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Permit No. 6077 City of Cho Hills APPI_ICA FOR Rl1Il_DING PERMIT • Community Development 2001 Grand Avenue Chino Hills,CA 91709 Building Address: Proposed Use - St No. 2710 Street� CALLE VISTA SINGLE FAMILY RESIDENCE APN 10�2— I L - 4 b THE FOLLOWING WORK IS AUTHORIZED BY THIS PERMIT Lot 1 ( 3) Block Tract 15660 — 1 — = - _...-- Applicant WESTERN PACIFIC HOUSING `� y St No. 18001 Street COWEN ST STE H Type of Project -' -' • ,,-..."...7.., ; City IRVINE Zip 92714 Phone 714-442-6193 ;i' �:. .."" . " uw:``:'`. L`"'v '" r`;.s ` i... ' '."", Owner WESTERN PACIFIC HOUSING Project I Location on I Size 18001 COWEN ST STE H Description Property in Sq. Feet St No. Street City IRVINE Zip 92714 Phone 714-442-6199'' LIVABLE I I 1443 Engr/Arch Lic No. 2. GARAGE I I 389 St No. Street 3. I I City Zip Phone 4 I I Contractor WESTERN PACIFIC HOUSINGREMARKS/SPECIAL CONDITIONS/PROJECT DESCRIPTION Lic NO. Sewer I Mtn. Depth I S/F/100 I Size St No. 18001 Street COWEN ST STE H YES City IRVINE Zip 92714 Phone 714-442-619 ubic Yards Excavation Fill Over Excavation City Business License License No. 2487 Expiration Date 9/30/96 Licensed Contractor's Declaration PLAN 3 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 Date '.Contractor • SAME 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 — — „..---- Dat P .___-_M—Date Initial Workers' Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations. Zoning Land Use Da. I have and will maintain a certificate of consent to self-insure for workers' PD,FR1 compensation as provided by Section 3700 of the Labor Code, for the performance of the [work for which this per ued. Setbacks I Model/Plan la-67 rwI 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 workei's RY ( SS' li compensation insurance carrier and policy number are. Ins. Co.: Group/Division/Type Policy No: R3/VN 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 not employ any person in any manner so as to become subject to the Workers' Compensation PERMIT FEES Laws of California and agree that if I should become s bject to the workers' compensation provisions of Section 3700 of the Labor Code. I she .rthwith comply with those $1 58 7� $778.8 provision. CC l/ EElectricalStructural ate_ - (5) / C/— - — Signatu,( 1_, _=--Z , Warning: Failure to secure workers' compensa ion coverage'is unlawful, and shall subject an Plumbing $210.0(' Grading $75.0 employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest, and attorney's fees Mechanical $108.71I Issuance $29.0C I certify that I have read this application and state that the above information is correct. I agree to comply with all City Ordinances Geo Review Plan Check and state laws and hereby authorize representatives of this City Issuance Approved Total Permit Fee to ent u o t 'above mentioned property for inspection I $1,360.31 purposes. I " ��� (-11V - Date Issued Permit Number Signafur of"Applic'aht or Agent Date 4/18/96 6077 FINANCE CODE CENSUS CODE Print Applicant's/Agent's Name C4 101 NSTRUCTION LENDING AGENCI, ,EREBY AFFIRM THAT THERE IS A CONSTRUC1 IO'J LENDING AGENCY FOR THE PERFORMANCE OF Tf 1E WORK FOR WHICH THIS PERMIT IS ISSUED EC.3097.CIV.C.). :NDER'S NAME LENDER'S ADDRESS DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION HE CALIFORNIA HEALTH AND SAFETY CODE REQUIRES A DIVISION OF INDUSTRIAL SAFETY PERMIT AS A PREREQUISITE TO PERMIT ISSUANCE UNLESS HE 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,FALSE WORK,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. IVISION OF INDUSTRIAL SAFETY PERMIT NUMBER • HAVE READ THE HAZARDOUS MATERIALS QUESTIONNAIRE AND THE WORK APPLIED FOR ON THIS PERMIT DS DS NOT SUBJECT TO THE PPLICABLE REQUIREMENTS OF THE HEALTH AND SAFETY CODE AND THE LOCAL AIR QUALITY AGENCY. BUILDING INSPECTIONS RECORD DATE INSPECTORDATADAINSPECTOR setback/location I-c -/—q ` Rough Plumbing � /771 ke I 4 / emporary Power I- i / U Shower Pan Test (-11 CIA-7( f j? /17 • l' oundation Reinforcing Stee7 /—) /" //A AStucco Mesh or Exterior Siding"+ .xcavation and Forms f' . )/'//— z2167 i./ I Insulation 6—Z47-- Y, .riV1/, ;lab Grade / IE'/ /V I Sewer I iround Plumbing Soil I�—��ro 717V, I Intercepior iround Plumbing Water Septic Tank Ii Inderslab Ducts I Leach'Line or Seep Pit Inderslab Conduit , Water Service Inderslab Gas Lath or Drywall Nailing 6-227.--a6, \/ ireplace Foundation Gas Line Air Test of—/'_jam, .497 oists and Girders Final Energy I - lectrical Ground Final Plumbing I ftg/1` lid-Height Bond Beam Final Heating/A.C. I-..1�� �� -Foot Bond Beam Final Construction 1 / inal Bond Beam Final On Site Improvements I fireplace Bond Beam , J Final Off Site Improvements I oof Sheathing 41-ill Pvl (. Final Dedication raming and Ventilation N i h Final Zoning � oof Covering /1 \I,,/ I I Final Electrical I - ough Heating ( n \I 7,��_ _\ I Final Gas I��� w ervice and Ground v v I"t1, \ 1,7,4 1h I Developer Fees Paid ough Electrical �� \- Lt/ I\M Fire Dept. Approval Verified onding l.J I '. \ Certificate of Occupancy I Iver Head Electrical once Height ates I I eater I I ool Drainage EPTIC TANK GALS. EEP. PIT X EACH LINE WIDE LONG X DEPTH OF ROCK N. '• E. r. S. Inspector's Signature and Initials - DATE OF ISSUANCE PERMIT NUMBER