HomeMy WebLinkAbout11-549 - __ _ -
-- -
__ �
. �� � CITY OF DIAMOND BAR ��I�(� ��
DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVI t1 l! ���
21825 Copley Drive,Diamond Bar,CA 91765 p.
'� (909)839-7020 Fax(909)861-3ll7 Building Inspection Hotline(9 9-7027
��9�'�w BUILDING PERMIT APPLICATION ������
N JOBSITE LX C�'f �j DATECATION�� 9� NU BER��/C
¢ ADDRESS � �
ISSUE ! TYPE OCC
� APN LOT TRACT DATE ��/ �� CONST.�GROUP
p OWNER
� � ';lA' CL�(r1/-r'Z`I�1?ST ZONING SETBACKS
o ADDRESS U FRONT RW ❑
Z CITY ��� ZIP 11i�`I TEL - "Z o REAR ❑
g APPLICANT TEL. SIDFJSIDE STREET RW ❑
� CONTRACTOR � �J � SIDE
Q ADDRESS PROPOSED USE
� CITY ZIP Z TEL. -
w ARCWENG/
z DESIGNER NO.DWEL. NO. NO.
a ADDRESS UNITS STORIES BEDROOMS
� C�7y 21P TEL.
� DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION
�
� OWNER-BUILDER DECLARATION SFR/ADD/REM
O
0 I HEREBY AFFIRM UNDER PENAL7Y OF PEP.IURY THAT I AM E%EMPT FROM TNE CONTRACTORS LI- G0f8QB/CB�OR
W CENSEUWFORTHEFOLLOWINOREASON(SEC.7031.6BUSINESSANDPROFESSIONSCODE:ANYCITYOR (n
U COUNTVVh11CN0.E4U�RESAPEfiM1TTOCQNSTRUCT.ALTER.IMP0.0VE,0EMOU5H2ORREPAIRANYSTqVC- W P8I10/DBC1f '
wTURE.PRIOR TO ITS ISSUANCE,ALSO RC-0UIRES THE APPLICANT FOP SUp1 PERMIT TO FIIE A SIONED
g STATEMENT THAT HE OR SNE IS LICENSED PURSUANT TO TME PROVISIONS OF THE CANTRACTORS LF
� CENSE UW(CNMTER e(COMMENCWp WIiH SECTION 7000}OL DIVISfON 7 0F TME BUS�NESS AN�PFO- � POOVSP2
I � FESS10113 COOE)OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALIEGED E%EMP- I
TKKJ.ANY VIOlAT10N OF SECTION 7031.5 BV ANV APPLICANT FOR A PEFlMIT SUBJECTS THE APPLICANT TO Z qe-Roof
� A GIVIL PENALTY OF NOT A10RE TI IM!FIVE HUNDRED DOLlARS(f50D).):
^ ❑I,ASON?JEROFTHEPROPERTV,ORMVEMPLOVEESWITHWAGESASTHEIRSOLECOMPENSATION, � COrt1111BfC181
j VALL DO THE W�RK.AND THE STRl1CTl1RE IS NOT INTENDED OR OFFERED FOR SALE(SEQ 7oN,BU51- ..J
N NE55/V!D PROFESSIONS CODE TME CANTRACTORS UCENSE LAW DOES NOT APGLY TO AN OWNER OF �
VqOPERTVWHOBUILOSORIMFROVESTHEREON,ANDWHODOESSUCHWORKHIMSELFORHERSELFOR m
Q 7HHOUON MIS OR HER OVM EMPLOYEES,PROVIDED THAT SUCH IMPROVEMENTS AAE NOT INTENDED OR
W OFFEREDFORSALEIF,HOWEVER.7HEBUILDINOORIMPROVEMENTISSOLDWfTHINONEYEAROFCOMPLE-
0 TION,THE OWNER-BUIIDEP WILL HAVE THE BURDEN OF PROVINO THAT HE OR SHE DID NOT BUILD OR
Z UAPROVE FOR THE PURPOSE OF SAL�.
_ ❑I,AS OYMER OF THE PROPERTV.AM E%CLUSNELV CONTMCTIN(3 WfTH UCENSED CONTRACTORS
¢ TO CONSTRUCT THE PRQIECT(SEC.70�d,9USINESS AND PROFESSIONS CADE:THE CONTMCTORS LI- VelUHflOn ADJ.AREA
� CENSEUWDOESNOTAPVLVTOANOWNEROFAPROPERTVWHOBUILDSORIMPROVESTHEREON,AND
WFIOCONTMCTSFOHSUCHPRQIECTSWITHACONTRACTOR(S�LICENSEDPURSUANTTOTHECANTRAG QUANTITY DESCRIPTION FEE
Y 70R5 LICENSE UW.).
O ❑I AM EXEMPT UNDEfl SEC. B.d P.C.FOR THIS REASON �
� �
� D�TE OWNEH V
W
� LICENSED CONTRACTORS DECLARATION w
� 1 MEREBV AFFIRM UNDER PENILTY OF PERNiiV THAT 1 AM LICENSED UNDER PROVISIONS OF CHAPTER � �
d 9(COMMENGNO WfT11 SECTION 7000)OF DIVISION 3 0F THE BUSINE55 AND PROFESSIONS COOE.AND Z
X MY UCENSE IS fN FULL FO CE AND EFFECT. m
UJ �J�{'�J �n r2
� LICENSE LA�S —v LIG.NO. O`�O J �
� pp7E CONTRACTOR d
� WOHKERS'COMPENSATION DECLARATION wrv 1 ,W� � �
� I HEHEBV AFFfRM IJNDER PENALI'/OF PERJUftY ONE Oi�HE FOLLOWING DECUAATIONS: U I
N Q �
� _I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF�INSURE FOR WORKERS' _
Q (',OMPENSATION,AS PROVIDED BY SECTION 370o OFTHE IABOR CODE,FOR THE PERFORMANCE W
F THE WORK FOR WHICH THIS PERMIT IS ISSUEO. �
�
I NAVE AND WILL IAAINTAW WORKERS'COMPENSATION INSUqANCE.AS REWIRED BV SECTION
QQ �7aa OF THE LABOR CODE,FOR THE PERFOFMANCE OF THE WORK FOR WHICH THIS PERMIT IS
ISSUED.MY�ERAS'/��r�t jP/ENyS�ApTro/��+�NSU�F^iANyC�E C�AR IER ANeD 1P�OLICY NUMBERARE: CONSTRUCTION
� C�HRIEF f�`�'��`�^ �'`-�'/� G*�`-r U� PIAN FEVIEW
� POLICV NUMBER LAI I3 VL Z- ELECTRIC
� (fFiSSECTIONNE�hI�TBEODMR_ETmOF7YgPEWMISFOROMEFAN�D�1��0�1P�%(f�001a1LF551 PLUMBING �
w MECHANICAL �
Z I CERTIFY THAT IN THE PERFORMANCE OF THE WOR1C FOR WHICH THIS PERAl1T IS ISSUED,I
�J SHALL NOT EMPLOV ANV PERSON IN ANV MANNER 50 AS TO BECA E SUBJECT TO THE
� �MDRNERS'COMPENSATIONLAWSOFCALIFORNIA,ANDAGREE7 BECOME INSPECTIONFEE
SU&IECTTOTHEWORKERS'COMVENSATIO ROVISIONSOFSE T N37000F IELABOR ISSUANCE �����
OGOD I SHA FORTHWITH COMPLV WITH ISIONS.
p DATE:� APPLICAN: i SMIP
J � � ENERGY P/C
J WARNING FAILURE TO SECURE W�RKERS' SATION CAVERAGE IS UNLAWFUL,AND SHALL BE
�y SUBJECT AN EMPLOYEFTO CRIMINAL PENALTIES ANO CIVII FINES VP TOONE MUNORED TNWSAND ENERGY PERMIT
DOLLARS(f100.000).IN ADDITION TO THE COST OF GOMPENSATION,DAMAOES AS PROVIDED FOR IN � ^�
J SECTION 3708 OF THE LABOR COOE,INTEREST,AND ATTORNEV'S FEES. RETENTION FEE: � .
�
w CONSTRUCTION LENDING AGENCY PRE-ALT FEE:
a
O
� 1 HEREBV AFFIRM UNDER PENALTV OF PERIURV THAT THERE IS ACANSTRUCTION LENPINO AGENCV
FOR THE PERFORMANCE OF TME WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.30G7,CIV.C.�.
Z
W
� LENDER'S NA/AE
H LENDER'SADDRE55 /r}
� I CERTIFY TNAT I HAVE READ THIS APPUCATION AND STATE THAT THE ABOVE INFORMATION IS CARRECT. TOTAL F E ES / �/�
W I AGREE TO CAMPLV WITN ALL CITV/W0 CAUNTV ORDINANCES AND STATE UWS REUTINO TO BUILOINO
� CONSTRUCTlON,AND HEREBY UTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE
ZVE-MENTIONED P ER OR INSPECTION PURVOSES. COMMENTS
� �J
�
m PE 1 EE (PR1NT �
Q
CfJ
� SIG E E ATE
RECPT.NO. PAID BY VALIDATION
� ITE—Depariment Copy,YELLOW�inence Copy,PINK—Assessor Copy,GOLDENRO�Ie Capy,GREEN--Applicant's Copy
��,�.� � � G;>!.�"'�:��`� CETV OF DIAiUi06VD �,4Fi �
,��;��`; �� �', � � �� ���� � INS��C�10� �i�CORD
�uc=. v u �'' t������.�Sl
�,,_•_ ,�,, ,t 'I�-; >�'� �
.,, Oa DGJ4l� OG�?�PCC�S�OG3 O[�I�pCC�400f�1 � [DGJ4C� OG��pC�C��40G3
SET BACK � ` • FLOOR JOIST � �
FTGS/FORMS/STEEL FHA REQMTS
ELECTRIC GROUND UNDER F�OOR DUCT ' -
GROUND PWMBING UNDER FLOOR GONDUIT �
SLAB GRAOE FIREPLACE FOUNDATION
TEMP POWER FIREPLACE BOND BEAM
WATER SERVICE MID H'T. BOND BEAM
ROOF SHEATHIIVG 8 FT. BOND BEAM
FRAMINGNENTILATION FINAL BOND BEAM
ROOF COVER PRE-GRADING
ROUGH HEATING j� BENCHING
ROUGH ELECTRIC ROUGH GRADING
ROUGH PLUMBING FINISH GRADING
SHOWER/TUB TEST POO�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
C�f�?��� : �
. ; tT i
COMMENTS ��t—� ;
SEPTIC TANK SIZE
SEEP PIT/U SIZE
a
� a
�
�
. (�
l ASI��
CERTIFICATE OF FIELD VERIFICATION 8� DIAGNOSTIC TESTING CF-4R-MECH-21
Duct Leakage Test— Existi�g Duct System (Page 1 of 2)
Site Address: Enforcement Agency: Permit Number:
y. 2834 Eaglecrest PI, Walnut CA 91789 (System 1) City of Diamond Bar PRll-549
Enter the Duct System Name or ldentification/Tag:
Enter the Duct System Location or Area Served:
Note: Submit one Installation CertiFcate for each duct system that must demonstrate compliance in the
d welling.
This installation certi�cate is required for compliance for alterations and additions in existing dwellings to
space conditioning systems and duct systems.
Note: For existing dwellings, a completely new or replacement duct system can also include existing parts of
the original duct system (e.g., �egister boots, ai�handle�, coil, plenums, etc.) if those parts are accessible
and they can be sea/ed. Fo�a completely new or replacement duct system installed in an existing dwelling,
use the Installation Certificate titled "Duct Leakage Test- Completely New or Replacement Duc[System."
Duct Leakage Diagnostic Test-existing duct system
Select one compliance method from the following four choices.
� 1. Measured leakage less than 15% of fan Flow
�2. Measured leakage to outside less than 10%of Fan Flow
�3. Reduce leakage by 60% and conduct smoke and fix all leaks
�4. Fix all accessible leaks using smoke and HERS rater verify
Note:.(One of Options 1, 2, or 3 must be attempted before utilizing Option 4.)
Determine nominal=F�an�Flow using one of the following.three calculation-rnethod�s. f^u- —;i �r ��--`�».-y
❑Cooling system method: Size of cond�ser in Tons=x 400"=_CFM i�'� ,� , (' ;�,� �+:
� � ._ r�.�"5 ' t"' ;� ,� 1 � rf .. .�, � . !\l: : -• ,
❑Heatmg system method, 21 7 x�Output Capacity in Thousands of-Btu%hr = ! CFM � `�, r,
� �:r� �' � � ` ;
✓�Me�su�ed system�airfl w:�using RA3.3,airFlow,testiprocedures: ! CFM . , ,� �: ; ; "j �'�4� ��/t'` � '``�
Opt�on�i;used then ;,. .• �; _ �� _ s; ��, ��;:�.. ._ �-- ' .'i' �`r°� - �
�, ��;.<�':�i:x
1 Allowed�leakage = Fan Flow_�x 0 15 =� r CFM ''mmT ' -
Actual Leakage =_CFM
Pass if Leakage Actual is:less than Allowed Pass Fail
Option 2 used then: •
z Allowed leakage = Fan Flow '. ' x 0.10 =_CFM • �
Actual Leakage to outside = CFM
Pass if Leakage Actual isJess than Allowed Pass Fail
Option 3 used then: - .
Initial leakage prior to start of work= CFM
Final leakage after sealing all accessible leaks using smoke test= CFM'� '�
3 Initial leakage_- Final leakage_= Leakage redudion_CFM
((Leakage reduction_/Initial leakage� x 100% _ % Reduction
Pass if% Reduction > 609�o Pass Fail •
Option 4 used then:
4 All accessible leaks repaired using smoke. HERS rater must verify (No sampling). No smoke
allowed to leak from system. Including ducts, plenums, air handler and door panel.
Pass if all accessible leaks have been repaired using smoke Pass Fail
w,
Reg: 211-A0025970A-M2100001A-M21A Registration Date/Time: 2011/08/09 17:16:24 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms March 2010