HomeMy WebLinkAbout14-4967 . o ,
;�4�-� �, CITY OF DIAMOND BAR .-- -
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• . ; . _„ ;, DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES a• -I
-- _.,__ _ PRESS
21810 Copley Drive,Diamond Bar,CA 91765
rtw,,,� (909)839-7020 Fax:(909)861-3117 Building Inspection Hotline(909)839-7027 FIRMLY
`'��"� BUILDING PERMIT APPLICATION
� JOB SITE ADDRESS�v�� ��� ' �� APPLICATION DATE: �- P/C#
1 ISSUEDATE: �U���d-V�� PERMIT# � � � �_ i
z APN /�LOT TRACT
� OWNER ��,,L-_L�L��+ TO q�Q_ �'PE CONST. OCC GROUP: �
n ADDRESS "�v � ZONING SEfBACKS
� CITY y�� ` ���ZIP TEL � FRONT RW ❑
= APPLICANT /"tl_LJ� TEL.��I 1 Sy'dI�-�o REAR �
� SIDE/SIDE STREEf RW ❑
Q CONTRACTOR ��� SIDE �
� ADDR/E�SS �oL�oL' '�e] /�.���'�R���- n�
s CITY l .��tJU�- ZI�G p O\ TEL. 5I C�C.�-����3 PROPOSED USE
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� ARCH/ENG/DES�GNER
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� ADDRESS #DWEL.UNITS #STORIES #BEDROOMS
z CITY ZIP TEL.
¢ DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION j
a OWNFA-BUILDEfl DECLANATION I
= I hereby affirm under penalty of perjury that I am exempt from the Contrador's State License Law for the reason(s) SFFUADD/REM
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� indicated below by the checkmark(s),I have placed ne�t to the applicable item(s)[Section 7031.5,Business and Garage/CarpoR
�-' Professions Code:Any city or county that requires a permit to construct,alter,imprave,demolish,or repair,any
z shucture,prior to its issuance,alsa requires the applicairt for the permit to file a signed sfatement that he or she � Patio/Deck I
i is Ilcensed pursuant to the provisions of the Contractor's Staffi License Law(Chapter 9)Commencing with Section W I
� 7000 ot Division 3 of the Business and Protessions Code]or that he or she is exempt fmm licensure and the basis for u. Pool/Spa
� the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty � I
n of not more than five hundred dollars($500). Z Re-Roof
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� (,I,as owner of the property,or my employees with wages as their sole compensation,will do(,all of or(�portions -� Commercial �
y of the work,and the structure is not iMended or offered for sale(Section 7044,Business and Professions Code:The m I
� Contractors'State License Law does not apply to an owner of property who,through employees'or personal effort,builds
� or improves the pmperty,provided that the improvements are not intended or oftered for sale.If however,the building or I
improvement is sold within one year of completion,the Owner-Builder will have the burden of proving that it was not built
� or improved for the purpase of sale.). I
"� (�I,as owner of the property,am exclusively cont2cting with licensed Contractors to construct the project(Section
Z 7044,Business and Professions Code:The Contractors'State License Law does not apply to an owner of property who ValuatiOn: Adj.Ar88: I
� buildsorimprovesthereon,andwhocontractsfortheprojectswithalicensedContractorpursuanttotheContractors'State QUANTIIY DESCRIPTION FEE I
Y License Law.). I
� (J I am exempt from licensure under the Contractor's State License law for the following reason(s�: � I
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1 By my signature below I acknowledge that,except for my personal residence in which I must have resided for at least one w I
� year prior to completion of the improvements covered by this permit,l cannot legally sell a structure that I have built as an w I
owner-builder if it has not been constructed in its entirety by licensed conhactors.I understand that a copy of the applicable
� law,Section 7044 of the Business and Professions Code is available upon request when this applicatlon is submitted or at I
i the following Web site:http/www.leginfo.ca.gov/calaw.html. Z �
= DATE: SIGN: � �
— UCENSED CONTIIACTOH'S DECLAflATION � I
� y I hereby affirm under penalTy of perjury that I am licensed under provisions of Chapter 9(commencing with Section 7000) I
� of Division 3 of the Business and Professions Code,and my license is in full force and eNed. J , \/ I
� '^ /� 1—! (�[�C.J ¢ l`�
n LICENSE CLASS:C C t� 1...'� LIC.NO.: Q I
Z DATE: (�^Zq�I CONTRACTOR� w I
Q WOHI�H'S COMPENSATION DECLAMTION � I
� I HEREBY AFFIRM UNDER PENALTY OF PERJURV ONE OF THE FOLLOWING DECLARATIONS:
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a I have and will maintain a Certificate of Consent to Self-Insure for Worker's Compensation,as provided by CONSTRUCTION:
J Section 3700 of the Labor Code,for the pertormance of the work for which this permit is issued. p�p,N REVIEW: I
> I have and will maintain Worker's Compensa6on Insurance,as required by Section 3700 of the Labor Code,for ELECTRIC:
� the performance of the work for which this permit is issued.My Worker's Compensation Insurance Carrier and
¢ PoIi�yNumberare: i �y�y.�� PLUMBING:
y CARRIER LI�C�C��-1 MECHANICAL: F�r'S�7
� PouCYNUMBER 1(�.TI 3\S� ��� INSPECTION FEE:
n (T}iIS SECIION NEED NOT BE CAMPLEfED IFhIE PFAMfT IS FOR ONE HUNDRED DOLIMS($100)OR LESS). ISSUANCE: �.���
� I certily that in the performance of tl�e work for which this pertnK is issued,I shall not employ any person in any manner so as to
= become subject to ihe Worker's Compe ' Laws o Califomia.Md agree ihat if should become subjec[to the Worker's SMIP:
JCom nsation v�so`n ofSection37 Oofthe r d h f - witl�com I provisions. ENERGY P/C: I
i DATE�U" —I APPLICA ' ENERGY PERMIT:
= WARNING:Failure to secure Worker's Comp n tion coverage is unlawful,and shall su6ject an employer to criminal RETENTION FEE: .IA�
y penalties and civil fines up to one hundred t usand dollars($100,000�,in addition to the cost of the'compensation,
i damages as provided for in section 3706 of the labor code,interest,and attorney's fees. PRE-ALT FEE:
�
i CONSiAUCTION LENDING AGENCY BSAF:
y I hereby affrm 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.).
�
LENDER'S NAME:
� LENDER'SADDRESS:
i I certify that I have read this application and state that me above information is correct.I agree to comply with all city and TOTAL FEES . r�}n�
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Z county ordinances and state lavrs relating to building construction,and he2by authorize 2presentatives of this county to COMMENTS:
J en e above-men ion d property for inspedion purposes.
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= RE F PERMITfE ' DATE RECEIPT# PAID BY: Y �J 1 YI{r VALIDATION:
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WHITE—Department Copy,YELLOW—Finance Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Applicant's Copy
CITY OF DIAM.OND BAR '
INSPECi`IOfV RECORD , . �
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�ETBAGI(i LEfi�TER ,-0�:� , � � ��� TRACTAND LEDGER
FOOTINGS FORMS -���� .. _ � � ' � SWITCH GEAR
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�SLAB ��. ; . �;.�. � , _
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COMMERCIAL HOOD .
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UG:PLI�MBING , , " � � T-BAR
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UG.:ELECTR�CAL�_� ., _- w;"���� „ �`°, ���� INTERCEPTER
UFER CROUNI� '��f � � � � �� � - � � HOT MOP/SHOWERPAN
SEWER LATERAL SEPTIC/CESSPOOL
PJIAIN WATER LINE HERS REPORT RECEIVED
SEWER CLEANOUT DEMOLITION
ROOF SHEATHING ROOF DRAINS
FLOOR SHEATHING ROUGH CONDUIT
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:SHE1�R WALtS`EXTERIOt� >a. � � � ��POOUSPA �
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,SHFARWAttS51NTERIOR �:.; . ` ROUGN P'�UMB(NG
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FRA(t�IItVGNENTiNG_=t „� - � " ��:� �� � � ROUGH ELECTRICAL
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ROl1�N�MEGNANICAL '�` .;'` " ;".:�� ��:� � � � �� ��ROUGH MECHANICAL
ROUGH ELECTRICAL UU( 1`'E'j 1������ �� ��:� 6AS TEST � � _
-� ; . . ,- -, ,_ _
:ROU�H PLUMBING�, ���;t :_. �PRE GUNITE�
INSULATION WALL 'POOL PRE DECK BONDING
INSULATION CEILING � P-TRAP
QRYWALL �FENCE I GATE/ALARM
LATN(PREI 'FINAL POOL
LATH EXTERIOR �yp��g;
LATH INTERIOR WALL FOOTING/STEEL
GAS TEST WALL STEEL 1 sr� �ZNei )LIFT
SCRATCH COAT WALL BOND BEAM
ELECTRIC METER RELEASE ' WALL DRAIN/SEAL
GAS METER RELEASE WALL FINAL
SPECIAL INSPECTION RO.FRAMINGPLANNINGAPPROVAL
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FINAt:6UIlDIP3G, �a_ � .. �
_���„-� � - � ROUGN FIRE APPROVAL
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FINAIaM�CHAt�iCAL " �.��- � :�1���.; �yv� � °,;;.. FINAL FIRE DEPARTMENT �
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�FINAL�ELECTRICAL "��� F�`� u-;; , �:e: �°°'" 'FINAL PLANNING
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INALP�UMBING �;� . - �,<<•�_ .��
� _ �__ ,_ „t °��`� �T��' '"�� � ��� FINA'L ENGINE�RINGI PW
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�:C.�of�OCGUPQNCY y �� `�,. ��,�,< � -� a � � FINAL COMMUNITY SERVICES
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��ERT�6f OCCUPANCY �� �° ' �,�, ��� � �`� °` � � �� � FINAL HEJ�LTH DEPT. �
fINAL INdUSTRIAI WASTE
COMMENTS:�d a�•,c �..ev��. �Ot1.�,�(�w
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CERTIFICATE OF INSTALLATION CF2R-MCH-20-H
Duct Leakage Diagnostic Test (Page 1 of 3)
Project Name: TONY VILLAFLOR Enforcement Agency: City of Permit Number: 14-4967
Walnut
Dwelling Address: 20863 STARSHINE RD City: Walnut Zip Code: 91789
A.System Information
Ol Space Conditioning System Identification or Name System 1
02 Space Conditioning System Location or Area Served Location 1
03 Building Type from CF-1R Single family
04 Verified Low Leakage Ducts in Conditioned Space No,credit is not taken
(VLLDCS)Credit from CF1R?
OS Verified Low Leakage Air Handling Unit(VLLAHU)Credit No,credit is not taken
from CF1R?
06 Duct System Compliance.Category � ;. .�Alteration_., v�
�,- ` �� ��;� ��. �
ca
MCH-20d-Complete Replaceme t or Altered Dud System �,,,;,�, ���
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B. Duct Leakage Diagnostic Test
01 Condenser Nominal Cooling Capacity(ton) 5
02 Heating Capacity(kBtu/h) 0
03 Conditioned Floor Area served by this HVAC system(ft2) 2500
04 Duct Leakage Test Condition Test final
05 Duct Leakage Test Method Total leakage
06 Leakage Factor 0.15
0� Air Handling Unit Airflow(AHUAirflow)Determination Cooling system method
Method
O8 Measured AHUAirflow This field or section is not applicable
09 Calculated Target Allowable Duct Leakage(cfm) 300
10 Actual duct leakage rate from leakage test measurement 296
(cfm)
11 Compliance Statement:System passes leakage test
Registration Number:214-A0126094A-M2000002A-0000 Registration Date/Time: 2015-01-20 18:19:28 HERS Provider:CaICERTS
CA Building Energy Efficiency Standards Report Version:2014-05-OS Report Generated:2015-01-20 18:16:29
2013 Residential Compliance Schema Version:0.515DD
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CERTIFICATE OF INSTALLATION CF2R-MCH-20-H
I Duct Leakage Diagnostic Test (Page 2 of 3)
C.Additional Requirements for Compliance
Ol System was tested in its normal operation condition.No temporary taping allowed.
Outside air(OA)ducts for Central Fan Integrated(CFI)ventilation systems,shall not be sealed/taped off during duct leakage
0z testing.CFI OA ducts that utilize controlled motorized dampers,that open only when OA ventilation is required to meet
ASHRAE Standard 62.2,and close when OA ventilation is not required,may be configured to the closed position during duct
leakage testing.
03 All supply and return register boots were sealed to the drywall.
04 Building cavities were not used as plenums or platform returns in lieu of ducts.
05 If cloth backed tape was used it was covered with Mastic and draw bands.
06 All connection points between the air handler and the supply and return plenums are completely sealed.
If the system complies using the Smoke Test method,the smoke test was conducted in accordance with the requirements
07 of Reference Residential Appendix RA3.1.4.3.6.Systems that comply using smoke test shall not be included in sample
groups for HERS verificati,on compliance z,�e � ; ,�� ������ s��:,�
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The responsible persons signature on:this�compliance document affirms that all applicable requirements in this table have
been met. �� � ��a � ��,�� �`� �� �,�., �•�
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Registration Number:214-A0126094A-M2000002A-0000 Registration Date/Time: 2015-01-20 18:1928 HERS Provider:CaICERTS
CA Building Energy Efficiency Standards Report Version:2014-05-08 Report Generated:2015-01-20 18:16:29
2013 Residential Compliance Schema Version:0.515DD
. ,
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CERTIfICATE OF INSTALLATION CF2R-MCH-20-H
Duct Leakage Diagnostic Test (Page 3 of 3)
Documentation Author's Declaration Statement
1. I certify that this Certificate of Installation documentation is accurate and complete.
Documentation Author Name: Documentation Author Signature: /J�� �
Josh Pugh p�
company: signature oate: 2015-01-20 18:18:37
Construction Performance Services
Address: CEA/HERS Certification Identification(if applicable): ,
25142 Vespucci CC2005640
City/State/Zip: Phone:
Laguna Hills CA 92653 714 878 4215
Responsible Person's Declaration statement
I certify the following under penalty of perjury,under the laws of the State of California:
1. The information provided on this Certificate of Installation is true and correct.
2. I am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design,
construction,or installation of features,materials,components,or manufactured devices for the scope of work identified on this Certificate of
Installation and attest to the declarations in this statement(responsible builder/installer),otherwise I am an authorized representative of the
responsible builder/installer.
3. The constructed or•installed features,materials,componentr or;manufactured devices(the installation),identified,on this Certificate of Installation
�� ,� _¢�. ��� sa,<. �� ; -� �
conforms to all�applicabletodes and regulaLons;and the installation conforms to the requirements given on the plans and specifications approved by
theenforcement,agency. � , ���' � � � �' �_ � :� +�
4. I understand that a HERS reter will check the mstailation to venfy compliance and that if such checking�dentifi s defeds I am required to take
�� �:. � � ,�•_ _ ��: � �: r�
corrective actwn at my expense�`i understand tfiat Energy Commission and HERS_P�ovider representatives will also perfo�m quality assurance checking
7 :, .�:_; . . _ � r
of installations,including tkose appioJed as partaof.a sample group:but not checked by�a HERS rafer,and if those�installafions�fail�to,meet the
requirements of such quality assurance checking,Ehe required corrective action and additional checking/testing ofother installations in that HERS
sample group will he performed at my expense.
5. I reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of
construction or installation identified on this Certificate of Installation,and I have ensured that the requirements that apply to the construction or
installation have been met.
6. I will ensure that a registered copy of this Certificate of Installation shall be posted,or made available with the building permit(s)issued for the
buiiding,and made available to the enforcement agency for all applicable inspections.I understand that a registered copy of this Certificate of
In;tallation is required to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Builder/Installer Name: Responsible Builder/Installer Signature:
Robert Mcginnis
Company Name:(Installing Subcontractor or General Contractor or Position With Company(Title):
Builder/Owner) Owner
ARS AMERICAN RESIDENTIAL SERVICES OF CALIFORNIA INC
Address: CSLB License:
965 RIDGE LAKE BLVD SUITE 201 791820
City/State/Zip: Phone: Date Signed:
MEMPHIS TN 38120 (858)457-6558 2015-01-20 18:19:28
Third Party Quality Control Program(TPQCP)Status: Name of TPQCP(if applicable):
Digitally signed by CaICERrS. This digital signature is provided in order to secure the content of this�egistered document,and in no way implies Registration Provider
responsibility for the accuracy of the information.
Registration Number:214-A0126094A-M2000002A-0000 Registration Date/Time: 2015-01-20 18:19:28 HERS Provider:CaICERTS
CA Building Energy Efficiency Standards Report Version:2014-05-08 Report 6enerated:2015-01-20 18:16:29
2013 Residential Compliance Schema Version:0.515DD