Loading...
Permit No. 3207 • • 7. :?^'N ` CITY OF CHINO HIL S APPLICATION FOR A BUILDING PERMIT AND Be : COMMUNITY DEVELOPMENT A CERTIFICATE OF USE & OCCUPANCY -...--.1::: 2001 Grand Avenue _ Chino Hills, CA 91709 BUILDING PROPOSED USE w ADDRESS 16500 CELADOV COURT NEW] SSR F 0 APN 1017-732-060000 0 THE FOLLOWING WORK IS AUTHORIZED BY THIS PERMIT s. LOT BLOCK TRACT TRUCT PLUMB0 ECH ELECT ❑ GRADING 21 13507-5 s TYPE OF PERMIT 0 NEW 0 ALTER 0 ADDITION CD In APPLICANT SALVE AS Q^INERTis 0 REPAIR 0 CONVERT 0 DEMO 0 OCCUPANCY PMT ADDRESS PROJECT I LOCATION ON I SIZE DESCRIPTION PROPERTY IN SQ FEET CITY ZIP PH 1 LIVING I • I 2418 OWNER SUMITOMO REALTY & DEVELOPMENT CA. . INC. 2 GARAGE I I 642 ADDRESS 23046 AVENIDA DE LA CARLC7PA #300 714 G PATIO I 54 CITY LACUNA HIP if S 92653 PH SR6-1011 4 I I ARCHITECT ENGINEER LIC NO REMARKS/SPECIAL CONDITIONS/PROJECT DESCRIPTION ADDRESS NO STORIES NO DWELLING UNITS BEDROOMS CITY ZIP PH ROOF I FLOOR I EXT WALL I INT WALL ^ CONTRACTOR sAmE AS a' LIC NO 678246\ ADDRESS CEILING HEATING I FIREPLACE O METAL MASONRY CITY ZIP PH O SEWER I MIN DEPTH S/F/100I SIZE '1 1 CITY BUSINESS LICENSE LICENSE NO 1318 EXPIRATION DATE 9-31-94 LICENSED CONTRACTOR'S DECLARATION CUBIC YARDS EXCAVATION FILL OVER EXCAVATION ry I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000 1 R of Division 3 of the Business end Profess ions Code,and my license is in full force and effect License Class B License Number Fi 7R24H PLAN 3 V Det7/21/94 Contractor SUDIITOMO REALTY & ADDREsc 41/4 ions CodeCA. ,INC. O CITY AND ZIP PHONE OWNER-BUILDING DECLARATION ^ I hereby affirm that I am exempt from the Contractor's License Law for the following reason 1 O I,as owner of ih•property,or my employees with wages as their sole compensation will do V'C the work end the structure is not intended or offered for sale O I,as owner of the property am exclusively contracling with licensed contractors to construct ^� the protect ZONING I LAND USE O I am exempt under Sec BAPC for this reason rm/pn I r'R1 Ni. Date INITIAI SETBACKS I MODEL/PLAN f WORKERS COMPENSATION DECLARATION FY I SY I hereby affirm that I hays a certificate of consent to self insure,ore certificate of Workers I Compensation Insurance or a certified copypythereof RY SSY COMPANY KADOWAKI ASSOC.POLICY NO WC'P 900011R GROUPR DIVISION 3 TYPE VN O Certified copy is hereby furnished DATE EXPIRES 9-1-94 IIXCertdieis d copyfiled with the city CITY VERIFIED VALUATION I L49 i Dale 7-21-94 APPLICANT r Lig FEES CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATION INSURANCE I certify that in performance of the work for which this permit a is issued,I shall not employ any ELECTRICAL Ir //O/'y I STRUCTURAL( �,-v r 11.4 person in any manner so to become subject to the Workers Compensation Law of Cal dorms STRUCTURAL/ U Date APPLICANT c� y PLUMBING 14(0---�—� GRADING NOTICE TO APPLICANT If,after making this Certificate of Exemption you should become �1 �T subject to the Workers'Compensation provisions of the Labor Coda you must forthwith comply pp�, with such provisions or this permit shall be deemed revoked MECHANICAL , ISSUANCE FEES a L/ '� I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMA ' f^ TION IS E TO OMPLY TH ALL CITY ORDINANCES ND ATE LAWS, IAENTIAND ED RE TEORG OR INC PECTIORIZE REPR TNVIPU POSES ES OF CITI'T�NT�PONT�� VE SSOUANCE APPROVED TOTgREVIEW I NL PERMICHECK T (O/ (6) Si n IL7e 6(ApplicaiorrAAgent Dete j G / I I.7'17 R v DATE OF ISSUA CE PERMIT NUMBER ITTh r 7�d.S�i' I I 3d 0 7 __ Print Applicant s/Agent's Name qFINANCE CODE G C;era:L,r: INA Lank 4: Ott000122E WHITE- FILE/GREEN- FINANCE/YELLOW- OFFICE/PINK-OWNER L G2: !/=5/�9 0 r1EceLPt A% $17;Q93; at-L1/4 GOLD-ASSESSOR/MANILA - INSPECTOR CONSTRUCTION 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 ADDREPe DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION THE CALIFORNIA HEALTH AND SAFETY CODE REQUIRESA DIVISION OF INDUSTRIAL SAFETY PERMIT AS A PREREQUISITE TO PERMIT ISSUANCE UNLESS THE APPLICANT SIGNS ONE OF THE CERTIFICATES BELOW 0 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 ❑IS 015 NOT SUBJECT TO THE APPLICABLE REQUIREMENTS OF THE HEALTH AND SAFETY CODE AND THE LOCAL AIR QUALITY AGENCY :,. , I . \ • t '-1oIIT'L2•'t`T--Y}rarlsYS V iiJ7:71f r.lr IP,r-:74e WT,-.r431:'174„_,,,¢r"7srr.rWei"onr. . . •_4.n, ' .. . ' ' I ( t: CITY OF CHINO HILLS . - APPLICATION FOR A BUILDING PERMIT AND COMMUNITY DEVELOPMENT A CERTIFICATE OF USE & OCCUPANCY 'I 2001 Grand Avenue _..;qtr MINISIMil Chino Hills, CA 91709 BUILDING PROPOSED USE 03C ADDRESS 16500 own N $ SFRF v APN 1017-732-060000 THE FOLLOWING WORK IS AUTHORIZED BY THIS PERMIT D LOT 21 BLOCK TRACT 13507_5 OATRUCT LizPLUMB MECH ;ELECT 0 GRADING 9 TYPE OF PERMIT 0 NEW 0 ALTER 0 ADDITION m APPLICANT pg AS UMILIt n n 0 REPAIR 0 CONVERT 0 DEMO 0 OCCUPANCY PMT ADDRESS PROJECT I LOCATION ON I SIZE DESCRIPTION PROPERTY INSOFEET CITY ZIP PH 1 LIVING I I `418 OWNER SIMITIZZO MATADC 6 .. VELOPIEN Cek., D . 2 9!.r Aar;t- I I 642 ADDRESS 23046 At/:t4 E E IA 1300 YY�V.. � I I 54 3 p iia CITY La HIAL3 92653 PH 586-1011 4 I I ARCHITECT ENGINEER LIC NO REMARKS/SPECIAL CONDITIONS/PROJECT DESCRIPTION ADDRESS NO STORIES NO DWELLING UNITS BEDROOMS CITY ZIP PH ROOF I FLOOR I EXT WALL I INT WALL -` CONTRACTOR SAM Asngt LIC NO 678246 t ADDRESS CEILING HEATING I FIREPLACE METAL MASONRY CITY ZIP PH SEWER I MIN DEPTH I S/F/100I SIZE LICENSE NO 1310 EXPIRATION DATECITY BUSINESS CENSE 8-31-84 LICENSED CONTRACTORS DECLARATION CUBIC YARDS EXCAVATION FILL OVER EXCAVATION I hereby affirm that I am licensed under provisions of Chapter S(commencing with Section 7000 of Division 3 of the Business and Professions Code,and my license is In full force and effect . License Class '� License Number 6786 P1 3 7/21/94 SLE`TF1CJtS0 RUM 6 Date '-lontractor ' U1 V73LWASlati (A.oat r ADDRESS , ti CITY AND ZIP PHONE V OWNER-BUILDING DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason 4' O 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 male O I,as owner of the property am exclusively contracting with licensed contractors to construct the pro1.ct ZONING I LAND USE O I am exempt under Seo B BPC for this reason CHAD I FR1 �i - Date INI TIAL SETBACKS I MODEL/PLAN 4 WORKERS COMPENSATION DECLARATION FY I SY 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 RY I SSYI tel 9000118 COMPANY ASSOCe POLICY NO �A GROUP R DIVISION 3 TYPE 'JN , 0][Certified copy n hereby furnished DATE EXPIRES 9-1-94 0rbertd led espy s tiled with the city CITY VERIFIED VALUATION IL..1+'j - �� 2 "" i—Li-94 1 t ' Date APPLICANT PERMIT FEES CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATION INSURANCE I certify that in performance of the work for which this permit is issued,I shall not employ any ELECTRICAL I r I.- �!f I STRUCTURALf^ r' person in any manner so as to become sublect to the Workers Compensation Law of California ...wit.. rss f I ' i) L Date APPLICANT IL vv..vv.. I y PLUMBINGfi: GRADING NOTICE TO APPLICANT If,after making this Certihcele of Exemption,you should become sublect to the Workers Compensation provisions of the Labor Code,you must forthwith comply SS)). q`- J 'y with such provisions or this wenn shell be deemed revoked MECHANICAL S y � ISSUANCE FEES 3 ..... I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMA- TION IS CORRECT I AGREE TO COMPLY WITH ALL CITY ORDINANCES AND STATE LAWS, GEO REVIEW I PLAN CHECK V ; f^-' AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS CITY TO ENTER'UPON THE ABOVE \ MENTIONED PROPERTY FOR INSPECTION PURPOSES J/ .— — ISSUANCE APPROVED TOTAL PERMIT FEE ' y) Signature of^APPficent or Agent�yy1,-A�� Dab ,^ • ') / - - KUM £C75 DATE OF ISSUANCE PERMIT NUMBER •Print Applicant s/Agent•Name I r 1 / / `, J` c" JC FINANCE CODE WHITE- FILE/GREEN- FINANCE/YELLOW- OFFICE/PINK- OWNER GOLD-ASSESSOR/MANILA - INSPECTOR •ONSTRUCTION LENDING AGEN• 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 NAMF LENDERS ADDRFP9 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 D 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 D 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 DATE I INSPECTOR I / DAriE . INSPECTOR/ Setback/Location 2 \ I N I Rough Plumbing nliot; I /1-rir )-I(`) Q\\ \ N\ N ,Shower Pan Test {y. I /A, v Foundation Reinforcing Steel \ �" \ �� �) /I Stucco Mesh or Exterior Siding (p//y/may I v`fd1-/l�-- Excavation and Forms I I Insulation /D _ Slab Grade , 774-r _ -te---/ t-: I Sewer / /Y 44 _ /- - �/ Ground Plumbing Soil L:\--,C1-0y IN--\N._._:\ I Interceptor Ground Plumbing Water 8//7/riy 7,41.74ChSeptic Tank Underslab Ducts I peach Line or Seep Pit Underslab Conduit Water Service 9//3/,.4, .? Z Underslab Gas 1961Is-or Drywall Nailing /D/iy//mac/ '-/ Fireplace Foundation Gas Line Air Test I /y/�,cr aZ/Z� Joists and Girders Final Energy - I Electrical Ground Final Plumbing Iat(/ 7- Mid-Height Bond Beam Final Heating/A C ,,I177% Y 8-Foot Bond Beam Final Construction IX" /xS�— Final Bond Beam Final On Site Improvements Fireplace Bond Beam Final Off Site Improvements Roof Sheathing 9//(v/4y me--40-cr7 .Final Dedication Framing and Ventilation /' 1 /' A Final Zoning Roof Covering i ,I. / ,I / / Final Electrical ) ,/ 'I '- ' /mil Rough Heating I \ &IV A II W Final Gas y21 Service and Ground -. 14M7 J,/ 'I,IV Developer Fees Paid Rough Electrical LI 12' 11 f/ Fire Dept Approval Verified Bonding ,% / Certificate of Occupancy Over Head Electrical Fence Height I ` Gates Heater Pool Drainage /2 - 7-4? ./...1/ ...,,, Coe t -CE--. '.-""-- SEPTIC TANK GALS - SEEP PIT X LEACH LINE WIDF _ LONG X DEPTH OF ROCK • N W E S Inspector's Signature and Initials 1 DATE OF ISSUANCE PERMIT NUMBER