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Home My WebLink About15-1026CITY 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 ADDRESSaQ9 r7 n APN LOT TRACT OWNER Anna ADDRESS -� CITY U In Lre, ZIP 9112M TEL APPLICANT CsL TEL. CONTRALTO ICSH+ ADDRESS IPL CIMrb Qp TEL tL� 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 pursuant 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). CJ I, as owner of the property, or my employees with wages as their sole compensation, will do U 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 1, 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 contrac rthe projects with a licensed Contractor pursuant to the Contractors' State License Law.). U I am exempt from licensure under the Contra ' State License law for the following reason(s): By my signature below I acknowledge that, except for my p nal residence in which I must have resided for at least one year prior to completion of the improvements covered by this mit,l cannot legally sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licen contmdors. understand that a copy of the applicable law, Section 7044 of the Business and Professions Code is available'llfK<quest 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 jand jeffect. LICENSE C S: �O C3 LIC. NO.: L 1 / O DATE: CONTRACTOR WORKER'S COMPS SATION OECLARATION if 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, 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 Carrier and Policy Number are: 1 CARRIER W CAC—' POLICY NUMBER CF B(Z. L 0 Q D (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 s bject y the Worker's Compensation Laws of California. And agree that if I should become subject to the Worker's Compe�.: f Section 3700 of the Code, all forthwith comply with those provisions. DATE:APPLICANT: WARNINre Worker's Compensation coverage is unla and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,000), in 'tion 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 th 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, an hereby authorize representatives of this county to ente pan the above -menti ed property for inspection pur ses. An TTE N E (PRI SIGNATURE E DA [li PRESS FIRMLY APPLICATION DATE:� �/ T 1 P/C# ISSUE DATE: J - f 7/ a -� PERMIT# TYPE CONST. OCC GROUP: ZONING SETBACKS FRONT RW ❑ REAR ❑ SIDE/SIDE STREET RW ❑ SIDE ❑ PROPOSED USE # DWEL. UNITS # STORIES # BEDROOMS DESCRIPTION SQ. FT. FACTOR PSF ADJ. AREANALUATION SFR/ADD/REM Garage/Carport U, Patio/Deck LL ZRe Pool/Spa -Roof O m Commercial V9 mgmn LONAMAN Valuation: Adj. Area: QUANTITY DESCRIPTION FEE a U I U J I w m z m d U a T 1 OL;IE 5A ME Iw CONSTRUCTION: PLAN REVIEW: ELECTRIC: PLUMBING: MECHANICAL: �fyr �i7 INSPECTION FEE: ISSUANCE: j' 7 SMIP: ENERGY P/C: ENERGY PERMIT: RETENTION FEE: L/ C/ PRE-ALT FEE: BSAF: TOTAL FEES COMMENTS: RECEIPT # 7 AID BY: 7 VALIDATION: I WHITE — Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy, GOLDENROD — File Copy, GREEN — Applicant's Copy CITY OF DIAMOND BAR INSPECTION RECORD SETBAGKhLETTER, `".' �' TRACTAND LEDGER FOOTINGS FORMS`' SWITCH GEAR ;SLAB° p . Y 3 COMMERCIAL HOOD ,UGC PLUMBING = � m ; ; .. T -BAR ,UG. ELECTRICAL" INTERCEPTER YFER GROUND..', m . '� 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 E? TERIORa POOL/SPA ,SHEAR WALLS INTERIOR . z ' ROUGH PLUMBING ' FRAMINGNEN ROUGH ELECTRICAL ROUGH,MECHANICAL : ROUGH MECHANICAL ROUGH'ECECIIC�L W)�. { .J . , r GAS TEST RO ; H'PLt1MBINO .`41;.;`� ' PRE GUNITE INSULATION WALL POOL PRE DECK BONDING INSULATION CEILING `'' '" ` '' P -TRAP DRYWALL FENCE / GATE/ ALARM LATH (PRE) FINAL POOL LATH EXTERIOR WALLS: LATH INTERIOR WALL FOOTING/STEEL GAS TEST WALL STEEL 1 Sr( )2 ND( ) LIFT SCRATCH COAT WALL BOND BEAM ELECTRIC METER RELEASE WALL DRAIN/ SEAL GAS METER RELEASE WALL FINAL SPECIAL INSPECTION _ RO. FRAMING PLANNING APPROVAL. 'FINAL BUILDING ,,'INALVtCHANICALWO x.��x , FINAL ELECTRICAL G ' ROUGH FIRE APPROVAL FINAL FIRE DEPARTMENT FINAL PLANNING FINAL PLUMBING - 2' - ` ` FINAL ENGINEERING/ PW ,T.0 of=OCCUIPANCY y FINAL COMMUNITY SERVICES CELT. of=OCCUPANCY , FINAL HEALTH DEPT. FINAL INDUSTRIAL WASTE COMMENTS: STATE GF CALIFORNIA ALTERATIONS - HVAC CEC-C)'9R-ALT-04-E Revised 06/14 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ALT-04-E Alterations - HVAC CZ 2, and 8-15 (formerly CF -1R -ALT -HVAC) (Page 1 of 1) Site Address: D E cement A ncy D rep red: Permit#: New ucting, Plenums, tine5F' Co iti ed Equipment Type Equipment Efficiency Required R -value Floor Area (sq ft) Thermostat ❑ Packaged System ❑ Evaporator Coil 'AFUE COP ❑ R-6 (CZ 2, 8-13) Ducting Served by system ❑ Setback ❑ Split System ndensing Unit ❑ R-8' (CZ 1I, 14, 15) Ducting sgft (If not already ❑ Mini Split ❑ Compressor SEER HSPFpresent, ❑ R-6 (al! CZ's) Plenums must ace Lin ❑Lin EER Eleset R-5 or R7.5) Lineset be installed) _ ❑ HERS VER -If `ICATION 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. AC Changeout/Repair Required Compliance Documents to be left on site for Final: All Equipment, CFIR-ALT-02-E Condenser Unit, Evaporator Coil, CF2R: MECH-01, 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 >_ 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' CF111-ALT-024 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)-HERS2, MECH-25-HERS' Mini Splits require CF1R-ALT-02-E, CF2R-MECH-01, and (CF2R-CF3R) MECH-25-HERS Installer Requirement: Duct leakage < 6%, Fan Efficacy (.58W/CFM), Air Flow >_ 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 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 Exempted from duct leakage testing if: ❑ 1. Existing duct systems are constructed, insulated or sealed with asbestos ❑ 4. New Ducting over 40 feet Required Compliance Documents to be left on site for Final: New ducting but less than All New Duct53 CF 1R -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 Ducts is when at least.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-23/.",-3.5 to 4T-2'/.", 5T -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 Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. Responsible Na Responsible Designe i ature: Da;� / License: �^ y LCp g: u ror assistance or gGestlons regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-33p0