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Home My WebLink About11-581 � 1��_ CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES ' 21825 Copley Drive,Diamond Bar,CA 91765 �W� (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS ��'9N'� BUILDING PERMIT APPLICATION FIRMLY oN JOBSITE APPLICATION PERMIT ��J P/C ADDRESS cnlO T�� Lr✓. DATE NUMBER � }t � D TEE � /z- / TYFE OCC APN LOT TRACT CONST. GROUP p OWNER 6 T' a ADDRESS �1-/a :�sr.r /_,rt/'_ ZONING SETBACKS z CITY(}.��vs��,2 ZIP 7 EL��(��(a�O�/5Dd FRONT qyy � o APPLICANT ` - TEL.�bB9•%�nrqY4G REAR � ¢ SIDE/SIDE STREET qyy p � CONTRACTOR - SIDE � � CITI' ��+n�'ti.�►dr_ ZIP�j�TEL.�3�_T�S�/�L` PROPOSED USE -� g1�L�7�' p ° 7 o ARCH/ENG/ � - z DESIGNER w NO.DWEL. NO. NO. a ADDRESS v� UNITS STORIES BEDROOMS � CITY ZIP TEL. � DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREA/VALUATION p� OWNER-BUILDER DECLARATION SFR/ADD/REM O p 1 HEREBY AFFIRIA UNDER PENAL7V OF PERJURV THAT I AM EXEMPT FROM THE CANTRACTORS LI- G8f8 B/C8 h W CENSELAWFORTHEFOLLOWIN�REASON(SEC.7031.5BUSINESSANDPROFESSIONSCODE:ANVCIiYOF (n 9 � U COtJN7'yWHIp1RE0U1RESAPEqMITTOCONSTRUCT,ALTERIMPROVE,DEMOLISH,ORREPAIqANYSTRUC� w w TURE,PRpR TO ITS ISSUANCE,AL50 FEdUIRES THE APPLICANT FOP SUqi PERMIT 70 FILE A SIGNED w P8�i0/DBCk � STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE COMRACTOFS LI� � CENSE UW(CHAPTER Y(COMMENCWG WITH SECTION 7000)OF DIVISION�OF 7HE BUSINESS AND PRO� � POOUSPB FESSIONSCODE)ORTHATHEORSHEISE%EMPTTHEREFROMANDTHEBASISFORTHEALLEOEDE%EMP- (� TION.ANV VIOLATION OF SECTION 7031.5 BV ANV APPLICANT FOR A PERMIT SUBJECTS THE AVPLICANi T0 Z Re-Roof A CIVIL PENALTV OF NOT MORE THAN FIVE HUNDRED DOLLARS(f600).): 0 ❑I,ASONMEROFTHEPROPERTV,ORMVEMPLOVEESWITHWAOESASTHEIRSOLECOMPENSATION, � COrt1rtIBfClB� Z WILL DO THE WORK,AND THE S7RUCTURE IS NOT IN7EN�ED OR OFFERED FOR SALE(SEC.7a�,BUSI� J � NESS AND PROFESSIONS CODE:THE CONTRACTORS LICENSE IAW DOES NOT APPLV TO AN OWNER OF � PqOPEHTV WHO BUILDS OR IMPROVES THEREON.AND NM110 DOES SUCH WORK HIMSEIF OR HERSELF Oq ' w THROUGH HIS OR HER OWN EMPLOYEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT WTENDED OR m � OFFEREDFORSALEIF,HOWEVEi�7HE8UILDINGORIMPROVEMINTISSOLDWITHINONEVEAROFCOMiLE� Z TION.THE OWNER�BUILDER WILL HAVE THE BURDEN OF PROVINa THAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SALE). �y,� OI,ASOWNEROFTHEPROPERTV,AIAEJ(CLUSNELVCANTRACTINGWfTHLICENSEDCOMRACTORS � TO fqNSTRUCT THE VRQIECT(SEC.701�,BUSINESS AND PROFESSIONS CODE:THE CONTRACTORS LI- VflIUHHOfI ADJ.AREA W CENSELAWDOESNOTAPPLVTOANONRJEROFAPROPER7YWHOBUILDSORIMPROVESTHEREON,AND � WHOCONTRACTSFOqSUCHPRQIECTSWITHACONTRACTOR(S)LICENSEDPURSUANTTOTHECONTRAG QUANTITY DESCRIPTION TORS LICENSE UWJ. FEE � � O I AM EXEMPT UNDER SEC. B.8 P.C.FOR 7HIS REASON � � U LL DATE OWNER H Z U � LICENSED CONTRACTORS DECLARATION w � � 1 HEREBV AFFIRM UNOER PENALTY OF PERJURY THAT I AM UCENSED UNDER PROVISIONS OF CHAPTER � � o(OOMMENCINO WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE,AND Z �� MY LICENSE IS IN FULL FORCE AND EFFECT. m � UCENSE CLASS LIC.NO. V'lP��'Y/ � WDATE � CONTRACTOR�+��'L��a� d / V , � WORKERS'COMPENSATION DECLARATION Q U � I HEREBY AFFIRM UNDER PENALTV OF PERIURV ONE OFTFIE FOLIOWiNG DECURATIONS: Z 0Z _IHAVEANOWILLMAINTAINACERTIFlCATEOFCONSENTTOSEIF�INSUqEFORWORNERS' a Q COMPENSATION,AS 7ROVI�ED BY SECTION 3700 OF THE IABOR CODE,FOR THE PERFOFiMANCE U THE WORK FOR WHICH TMIS 7ERMIT IS ISSUED. W � � I HAVE AND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE,AS REWIRED BV SECTION Q 3�Oo OF THE LABOR COOE.FORTHE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS / ISSUED.MV/y�pI qKERS'COMPENSATION I URANCE CAtRRIE�R AND P/p�LICV NUMB�ER)ARE: CONSTRUCTION //� � j CARRIER WY►?j��m�pJ ��I'��l/ �"' (�Ccc�Ct.L[.(�'Y1 PLANREVIEW � Z POLICV NUMBER C�PLA I�.1�I ELECTRIC ¢ � (n+ssEcraraNE�r�orseoo�.wFrF�oFnepEw,�r�5roaor�Mx�or�ooalnasR�roloa�Essl PLUMBING w Z I CERTIFV iHAT IN THE PERFORMANCE OF THE WORN FOR WHICH THIS PERMIT IS ISSUED,I MECHANICAL ' C,�} SHALL NOT EMPLOV ANY PERSON IN ANV MANNER SO AS TO ECOME SU&IECT TO THE (/� WORNERS'CAMPENSATION LAWS OF CALIFO IA,AND AG IF I SHOUL�BECOME INSPECTION FEE � = SU&IECT TO THE WORNERS'COMPENSAT OVISION � ON 370o OF THE lAgpq + CODE ISH FORTHWITHCOMPLV T S ISSUANCE � p OATE: �a' � APPLICA � SMIP � �j W J WAANINO:FAILURE TO SECURE WOFKERS' P SATION ERAOE IS UNLAWNL,AND SHALL BE ENERGY P/C � J � SU&IECTAN EMPIOYER TO CRIMINAL PEN I AND CIVI INES UP TOONE HUNDRED THOUSAND ENERGY PERMIT DOLURS(f 100.000),IN MDITION TO THE C OF CqMPENSATqN,DAMAGES AS PROVIDED FOR IN J SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATTORNEV'S FEES. W RETENTION FEE: `7 O CONSTRUCTION LENDING AGENCY PR -ALT FEE� � I HEREBV AFFIRM UNDER PENALTY OF PERJURV THAT THERE IS ACONSTRUCTION LENDW�AOENCV �� d FOR THE PERf-0RMANCE OF THE WOFK FOR WHICH THIS PERMIT IS ISSUED(SEC.3007,CIV.C.). � Z W � LENDER'S NAAIE � LENDERSADORESS � w I CENTIFV THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATbN IS CARRECT. TOTAL FE ES �SV.-'� � I AGREE TO COMPLV Wf7H ALL GTY AND COUNTY ORDINANCES AND STATE LAWS REI.ATINO TO BUILDINO � � CONSTRUCTION,AND HEREBV AUTHORIZE REPRESENTATIVES OF THIS COUNTV TO ENTER UPON THE Z ABOVE-MENiqNED PROPERTV FOR INSPECTION PURPOSES. COMMENTS � O / J / ! ' � � m PERMITTEE (PRINT) ' � � ¢ ! � � c� o E qECPT.NO. PAID BY ��c7— VALIDATION � WHITE—DepaAment Copy,YELLOW�Inance Copy,PINK—Assessor Copy,GOLDENRO�File Copy,GREEN—AppNcanYs Copy ClYV O� DI�►MOY�D �AL� . Ii�S6�l�C�'VO� ��CORD . -� � o o ��-3=- o ': : ,� D�n1�C C��00GJ DD Q4C� DUyJ�p(�C�'�G��«a: �I�C�C�4�QG�], 4i -� '� r�'�:� OG+I�C�C�i�01� SET BACK FLOOR JOIST FfGS/FORMS/STEEL FHA REQMTS ELECTRIC GROUND UNDER FLOOR DUCT GROUND PLUMBING UNDER FLOOR CONDUIT SLAB GRADE F►REPLACE FOUNDATION TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID H'L BOND BEAM ROOF SHEATHING _ � 4_ 8 FT. BONQ BEAM FRAMINGNENTILATION FINAL BOND BEAM ROOF COVER PRE-GRADING 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 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�t�OC��; . COMMENTS SEPTIC TANK SIZE SEEP PIT/U SIZE > a ;, 4, _ .�? � � ��, �.. �a _ �"�_Yi` a�++t'"` '�:; � � � i ;rescriptive Certificate of Compliance: Residential Reroof cr-7 K-AL 1-K@hCOOT � 'roject Addr,ess: Climate Zone Perrnit# ° D 7' r �.Q.� � i�ivs�� i� a/" �. 1�!v �OOFING PRODUCTS (COOL ROOFS) §151(fl12 Nhen the area of exterior roof surface fo be replaced exceeds 50%of the exisfing roof area,or 1,000 ,whichever is/ess, the new �oofing area must meet the roofing product"Cool RooP'requirements of§152(b)1H(, 152(b)1Hii, or 152(b}1Hiif. :heck applicable alternative or exception below if the roof alterafion is exempf from the roofing product"Cool RooP°requirements:: ❑ 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-sloped roofs(greater pitch than 2:12)and product weight less than 5/Ib/ftZ. 4ltematives to§152(b)1 Hi and§152(b)HiI,Steep-slope roof(pftch>2:12) ❑ Insulation with a thermal resistance of at least 0.85 hrft2•"FBtu or at least a 3/4 inch air-space is added to the roof deck over an attic;or ❑ F�asting ducts in the attic are insulated and sealed according to§151(fl10;or �imate zones 10,12 and 13,with 1 ft2 of free ventilation area of attic ventilation for every 150 ft2 of attic floor area,and where at least 30 percent of the free ventilation area is witl�in 2 feet vertical distance of the roof ridge;or . ❑ Building has at least R-30 ceiling insulation;or 0 Building has radiant barrier in the attic meeting the requirements of§151(fl2;or , ❑ Building has no ducts in the attic;or ❑ In climate zones 10,11, 13 and 14,R-3 or greater roof deck insulation above vented attic. Exceptlon to§152(b)1 Hiii,Low-slope roof(pftch 52:12) - ❑ Building has no ducts in the attic. Other,Euceptions � ❑ Roofing area is covered by building integrated;photovoltaic panels and solar thermal panels are exempt from the Cool Roof criteria. ' ❑ Roof constrvctions that have thermal mass over the roof inembrane with at least 25 Ib/ft2 are exempt from tl�e Cool Roof criteria. � NOTE:If any one of fhe altematives or excepfion is checked ihe Aged Solar Reflecfance and Thermal Emittance requirements for roofing �roducts in§118(i)are not applicable. Do not fiq fable below. - Roof Slope Produd Weight Product Aged Solar Thermal � CRRC Product ID Number� <_2:12 >2:12 < 51b/ft2 z 51b/ft2 T e2 Reflectance3'4 Emittance SRIS ❑ ❑ ❑ ❑ ❑4 ❑ 0 ❑ ❑ p4 Nofe:!f no CRRC-1 label is available, fhis compliance mefhod cannof be used use the Performance Approach to show compliance, ' 1.The CRRC Pruduct ID Number can be obtained from the Cool Roof Rating Council's Rated Product Directory at www.coolroofs oro/products/sear�h vhn 2 lndicate the type of product ls being used for the,roof top,i.e.single-ply roof, asphaR raof,mefa!roof,etc. . If the Aged Reflectance is not available in the Coo/Roof Rating CounciPs Rafed Product Directory then use the Inftial Reflectance value fiom the same directory and use the equation(0.2+0.7(p,,,�,-0.2)to obtain a calculated aged value, lNhera p is the Initial Solar Reflectance. . Check box if fhe Aged ReFlectance is a calculated value using the equafion above. . 5. Calculate the SRI value by using the SR/-lNorksheet at htto✓/www.enerav.ca.qovRitle24/and enter the resuRing value in the SRl Column a6ove and a(tach acopy of the SRI-Worlcsheet to the CF-iR. o apply Liquid Field Applied Coatings,the coating must be applied ecross the entire roof surface and meet the dry mil thickness or coverage ecommended by the coatings manufacturer and meet minimum perfortnance requirements listed in§118(i�. Select the applicable coating; ❑ Aluminum-Pigmented Asphalt Roof Coating ❑ Cement-Based Roof Coafing ❑ Other NOTE: When a Coo!Roof is required, the insfalling contractor sha!!comp/efe and su6mit ihe CF-6R-ENV-01 for final inspection. Declaration Statement • I certify under penalty of perjury,under tha laws of the State of Califomia,the information provided on this form is accurate and complete. • I certify that the energy features and pertormance specifiqtions identified on this Certificate of Com ' nce conform to the requlrements of TiUe 24,Parfs 1 and 6 of the Califomfa Code of Regulations. Name: Signature• ` - 1l �a�v� Company: ^ l�� Date: l,2 / Address: License: /5 ya� r`o�v T� . '/9� City/State2ip: Phone: ��u- ��s �_.�-8�91� For assisfance or questions regarding the Energy Standards, contact the Energy Hofline af: 1=800-772-3300. . INSTALLATION CERTIFICATE: Residential Reroof CF-6R-ENV-01 I Site�ddress• Enforcement Agency: Permit Number: • • I more than one person has responsibiliry for instatlation of the iiems on this certif cate,each person shall prepare and sign a certificate pplicable to the portion of construction for which they are responstble;alternatively,the person with chief responsibility for constructiors shall prepare and sigri this certifcate for the entire construction. All applicable Mandatory Measures with check boxes are required to be checked to ensure the mandato measures have been met. CEILING INSULATION ��d: Brand Name: Batt or Blanket Type: Brand Name: Loose Fi11 Type: `I'hermal Resistance(R-Value): - Spray Foam Type: Brand Name: Installed Actual Thiclmess(inches): Contractor's min installed weightJftz 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: O §118(a): Insulation installed meets Standards for Insulating Material. � � §150(g):Mandatory Vapor barrier installed in Clunate Zones 14 or 16. ROOFING PRODUCTS(COOL ROOFS}�ISI(�72 ❑ Check this box if the newly installed roof is exempted from the roofing product"Cool RooP'requuements as indicated on the CF-1R-Alt- - Reroof form for this project.Otherwise fill in the table below. � Roof Slope Product We➢ght .Aged Solar Thermal CRRC Product ID Number' s z:iz >2:12 < Slb/ft2 z Slb/ft2 Product Type2 Reflectance3'4 Emittance ❑ ❑ ❑ ❑ ❑4 p ❑ ❑ ❑ �4 1.CRRC-1 label information is available is on the package of t6e roofng product being installed and attach the CRRC iabe{to this Sorm.. � 2.Indicate the type of product is being used for the roof top,i.e.single-ply roof,asphalt roof,rreetal roof,etc. ' . If the Aged Reflectance is not available in the Cool Roof Rating Counci!'s Rated Product Directory then use the Initial Reflectance value from the same directory and use the equation(0.2+0.7(p�,;t;a�—0.2)to obtain a calculated aged value. Where p is the Initial Solar Re,flectance. . Check box iJthe Aged ReJlectance is a calculated value using the equation above. o apply Liquid Field Applied Coatings,the coating must be applied across the enrire roof surface and meet ihe dry mil thiclrness or coverage ecommended by the coatings manufacturer and meet minimum performance requirements listed in§118(i�. Select the applicable coaring. ❑ Aluminum-Pigmented Asphalt Roof Coating ❑ Cement-Sased Roof Coating ❑ Other DECLARATION STATEMENT � �i • 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 and Professions Code to accept responsibility for construction,or an authorized representative of the person responsible fot construction(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-1R that appiy to the installation have been met. • I will ensure that a completed,signed copy of this Installation Certificate shall be posted,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 of this Installation Certificate is required to be included with the documentation t6e builder provides to the building owner at occupancy. Company Name: (Installing Subcontractor or Genera]Contractor or Builder/Owner) Responsible Person's Name: Responsible Person's Signature: , CSLB License: Date Signed: Position With Company(Title): 2008 Residentia!Compliance Fornu • August 2009