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Home My WebLink About11-582 . ' CITY OF DIAMOND BAR �� ---��'— DEPARTMENT OF COMMUNITY&DEVELOPMFrN VIC S �� I 21825 Copley Drive,Diamond Bar,CA 91765 ��}'� �� ` (909)839-7020 Fax(909)861-3117 Building Inspectio�yt!' e(909)839- �''"'�u $$ �'°"'� BUILDING PERMIT APPLICATION FIRMLY y�, JOBSITE APPLICATION PERMIT '��/� o ADDRESS� VQ✓ � ✓' DATE NUMBE�I-5�'�g � ISSUE �C /� TYPE OCC APN LOT TRACT DATE / � CONST.� GROUP p OWNER p ADDRESS 'Z ✓ i1lK"� ,r ZONING SETBAC S z CITY P EL. FRONT qyy � ' o APPLICANT 'a � TEL.$��'7 Vi REAR ❑ � SIDE/SIDE STREET qyy p � CONTRACTOR �L��-e -P_✓V[C-�f SIDE p � ADDRESS ( (�7S'Y"f-vrc5lt ,/� � CITY ' � v ZIP TEL •�CO.. � PROPOSED USE_/V L� ��C.. �I'O''1 �3 S-P.¢� o ARCW NG/ L��/1�• r^j-� �z DESIGNER NO.DWEL. NO. NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION � OWNER-BUILDER DECLARATION SFR/ADD/REM O � I HEREBY AFFIRM UNDER PENAL7Y OF PERJURV THAT I AM E%EMPT FROM THE CONTMCTORS LI- GafBQB/CBfpOff W CENSE LAW FORTHE FOLLOWINQ REASON(SEC.7031.6 BUSINESS AND PROFESSIONS COOE:ANV CITYOq (n C� COUNTYWHICHREOUIRESAPERMITTOCONSTiiUCT,ALTER,IMPROVE,DEMOLISH,ORREPAIRANVSTRUC� P8�10/DBCI( w TURE.PRIOR TO ITS ISSUANCE,ALSO REOUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIONED w � STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CON7RACTORS LI- � CENSE LAW(CHAPTER D(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PRO- � POOUSPB FESSIONSCODE)OR7}UTHEORSHEISFJ(EMPTTHEREFROMANDTHEBASISFORTHEALLEGEDE%EMP- (� TION.ANV VIOLATION OF SECTION 707/.5 BV ANV APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO Z Re-Roof A CIVIL PENALTV OF NOT MORE THAN FIVE HUNORED DOLLARS(f600).): � ❑I,ASOWNEROFTHE7ROPERTV,ORMVEMPLOVEESWITHWAOESASTHEIRSOLECOMPENSATION, � COR1rt18fC18I Z WILL DO THE WORK AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7W1,BUSI� J � NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF � PROPEHTY NM1iO BUILDS OR IMPROVES THEREON.AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR Q THROUGH HIS OR HER OWN EMPLOVEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT IMENDED OR m � OFFEREDWRSALEIFHOWEVER111EBUIlDINGORIMPROVEMENTISSOLDWITHINONEVEAROFCAMPIE- Z TqN,THE OWNER�BUIL�ER WILL HAVE THE BURDEN OF PROVINO THAT HE OR SHE DID NOT BUIID OF � IMPROVE FOR 7HE PURPOSE OF SALE). W ❑I,ASOWNEROFTHEPROPERTV,AMEXCLUSNELVCANTRAC7INOWRHLICENSEDCONTRACTORS � TO CONSTRUCT THE PRQIECT(SEC.70N,BUSINESS AND PROFESSIONS CODE:THE CANTRACTORS LI- V81U9�1Of1 ADJ.AREA W CENSE LAW DOES NOT APPLV TOAN OWNER OFA PROPERTV WHO BUILDS OR IMPROVES THERC-0N,AND - � WFIOCONTRACTSFORSUCHPROJECTSWITHACONTRACTOR(5)LICENSEDPURSUANTTOTHECONTMG QUANTITY DESCRIPTION Y TORSIJCENSELAW.). FEE � O I AM E7(EA/PT UNDEfi SEC. B.8 P.C.FOR THIS REASON Q � U � DATE OWNER H Z U �Q LICENSED CONTRACTORS DECLARATION w ¢ 1 HEREBV AFFIRM UNDER PENALTV OF PERJURV THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � � Y(COMMENCINO WITH SECTION 7000)OF DIVISKKJ 3 OF THE BUSINESS AND PROFESSKKJS CODE,AND Z �� W LICENSE IS IN FULL FORCE AND EFFECT. �7 m � LICENSE CLASS � VV LIC.NO. � � ! � I wDATE ��I L' '/ CONTRACTOR '� _ V• l a � WORKERS'COMPENSATION DECLARATION Q y r� _ �� U � � � I HEREBV AFFIRM UNDER PENALTY OF PERJUFV ONE OF THE FOLLOWING DECURATqNS: Z . . • � I HAVE AND WILL MAINTAIN A CERiIFICATE OF CONSENT TO SELF-INSURE FOR WORKERS' a Z — _ Q C0IAPENSATION,AS PROVIDED BY SECTION 3700 OF THE LABOR CADE,FOR THE PERFORMANCE U OF THE WORN FOR WHICH THIS PERMIT IS ISSUED. � � w _I HAVEAND WILL AIAIMAIN WORKERS'COMPENSATION INSURANCE,AS REOUIRED BY SECTION Q 3�00 OF THE LABOR CA�E.FOR THE PERFORMMICE OF THE WORK FOR WHICH 7NI5 PERMIT IS ISSUED.MV WOR/K�/RS'COMPENSATION INSURANCE CARRIER AND POLICV NUMBER AAE: CONSTRUCTION jCARRIEn YV'�SPv✓�� PLANREVIEW Z POLICY NUMBER CG I CO Z_ ELECTRIC Q 0 �SEC�qNNE�NOTBE00MPLEfEDOFTI-�PERMfTISFpRONEFtN�DRmDOILARS(5100)ORLESS). PLUMBING W Z I CERTIFY THAT IN THE PERFORMANCE OF THE WOR1C FOR WHICH THIS PERMIT IS ISSUED,1 MECHANICAL ' C.�} SHAIL NOT EMPLOY ANV 7ERSON IN ANV MANNER 50 AS TO U&IECT TO THE � (/� WORNERS'CAMPENSATIOfJlAW50FCALIFORNIA�NDA� E7HATIF SFIOULDBECOME INSPECTIONFEE SUBJECT TO THE WORKERS'COM7ENSATION PROVISION F SECTION 37o0OF THE UBOR �^ � s CODE,I SHALL FOR7HWITH COMPLY WITH THOSE PROVIS NS. ISSUANCE / � p DATE: �lZ/ APPLICANL SMIP W J WARNINO:FAILURE TO SECURE WORKERS'CQNPENSATION COVERAGE I L,M1D SHALL BE ENERGY P/C � J � SU&IECTAN EMPLOVER TO CRIMINAL PENALiIES AND CIVIL FINES UP TOONE HUNDRE�TNOUSAND ENERGY PERMIT DOILARS(5100,000),IN ADDITION TO THE COST OF CAMPENSATION,DAMAGES AS PROVIDED FOR IN J SECTION 3708 OF THE LABOR CODE,INTEqEST,AND ATTORNEV'9 FEES. �� w RETENTION FEE: O CONSTRUCTION LENDING AGENCY PRE-ALT FEE: � I HEREBV AFFIRM UNDER PENALTV OF PERJURY THAT THEFE IS A CqNSTRUCTION LENDING ADENCV � FOF THE PERFORMANCE OF THE WORK FOR WHICM THIS PERMIT IS ISSUED(SEC.30D7,CIV.C.). ' Z W � LENOER'S NAME 1— LENDER'SAODRE55 W I CEFTIFY TFIAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATKKJ IS CAqRECT. TOTAL FE ES ��/� � I AGREE TO COMPLV WITH Af.L CITV AND COUNTV ORDINANCES AND STATE LAWS REUTIN6 TO BUILOIN6 � CONSTPUCTFON,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS COUNTV TO ENTER UPON iNE ', � Z ABOVE�MENT PROPERTV FOR INSPECTION PURPOSES. COMMENTS � � �f v ' J � m PERMI77EE NAME(P ' � Q � � SIONA7URE OF PE EE DATE � � AECPT.NO.�� PA1D BY VALIDATION WHITE—DepaRment Copy,YELLOW—Finance Capy,PINK—Asaessor Copy,GOLDENROD—File Capy,GREEN—Applicanl's Copy (��`�� `'' .; �. �.`.`��n^j Y-?'3 j?� •. � 1�11�'.1 - �� is��t:#'� C�TV O� DE�,NiO�D �AFi ,. � - ��;��'� � �1�� i I�SPIEC�'60iV �i�COF�D ' � '��r,��.�.;��' _ =:x`Da�3pC�G4�C�Gl DG�i�I� 4= Q(Y1�31�L(�40a . OGrJ�pCC�400a ` DGJQG �Of�I�PC�CC40G1` 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 H'T. BOND BEAM - ROOF SHEATHING 8 FT:BOND BEAM FRAMINGNENTILATION FINAL BOND BEAM ROOF COVER PRE-GRAOING 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 LANDSCAPElIRRIG. 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 PAIQ FINAL PLUMBING ENERGY �� COMMENTS ��v � �z SEPTIC TANK SIZE SEEP PIT/U SIZE a � a �. �� r;,vr;, . :h � _ . , � INSTALLATION CERTIFICATE CF-6R-MECH-04 S ace Conditionin S stems,Ducts and Fans Pa e 2 of 2 Site Address: Enforcement Agency: Permit IVumber: 2255 Evergreen Spring Dr Diamond Bar CA 91765 City of Diamond Bar 11-582 Ducts and Fans §150(m):Duct and Fans ❑✓ 1.All air-distribution system ducts and plenums installed,sealed and insulated to meet the requirements of CMC Sections 601,602,603,604,605 and Standard 6-5;supply-air and return-air ducts and plenums are insulated to a minimum installed level of R-4.2 or enclosed entirely in conditioned space. Openings shall be sealed with mastic,tape or other duct-closure system that meets the applicable requirements of UL 181,UL 181A,or UL 181B or aerosol sealant that meets the requirements of UL 723. If mastic or tape is used to seal openings greater than 1/4 inch,the combination of mastic and either mesh or tape shall be used;and � 1.Building cavities,support platforms for air handlers,and plenums defined or constructed with materials other than sealed sheet metal,duct board or flexible duct shall not be used for conveying conditioned aic Building cavities and support platforms may contain ducts. Ducts installed in cavities and support platforms shall not be compressed to cause reductions in the cross-sectional area of the ducts. ✓❑ 2D.Joints and seams of duct systems and their components shall not be sealed with cloth back rubber adhesive duct tapes unless such tape is used in combination with mastic and draw bands. ✓❑ 7.Exhaust fan systems have back draft or automatic dampers. �✓ 8.Gravity ventilating systems serving conditioned space have either automatic or readily accessible,manually operated dampers. ✓� 9. Protection of Insulation.Insulation shall be protected from damage,including that due to sunlight,moisture, equipment maintenance,and wind.Cellular foam insulation shall be protected as above or painted with a coating that is water retardant and provides shielding from solar radiation that can cause degradation of the material. ❑✓ ]0.Flexible ducts cannot have porous inner cores. DECLARATION STATEMENT • I certify under penalty of perjury,under the laws of the State of Califomia,the information provided on this form is true and correct. • I am eligible under Division 3 of the Business ar�d Professions Code to accept responsibility for conswction,or an authorized representazive of the pecson responsible for wnsWction(responsible person). • I certify that the installed features,materials,components,or manufactured devices identified on this certificate(the installation) conforms to all applicable codes and regulations,and the installation is consistent with the plans and specifications approved by the enforcement agency. • I reviewed a copy of the Certificate of Compliance(CF-1 R)form approved by the enforcement agency that identifies the specific requirements for the installation. I certify that the requirements detailed on the CF-1 R that apply to the installation have been met. • 1 will ensure that a completed,signed copy otthis Installation Certificate shall be posteJ,or made available with the building permit(s)issued for the building,and made available to the enforcement agency for all applicable inspections. I understand that a signed copy ofthis Installation Certi6cate is required to be included with the documentation the builder provides to the building owner at occupancy. Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) CO�@ S@I'VIC@S Responsible Person's Name: Responsible Pe n'�Signa�u : Ever Bol � �� CSLB License: Date Signed: Position Wi Co pany(Title): 718978 Manager 2008 Residential Complrance Forms August 2009