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Home My WebLink About11-465 _�� CITY OF DIAMOND BAR � . DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 21825 Copley Drive,Diamond Bar,CA 91765 (909)839-7020 Fax(909)861-3ll7 Building Inspection Hotline(909)839-7027 PRESS �'9M' BUILDING PERMIT APPLICATION. FIRMLY ¢ DDRESS L� 6j� ��'v � �`T� S�_ APPLICATION ( PERMfT p/C p DATE � � NUMBER�# � APN LOT TRACT DATE �� I ONST.�2� GROUP p OWNER `l ADDRESS�2f�� A �f"' ZONING SETBACKS � �-d �t�l L �' z CITY ZIP TEL. FRONT qyy � o APPLICANT G TE�. SIDE/SIDE STREET qyy ❑ � CONTRACTOR � t t� SIDE � � ADDRESS ' � CITY �^ i�J a � ZIP �j!')t 0 TEL. PROPOSED USE�FMOVE T�L,F ��d �.EMaVF �(�T P� RL(rn�l w-A � 30�� , 'j� F w ARCH/ENG/ �-i�(� � I�---�� z DESIGNER �11�i—�L�#T��!�-T d�� n 'T w NO.DWEL. � NO. NO. a ADDRESS cn UNITS STORIES � BEDROOMS�_ � CITY ZIP TEL. � DESCRIPTION S�.FT. FACTOR PSF ADJ.AREANALUATION p� OWNEF-BUILDER DECLARATION p SFR/ADD/REM � I HEREBV AFFIRM UNDER PENAL7Y OF PERri1RV THAT I AM EXEMPT FqOM THE CONTRACTORS ll� GBfe JB/C8lPOfl W CENSEUWFORTHEFOLLOWINOREASON(SEC.7071.6BUSINESSANDPROFESSIONSCODE:ANVCITVOR (n n�,,� U �JpJTyWryICHREOUIRESAPERMITTOCONSTFiUCT,ALTER,IMPROVE,DEMOLISH,ORFEPAIRANVSTqUC� Py�lO/DBCI( �TCVV� w NRE.PFIOq TO ITS ISSUANCE,/�150 REOUIFES THE APPLICANT FOR SUCH VERMIT TO FILE A SIONED w � STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTOqS LI- � CENSE LAW(CHAPTER B(COMMENCINO WITH SECTION 7000)OF DIVISION 3 OF iHE BUSINESS AND PRO- � POOUSPB FESSIONSCODE)ORTHATHEORSHEISEJ(EMPTTHEREFROMANDTHEBASISFORTHEALlEOEDE%EMP- (� TION.ANY VIOUTION OF SECTION 7031.5 BV ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO Z Re-Roof A CML PENALTV OF NOT MORE THAN FIVE HUNDRED DOLLARS(f600).): � ❑4.�SOWNEROFTHEPROPEHTV,ORMVEMPLOVEESWITHWAGESASTHEIRSO�ECAMPENSATION, � COR1rt1BfCl81 Z VALI DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.7W�,BU51� J ,� NE55 Ml�PROFESSIONS CODE:THE CQNTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF � PqOPERTV N?10 BUILDS OR IMPROVES THEREON,AND NMO DOES SUCH WORK HIMSELF OR HERSELF OR Q THROU(3H HIS OR HER OWN EMPLOVEES,7ROVIDED THAT SUp1 IMPROVEMENTS ARE NOT WTENDED OR m Q OFFEREDFORSr1EIF,HOWEVERTMEBUILDINOORIMPROVEMENTISSOLDWITHINONEVEAROFCOMPIE� Z TqN,TME OWNER-BUIIAER WILL HAVE THE BURDEN OF PROVINO TFWT HE OR SHE OID NOT BUILD OR � IMPROVE FOR 7HE PURP0.5E OF SALE�. ' w ❑I,AS ONTJER OF THE PHOPEHTV,AM E%CWSNELV CANTMCTINO WITH UCENSED CONTRACTORS � TO CONSTFUCT THE PR0.IECT(SEC.7W1,BUSINE55 AND PROFESSIONS CODE:THE CONTRACTORS LI- V8Ill8flOf1 db � ADJ.AREA W CENSE UW DOES NOTAPPLV TO AN OWNER OF A PROPERTV WMO BUILDS OR IMPROVES THEREON,AND • � WIiOCONTRACTSFORSUCHPqq1ECT5WITHACONTRACTOH(S)UCENSEDPURSUANTTOTHECONTfiAG OUANTITY DESCRIPTION � 70FS UCENSE UW.). FEE � ❑I AM EXEMPT UNDEH SEC. 8.8 P.C.FOR THIS REASON � � U LL DATE OWNER � � LICENSED CONTRACTORS DECLARATION w � 1 HEREBY AFFIRM UNOER PENALTV OF PERJURV THAT I AM LICENSED UNDER PROVISIONS OF CHAPTEFl � � 8(COMMENCINO WITH SECTION 7oao)OF DIVISION 3 OF 7HE BUSINE55 ANO PROFESSIONS CODE,AND Z �� MY IICENSE IS IN FULL FpRCE AND EFFECT. m � � LICENSE CLASS ��;'� �� CONTRACTOR , d DATE T i.. � WOFKERS'COMPENSATION DECLARATION Q N IHEREBYAFFIRMUNDERPENALTYOFPERJURVONEOFTHEFOLIOWINGDECURATIONS: U �� N Z 0 I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSEM TO SELF-INSURE FOR WOqKERS' _ � C�IAPENSATION,AS PROVIDED BV SECTION 370o OF THE LA90R CODE,FOFl THE PERFORMANCE U iQF 7HE WORK FOR WHICH THIS PERMIT IS ISSUED. � 0 w �I FUVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS FEWIRED BV SECTION Q 370o OF THE LABOR CADE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS � �/�, �r ISSUED.MY WOPKERS'CAMPENSATION INSURANCE CAARIER�Jy D POLICV NUMBER ARE: CONSTRUCTION ��' � jCARFIER STAT..77E YJIUN PLANREVIEW 0 POLICV NUMBEF I q_y_? �7 7d. � ELECTRIC p (IHLSSECilON1��NO7BECOhWLETEpOF7F�pEpAAfTISFpqpryEF#li1REDD0I.LARS(it00)ORLFSS). PLUMBING W Z I CERTIFY 71ihT IN THE PERFORMANCE OF THE WORK FOH WHICH THIS PERA/lT IS ISSUED,I MECHANICAL � SHALL NOT EMPLOY ANV PERSON IN ANV MANNER SO AS TO BECOME SUBJECT TO THE ' (,/) WORKERS'COMPENSATION UWS OF CALIFORNIA,AND AGREE THAT IF I SHOULD BECOME INSPECTION FEE SU&IECT TO THE WORKERS'COMPENSATION PROVISIONS OF SECTION 3700 OF THE LABOR S CODE,1 SHALL FORTFIWITH COMPLV WITH THOSE PROVISIONS. ISSUANCE � y� � s p DATE: APPLICANT: SMIP � W � WARNING:FMWRE TO SECUFE WORKERS'COMPENSATION COVEFiAGE IS UNLAWFUL,AND SHALL BE ENERGY P/C � SU&IECTMI EMPLOVEF TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDREO TNOUSAND ENERGY PERMIT DOILARS(Stao,000),IN PDDITION TO THE COST OF CAMPENSATqN,DAMAGES AS PROVIDED FOR IN W SECTION37080FTHELABORCODE.INTEREST,ANDATTORNEV'SFEES. RETENTIONFEE: p� Q O CONSTfiUCTION LENDING AGENCY P ALT FEE: � I HEREBV AFFIqM UNDER PENALTV OF PERJURV THAT THERE IS A CONSTRUCTION LENDWO AGENCY �� / �/� � FOR THE PERFORMANCE OF THE WORN FOR NTiICH TH15 PERMIT IS ISSUED(SEC.3081,CIV.C.). Z W � LENDER'S NAME � LENDER'SADDRESS � I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CARRECT. TOTAL FE ES � � ��'"�� I AGREE TO COMPLV WITM ALL CfTY AND COUNTV ORDINANCES AND STATE UWS RELATINQ TO BUILDINO � CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE Z ABOVE-MENTqNED PROPER OR INSPECTION PURPOSES. COMMENTS � �� J � m PERMITTEE NAME(PRINn ' � � �/ - 2`L_ /I � SKlNATU EE . DATE � � RECPT.NO. PAID BY VALIDATION WHITE—DepaAment Copy,YELLOW�inence Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Applicanfs Copy F. . CITV O�' DIAIViO�lD �AR I�S�EC�'10� ff��COR� ��a�p�c��oo� ��c�� : , �i�p�c��a� . oa�p��ooa . o�.��."�� ,.„ o �, .. _ � - � ,� � 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 �/l 8 FT. BOND BEAM FRAMINGNENTILATION FINAL BOND BEAM ROOF�f'lilVJYL OL'C PRE-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWERri'UB 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 � �� COMMENTS SEPTIC TANK SIZE SEEP PIT/U SIZE a � � �-x. � �:�., r � ' �� :rescri tive Certificate of Com liance: Residential Reroof � Lr-�K-AL 1-Kercoor 'roject Address:� � Climate Zone Permit# � . , �i 16 �-��r�I ad�C, �%� ; ��MaNd 3 �r-rZ � �OOFING PRODUCTS (COOL ROOFS) §151(�12 Nhen the area of exterfor roof surface to be replaced exceeds 50%of the exFs6ng roof area,or 1,000 ,whichever is less, the new �oofng area must meet the roofing product"Cool RooP'requlrements of§152(b)iHI, 152(b)1Hii, or 152(b)1Hfi1. �heck applicable alternative or exception below if the roof alteration is exempt from the roofing product"Cool RooY requirements:, O Cool roofs not required in Climates Zones 1-12,14,and 16 with a low sloped roof pitch(less or 2:12 pitch). � Cool roofs not required in Climates Zones 1-9,and 16 with a steep-sbped roofs(greater p'itch than 2:12)and product weight less than 5flb/ftZ. 4ltematives to§152(b)1Hf and§152(b)Hii,Steep-slope roof(pftch> 2:12) 0 Insulation with a thermal resistance of at least 0.85 hr•fl��'FBtu or at least a 3/4 inch air-space is added to tt�e roof deck over an attic;or ❑ F�dsting ducts in the attic are insulated and sealed according to§151(fl10;or � In di �e zones 10, 12 and 13,with 1 ft2 of frce ventilation area of attic ventilation for every 150 ft2 of attic floor area,and ere at least 30 percent of the free ventilation area is within 2 feet vertical distance of the roof ridge;or Building�as at least R-30 ceiling insulation;or � ❑ Building has radiant barrier in the attic meeting the requirements of§151(fl2;or CJ Building has no ducts in the attic;or O In dimate zones 10,11, 13 and 14,R-3 or greater roof dedc insulation above vented attic. Exceptlon to§152(b)1 Hiii,Low-slope roof(pPtch 52:1t2) � Bulding has no ducts in the attic. Other Exceptions � ❑ Roofing area is covered by building integrated;photovolhaic panels and solar thertnal panels are exempt from the Cool Roof criteria. � O Roof constructions that have thermal mass over the roof inembrane with at least 251b/ft2 are exempt from the Coo!Roof criteria. ' NOTE:If any one of fhe altemafives or excepfion is checked the Aged Solar Reflectance and Therma!Emittance requirements for roofrng oroducts in§118(i)are not applicable. Do not fill table below. Roof Slope Product Weight Product ,4ged 5olar Thermal � CRRC Product ID Number� 5 2:12 >2:12 < 51b/ft� z 51b/ft� T e2 Reflectance3'4 Emittance SRIs ❑ o ❑ o 04 o ❑ o ❑ � 04 Nofe:If no CRRC-1 label is available,fhis comp/iance mefhod cannof be used, use the Performance Approach to show compliance, 1.The CRRC Product ID Number can be obtained from fhe Cool Roo(Ra6ng Council's Rated Pr�duct Directory at www.coolroofs oro/nroducts/sear�h ohn 2 Indcate the type of praduct is being used for the roof top,i.e. single-�/y roof, aspha/t roof,meta!roof,etc. . !f the Aged Reflectance is not availab/e in the Cool Roof Rating Council s Rated Product Directory then use the Initial Reflectance value fiom the same directory and use the equation(0.2+0.7(p�,�,,—0.2)to obtain a calculated aged value. Where p is the Initial Solar Reflectance. 4. Check box if fhe Aged Reflectance is a ca/culated va/ue using the equation above. . � 5. Calculate the SRl value by using the SRI-Worksheet af hltoJrbv�a►v.enerav.ca.00vRitle24/and enter the resulting velue in the SRI Column above and attach acopy of the SR!-Worksheet to the CF-JR. 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: ❑ Aluminum-Pigmented Asphalt Roof Coating ❑ Cement-Based Roof Coating ❑ Other NOTE: When a Coo/Roof is required, the installing contractor shall complete and submit the CF-6R-ENV-01 for final inspecSon. Declaration Statement • I certify under penalty of perjury,under the laws of the State of Califomia,the information provided on this form is accurate and complete. • 1 certify that the energy features and performance specifications identified on thls Certificate of Compliance conform to the requirements of TiUe 24,Parts 1 and 6 ot the Calffomla Code of Re ulations. Name: Signature• �� -e r�-t Company: Dat . �-� '� r �I G� � Address�DO • ( s n�'^/ �V� License: J v cr City/State2ip: < �J„ /� � ,�j .� ! Phone: v�. � �Sl �� 02� For assistance or questions regarding fhe Energy Sfandards, contact the Energy Hofline at: 1-800-772-3300. . INSTALLATION CERTIFICATE: Residential Reroof CF-6R-ENV-01 , Site Address: Enforcement Agency: Permit Number: ., . _ �,� � �7� If more thare one person has responsibitiry for installation ojthe items on this cenif:cate,each person shall prepare and sign a certificate applicable to the portion of construction for which they are responsible;alternatively,the person with chief responsibility for construction shall prepare and sigri this certificate for the entire construction. All applicable Mandatory Measures with check boxes are required lo be checked to ensure the mandato measures have been met. CEILING INSULATION ��d. Brand Name: _ Batt or Blanket Type: � •3 0 � Brand Name: `l1 � - � Loose Fill Type: Thermal Resistance(R-Value): Spray Foam Type: Brand Name: Installed Actual Thiclrness(inches): Contractor's min installed weight/ft2 lb Manufacturer's installed weight per square foot to achieve Thermal Resistance(R-Value): ❑ §150(a):Minimum R-19 insulation in wood-frame ceiling or equivalent U-factor. ❑ §118(a): Insulation installed meets Standazds for Insulating Material. � §150(g):Mandatory Vapor barrier installed in Climate Zones 14 or 16. ROOFING PRODUCTS(COOL ROOFS)�I51(n1z ❑ Check this box if the newly installed roof is exempted from the roofing product"Cool Roof'requirements as indicated on the CF-1 R-AIt- Reroof form for this project.Otherwise fill in the table below. " Roof Slope Product Weight Aged Solar T6ermal CRRC Product ID Number' s 2:1z >2:12 < Slb/ft2 z Slb/ft� Product Type2 Reflectance3'4 Emittance ❑ ❑ � ❑ �4 . . ❑ ❑ O ❑ Cl4 1.CRRGl label 9nformation is available is on the package of the roofing product being instalfed and attach the CRRC fabel to this form. 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(pk;t;a�—0.2)to obtain a calculated aged value. Where p is the Initial Solar Reflectance. . Check box iJthe Aged ReJlectance is a cafculated value using the equation above. o apply Liquid Field Applied Coatings,the coating must be applied across the enrire roof surface and meet the dry mil thiclrness or coverage ecommended by the coatings manufacturer and meet minimum performance requirements listed in§118(i�t. Select the applicab]e coaring. ❑ Aluminum-Pigmented Asphalt Roof Coating ❑ Cement-Based Roof Coating ❑ Other DECLARATION S7ATEMENT ' • I certify under penalty of perjury,under the laws of the State of California,the information provided on this form is true and correct. • I am eligible under Division 3 of the Business and Pmfessions Code to accept responsibility for construction,or an authorized representative of the person responsible for construction(responsible person). • 1 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 speci5cations approved by the enforcement agency. • 1 reviewed a copy of the Certificate of Compliance(CF-1R)form approved by the enforcement agency that idenrifies the specific requirements for the installation. I certify that the requirements detailed on the CF-1R that apply to the installation have been met. • I will ensure that a completed,signed copy oi this Installation Certificate shall be posted,or made available with the building permfit(s)issued for the buildIng,and made available to the enforcement agency for all applicable inspections. I understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder provides to the building owner at occupancy. Company N me: (I talling Subcontra� r or Genera]Contractor or Builder/Owner) . �or�► � 6 Resp nsible Person's Responsi e Person's Si ture: � �� G- �-2 2 �, CSLB L�cen�� Date Signedi / Posi n With Company(Title): rJ 2008 Residentia!Compliance Forms August�009