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Permit No. 17141 BUILDING ADDRESS: 16127 FIRESTONE LANE PERMIT NUMBER: 17141 BUILDING INFORMATION APPLICANT INFORMATION (-7 ,- ,o-t BUILDING PERMIT APPLICATION Address: 16127 FIRESTONE LANE Name: !RALPH JAMES Community Development APN: 11017-022-20 Address: 1786 PINEFALLS AVENUE 2001 Grand Avenue Lot: 120 City,Zip Code. (WALNUT,CA 91789 Chino Hills,CA 91709 iY` ' Cross Streets: ! Phone/Pager: 1(909)594-7547 I ext. 1 ,y o "..H.. LICENSED CONTRACTOR DECLARATION Tract/Parcel• 113295 ! City Bus Lic 1N/A I hereby affirm that I'm licensed under the provisions of Chapter 9(commencing with Section Valuation. 1$3,168.00 ENGINEER/ARCHITECT INFORMATION 7000 of Division 3 of the Business and Professions Code)and my license is in full force and effect OWNER INFORMATION Name. 1N/A OWNER BUILDER DECLARATION Name: DAVID HECKMAN Address ( 1 I hereby affirm that I'm exempt from the Contractor's License Law for the following reason: Address: 16127 FiRESTON LANE City,Zip Code:I I,as the owner of the property,or my employees with wages as their whole City,Zip Code: CHINO HILLS,CA 91709 Phone: 1 I ext I 0 compensation,will do the work,and the structure is not intended or offered for sale Phone: ! ext. I Lic#: 1 ! O 1,as owner of the property,am exclusively contracting with licensed contractors to Bus Lie#• N/A City Bus Lic#: 1 construct the project • ® I am exempt under Section I I BPC for this reason I I Bus Exp: APPROVAL INFORMATION WORKERS'COMPENSATION DECLARATION CONTRACTOR INFORMATION issued By: YVETTE MARTINEZ I hereby affirm under penalty of perjury one of the following declarations: Contractor: WEST COAST CUSTOM ROOMS I Date Issued: 10/11/00 Address: 786 PINEFALLS AVENUE 1 Finance Code: C4-SM I have and will maintain a certificate of consent to self-insure for workers'compensation as provided by Section 3700 of the Labor Code,for the performance of the work for City,Zip Code: WALNUT,CA 91789 Census Code. which this permit is issued Phone or Pager: (909)597-7547 I ext. I Final Date• `' Bus.Lic.#: NEW Final B I have and will maintain workers'compensation,as required by Section 3700 of the By. Labor Code,for the performance of the work for which this permit is issued. My Lic # 471619 I Extension. workers'compensation insurance carrier and policy number are: Exp Date: 4/30/01 I Reviewed By LAURO BUGARIN Lic.Class. B,HIC INSURANCE INFORMATION Approved By: LAURO BUGARIN Insurance Company: 1CALIF INDEMINITY ( PROJECT INFORMATION Policy Number. 1N6052414C I PROJECT DESCRIPTION LOCATION SQUARE FT. Expiration Date: 101/01/01 1 ! 1 1 I I tructure. Section need not be completed if permit is for one hundred dollars($100)or less Garage: 1 1 1 I certify that in the performance of the work for which this permit is issued I shall not employ Patio. (LATTICE 1REAR 1 ! 264 41. any person in any manner so as to become subject to the Workers'Compensation Laws of Porch: I 1 1 1 I California and agree that if I should become subject to the workers'compensation provisions of Other: Section 3700 of the Labor Code. I shall comply with those provisions PROPOSED USE LATTICE PATIO COVER Date: i i Signature: i i LEDGER INSPECTION REQUIRED. I certify I have read this application and state that the above information is corr et I agree to comply with all City Ordinances and state laws and hereby, thorize repr en trues of this City to COMMENTS enter upon the above mentioned property for inspection surposes Date: j///N I Signature: --d 'A - . `. OTHER FEES REQUIRED ifr ZONING SETBACK S I/, • /ING PRIOR TO ACTUAL PERMIT / ISSUANCE PERMIT FEE INFORMATION Zoning 1PD Front Yard. 21 Over X: 1 0 Issuance: 1 $29.00 ! Electrical. ! $0.00 Land Use. IFR-1 1 Side Yard: 5/5 School. I NO 1 Permit Fees Plan: Rear Yard: 15 1 0 ! Plan Check: $49.14 Plumbmg' $0 00 $153.74 I Cut: 1 I Fill: 1 0 Development: NO SMIP: 1 $0.50 1 Occ: 1ACCESSORY SSY: Total: 0 Sewer: 1 NO 1 Mechanical. 1 $0.00 I Structural. 1 $75.60 I Type• ITO R3 VN 1 1 Water: 1 NO 1 Geo Review. 1 $0.00 I Grading: 1 $o.o0 I Total Fee Due 1 $154.24 1 . ~ ^ INSPECTION RECORD . I. ^ INSPECTION DATE INSPECTOR Grading: INSPECTION DATE INSPECTOR Block Wall �� P�y�u��aehng Rough Grade Footing, ReBar Terraces 1st Lift Bond Beam 2nd uhBond Beam Sub Drains 3rd U�Bond Beam Finish Grading Drain Seal Soils Certification � Grading Certification ReRoof� on Rough Tear-off, Existing Conditions Sheath Nailing AsBuilt Appm,eu Underground Site Inspections: Roof Final Building Sewer Line Swimming Pools : Supply Water Line Location/Rebar/Bonding/Light Storm Drain/Catch Basins Gas Test G,�ongui�/�os!�c� UxSConUuiuBem�ca| DO NOT BACKFILL UNTIIS �novs APPROVED Pre-Deck Verify Soils Engineering: POOL NOT TO BE FILLED UNTIL FENCING IS COMPLETE Compaction,moisture,conditioning,etcFence,� Gate&Alarm unuernvor/unuu,s|aumspocuon: Final Pool U/F Waste Plumbing Fire Protection Equipment: U/F Water UG Pipe U/F Mechanical Thrust Blocks U/F Electrical Hydro U/F Framing Flush Insulation Weld Outlet lnsp. SubDoor Overhead Hydro ABOVE IS REQUIRED PRIOR TO FOUNDATION INSPECTION, Foundation Inspection: Temp Power Pole Electric Release Oo�acx/F000ng . UFER Ground(Rebar/Copper) Gas Test Hardware/Hold-Downs FINAL INSPECTIONS Piers/Caissons/Tendons DO NOT POUR CONCRETE UNTIL ABOVE IS APPROVED NO OCCUPANCY PERMITTED WITHOUT FINAL I Shear Inspection (Wood): County Environmental Health Dept (33,'757U) RoofNailing Exterior Walls Planning Dept (35*'z75n) Interior Walls Public Works (3ox'ur7O) Fire (o9�'3888> Hardware/Hold-Downs Fire Landscape (354'2rS7) Combo Inspection: Trust Accounts....(Framing Rough Electric ALL ABOVE MUST BE APPROVED BEFORE FINAL BLDG. Final Electric Rough Mechanical Rough Plumbing/Topout Final Grade Fma| P|�mbing COVER wovvOnnUNTIL ABOVE IS APPROVED Final Mechanical Insulation rina/ Buimin�Consoocunn �-�-/J/ ,4"- .�r�/�omopocxion� �, , , nterior Water Meter Number Exterior -mx CERTIFICATE OF OCCUPANCY 3tucco Scratch OK TO ISSUE wmosLLAwsoum /wspscTmws wasnnryFi,e Fireplace VT s / "lT/es. rima|ocx. ' /YC,° ��**�� k,,4 C/r itit. "/ ~^~ — "�� mDeck : �nn \ccess/Light/Switch • "auormaJ.-G-01 47~ • a_������� �� /x,�/ �� .4 ' , III III �� �� ��