covered with Mastic and draw bands.
06 All connection points between the�air handler and the supply and return plenums are completely sealed.
If the system complies using the Smoke Test method,the smoke test was conducted in accordance with the requirements
07 of Reference Residential Appendix RA3.1.4.3.6.Systems that comply using smoke test shall not be included in sample
groups for HERS verification compliance »�� "����, � ,�� , '���, �
�;��.E, ��E � r��tl:� �,, .���„ �.�-�
. �,.. �� >, �
� a ���� � .. �w� � »:":.
08 Verification Sta[us: � �� . � E ,�,��Pass all applitable requirements are rnet �� �
I E� r �a` ,�va���;��,�,.� � ��
- a,�.�� r.� � � .� A.,., .
09 Correction Notes,for�this table ��� ��� �� ; ��� �� ; ,��� �'� " ���
�� � , �: � r
���.:,� �� w��, M -� ,, ��,. .���.� ��
_ _ _ . _
The responsible persons signature on this`compliance document affirms that all applicable requirements in this table have
been met unless ofherwise noted in the Verification Status and the Corrections Notes in this table.
�:;,
D.Determination of HERS Verification Compliance
All applicable sections of this document shall indicate compliance with the specified verification protocol
requirements in order for this Certificate of Verification as a whole to be determined to be in compliance.
Ol Complies:All specified verification protocol requirements on this document are met.
Registration Number:214-A0146838A-M2000002A-M20A Registration Date/Time: 2015-01-06 15:04:14 HERS Provider:CaICERTS
CA Building Energy Efficiency Standards Report Version:2014-05-08 Report Generated:2015-01-06 13:40:07
2013 Residential Compliance Schema Version:0.51SDD �
, , .
I— --------------�---------�------------ --- ---------—...---- --._.. — _ _ __ . -
CERTIFICATE OF VERIFICATION CF3R-MCH-20-H
Duct Leakage Diagnostic Test (Page 3 of 3)
Documentation Author's Declaration Statement
1. I certify that this Certificate of Verification documentation is accurate and complete. •
Documentation Author Name: Documentation Author Signature: �/ /'
lan Jacoby c�an�a�ony
Company: Date Signed:
Stratz Permit Service 2015-01-06 13:40:29
Address: CEA/HERS Certification Identification(if applicable):
5858 Dovetail Drive 10059
City/State/Zip: Phone:
Agoura Hills CA 91301 818-735-7876
. Responsible Person'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 Certificete of Verification is true and correct.
2. I am the certified.HERS Rate�who perfo med the verification identified and reported on this Certificate of Verification(responsible reter).
3. The installed features,materials,compo ents,manufactured devices,or system performance diagnostic results that require HERS verification
identified on this Certificate of Verificat�on comply with the applicable requirements in Reference Appendices RA2 RA3,and the requirements
spe�ified on the Certihcate'"of Complianceafor the£bwiding approved by the enforcement age cn y � - ' '
,�°'�,3 �'�i: � �„_ ��z" �z� a�. :�,rs �'`.� t. �:'tt �S,'':
4. The informatwn.reported on applicable sections of the Certificate(s)of Installatton(Cf2R)signed�and subm�tted by fhe person(s)responsible for the
�� �� r� ��s� ,� � �� � t �a�
construcUon or in3tallation conforms to the requirements specified on the Certificate(s)',of Compl�ance(CFSR)approved by the enforcement agency.
5. I will ensure t�`hatka registered copy�of th�is Ce�rt�ificate of Verification'shall be posted or�made avallable wrth the budding;permrt(s)issued fo�the
�a ,��a ,�� �a,� � � ��°�' ,� ,�� x �an�- � �rc
building,and made a�,vaflable�to�t�he�enf�orcemen,�agen�cY fo�rr,al�ap�pl�able insp�ettion�s�funderstancl that�a,registered co�py�f this Cert��ficate of
Verification is required to be'mcluded wtth the:documentation the builder provides to the builtling'owner at occupancy. "'
. �.,�,xe� . - s���.�
Builder Or Installer��lnformation As Shown On The Certificate Of Installation
Company Name(Installing Subcontractor,General Contredor,or Builder/Owner):
Total Comfort,Inc.
Responsible Builder or Installer Name: CSLB License:
Steven C Cooper 935238
HERS Provider Data Registry Information
Sample Group Number(if applicable): Dwelling Test Status in Sample Group(if applicable)
Tested
� HERS Rater lnforrnat�a^
HERS Rater Company Name:
Stratz Permit Service RiU/J�I�LGd�
Responsible Rater Name: Responsible Rater Signature:
Ryan Faris 2015-01-06 15:04:14
Responsible Rater Certification Number w/this HERS Provider: Date Signed:
CC2006345
Digitally signed by CaICERTS. This digital signature is provided in order to secure the content of this registered documenL and in no way implies Registration Provider
responsibility/or the accuracy of ihe information.
Registration Number:214-A0146838A-M2000002A-M20A Registration Date/Time: 2015-01-06 15:04:14 HERS Provider:CaICERTS
CA Building Energy Efficiency Standards Report Version:2014-�5-08 Report Generated:2015-01-06 13:40:07
2013 Residential Compliance Schema Version:0.515DD
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