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Home My WebLink About11-013 (5)CITY OF DIAMOND BARITER11", RATER -.�-` � ""--��` DEPARTMENT OF COMMUNITY &DEVELOPMENT SERVICE 21825 Copley Drive, Diamond Bar, CA 91765 (909) 839-7020 Fax (909) 861-3117 Building Inspection Hotline (909) -7027 fi Eat: BUILDING PERMIT APPLICATION11me - - DDRIESS Z —0 wS S )I (8� lI' I ` APN LOT TRACT OWNER M41P ,tzogjLLN/ ADDRESSH7L CITY ZIP TEL. APPLICANT TEL. CONTRACTOR ADDRESS I O . CITY ZIP TEL.-q'4I-03S ARC ENG/ ` DESIGNER ADDRESS CITY ZIP TEL. OWNER -BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM EXEMPT FROM THE CONTRACTORS LI- CENSE LAW FOR THE FOLLOWING REASON (SEC. 7031,5 BUSINESS AND PROFESSIONS CODE: ANY CITY OR COUNTY WHICH REQUIRES A PERMIT TO CONSTRUCT, ALTER, IMPROVE, DEMOLISH, OR REPAIR ANY STRUC. TURE. PRIOR TO ITS ISSUANCE, ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI- CENSE LAW (CHAPTER 9 (COMMENCING WITH SECTION 7000) OF DIVISION 3 OF THE BUSINESS AND PRO- FESSKONS CODE) OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED EXEMP. TION. ANY VIOLATION OF SECTION 7031.5 BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO A CML PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS (f500).): ❑ L AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (SEC. 7044, BUSI- NESS AND PROFESSIONS CODE: THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF PROPERTY WHO BUILDS OR IMPROVES THEREON, AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR THROUGH HIS OR HER OWN EMPLOYEES, PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR OFFERED FOR SALE IF, HOWEVER THE BUILDING OR IMPROVEMENT IS SOLD WITHIN ONE YEAR OF COMPLE- TKON, THE OWNER -BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE). ❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEC. 70", BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS LI. CENSE LAW DOES NOTAPPLY TO AN OWNER OFA PROPERTY WHO BUILDS OR IMPROVES THEREON, AND WHO CONTRACTS FOR SUCH PROJECTS WITH A CONTRACTOR(S) LICENSED PURSUANT TO THE CONTRAC- TORS LICENSE LAW.). ❑ 1 AM EXEMPT UNDER SEC. B. 8 P.C. FOR THIS REASON DATE OWNER LICENSED CONTRACTORS DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT IAM LICENSED UNDER PROVISIONS OF CHAPTER Y (COMMENCING WITH SECTION 7000) OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE, AND MY LICENSE IS IN FULL FORCE AND EFFECT. LICENSE CLASS -2- 1n) LIC. NO. DATE I — u� I ' CONTRACTOR WORKERS' COMPENSATION 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 WORKERS' 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 WORKERS' COMPENSATION INSURANCE, AS REQUIRED BY SECTION 3700 OF THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. MY WORKERS' COMPENSATION INSURANCE CARRIER AND POLICY NUMBER ARE: CARRIER POLICY NUMBER (ROS SECTION NEED NOT BECOMPLETEDOFTHE PERMIT IS FOR ONE HUNDREDDOU.ARS($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 SUBJECT TO THE WORKERS' COMPENSATION LAWS OF CALIFORNIA, AND AGREE THAT IF I SHOULD BECOME SUBJECT TO THE WORKERS' COMPENSATION PROVISIONS OF ��ON�THE CODE. I SHALL FORTHWITH COMPLY WITH THO PRO DATE:/ -S-/ t APPLICA WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL BE SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (!100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST. AND ATTORNEYS FEES. CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED (SEC. 3097, CIV. C.). LENDERS NAME LENDER'S ADDRESS 1 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, AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE-MENTIONED PROPERTY FOR INSPECTION PURPOSES. PERMITTEE PRINT SIGNATURE OF EE DATE WHITE—Department Copy, YELLOW—Finance Copy, PINK APPLICATION PERMIT /C DATE NUMBER�"�� ISSUE Dom— / / `` TYPE OCC DATE v / /T— CONST. 7 GROUP ZONING SETBACKS FRONT RW E] REAR D SIDE/SIDE STREET RW p SIDE PROPOSED USE C 2 t NO. DWEL. NO. NO. UNITS STORIES BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ. AREANALUATION SFR/ADD/REM U) Garage/Carport WPatio/Deck LL 0 PooUSpa Z Re -Roof Commercial m Valuation ADJ.AREA QUANTITY DESCRIPTION FEE J Q U cc Ccs LU �. W 0 Z m a Q U Z Q �h 2 U W CONSTRUCTION PLAN REVIEW ''�BIR�E M P G CH IC INSPECTI EE S NCE SMIP ENERGY -P/C ENERGY PERMIT RETENTION FEE: roc C PRE -ALT FEE: c TOTAL FEES ` COMMENTS RECPT NO. PAID BY VALIDATION wpy, uvwennvu—rlre L.opy, UHFLN—Applicant's Copy CITY OF DIAMOND BAR INSPECTION RECORD 0 SET BACK FLOOR JOIST' FTGS/FORMS/STEEL FHA REQMTS__- ELECTRIC GROUND UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CONDUIT SLAB GRADE FIREPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID HT. BOND BEAM ROOF SHEATHING 8 FT. BOND BEAM FRAMING/VENTILATION FINAL BOND BEAM ROOF COVER PRE -GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWER/TUB 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 I COMMENTS SEPTIC TANK SIZE SEEP PIT/U SIZE ;i' Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC CF -1R -ALT -HVAC Alterations Climate Zones 2, 9 Site Address: Enforcement Agency: Date: Permit #: 1302 S. DIAMOND BAR Diamond Bar, CA 91765 City of Diamond Bar ]an 4, 2011 Duct insulation Conditioned Floor Equipment Typel List Minimum Efficiency2 requirement Area Thermostat ❑ Package Unit 0 Furnace ® AFUE 80% ❑ COP Served by system 0 Setback P1 Indoor Coil 0 SEER 14.0 ❑ HSPF ❑ R 6 (CZ 2 and 9) 820 sf If not already present, 0 Condensing Unit ❑ EER ❑ Resistance must be installed) ❑ Other 1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF -IR -ALT -HVAC for each system. 2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPF for typical residential systems. HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteration 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 conducted. A copy of the forms shall be left on site for final inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this form was in fact the work completed by the installer. The inspector also verifies that each appropriate CF -6R and registered CF -4R forms (no hand filled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF -1R and CF -6111 shall also be on site for final inspection. ® 1. HVAC Changeout Required Forms: . All HVAC Equipment CF -611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS replaced CF -411 forms: MECH-21 and (for split systems) MECH-25 . Condenser Coil and /or . Indoor Coil and /or CF -611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS . Furnace CF -4R forms: MECH-21 and (for split systems) MECH-25 For Split Systems: Duct leakage^;x;15 percent; RC, CCA z 300 CFM/ton, TMAH For Packaged Units: Duct leakage;;.<" 15 percent Exempted from duct Jeagage testing';if:. ❑ 1. DucYsystem was documented to have been previously sealed and confirmed through HERS verification, or 0.2. Duct systems with less than';40.linear feet in unconditioned space, or 3. Existing'due�t�systems are constructed in ulated or sealed with asfiestos ✓ t- 72NeW,�"VA,C' y '` ` . , lf Require�Forms: �'' � "" - k s �, :� .°t a Systemj. d�wff . Cut in orfChan eout with neve ducts (all new d'uc�t ng &aapall , = m. GF 6 formstlECH 04, MECH�21 HERS and'�(forsplit systems) MECH-2 5 `HERS GF 4�forms MECH 2,,ff systems) MECH 25 n.ni. WWOli •':r.� P. E'Ri, I'�A ¢.a.: For Split Systems: Duct leakage s-`6;perceht -'RC, CCA `s>' 300 CFM/ton,'TMAH ' For Packaged.Units: Duct leakage._< 6 percent ❑ 3. N64 Ducts witl ,Replacement Required Forms: . Includes replacing or installing all,; new ducting and/or outdoor condensing unit and/or indoor, coil.. CF -6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS and/or furnace. Not all equipment CF -4R forms: MECH 21 and (for split systems) MECH 25 changed. For Split Systems: Duct leakage < 6 percent; RC, CCA z 300 CFM/ton, TMAH For Packaged Units: Duct leakage < 6 percent ❑ 4. New Ducting over 40 feet Required Forms: . Includes adding or replacing more than 40 linear feet of duct in CF -6R forms: MECH-04, MECH-2I-HERS unconditioned space. CF -4R forms: MECH-21 For split system or packaged units: Duct leakage < 15 percent ❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos. Contractor (Documentation Author's /Responsible Designer's Declaration Statement) • I certify that this Certificate of Compliance documentation is accurate and complete. • I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance. • I certify that the energy features and performance specifications for the design identified on this Certiflcate of Compliance conform to the requirements of Title 24, Parts 1 and 6 of the California Code of Regulations. • The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application. Name: WILLIAM FARNELL Signature: WILLIAM FARNELL Company: AIR CONTROLLED ENVIRONMENTS Date: Jan 4, 2011 Address: P O BOX 249 License: 623782 City/State/Zip: RANCHO CUCAMONGA / CA / 91729-0249 Phone: (909) 941-0354- E3 Reg: 211-A000045OA-00000000-0000 Registration Date/Time: 2011/01/04 20:17:43 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms July 2010 Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC CF-IR-ALT-HVAC Alterations Climate Zones 2, 9 Site Address: Enforcement Agency: Date: Permit #: 1302 S. DIAMOND BAR Diamond Bar, CA 91765 City of Diamond Bar ]an 4, 2011 Duct insulation Conditioned Floor Equipment Typel List Minimum Efficiency2 requirement Area } Thermostat ❑ Package Unit RI Furnace ® AFUE 80% ❑ COP Served by system 0 Setback 0 Indoor Coil R SEER 14.0 ❑ HSPF ❑ R 6 (CZ 2 and 9)820 sf If not already present Epi Condensing Unit ❑ EER ❑ Resistance must be installed) ❑ Other 1. Equipment Type: Choose the equipment being installed; If more than one system, use another CF-1R-ALT-HVAC for each system. 2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPF for typical residential systems. HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteration 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 conducted. A copy of the forms shall be left on site for final inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this form was in fact the work completed by the installer. The inspector also verifies that each appropriate CF-6R and registered CF-4R forms (no hand filled CF-4Rs allowed) are filled out and signed.Beginning October 1, 2010, a registered copy of the CF-111 and CF-6R shall also be on site for final inspection. 8 1. HVAC Changeout Required Forms: . All HVAC Equipment CF-611 forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS replaced CF-4R forms: MECH-21 and (for split systems) MECH-25 . Condenser Coil and /or . Indoor Coil and /or CF-6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS • Furnace CF-4R forms: MECH-21 and (for split systems) MECH-25 For Split Systems: Duct leakage .<;15 percent; RC, CCA z 300 CFM/ton, TMAH For Packaged Units: Duct leakage;-<,:15 percent Exempted from duct leagage testing if: ❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or 0 2. Duct systems with less tha;n'`40 linear feet in unconditioned space, or ❑ 3: Existingltluet systems are �cnon'structed aingulated o,rfsealleed withLaasbese tos ❑ 2 N 6WA4VAC l Required,Form S, SystemfI'�i�,^ kx�r` uk, .Cut irijor�Changeout with new,ltlucts (all o F r�'"y ,! .. CF 6Rforms MECH-04, MECH 21-HERS and (fors lits stems MECH 25 HERS MEC new ductrng�p� all ui' mentr`�3x C�F 4 forms° MECH 20',and (for'splitsyst ms) 25 f t c w new a q P)X+sr „ xt ,�IV,, ,. a ^"'zi.,�.h-tl,a i� �3?_^r." . 4�✓ls'.�a.,,z'�`�'', � r1 ,:��54 ��3 �. For Split Systems: Duct leakage .=c6'percent; RC,.CCA z 300 CFM/ton,TMAH d Uts: Duct leakagex<6 percent For Packageni fwith' 013. New`Ducts Replacement` Required Forms: . Includes replacing or installing,alll" new ducting and/or outdoor ° condensing unit and/or indoor coif: CF-6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS , , and/or furnace. Not all equipment CF-4R forms: MECH 21 and (for split systems) MECH 25 changed. For Split Systems: Duct leakage < 6 percent; RC, CCA >_ 300 CFM/ton, TMAH For Packaged Units: Duct leakage < 6 percent ❑ 4. New Ducting over 40 feet Required Forms: • Includes adding or replacing more than 40 linear feet of duct in CF-6R forms: MECH-04, MECH-2I-HERS unconditioned space. CF-4R forms: MECH-21 For split system or packaged units: Duct leakage < 15 percent ❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos. Contractor (Documentation Author's /Responsible Designer's Declaration Statement) • I certify that this Certificate of Compliance documentation is accurate and complete. • I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of Compliance. • I certify 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. • The design features identified on this Certificate of Compliance are consistent with the Information documented on other applicable compliance forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application. Name: WILLIAM FARNELL Signature: WILLIAM FARNELL Company: AIR CONTROLLED ENVIRONMENTS Date: ]an 4, 2011 Address: P O BOX 249 License: 623782 lPhone:-(909) City/State/Zip: RANCHO CUCAMONGA / CA / 91729-0249 941-0354 0, Reg: 211-A000045OA-00000000-0000 Registration Date/Time: 2011/01/04 20:17:43 HERS Provider: CalCERTS, Inc. 2008 Residential Compliance Forms July 2010