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2016-31846 1-28-2016 13721 SHADOW RIDGE DUCT REPLACEMENT -no BUILDING DIVISION OF COMMUNITY DEVELOPMENT DEPARTMENT Coty of ChHills 14000 City Center Dr.,Chino Hills,CA91709 Counter Phone (909)364-2780 u x Building i 24-Hour Inspection Line (909)364-2790 (NOTE:You must call before 3p.m.for a next business day inspection) City Hall Main Number (909)364-2600 j amt+ 4$ +t,> 4 nam*-am a NOTICE: THIS PERMIT BECOMES NULL AND VOID IF WORK IS NOT COMMENCED WITHIN PLEASE USE PERMIT NUMB:R 180 DAYS FROM DATE OF ISSUANCE,OR IF WORK IS SUSPENDED AT ANY TIMEBELOW WHEN MAKING I QIIRIE THAN IF WORK IS DONE IN VIOLATIONI T OR REQUESTING INSPECTIONS-- RELATING THERETO. PROJECT DESCRIPTION 1,PROJECT No. PERMIT No. DUCT REPLACEMENT 7 SUPPLY 2016-31846 BUILDING ADDRESS 1 APT./UNIT NO. ISSUED DATE ISSUED BY 13721 SHADOW RIDGE DR I1/28/2016 Freeman,Nicole APN TRACT MAP# LOT FLOORS/UNITS PROJECT PERMITS 102408256 TR 13651-2 1175 / CENCUS CODES CONST.TYPE ZONING TYPE OCCUPANCY TYPE VALUATION TOTAL SQFT BLDG.SQFT 434_Res Add/Alter VB R-3 $5,000.00 0.00 Current Owners: Fees Name:JOVITO MALIXI Fee Group/ Fee Description Fee Amount Payments Address: 13721 SHADOW RIDGE DR CHINO HILLS CA 91709 Transaction Type Ph: 111-111-1111 Mechanical C/O $202.00 Email: m@ch.org Contractor SERVICE CHAMPIONS-SERVICE CHAMPIONS SB1473 $1.00 1.00 Address: 22911 SAVI RANCH PKWY YORBA LINDA CA 92887 Misc Mechanical $201.00 201.00 Ph: 714-692-7977 Email: m@ch.org Lic.Information799170 Exp.Date:9/30/2017 TOTAL FEES 202.00 LICENSED CONTRACTORS DECLAFtATIONLICENSED CONTRACTORS DECLARATION AMOUNT P D $202.00 I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9(commencing with Sec.7000)of Division 3 of the Business and Professions Code,and my license is in full force and BALANCE DUE $0.00'' effect. In securing this permit I am acting with the knowledge of and on behalf of the owner of the property. Date: ii/Z ,4,4Contractor: aa '7-1 • OWNER-BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's Licence Law for the following reason,(Sec,7031.5,Business and Profesional 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 Sec.7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more that five hundred dollars($500.00) I,as owner of the propterty,or my employees with wages as their sole compensation,will do the work,and the structure is not intended or offered for sale(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 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 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 Contractor's 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 article 3 of the Business and Professions Code. Date: Permittee: Print Full Name: WORKERS COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self-insure for workers'compensation,as I certify that I have read this application and state that the above information is correct. I agree to comply provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is with all city and county ordinances and state laws relating to building construction,and hereby authorize issued. representatives of this city to enter upon the above-mentioned proptery for inspection purposes. I have and will maintain workers'compensation insurance,as required by Section 3700 of the L bor'°-de,for the performance of the work for which this permit is issued. My worker's compensation insurance carrier and olic number are: rtl 6. Carrier: , n' f �,k" r Policy APPLICANT SIGNATURE 4" __ DATE ((�� a C`,. Applicant: ROBERTGO®. 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 worker's compensation laws of California,and Address: 41085 GOLDEN GATE CIR MURRIETA CA 92562 agree that if I should become subject to the worker's compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with those provisions. Ph: 818-735-7876 Email: M@CH.ORG Lic.Information Exp.Date: Date: . Applicant:: F..41,' � I certify that the user of this facility shallcomplywith sections 25506,25533 and 25534 of the Health and Safety Code,which regulate the storage,handling and use of hazardous materials WARNIN : Fail e to secure worker's compensation coverage is unlawful,and shall subject an employer to criminal penalities 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. CITY OF CHINO HILLS COivi Fi1JrUTY DE\IELOP FENJT—BUILDING SAFETY DI is i0I :144-2701) pan..itOf nnspiacti,con Post in a safe, conspicuous place at front of job. Provir.Je permit number when callinci for inspection. Have approved plans on job at time of inspection. SH IL BE COVE Ft ED iPaillaH 111 7 TI Li rile this perrnit with your permanent records vyileil job is complete. P C:7 KJ,[rj1 RE INSPECTlON DATE INSPECTOR INSPECTION DATE INSPECTOR Gradhg: Block Wall kmr.mdi N Pregrade Meeting Footing,Rebar Rough Grade l 'Lift Bond Beam Terrace:s 2111 Lift BOrd Beam Sub Drains 3 Lift Bond Beam Finish Grading Drain I Seal Soils Certification Grading Certification Rough ReRoof: Tear-off,Existing Conditions Uroda-grotild Se 4 Sheath Nailing Building Sewer Line Roof Final Water Supply Line U/G Electrical Service Conduit Swki "rg Pcm : Location I'Rebar Bonding/Light Storm Drain Catch Basin DO NOT BACKFILL UNTIL ABOVE IS APPROVED Gas Test Gr Conduit Wally Soils Engi Eng: Ro Elect Compaction,moisture,conditioning,etc. POOL NOT TO BE FILLED UNTIL FENCING IS COMPLETE Fence,Gate&Alarm UndeiflN r lab kis m: Final Pool UF Waste Plumbing UIF Water Fire lkotedi i Equi 1! UiF Mechanical UG Pipe UF Electrical Thrust Blocks UF Framing Hydro UF Insulation Flush Sutofloor Weld Outlet Insp. ABOVE IS REOUIRED PRIOR TO FOUNDATION INSPECTION Overhead Hyd'o Foundation I - 1 P1' .4- Pole Setback Footing—OK to Pour Electric Role - UFER Ground(Rebar/Copper) Gas Hardvvere I'Hold-Downs Piers/Caissons Tendons FINAL INSPECTIONS Slab Grade—OK to Pour NO OCCUPANCY PERMITTED WITHOUT FINAL DO NOT POUR CONCRETE UNTIL ABOVE IS APPROVED County Environmental Health Dept. (391-7570) Shea'ts ion(Wxl): Planning Dept.(364-2752) • Roof Nailing Public Works (364-2774) Exterior Walls Fire (393-3386) --- Interior Walls Landscape (364-2766) Harthvete Hold-Downs ALL ABOVE MUST BE APPROVED BEFORE FINAL BLDG. Final Grade Cultc)- Final Electric • Framing Final Plumbing Rough ElectricFinal Mechanical (3.1 Rough Mechanical Final Building/Construction Rough Plumbing I'Topout Water Meter Number _ COVER NO WORK UNTIL ABOVE IS APPROVED CERTIFICATE OF OCCUPANCY Irmuldicki OK TO ISSUE D all kmidim: OTHER: Interior Exterior EXT LATH Stucco Scratch (. 1 S 01 MlsoelI iusispeW 4 M Fi-eplam Plate Ties,Fire Block Patio/Deck: Footing Frame Light 1 Svvich NOTICE TO OWNER:Call for FINAL INSPECTION on e :01). Th"rernt will emi-e if is s - -d or aboub for a Patio Final period of 180 d.