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Home My WebLink About11-620 �_., ___, �„�_ CITY OF DIAMOND BAR � p O � �� , � DEPARTMENT OF COMMUNITY& �E�— �� 21825 Copley Drive,Diamond Bar,CA 91765 n (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 � � �I'��;� �'•�' .W BUILDING PERMIT APPLICATION �� L ' M� oN JOBSITE � /� �� APPLICATION PERMIT p/C ADDRESS rZ��Dls''- � DATE NUMBER ' ��# ISSUE 7ypE � °-° APN LOT TRACT DATE D I� CONST. �E' GROUP p OWNER -,nff�/�/Cr o ADDRESS ..SSd¢�1 L= ZONING SETBACK z CITY ZIP TEL. FRONT Ryy p � APPLICANT TEL. REAR p � SIDE/SIDE STREET RW ❑ a � CONTRACTOR �LL� � l/(`e@ SIDE ❑ ADDRESS T k��2N�C[, 'TLt� � CITY _ ZIP�/'7'Zq TEL.�-4�11-Cl3S�'I PROPOSED USE�� — T�% o ARCWENG/ -�-T�� z DESIGNER w NO.DWEL. � NO. � NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS � cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O I HEREBY AFFIRM UNDER PENALTV OF PERIURV THAT I AM EXEMPT FROM THE CONTRACTO Garage/CarpoA W CENSEUWFORTHEFOLLOWINGREASON(SEC.7031.SBUSINESSANDPROFESSIONSCAD� CI7VOR (n U COUN7VWHICHREOUIRESAPERMITTOCANSTRUCT,AL7ER,IMPROVE,DEMOLISH, AIRANYSTfiUG � w TURE,PRIOR TO ITS ISSUANCE,AL50 REOUIRES THE APPLICANT FOR SUC MIT TO FILE A SIGNED w Patio/Deck � STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROV 5 OF THE CANTRACTOiiS LI- � � CENSE UW(CHAPTER B(COMMENqNG WI7H SEC710N 7000)OF ION 3 OF 7HE BUSINESS AND PRO- POOVSp2 Q FESSIONSCODE)OHTHA7HEORSHEISEXEMPTTHEREFR DTHEBASISFOR7HEALLEGEDEXEMP� (� V 710N.ANV VIOUTION OF SECTION 7031.5 BV ANV APPLI FOR A PEFiMIT SUBJECTS THE APPIICANT TO Z RB-ROOf � A CIVIL PENALTY OF NO7 MORE THAN FIVE HUNDR OLURS(5500).): � Z ❑I,ASOWNEROFTHEPROPER7V,ORM PLOYEESWITHWAGESASTHEIRSOLECAMPENSATION, � Commercial WILI DO THE WORK,AND THE STRUCTU NOT INTENDED OR OFFERED FOR SALE(SEC.70��,BUSI� J � NESS AND PROFESSIONS CODE:TH NTRACTORS LICENSE LAW DOES NOT APPLV TO AN OWNER OF � . , PROPERTV NRiO BUILD50R IMP S THEREON,AND NMO DOES SUCH WORN HIMSELF OR HERSELF OR � THFIOUGH HIS OR HER OWN LOVEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR m w OFFEREDFORS�LE.IF,H ERTMEBUILDINGORIMPROVEMENTISSOLDWI7HINONEVEAROFCOMPLE- 0 TION,THE OWNER-8 ER WILL HAVE THE BUPDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR Z IMPROVE FOR 7H RPOSE OF SALE). _ ❑I,A50 R OF THE PROPERTV,AM EXCLUSIVELV CONTRACTING WITH UCENSED CONTRACTORS W Q i0 CON57 7 7HE PRQIECT(SEC.7o1I,BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS LI- V81U8SIOn ADJ.AREA W CENSE DOES NO7APPLV 70 AN ONMER OF A PROPERTV WFIO BUILDS OR IMPROVES 7HEREON,AND � WHO TRACTSFOqSUCHPRQIECTSWITHACONTRACTOR(5)LICENSEDPURSUANTTOTHECANTRAC- QUANTITY DESCRIPTION FEE Y 70RSUCENSELAW.). � �I 6YEMPT UNDER SEC. B.6 P.C.FOR THIS REASON Q � � U � DATE OWNER � 0 w � LICENSED CONTRACTORS DECLARATION W � I HEREBV AFFIRM UNOER PENALTY OF PERJURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � � e(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE,AND Z �� MY LICENSE IS IN FULL FORCE AND EFFECT. /� m � LICENS�E*�CLASS �.`Z v LIC.NO, l!/�J / �Z j � V DATEs1 � 2�� I I CONTRACTOR�f� �'.7J�� (�/�C a W � , WORKERS'COMPENSATION DECLARATION Q � I HEREBV AFFIRM UNDER PENALTV OF PERIURV ONE OF THE FOLLOWING DECURATIONS: Z � _IHAVEANDWILLMAINTAINACERTIFICA7EOFCONSENTTOSELF-INSUREFORWORNERS' a 2 Q COMPENSATION,AS PROVIDED BY SECTION 3700 OF THE LABOR CODE,FOR THE PERFOFiMANCE U OF 7HE WORK FOR WHICH THIS PERMIT IS ISSUED. w � � w _I HAVE AND WILI MAMTAIN WORKERS'CAMPENSA710N INSURANCE,AS RE�UIRED 8Y SEC710N Q 3700 OF THE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.MY WORKERS'COMPENSATION INSURANCE CARRIER AND POLICV NUMBERA(iE: CONSTRUCTION J � CARRIER PLAN REVIEW Z POLICY NUMBER ELECTRIC Q � (iHISSECTqNNE�NOTBEOJMR.ETEDOF7V�PERMfTI5F0{iONEHUI�DREDDOUTAS(f100)ORLESS) PLUMBING Z I CERTIFV THAT IN THE PERFORMANCE OF THE WORN FOR WHICH THIS PERMIT IS ISSUED,1 MECHANICAL � (,'} SHALL NOT EMPLOV ANV PERSON IN ANY MANNER SO AS TO BECOME SUBJECT TO THE �/j WORKERS'COMPENSATION LAWS OF CAUFORNIA,AND AGREE THAT IF I SHOULD BECAME INSPECTION FEE = SU&1EC770 THE WORKERS'CAMPENSATION PROVISIONS OF SECTION 370o OF THE LABOR y J CpOD�E,I SHALL FORTHWITH COMPLV WITH THOSE PRO SIONS. ISSUANCE �� ) p DATE:> � Z'� `'�� APPLICA�T��I � �-�� SMIP J WARNING:FAILURE TO SECURE WORKEFiS'COMPENSATION COVERAGE IS UNUWFUL.AND SHALL BE ENERGY P/C � SU&IECTANEMPLOVEFTOCRIMINALPENALTIESANDCIVILFINESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOLURS(S1oo.oao),IN ADDITION TOTHE COSTOF COMPENSATION,DAMAGES AS PROVIDED FOR IN h y�� SECTION 37oe OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. RETENTION FEE: .rL.- �(J � CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O � I HEREBV AFFIRM UNDER PENALTV OF PERJURY THATTHERE IS ACONSTRUCTION LENDING AGENCV FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.7097,CIV.C.). Z W �Z LENDER'S NAME � F— LENDER'SADDRE55 � � TOTAL FEES �(o, /� � I CERTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CARRECT. w I AGREE TO COMPLV WITH ALL CITY AND COUNTV ORDINANCES AND STATE LAWS RELATING TO BUILDING � CANSTRUCTION,AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE � ABOVE�MEN710NED FfiOPERTY FOR INSPEC710N PURPOSES. Z a COMMENTS � /J��C-� /��Z-�/L�-� m PERMITTEE NAME PRIN� .� � ¢ �-�;� S Zc�^� � � � ' ATUREOFPERMITTEE DA7E = RECPT.NO. PAID BY VALIDATION ~ WHITE—De artment Co YELLOW—Finance Co PINK—Assessor Co GOLDENFiOD—File Co GREEN— P PY, PY, PY, PY, ApPlicanPs Copy J �,��,��a r-ti r�• �> �� 1� �a C I�V �IF �9�►If V�C)V\9� ��a�$ � --=a ��'��.�{.�r �"��i ?��''�'�, �1f�z�;:::3�,4 41 '� . �,� f �,:-�r �� ;, E��fP(��'001� �3�� ''�.'- i(I-i:kis,lT`l.�)i� �rr� ' , . ..`.`Oa�pGC�4Q o bGJ`� �� 0'[��l�C r �� ' Da�3C�C�C�O(��' DGJ4C��" ��"�[�l Y�C�C��GI j ` ` SET BACK FLOOR J�IST 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-GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGN 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 —___..---_.. ---------.—.--- --_.._ __.___— --_--- ._---------- ��o � COMMENTS � SEPTIC TANK SIZE SEEP PIT/U SIZE a � � --- --- --- ------.___--- �` � � . ., � . . . . Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC CF-iR-ALT-HVAC Alterarions Climate Zones 2,9 Site Address: Enforcement Agency: Date: Permit#: 2641 SHADY RIDGE LN Diamond Bar, CA 91765 City of Diamond Bar May 19, 2011 Duct insulation Conditioned Floor Equipment Typel List Minimum Efficiencyz requirement Area Thermostat p Package Unit [�Furnace fJ AFUE 80% ❑COP Served by system 0 Setback �Indoor Coil p SEER 17.0 ❑HSPF ❑R 6 (CZ 2 and 9) 2800 sf If not already present, 0 Condensing Unit ❑EER ❑Resistance must be installed) ❑Other 1.Equipment Type:Choose the equipment being installed;if mo�e than one system, use anothe�CF-1 R-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 teft 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-6R shall also be on site for final inspection. 0 1. HVAC Changeout Required Forms: .All HVAC Equipment CF-6R 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 CF-6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS .Indoor Coil and/or CF-4R#orms: MECH-21 and (for split systems) MECH-25 .Furnace For Split Systems: Duct leakage�'�-15 percent; RC, CCA >_ 300 CFM/ton,TMAH �-.. Exempted from-duct,leakage testing��f: ❑1. Duct system was documented to have been previously sealed and confirmed through HERS verification,or ❑2. Duct systems with less than.,40 linear feet in unconditioned space, or ❑3. Existing�duct�systems are�constructed�in �late or seal,�ed with asb�tos � � �;-_�,� �p �, ❑4.Th�K�s�ystem k�nr�ill;;not be Du�ed ��'Ductless Mini'sS�plit.System (Also Exempt from Refn erahtrCharge) �, �� ,. � ��. �9.��. � �2 New(p�rHVAC ` Requiretl�Forms�: � � � �� System t�'� � � � � � f g"�h � ':Y . � A� i i�rt � i �. �a� � • . �r .Cut in�ar;hChangeout��,r��,�'' � r � ��' �- � '� �� ;�� E ' 3', r �: with new�4duc.��(atl�� ;�CF��R�fq�rms !��ECH�Q4 �_MECH�20.H,�ER�S and�(for split sy�terns)�MEC�H�25-H RS h �� , � new ducE�ng��n ;all � �CF�4R�forms�MEFC�Q a�d�(fo�plit�s�yst ms) MECH�25 .� � �� _ � , ; - " . new equiprrient)� � , T � � � �� -� For.Split Systems:�;Duct leakag�e��<�6 percent; RC, CCA >_ 300 CFM/ton,TMAH For Pac(iaged Units:'Duct leakage�< 6 percent ❑3. New Ducts with Replacement Required Forms: .Includes replacing or installing all', new ducting and/or outdoor - `:' CF-6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS condensing unit and/or indoor'coil CF-4R forms: MECH 21 and (for split systems) MECH 25 and/or furnace. Not all equipment 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 CF-6R forms: MECH-04, MECH-2I-HERS than 40 linear feet of duct in CF-4R forms: MECH-21 unconditioned space. 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: yyI�AM FARNELL Company: AIR CONTROLLED ENVIRONMENTS Date: May 19, 2011 Address: P O BOX 249 License: 623782 City/State/Zip: RANCHO CUCAMONGA/CA/91729-0249 Phone: (909)941-0354 Reg: 211-A0024374A-00000000-0000 Registration Date/Time: 2011/O5/19 23:00:48 HERS Provider: Ca10ERTS, Inc. 2008 Residential Compliance Forms July 2010