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Permit No. 6953 City of C i no Hills APPLIC . ON FOR BUILDING PERMIT Community Development 2001 Grand Avenue Chino Mlle,CA 91709 Building Address: Proposed Use - St No. 14781 Street CALLE BRISA SINGLE FAMILY RESIDENCE APN ' i1 - 4( THE FOLLOWING WORK IS AUTHORIZED BY THIS PERMIT Lot 36 Block Tract 15660-1 Struct. ®Plumb. Applicant WESTERN PACIFIC HOUSING ® Meeh. ® Elect. ® Grading 18001 COWEN ST STE H Type of Project Ni New ❑Alter ❑Addition St No. Street City IRVINE Zip 92714 Phone 714-442-6199 CIRepair ❑ Convert. ❑ Demo [11Occupancy Permit Owner WESTERN PACIFIC HOUSING Project I Location on I Size 18001 COWEN ST STE H Description Property in Sq. Feet St No. Street 1 LIVABLE I 11443 City IRvINt Zip 92714 phone 714-442-6199 Engr/Arch Lic No. 2. GARAGE I 1389 St No. Street 3 I I City Zip Phone 4. I I Contractor WESTERN PACIFIC HOUSING Lic No. REMARKS/SPECIAL CONDITIONS/PROJECT DESCRIPTION 18001 COWEN ST STE H Sewer I Min. Depth I S/F/100 I Size St No. Street YES City IRVINE Zip 92714 phone 714-442-6199 Cubic Yards Excavation Fill Over Excavation 2487 City Business License 9/30/96 License No. Expiration Date PLAN 3 Licensed Contractor's Declaration I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000 of Division 3 of the Business and Professions Code) and my license is in full force and effect. License Class B ' License Number SAME Date Contractor ....... . .... ._... _.._..___ Address City and Zip Phone Owner Builder Declaration I hereby affirm that I am exempt from the Contractor's License Law for the following reason: ❑ I, as the owner of the property, or my employees with wages as their whole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ I am exempt under Sec. ,B&PC for this reason_______ _____ Date Initial Workers' Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations: ZoningI Land Use PD,FR1 Ela I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued Setbacks Model/Plan ❑ b. I have and will maintain worker's compensation, as required by Section 3700 of the FY I SY I LaborCode, for the performance of the work for which this permit is issued My worker's RY I SSY compensation insurance carrier and policy number are: Ins. Co.: Group/Division/Type R3/VN Policy No: Exp Date: VALUATION (This dection need not be completed if the permit is for one hundred doolars($100)or less). $89,000'00 ❑ c. I certify that in the performance of the work for which this permit is issued. I shall PERMIT FEES not employ any person in any manner so as to become subject to the Workers' C. pe ation Laws of California and agree that if I should become subject to the - ' „,.fkg provisions of Section 3700 of the Labor Code. I)hall—forthwithw , I. , $158.73 $778.80 provisions. ` `C� ` Ele-ctri cal Structural Date / —/ / Signatu\ r!/e// -.) � ` $210.00 $75.00 Warning: Failure to secure workers' compensatiovf coverage is 4n .t and shall sub an—)Iumbing Grading employer to cnminal penalties and civil fines up to one hundred tnousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the $10$.7$ $29.00 Labor Code, interest, and attorney's fees. Mechanical Issuance I certify that I have read this application and state that the above $50.62 information is correct. I agree to comply with ail City Ordinances Geo Review Plan Check and state laws and hereby a h• - ,,,epresentatives of this City Issuance Approved Total Permit Fee to enter upon the ab e -i '••-• property for inspection DC I $1,410.93 '947J f /9-C I/ . -.//�� �- ! Date Issued Permit Number Signature of Applica of Agent _� Date 9/5/96 6953 ”' r p` (,_51"N N��—7.-- . FINANCE CODE C4 CENSUS CODE 101 Print Applicant's/Agent's Name 1 liONSTRUCTION LENDING AGENC' I HEREBY AFFIRM 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'S ADDRESQ DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION THE CALIFORNIA HEALTH AND SAFETY CODE REQUIRES A DIVISION OF INDUSTRIAL SAFETY PERMIT AS A PREREQUISITE TO PERMIT ISSUANCE UNLESS THE APPLICANT SIGNS ONE OF THE CERTIFICATES BELOW. ❑ I CERTIFY THAT NO EXCAVATION 5 FEET OR MORE FEET IN DEPTH,INTO WHICH A PERSON IS REQUIRED TO DESCEND,WILL BE MADE IN CONNECTION WITH WORK AUTHORIZED BY THIS PERMIT,AND THAT NO BUILDING,STRUCTURE,SCAFFOLDING,FALSEWORK,OR DEMOLITION OR DISMANTLING THEREOF,WILL BE MORE THAN 36 FEET HIGH. ❑ AS OWNER/BUILDER I WILL NOT EMPLOY ANYONE TO DO WORK WHICH WOULD REQUIRE A PERMIT FROM THE DIVISION OF INDUSTRIAL SAFETY,AS NOTED ABOVE UNLESS SUCH PERSON HAS A PERMIT FROM THAT DIVISION. • DIVISION OF INDUSTRIAL SAFETY PERMIT NUMBER I HAVE READ THE HAZARDOUS MATERIALS QUESTIONNAIRE AND THE WORK APPLIED FOR ON THIS PERMIT DIS DIS NOT SUBJECT TO THE APPLICABLE REQUIREMENTS OF THE HEALTH AND SAFETY CODE AND THE LOCAL AIR QUALITY AGENCY. BUILDING INSPECTIONS RECORD /DATy INSPECT9R DATE INSPECTOR Setback/Location '/�^3/g 40 /��•/ Rough Plumbing 11 _ 11 n . A 1 Temporary Power I '( G , , Shower Pan Test I d' I "'( , Foundation Reinforcing Steel li,A, /�, /„n 4 _ / Stucco Mesh or Exterior Siding 19.—)1.:--C11/2 RV Excavation and Forms AN/ //e1/ //J1 / Insulation 11-• -•I I AID PM j Slab Grade / 17 1,7 6 Y /-1/ /V Sewer 1/-61--q4, / Ground Plumbing Soil - a/e-?/ )' Interceptor Ground Plumbing Water 117 f941 07;91 Septic Tank Underslab Ducts Leach Line or Seep Pit • Underslab Conduit Water Service /4.-i '-9*, it-4 Underslab Gas Lath or Drywall Nailing IX\0 Atp Fireplace Foundation Gas Line Air Test 1/2-/i '.. 14;j Joists and Girders Final Energy -------1 Electrical Ground Final Plumbing 907 A t Mid-Height Bond Beam Final Heating/A.C. . ,S'V X\ / 7/ 8-Foot Bond Beam Final Construction \," ( XV Final Bond Beam Final On Site Improvements V Fireplace Bond Beam Final Off Site Improvements Roof Sheathing `\ntN9,( /i_t3 —9 , /.�14 Final Dedication Framing and Ventilation /-1 N 1\ Final Zoning Roof Covering t ,,, \\IA \ \ Final Electrical ti,-'5 - 4'1 ( Rough Heating \Nh,J " 1111„ \ \ Final Gas t 3l—`,'i J Service and Ground 'f NV1_ \\ ' V14j 'U \X A ,\ Developer Fees Paid Rough Electrical 11,),IN \ W \/\\\\ \ Fire Dept. Approval Verified I _ '- c)—cr-t ( ,5-Ei>_J Bonding Certificate of Occupancy Over Head Electrical V Fence Height Gates Heater Pool Drainage SEPTIC TANK GALS. SEEP. PIT X LEACH LINE WIDE LONG X DEPTH OF ROCK N. W. E. ,S. Inspector's Signature and Initials (6) I ATEF ISSUANCE P RMIT NUMBER