Loading...
Permit No. 1058700140235A01 -i?r-F c 4.167 L • •'105 SAI BERNARDINO COUNTY—EPWA/LANDITANAGEMENT DEPT III OFFICE OF BUILDING AND SAFETY P E RMI T APPLICATION PERMIT NBR 105 87 00140 235A 01 I PAGE 1 OF 1 THIS IS NOT A PERMIT UNTIL ISSUED APPL DATE 06/13/88 ISSUE DATE 06/13/88 PARCEL NUMBER 1000-051-16-0000 1000-051-17-0000 1000-121-01-0000 1000-121-02-0000 PROPOSED USE: GRADING 1000-121-04-0000 CURRENT USE: VACANT TRACT I BLKI 000 LOT I SEC SEC5 102N I RNG 09W I PRCL MAP I PRCLRCOMMUNITY PLAN ZONE/LANDLNUSE ISTRICTGENERALPLAN 000 SUBDIVISION NAME SUBDIVISION PARCEL NO LOT DIMENSION CONST TYPE *BLDGS ON LOT GROUP APPLICANT NAME, MAILING ADDRESS, AND PHONE NUMBER *PLANS RECD 0 LAND USE PLOT 0 (INDEX NBR 5-157 C M ENGINEERING ASSOC STD PLAN/ICBG FHA 225 E AIRPORT DR SAN BERNARDINO CA 92408-0000 GRADING INITIAL ACTUAL (714) 884 — 8804 CU.YDS. EXC. 10543 CU.YDS. FILL 5122 OWNER NAME, MAILING ADDRESS, AND PHONE NUMBER UNOCAL LAND DEVELOPMENT ITEM CNT DESCRIPTION DETAIL TOTALS 1201 W 5TH ST GRADING FEE 360.60 LOS ANGELES CA 90017-0000 LAND SUB—TOTAL 360.60 (213) 977 — 7406 TOTAL AMOUNT 360.60 JOB SITE ADDRESS 16090 CANYON HILLS DR CHINO HILLS CA 91710-0000 CROSS STREET CARBON CANYON ROAD INSPECTN ACCESS CONTRACTOR NAME LICENSE NUMBER MAILING ADDRESS, PHONE NUMBER MINIMUM SETBACK DISTANCES MECHANICAL EQUIP NOT PERMITTED IN REQUIRED SIDE SETBACKS ✓ NO. STORIES NO. DWELLING NO. BEDROOMS FLOOR r. v ✓✓✓ UNITSTA Ris,'. EXT. WALLS INT. WALLS CEILING COM qr 4 ROOFHEATING FIREPLACES !+A �c " `�' I (METAL MASRY Lz,v -��4.' WATER I SEWER I MIN NODEPTHI S.F./100I OSIZE! NEW/REPAIR 000COMMENTS AMT WAIVED .00 AMT PAID 360.60 PAYOR NAME: UNOCAL PAID 06/13/88 \., RECEIPT : 11637 EMPL: CASTRO, K OICENSED CONTRACTORS DECLARATION di I HEREBY AFFIRM THAT I AM LICENSED UNDER T ROVISIONS OF CHAPTER 9 (COMMENCING WITH SEC N 7000) OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE, AND MY LICENSE IS IN FULL FORCE AND EFFECT. LICENSE CLASS LICENSE NUMBER CONTRACTOR DATE OWNER-BUILDER DECLARATION I HEREBY AFFIRM THAT I AM EXEMPT FROM THE CONTRACTORS LICENSE LAW FOR THE FOLLOWING REASON(SECTION 7031.5,BUSINESS AND PROFESSIONS CODE• ANY CITY OR COUNTY WHICH REQUIRES A PERMIT TO CONSTRUCT, ALTER, IMPROVE, DEMOLISH OR REPAIR ANY STRUCTURE, PRIOR TO ITS ISSUANCE, ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LICENSE LAW(CHAPTER 9(COMMENCING WITH SECTION 7000)OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE!OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED EXEMPTION. ANY VIOLATION OF SECTION 7031 5 BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO A CIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS ($5001 (- ❑ I,AS OWNER OF THE PROPERTY,OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION,WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SECTION 7044,BUSINESS AND PROFESSIONS CODE•THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF PROPERTY WHO BUILDS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR THROUGH HIS OR HER OWN EMPLOYEES,PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR OFFERED FOR SALE; IF, HOWEVER,THE BUILDING OR IMPROVEMENT IS SOLD WITHIN ONE YEAR OF COMPLETION, THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE). ❑ I,AS OWNER OF THE PROPERTY,AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT(SEC.7044,BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF PROPERTY WHO BUILDS OR IMPROVES THEREON, AND WHO CONTRACTS FOR SUCH PROJECTS WITH A CONTRACTOR(S) LICENSED PURSUANT TO THE CONTRACTORS LICENSE LAW). ❑ I AM EXEMPT UNDER SEC B AND P C FOR THIS REASON OWNER DATF WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM THAT I HAVE A CERTIFICATE OF CONSENT TO SELF-INSURE OR A CERTIFICATE OF WORKERS'COMPENSATION INSURANCE OR A CERTIFIED COPY THEREOF (SEC. 3800, LAB.C.). POLICY NO. COMPANY ❑ CERTIFIED COPY IS HEREBY FURNISHED ❑ CERTIFIED COPY IS FILED WITH THE COUNTY BUILDING INSPECTION DEPARTMENT APPLICANT DATE CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATION INSURANCE(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS IS 100! OR LESS). 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 LAWS OF CALIFORNIA. APPLICANT DATF NOTICE TO APPLICANT: IF, AFTER MAKING THIS CERTIFICATE OF EXEMPTION,YOU SHOULD BECOME SUBJECT TO THE WORKERS'COMPENSATION PROVISIONS OF THE LABOR CODE, YOU MUST FORTHWITH COMPLY WITH SUCH PROVISIONS OR THIS PERMIT SHALL BE DEEMED REVOKED. CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM THAT THERE ISA CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3097,CIV.C.(. LENDER'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 CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT, I AGREE TO COMPLY WITH ALL CITY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION, AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE-MENTIONED PROPERTY FOR INSPECTION PURPOSES. SIGNATURE OF APPLICANT OR AGENT DATE EXPIRATION NOTICE APPLICATIONS FOR WHICH NO PERMIT IS ISSUED WITHIN 180 DAYS FOLLOWING THE DATE OF APPLICATION SHALL EXPIRE,EVERY PERMIT SHALL EXPIRE IF WORK DOES NOT COMMENCE WITHIN 180 DAYS OF ISSUANCE OF SUCH PERMIT OR IF THE WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS, FEES PAID ARE NOT REFUNDABLE AFTER ONE YEAR FROM DATE OF PAYMENT, ALL FEES PAID MAY NOT BE REFUNDABLE. 12-17588-469 Owner NarnE04....r... .4066X----41L. Permit Numb �^ ,fINZ37 1 INSPECTION RECORD DATE I INSPECTOR I I DATE I INSPECTOR Setback Rough Plumbing Temporary Power Shower Pan Test Foundation Reinforcing Steel Stucco Mesh or Exterior Siding Excavation and Forms Insulation F.H.A. Foundation Req. Sewer Slab Grade Interceptor Ground Plumbing Septic Tank Underslab Ducts Leach Line or Seep Pit Underslab Conduit Water Service Fireplace Foundation Lath or Drywall Nailing Joists and Girders Gas Line Air Test Electrical Ground Final Energy Mid-Height Bond Beam Final Plumbing 8-Foot Bond Beam Final Heating/A.C. Final Bond Beam Final Construction Fireplace Bond Beam Final On Site Improvements Roof Sheathing Final Off Site Improvements Framing and Ventilation Final Dedication Roof Covering Final Zoning Rough Heating Final Electrical Electrical Service and Ground Final Gas Rough Electricpl Developer Fees Paid WC (YIN) \/ Ind Saf IV/We—I__ Certificate of Occupancy % Phe ar&Az G Pa.& snit .,ea 6-/f»og 8y-reat 047 /Jf 4,1114 ` &9 014GI*/ Iati4b:414,1 •6Te. CiU 1-3 I //'14. ...le" 4a/ 040#/1> Gl)7a r®i-or 7..42 /°vrL /'L� • SEPTIC TANK GALS. SEEP. PIT X R .-- LEACH LINE WIDE 2itrillRI X LONG X DEPTH OF ROCK et i 412‘ rm N. x � C cir tau S W. E. S. Inspector's Signature and Initials 12-17589-469 Rev.3/88