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Permit No. 6078 City of Cho Hills APPI_ICAIt FOR Rt111_I7ING PERMIT Community Development 2001 Gland Avenue Chino Hills,CA 91709 Building Address: Proposed Use - St No. 2704 StreetCALLE( VISTA SINGLE FAMILY RESIDENCE APN t.02_— i Z- -4' I THE FOLLOWING WORK IS AUTHORIZED BY THIS PERMIT Lot 1 ;.?pal Block Tract 15660 —( -- ==,> <.'' r;u,l,ia. u '.1 411. }y LIGil. t}f ti J111 4 Applicant WESTERN PACIFIC HOUSING St No. 18001 Street COWEN ST STE H Type of Project :"4 ,.,..-.uv 1""`, ' "",%L"11.411 City IRVINE Zip 92714 Phone 714-442-6193 ` 7.:;:-.,..;; ;: „rY,:. �_;,t� ; ...,,,,,S.“., ,:,...13 � �,;,, - Owner WESTERN PACIFIC HOUSING Project I Location on I Size Description Property in Sq. Feet St No. 18001 Street COWEN ST STE H City IRVINE Zip 92714 Phone 714-442-61931 LIVABLE I I 1647 Engr/Arch Lic No. 2 GARAGE I I 417 St No. Street 3. I I City Zip Phone 4. I I Contractor WESTERN PACIFIC HOUSING Lic No. REMARKS/SPECIAL CONDITIONS/PROJECT DESCRIPTION Sewer I Min. Depth I S/F/100 I Size St No. 18001 Street COWEN ST STE H YES City IRVINE Zip 92714 Phone 714-442-6199ubic Yards Excavation Fill Over Excavation City Business License License No. 2487 Expiration Date 9/30/96 PLAN 4 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 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 D. I, as owner of the property, am exclusively contracting with licensed contractors to � 1 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 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 permit is issued Setbacks I 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 I] 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) $101,000.00 ❑ 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' Compensation Laws of California and agree that if I should become bjec o the workers' compensation provisions of Section 3700 of the Labor Code .h. for w h comply with those $848.7E provisions r/J��// [/ Electrical $181.1;' Structural Date ��` j V' t7 _Signature Warning' Failure to secure workers' compensa•noverage is unlawful, and shall subject an Plumbing $222.01) Grading $75.0C 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 $78.8' Issuance $29.00 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 la and hereby authorize representatives of this City Issuance Approved Total Permit Fee to enteup e above mentioned property for inspection $1,434.7L purposes. , , V- 4-94 Date Issued Permit Number Signatu a of Appllbant or Agent Date 4/18/96 6078 • Print Applicant's/Agent's Name FINANCE CODE C4 CENSUS CODE 101 /,ilpNSTRUCTION LENDING AGENCI, O 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.). LENDEcI'S NAME LENDER'S ADDRESS 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 I DATE I INSPECTOR I . DATE, INSPECTOR Setback/Location Imo=/— (. I ,4-7/ Rough Plumbing Ir /1, ��. r I Temporary Power I I Shower Pan Test (,�if s✓O//D .0-7,9"\/ Foundation Reinforcing Steel I,----' ,--1wI / Stucco Mesh or Exterior Siding ?,g,y2,V-d9(o ,47-rf Excavation and Forms 'D /r)---7/_.,1 J'/,1/ Insulation (AO- .c--Pyr Slab Grade � " /'I f (K ,V Sewer —' — Ground Plumbing Soil1 --"--7—q to I 1-/' I Interceptor Ground Plumbing Water 4--(p (.., /1-).-\I Septic Tank Underslab Ducts ` Leach Line or Seep Pit Underslab Conduit Water Service Underslab Gas Lath or Drywall Nailing ,-2V—fes' 41-7-/ Fireplace Foundation Gas Line Air Test ` '�,-9C I .Q71 Joists and Girders Final Energy / Electrical Ground Final Plumbing s+91,gJ� nk- - Mid-He( ht Bond Beam 18/ I 7v' v 2.9 Final Heating/A.C. . �, 8-Foot Bond Beam Final Construction I Final Bond Beam Final On Site Improvements Fireplace Bond Beam i Final Off Site Improvements Roof Sheathing ', I7//14,, (,—(P (o k 4j Final Dedication Framing and Ventilations \ , i \ Final Zoning Roof Covering ( ,ry,,,,, �/. I \ \ Final Electrical i,v qC�� kii Rough Heating v�✓V y iie Ni'WI A 1nVy� t Final Gas It' Service and Ground Ah \I u','to f-'_\'k\I Developer Fees Paid Rough Electrical I ` ° \ I Fire Dept. Approval Verified Bonding \ I Certificate of Occupancy Over Head Electrical ' Fence Height I I Gates I I Heater I Pool Drainage ,, I I //✓ 4;..""%2.:27 .��/iYl� -4e-.;30- , '9_. ('//1v' v�i'2,' SEPTIC TANK GALS. SEEP. PIT X LEACH LINE WIDE LONG X DEPTH OF ROCK N. • W. E. S. Inspector's Signature and Initials 7;Z , _AA . DATE OF ISSUANCEPERMIT NUMBER