HomeMy WebLinkAbout13-1280 (7) CITY OF DIAMOND BAR � �
"�'—'^' - --��� -- DEPARTMENT OF COMMUNITY&DEVELOPMENT SEYtVICES �
21810 Copley Drive,Diamond Bar,CA 91765
(909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-702 P�E$S
� ''^'� BUILDING PERMIT APPLICATION FIRMLY
¢ DDRIESS 1 �� � � ( (��`C,a�-J W APPLICATION � � PEFiMIT •,, �P/C
o D� � DATE NUMBER��`�#
�' APN LOT TRACT DA EE �D ���(�� TMPE OCC
°C OWNER h�\ �— �— CONST. GROUP
O
p ADDRESS �303 �F SF(LT �.1Z1-1_a (,-> ZONING SETBACKS
Z CITY ����ON� �/�/Z ZIP �� TEL.�Ie�-2�v=I/� ' FRONT RW ❑
� APPLICANT $Y TEL. REAR ❑
� ry SIDE/SIDE STREET RW ❑
¢ CONTRACTOR 6��Y�� C�AwE� �Fi OLD� G�FS% /l�jl SIDE ❑ ,
p� ADDRESS I�f��c2 f�N JaS� A�f L
� CITY RU w L FFnI/7 �FIW�'rZrIP� TEL.�61";•7�6 2 PROPOSED USE
w ARCWENG/
z DESIGNER
w NO.DWEL. NO. NO.
a ADDRESS
� CITY ZIP TEL. UNITS STORIES BEDROOMS
�
cn DESCR�PTION SQ.FT. FACTOR PSF ADJ..AREANALUATION
¢ OWNER-BUILDER DECLARATION SFR/ADD/REM
O
�
1 HEREBY AFFlRM UNDEH PENALTY OF PERRIRY THA7 I AM EXEIAPT FqOM 7HE CANTRACTORS LI- GBfage/C8(POfI
W CENSEUWFORIHEFOLLOWINGREASON(SEC.7a71.58U51NE5SANDPROFE5510N5CODE:ANVCITYOR (n
U COUNttWHICHREOUIRESAPERMITTOCONSTRUCT.ALTER,IMPROVE,DEMOUSH,ORREPAIRANYSTRUG W PatiolDeck
W TURE,PRIOR TO RS ISSUANCE,ALSO REOUIRES THE APPLICAN�FOR SUCH PERMIT TO FILE A SIGNE� W
� STATEMENT THAT HE OH SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONiMCTORS LI- �
� CENSE UW(CHAPTER G(COMMENCING WITH SEC7ION 7000)OF DIVISION 3 OF iHE BUSINESS AND PR4 POOUSPB
� FESSIONSCAD�ORTHATHEORSHEISE7(EMPTTHEREFf10MANDTHEBA515FOHTHEALLEGEDEXEMP- (� _
V TION.ANY VIOUTION OF SEC710N 7031.5 BV ANY APPLICANT FOR A PERMIT SU&IECTS 7HE APPLICANT TO Z Re-Roof �
� ACIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLAHS(fSOD).):
❑I,ASOVMEROFTHE�ROPERTY,ORMYEMPLOVEESWITHIVAGESASTHEIRSOLECOMPENSATION, Q
Z WILI DO THE WORK AND TiE STRUCTURE IS NOT IHTENDED Oq OFFERED FOR SALE(SEC.7ou,BU51- J COrtIrtI0fCt81 -
� NESS ANO PpOFESSIONS COOE:THE CON7MC70R5 LICENSE UW DOES NO7 APPLY TO AN OWNER OF �
— PflOPERTYW�iOBUILD50RIMPROVESTHEREON,MIOWHODOESSUCHWORKHIMSELFORHERSELFOR
Q TH/iOUGH HIS OR HER OWN EMPLOYEES,PROVIDED THAT SUCH IMPROVEMEMS ARE NOT INTENDED OR m
� OFFEREDPDRSALEIF,FiOWEVERTNEBU1lDINGORIM7ROVEMENTI550lDWfTHINONEYEAROFCOM7LE-
z TION,THE OWNER�BUILDER N7LL HAVE THE BUROEN OF PROVING hiAT HE OR SHE DID NOT BUILD OR
� 11APROVE FOR THE 7URPOSE OF SAIE).
w ❑I,ASOWNEROF7HEPROPERTY,AMEXCLUSIVELYCAMRACTINGWfTHLICENSE�CONiRACTORS
� 70 CANSTRUC7 7HE PR0.IECT(SEC.7041,BUSINE55 ANO PROfES510N5 CODE:TME CAMMC70R5 LI- V81ua[IOn D� ADJ.AREA
W CENSEUWDOESNOTAPPLY70ANOWNEROFAPROPERiYWHOBUILD50RIMPROVESTHEREON,AND
� VlHOCAHiMCTSFORSUGiPR0.1ECT5WRHACANTRAC70R(5)LICENSEDPURSUANTTOTHECONTRAG QUANTITY DESCRIPTION FEE �
Y 70R5 LICENSE UW.).
� ❑I AM EXEMPT UNDER SEC. B.6 P.C.FOR THIS REASON Q
� U
� ¢
DATE _ OWNER_.. .,. . U
Z W
�Q LICENSED CONTRACTORS DECLARATION W
CC 1 HEREBY AFFIRM UNDER PENALN OF PERIURV THAT IAM LICENSED UNDER 7ROVISIONS OF CHAPTER �
� Y(COMMFNCINO WITM SECTION 70oD)OF DIVISION 70F iHE BUSINESS M1D PROFESSIONS CODE,AND Z
�� MY LICENSE IS IN FULL FORCE AND EFFECT, m
� LICENSE CLASS �3�i ���.No. R 334 0`I �
U DATE 6��i a/�� CONTRACTOR�-`1°LI}FIJ W`,T ��G r� h a
w
� WORKERS'COMPENSATION DECLARATION Q ,
� 1 HEREBv AFFIRM UNDER PENALTY OF PERIURY ONE OF 7HE FOILOWWG DECLARA710N5: Z
� _I HAVE AND WILL MAMTNN A CERTIFICATE OF CANSENT TO SELF�INSURE FOR WORNERS' _ ��
COMPENSATION,AS PROVIOED BV SECTION 370o OF 7HE U90R CODE,FOR iHE PERFOFMANCE �U
Q �F h1E WORN FOR WHICH TMIS PERMIT IS ISSUED. � �
W /
✓ I HAVEAND WILL MAINTNN WORKERS'COMPENSATION INSUMNCE,AS REOUIRED BY SECTION /���.
Q 970o OF THE LABOR CODE,FOR THE PERFORMMlCE OF THE WORN FOq WHIbi THIS�ERMIT IS /Q[y �� I
ISSUED.MY WORKEAS'COM�ENSATION INSURANCE CARRIER AND POLICY NUMBER ARE: CONSTRUCTION E C��7� I
¢ CAqRIER S T��� �uN� PLAN REVIEW II
>
ZPOLICY NUMBER ��1`��J�1—1�/�• ELECTRIC �
Q I� (IHL45ECf10NNFIDNDTBE00AflfTEDOF7HEPEPoNf6FORONEMNDiiED0011AftS�5100)ORLE55� PLUMBING
Z I CERTIFY THAT IN THE PERFOHMANCE OF THE WORK FOR WFIICN THIS PEiU11T IS ISSUED,I MECHANICAL I
LJ SHALL NOT EMPLOY ANY VERSON IN ANY MANNER 50 AS TO BECAME SU&IECT TO 7HE
� WORKERS'COMPENSATIDN LAWS OF CALIfORNl0.�ND AGREE iHA7 iF I SHOULD BECAME INSPECTION FEE 1� I
= SUBJECT TO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 37ao OF THE LA80R �
CODE,I SHALL FOfiTHWlh1 COMPLY WITHTHOSE PROV,,I�SIO/NS. l ISSUANCE
O DATE S�I'��� APPLiCANT: �1 oL n�1 V W��� ��{1N� .SMIP 1��
�
J WARNINU:FAIWRE TO SECURE WORICERS'COMPENSATION COVEMGE IS UNtAWFUL,AND SHALL BE ENERGY P/C
� SUBJECT AN EMPLOYER TO CRIMINAL PEN/LLTIES AND CNIL FlNES UP TO ONE HUNDRED 7YIOUSAND ENERGY PERMIT
DOLURS(i100,000),IN AODITON TO THE COST OF CAMPENSATION,DAMAGES AS PROVIDED FOR IN
¢ SECTION 37o80F THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. O
RETENTION FEE: Z'6�
OCONSTRUCTION LENDING AGENCY PRE//-77ALT,/F�EE• f�
� I HEREBY AFFlRM UNDER VENPLTY OF PERIURY THAT THERE IS ACONSTRUCTION LENDWO AGENCY �/�'� I� 1 �O
� FOR iHE PERFORMANCE OF 7HE WORK FOR WHICH 7HIS PERMIT IS ISSUED(SEC.3ov7,CIV.C.). �
Z
w
� LENDEHSNAME
F– LENDER'SADDRE55
� TOTAL FEES
� I CERTIFY THAT I HAVE READ THIS APPL�CATION AND STATE THAT THE ABOVE INFORMATION�S CARRECT.
w I AGREE TO COMPLY WITH ALL CRV AND CAUNTY OR�INANCES AND SiATE UWS pEU71NG TO BUILOING
� CONS7HUCTION,AND HEPEBV AUTHORRE REPRESENTATNES OF 7HI5 CWNTY TO EMER UVON hIE
� ABOVE-MEIfTIONED PROPER7Y FOR INSPECTION PURPOSES.
Z COMMENTS
0
J
�
m FERAI(TTEE NAME(FRINT) �
Q .
�
� SIGNA7UREOFPERMtTTEE DATE
= RECPT.NO. � PAID BY VALIDAT}O
~ WHITE—Oepadment Copy,YELLOW--Finance Copy,PINK—Assessor Copy,GOLDENROD--File Copy,GREEN—AppllcanYs Copy
0,3'J�JH�9 °t�1 C� ��Y^3�it?�#�7 Z:+ J;;:i^"a 4;[ � , .�..
�!\I��i'��4s a� ���1?7 Ii"1`�a,a,r�€"a�.,f .
��"�� E� �J`o� ��� � � � � �a�� - [ ±�'
.F _..,� .r--YT""�':_�F ..f .
,,�+ p ..'4' �} .^1 N�' �ti+ � �-?Y�� i. �—��TT—�-"- �•'T�
x:��rt3 J`w�� �. r R '� 3+` .7�-a F -r-.-. �"i� 7�`'Y rS 6'�'x; 'n�ik4"� ... i��, ��`� Y-�.... iry . ,� �a i �,.y �,:e r � ��. t���:
.�r��1.N�Y.'��f���,�����.;if�`g �4 L.. �.ti��'_L°r ...i,.gR.'-a"`5c�Y�k`:c;.�7 i fi�r;i. v«•-t��x..;� �ti.t�o ''� ,i�'�. ¢j �'{1!'I.�f i}�� ��:r1 r-:�,. ;.r�,"5,��i-�- z�.�� ;'+�' 1 �`� .i.t�
F.� .. � v. .r r�.....:t�r _r . . 5,� ..t.��: f �:�3.� `�'S-..'"�, ti �� � �i.l� .�[�r y��.F� �F����-� �
�a_ � -�:��...,.��rs�..,..�:d�:..:_:�..k. .V..�_r.;:..._'�-�_... _ ......�.�.,�,.�-.-..__..�_r'-..t� 9.���'F.w �::._:::.�$._d_._�'L--i.''�� ,_r.... � -«`�.s.:._�,�� ...,_..i,...:. i�� �;���•..?��.i'"�,'�
w_ .�.
r�E� b,'�CK ; � �r'G0�?JUIST �
- - - _- - ,--- -__ ..----- .---
---- --- --- ----------
1 F_. _ --- - --------- - --
.. _._
f TG�/f ORMS��fFrL � i FHA RtnI41T5 �
.._ _.. __ _ ._ __ _. . _-----
=l C�l f�l�GV'vU�ID � � � I�JNDFP Ft OC`R CUCI --- � - _ -- ------------------
__ _ ._ .. __ �
__ ._. __ �
� � G_ ._ _ -- — -— -- - --_ —--
GRGI�i��PLUiv1BING
j i fUNDER FLOOR C.ONDUIT
� -- --
�SLAE3;RADE ----— -- --- �- -- --------� rFiREPLAC[FOUt�Or�TIOPd T _--- --------
--- E-------- --1---- --- --
TEN9P PO;�VEI? ---_- --__-_—� _ -------- i I FIREPLFlCE E3UND 6EA��4
4VAT�R SERVICE ' � � t��lU HT.BOf�D 6EAPA
--- ' - -- ---; I------ --
HOOF SHEATHIP!G j a��c Qor•�r H�qN1
—;--� -- -��- ---------- -
------- -- — -- -----
FRAi141�!G!VENTILA.TI01�! ; � � � I FIRAL BOND 6�AA�1
•-------------------�-------�-------------- ---
ROOF COVER � � - I �-------------._..__. _.-----------------------------------
__._ _ _ PRE-GRADiNG `
---- ---------------=---.__------------- --------------..---------------------------------
fZOUGH HEATING � j � i BE�iCHIPJG
-- --- ---- � ----------------I •--------------- --------- -------
ROUGH ELECTRIC _ � _ __. i __ j I ROUGH GRADING
ROUGH PLUP�IQIPIG � I � �FINISH GRADING
SHOWER/TU61�E�T � --�
` I_____ i j PGOL ELECTRIC
[XT.LATH!SIDING j --� ;POOL FENCING
4VALL INSULATIOP! � � I I POOL FINAL
—�-------
i
CEII_iNG INSULATION � �— i OFF SITF IMPS.
--� ,
DRYUVALL NAILING � � �DEDICATIO.i�S
-------------------— �
- r---- __...----�-----------._------_---------� ;----- --._..-------- .-------�----------- --------
-------
SEN/ER � I �F I N AL[NG_--....--------------------...----------------------
SEFTICTANK � 'LAfJDSCAPE/IRRIG.
----------�---- �---------- -- --- -----------------
SEcP PITiL.L. ' ON SITE IMPS.
GAS AIR T[ST _� �
__ �FINAL ZOIVING
fINAL CONST. _�_ �.FIRE DEPT.FINAL
_ -..
fI�IAL HEATING ; �FIEALTH DEPT.fINAL
FINE\L ELECTRIC -T- � j DEV.FEES PAID
FINAL PLUN161NG ��- ENERGY
— � I
I r-
FINAL PLANING i
-- _�----- - — ._.
—- �— --- -- ---- - � ---- - -----
FINALENGINEERIfdG � � � �� I �j� �� � -�, �-.
-- ------- -- ---- � �'�# '.
�- -------- -�--..._ -- �..+�,�.F �_�6 -�n�,_•����'S .r� ---
COMMENTS .�.J'_ �,�,f�_.._�4,�'(,���l��
-- �- ----------------
�---_
SEPTICTANKSIZE
SEEP PIT/U SIZE --- ------ --------- --- -- — --------
� �.,��, - - �,
_ . _� --
. ----- — ---
•��,:, �, �� � ���;: ----------------�— --------- --
, '': � . �
. '� :� � � .
n �= --------- -------------- ---------------------..__
� - ���� ------..—_.
-.,� � � :'" �--�' ' ------
� •�,' ----- _.--- --------
� . �.3.n� __________'__.'_'.—__
..�;3 � ' _ ._'__—.______--_—" .
— '�y�. "_ �2 �
'�" -y �
� W5 �3t _____'_'____'____--__--'_
..___'__—_."________"_'"_______'—__'_'_'_—__'_"__"_'__
- �Y.i__ " � .
' •3
.m, - .. . _. ..,... __—'__'_—"—__" _—____'_""______
:-.`tlr ' 'f _ '_"__ "___"'_'__ __ '
'`�:�Y4 � �� .
�•' >' _
:: K�
.. '.�. : �.q.-y,.. .
( ♦ � _
Prescriptive Certificate of Compliance: Residential Reroof CF-1R-ALT-ReRoof
Project Address: Climate Zone Permit#
(3�3 oFs�n-T ������ �� E y �w r�Arc
ROOFING PRODUCTS(COOL ROOFS)§151(fl12
When the area of exterior roof surface to be replaced exceeds 50%of fhe existing roof area, or 1,000 ,whichever is less, the new
roofing area must meet the roofing product"Coo/Roof"requirements of§152(b)1Hi, 152(b)1Hii, or 152(bJlHiii.
Check applicable alternative or exception below if the roof alteration is exempt from the roofing product"Cool Roof' requirements::
�
p Cool roofs not required in Climates Zones 1-12, 14,and 16 with a low sloped roof pitch(less or 2:12 pitch).
p Cool roofs not r uired in Climates Zones 1-9,and 16 with a steep-sloped roofs(greater pitch than 2:12)and product weight less than 5/Ib/ft2:
— �9
, Alternatives to§152(b)1 Hi and§152(b)Hii,Steep-slope roof(pitch>2:12)
❑ Insulation with a thermal resistance of at least 0.85 hr�ftz�°F/Btu or at least a 3/4 inch air-space is added to the roof deck over an attic; or
❑ Existing ducts in the attic are insulated and sealed according to§151(�10;or
� ❑ In climate zones 10, 12 and 13,with 1 ft2 of free ventilation area of attic ventilation for every 150 ff2 of attic floor area, and
where at least 30 percent of the free ventilation area is within 2 feet vertical distance of the roof ridge;or.
❑ Building has at least R-30 ceiling insulation;or ,
❑ Building has radiant barrier in the attic meeting the requirements of§151(fl2;or �,j�,
❑ Building has no ducts in the attic; or '
I tion above vented attic.
� In climate zones 10, 11, 13 and 14, R-3 or greater roof deck insu a
Exception to§152(b)1Hiii, Low-slope roof(pitch<_2:12)
❑ Building has no ducts in the attic.
Other Exceptions
❑ Roofing area is covered by building integrated; photovoltaic panels and solar thermal panels are exempt from the Cool Roof criteria.
❑ Roof constructions that have thermal mass over the roof inembrane with at least 25 Ib/ft2 are exempt from the Cool Roof criteria.
NOTE:If any one of the alternatives or exception is checked the Aged Solar Reflectance and Thermal Emittance requirements for roofing
products in§118(i) are not applicable. Do not fill table be/ow.
Roof Slope Product Weight Product Aged Solar Thermal
CRRC Product ID Number� <_ 2:12 >2:12 < 51b/ft2 >_ 51b/ftz T e2 Reflectance3'4 Emittance SRIS
❑ � 0 ❑ �4
0 � 0 � ❑4
� Note: If no CRRG 1 label is available, this compliance method cannot be used, use the Performance Approach to show compliance,
1.The CRRC Product ID Number can be obtained from the Cool Roof Rating Council's Rated Product Directory at www coolroofs.orq/products/search.phA
2.Indicate the type of product is being used for the roof top,i.e.single-ply roof,asphalt roof,metal roof,etc.
If the Aged Reflectance is not available in the Cool Roof Rating Council's Rated Product Directory then use the Initial Reflectance value from the same
directory and use the equation(0.2+0.7(p;,,;ea�—0.2)to obtain a calculated aged value. Where p is the Initial Solar Reflectance.
4.Check box if the Aged Reflectance is a calculated value using the equation above. '
5. Calculate the SRI value by using the SRI-Worksheet at�://www.enerqv.ca.povRitle24/and enter the resulting value in the SRI Column above and attach
acopy of the SRI-Worksheet to the CF-1R.
o apply Liquid Field Applied Coatings,the coating must be applied across the entire roof surface and meet the dry mil thickness or coverage
recommended by the coatings manufacturer and meet minimum performance requirements listed in§118(i)4. Select the applicable coating: I
Aluminum-Pigmented Asphalt Roof Coating ❑ Cement-Based Roof Coating ❑ Other
NOTE:,When a Cool Roof is required, the installing contractor shall complete and submit the CF-6R-ENV-01 for final inspection.
Declaration Statement
• I certify under penalty of perjury,under the laws of the State of California,the information provided on this form is accurate and complete.
• I certify that the energy features and performance specifications identified on this Certificate of Compliance conform to the requirements of Title 24,Parts
1 and 6 of the California Code of Re ulations.
Name: Signature: ,
Com pany: � Date:
Address: License:
City/State/Zip: Phone:
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300.
�
` , .
.
� �
, � � � ,
� (� �� �
�. � � l
� � �,� . � -
\ � �.
� v
. e '�
��
� � �
�
� �s
�
1 •
CiT
c)r
� � I � '
_ � r� _
lll �"`' ''
�- � � -
,
���'�x��ox��c��
l�'pj°�
� City of Diamond Bar
21810 Copley Dr.
Diamond Bar, CA 91765
RECEIPT OF PAYMENT
Receipt Number: 2013015644
Receipt Date: 06/21/2013
Date Paid: 06/21/2013
Full Amount: $206.54
Payment Details: Payment VNethod Amount Tendered Check Number
Check $206.54 1058
Amount Tendered: $206.54
Change / Overage: $0.00
Contact (Paid By): Golden West Roofing Service, Inc., Address:11311 Tampa Ave., #23, Phone:(562)
307-6532
I Property Address: 1303 DESERT WILLOW LN DIAMOND BAR CA, 91765
FEE DETAILS:
Fee Description Reference Number Amount Owing Amount Paid
Building Permit Fees Residential PR20130001280 $168.07 $168.07
Building Permit Issuance Fee PR20130001280 $34.77 $34.77
Building Admin Special Revolving Fund PR20130001280 $1.00 $1.00
(Residential)
SMIP Fee (residential) PR20130001280 . $0.70 $0.70
Records Retention Fee (per sheet plan) PR20130001280 $2.00 $2.00
This receipt only acknowledges payment of fees to the City. It is not proof that a
license, permit or other approval has been issued. This receipt does not authorize
the commencement or conduct of any activity for which a fee has been paid.
� �