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Permit No. 18095 s BUILDING ADDRESS: 14794 CALLE BRILLANTE PERMIT NUMBER: 18095 \ BUILDING INFORMATION APPLICANT INFORMATION ot\ BUILDING PERMIT APPLICATIONName: ISOM CONSTRUCTION Address: 114794 CALLE BRILLANTE 3, #, Community Development APN 11032-142-09 J Address. 12760 WIHERSPOON RD. "`'" 2001 Grand Avenue Lot UNIT 13 City,Zip Code: CHINO,CA.91710 Chino Hills,CA 91709 Cross Streets: Phone/Pager: (909)627-3765 I ext. MY Or „.. LICENSED CONTRACTOR DECLARATION Tract/Parcel: 15660-1 City Bus Lic#: 9903881 I hereby affirm that I'm licensed under the provisions of Chapter 9(commencing with Section Valuation: $2,000.00 ENGINEER/ARCHITECT INFORMATION 7000 of Division 3 of the Business and Professions Code)and my license is in full force and effect. OWNER INFORMATION Name 1 OWNER BUILDER DECLARATIONName: CARRIE RANDALL Address: I hereby affirm that I'm exempt from the Contractor's License Law for the following reason. Address: 114794 CALLE BRILLANTE City,Zip Code:1 I,as the owner of the property,or my employees with wages as their whole City,Zip Code. 1CHINO HILLS,CA.91709 Phone. 1 ext. 1 0 compensation,will do the work,and the structure is not intended or offered for sale Phone 1(909)605-5507 ext. Lie#. O I,as owner of the property,am exclusively contracting with licensed contractors to Bus Lic#. City Bus Lic#: 1 �J construct the project. O I am exempt under Section i i BPC for this reason i I Bus Exp APPROVAL INFORMATION WORKERS'COMPENSATION DECLARATION CONTRACTOR INFORMATION Issued By: LAURO BUGARIN I hereby affirm under penalty of perjury one of the following declarations: Contractor: ISOM CONSTRUCTION Date Issued 14/16/01 Address: 112760 WIHERSPOON RD iFinance Code. C4 I have and will maintain a certificate of consent to self-insure for workers'compensation 1 as provided bySection 3700 of the Labor Code,for theperformance of the work for City,Zip Code CHINO,CA.91710 1 / Census Code which this permit is issued. Phone or Pager: (909)627-3765 ext. 1 I Final Date 1 7A to,; t Bus.Lic# 19903881 IFinal B Y. 1r � I have and will maintain workers'compensation,as required by Section 3700 of the 0 Labor Code,for the performance of the work for which thispermit is issued MyLic # B531291 Extension• workers'compensation insurance earner and policy number are: Exp Date. 11/30/97 Reviewed By 1LAURO BUGARIN INSURANCE INFORMATION Lie.Class B Approved By LAURO BUGARIN Insurance Company: Exempt l PROJECT INFORMATION Policy Number: 1 PROJECT D RIPTION LOCATION SQUARE FT. Expiration Date. 1 1 1 Structure 0 Section need not be completed if permit is for one hundred dollars($100)or less Garage I certify that in the performance of the work for which this permit is issued. I shall not employ Patio: • any person in any manner so as to become subject to the Workers'Compensation Laws of Porch: California and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code. I shall comply with those provisions Other: PATIO REAR CORNER 1 1 100 PATIO 100 SF PROPOSED USE Date: i I Signature: i i I certify I have read this application and state that the above information is correct I agree to comply with all City Ordinances and state laws and hereby authonze representatives of this City to COMMENTS enter upon the above mentioned property for inspection purposes. n i-, 1 I Date: I ci /(p—O r I Signature: I ‘ -----i OTHER FEES REQUIRED ZONING SETBACKS U GRADING PRIOR TO ACTUAL PERMIT PERMIT FEE INFORMATION ISSUANCE Zoning: PD Front Yard Over X• 1 0Issuance- 1 $29.00 Electrical $0.00 Land Use FR-1 Side Yard. 10/10 Cut: 0 School 1 N Permit Fees: $118.10 Development N Plan Check: 1 $35 10 Plumbing $0 00 Plan• Rear Yard. 7 Fill 0 p SMIP $0.00 1 Occ: R3 SSY: Total. 1 0 Sewer 1N Mechanical. 1 $0.00 Structural $54 00 - Type. VN Water 1 N Geo Review. 1 $0.00 Grading: $0.00 Total Fee Due $118.10 1 INSPECTION RECORD Permit Number Inspection Date Inspector Inspection Date Inspector Grading: Pregrade Meeting FINAL INSPECTIONS(Inspector verify following) Rough Grade NO OCCUPANCY PERMITTED WITHOUT FINAL ! Terraces County Environmental Sub Drains Health Dept Finish Grading Planning Dept Soils Certification Public Works Grading Certification Fire Rough Landscape As Built Approved Underground Site Inspections: ALL ABOVE MUST BE APPROVED BEFORE FINAL BLDG Building Sewer Final Grade Water Service Final Electric Storm Drain/Catch Basins Final Plumbing U/G Conduit/Electrical Final Mechanical / Compaction Report Final Building/Construction aj/26,/c, ABOVE IS REQUIRED PRIOR TO FOUNDATION INSPECTION Water Meter Number Footings UFER Ground(Rebar/Copper) CERTIFICATE OF OCCUPANCY Hardware/Hold-Downs Piers/Caissons/Tendons Slab Grade OTHER: DO NOT POUR CONCRETE UNTIL ABOVE IS APPROVED Shear Roof Nailing Exterior Walls Interior Walls Hardware/Hold-Downs Rough Electric Rough Mechanical Rough Plumbing/Topout Framing COVER NO WORK UNTIL ABOVE IS APPROVED Insulation Drywall Interior/Exterior Lath Stucco Scratch Roof Covering Block Wall Inspections : Footing, ReBar 1st Lift Bond Beam 2nd Lift Bond Beam 3rd Lift Bond Beam Drain/Seal SWIMMING POOLS : Location/Rebar/Bonding/Light Gr Conduit Ro Elect POOL NOT TO BE FILLED UNTIL FENCING IS COMPLETE Fence,Gate&Alarm Final Pool Temp Power Pole Electric Release Gas Test • •