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Permit No. 2012-25573 ( ") BUILDING DIVISION OF COMMUNITY DEVELOPMENT DEPARTMENT City of Chino Hills '1 14000unter CityPhoCenneter Dr.,Chino Hills,CA91709 Co (909)364-2780 Building Permit 24-Hour Inspection Line (909)3642790 (NOTE:You must call before 3p.m.for a next business day inspection) 4 u City Hall Main Number (909)364-2600 • NOTICE: THIS PERMIT BECOMES NULL AND VOID IF WORK IS NOT COMMENCED WITHIN PLEASE USE PERMIT NUMBER 180 DAYS FROM DATE OF ISSUANCE,OR IF WORK IS SUSPENDED AT ANY TIME FOR MORE BELOW WHEN MAKING INQUIRIES THAN 180 DAYS OR IF WORK IS DONE IN VIOLATION OF ANY CITY OR STATE LAWS OR REQUESTING INSPECTIONS RELATING THERETO. PROJECT N FURNACE CIO; AI EO LOCATION 1PROJECT 2012-5573 No. 13 2201T No. 1BUILDING ADDR ESN IAPT.I UNIT NO. I ISSUED DATE I ISSUED Heredia,Monica 6163 10 N 03304 1TR 10295 129 T 1FLOORS I UNITS 1PROJECT PERMITS IP.TYPE CENCUS Res CODES OD Sr 1 CONST.TYPE 'ZONING TYPE IOCCUPANCY TYPE 1VALUATION $1 200.001 TOTAL SOFT 0.001 BLDG.SOFT Add/A B Curtest Owners:.. .: Fees. Name:TERESA&BRAULIO VICTORIA Fee Group I Fee Description Fee Amount Payments ' Address: 16163 FIRESTONE LN CHINO HILLS CA 91709 Transaction Type Ph: 909-597-2421 Mechanical- l hanioal C/O = - -- -- -`-' --__ - =' r$75.50 - ` _=_ "-- Email: M@CH.ORG = _ _ Contractor. RELIABLE ENERGY.MANAGEMENT INC=RELIABLE ENERGY.MANAGEMENT INC.. B001 Permit Issuance Fee $53.00 53.00 Address: 7201 ROSECRANS AVE PARAMOUNT CA 90723 8110 FAU/A-C=<100,000BTU $21.50 21.50 Ph: 562-984-5511 Email: M@CH.ORG Uc.Information704414 Ems.Date:3/31/2013 ` : "" SB1473 $1.00 1.00 LICENSED CONTRACTORS DECLARATIONLICENSED CONTRACTORS DECLARATION TOTAL FEES 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 AMOUNT PAID $75.50 effect In securing this permit I am acting with the knowledge of and on behalf of the owner of the property BALANCE DUE $0.00 ate: -/-` Contractor, --7-7 v 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 mom 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 Cade: 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. LetI have and'will maintain workers'compensation insurance,as required by Section 3700 of the Code,for the performance of the work for which this permit is issued. My worker's compensation /,Z insurance carrier and policy number are: l Z it. 7")/ arrierThL-..-- .e.g/ec7L X.,s..c.,.c Policy PPLICANT SIGNATURE DATE ugh ra.` r lA�licenl:: JUAN MARTINEZ 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,and Address: 7201 ROSECRANS AVE PARAMOUNT CA 90723 . agree that if I should become subject to the workers compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply comply with those provisions. Ph: 562-984-5511 Email: M@CH.ORG •IT Date-/ /J2 Uc.Information Exp.Date: Applicant: ,---1-----, rl I certify that the user of this facility shall comply with sections 25506,25533 and 25534 of the Health and O Safety Code,which regulate the storage,handling and use of hazardous materials WARNING: Failure 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 COMMUNITY DEVELOP MENT—BUILDING& SAFETY DIVISION Call(909)364-2790 before 3:00 p.m.for next day inspection Post in a safe, conspicuous place atfront ofjob. Provide permit number when calling for-inspection. Have approved-plans.onjob at time of inspection. NO WORK SHALL BE COVERED WITHOUT INSPECTION- File this permit"with.your permanent records when job is complete. INSPECTION RECORD INSPECTION DATE INSPECTOR INSPECTION DATE INSPECTOR Grading: Block Wall Inspections: Pregrade Meeting Footing,Rebar Rough Grade 1 s'Lift Bond Beam Terraces 2nd Lift Bond Beam Sub Drains 3'd Lift Bond Beam Finish Grading Drain-I Seal Soils Certification Grading Certification Rough ReRoof: Tear-off,Existing Conditions Underground Site Inspections: Sheath Nailing Building Sewer Line .Roo f Final Water Supply.Line UIG Electrical Service Conduit Swimming Pools: Storm Drain/Catch Basin Location 1 Rebar'!Bonding I Light DO NOT BACKFILL UNTIL ABOVE IS APPROVED Gas Test Gr.Conduit Verify Soils Engineering: Ro Elect Compaction,moisture,conditioning,etc." POOL NOT TO BE FILLED UNTIL FENCING-IS'COMPLETE Fence,Gate&Alarm UnderfloorIUndersigkInspection: Final Pool OF Waste Plumbing UIF Water. Fire Protection Equipment; UIF Mechanical UG.Pipe • UIF Electrical :Thrust Blocks UIF Framing .Hydro UIF Insulation Flush Subfloor Weld Outlet Insp. ABOVE IS REQUIRED PRIOR TO FOUNDATION INSPECTION -.Overhead Hydra Foundation Inspection: 'Temp Power-Pole Setback/Footing-OK to Pour .Electric Release UFER Ground(Rebar(Copper) Gas-Test Harctw 'e-l.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: (391-757U); Shear,inspection:(Wood): Planning DepL(3$4-2752) Roof Nailing Public Works (364-2774) Exterior Walls Fire (393=3888) Interior Walls Landscape- (364-2766), Hardware"/Hold-Downs ALL ABOVE MUST BE APPROVEDBEFORE FINAL BLDG..• Fine(Grade. Combo nspedion: Final"Electric'- • Framing • Final;.Plambing \f , ,��-' Rough Electric`. . Final Mechanical. Rough Mechanical' - - 44p_ Final Building/Construction,• \e Rough'Plumbing'ITopout (. Water Meter Number COVER NO.WORK UNTIL ABOVE IS APPROVED CERTIFICATE OF OCCUPANCY Insulation OK"=T0 ISSUE Drywall Inspection: OTHER:, :-Interior Exterior. µEkS = PaSSed EXT LATH Car bore$ I S Mo Kes m_ •Stucco Scratch: Miscellaneous hrspeclians: MasorryFieplace Plate Ties;fire.Block Patio/Deck: Footing Frame: Access/Light I Such NOTICE TO OWNER:Call:for FINAL INSPECTION"on every job. This pemitwill expire if work is suspended or.abandonedfara Patio=Final 'Period af-180;days: