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Permit No. (12) 105 SAN BERNARDINO COUNTY-EPWA/LAND AGEMENT DEPT 4110 OFFICE OF BUILDING AND SAFETY P E RMI T APPLICATION PERMIT NBR 105 89 01814 805A 01 STATUS: PAID THIS IS NOT A PERMIT UNTIL ISSUED APPL DATE 06/05/89 I ISSUE DATE 00/00/00 I PG 1 OF 1 PARCEL NUMBER 1033-262-74-0000 PROPOSED USE: MD/8'14 HI ARCHWAY 17'6F ST PL CURRENT USE: RESIDENCE W/GARAGE 13401TRACT 1000 1117 I NSEC W07 1035 107W I P10142AP PRCL ACTIVITY : L833 L902 COMMUNITY PLAN ZONE/LAND USE DISTRICT GENERAL PLAN SUBDIVISION NAME SUBDIVISION PARCEL NO CHINO HILLS PUD RES 6 LOT DIMENSION IRREGULAR (CONST TYPE APPLICANT NAME, MAILING ADDRESS, AND PHONE NUMBER ABLDGS ON LOT 1 GROUP WROTH, COURTENAY F. 6220 FLEETWOOD LN *PLANS RECD 0 LAND USE PLOT 0 (INDEX NBR 62-177 CHINO HILLS CA 91709-0000 STD PLAN/ICBO FHA N (714) 597 - 1533 ITEM CNT DESCRIPTION DETAIL TOTALS OWNER NAME, MAILING ADDRESS, AND PHONE NUMBER MINOR DEVIATION 221.00 WROTH, COURTENAY F. MICROFILM COPIES 6.00 6220 FLEETWOOD LN TOTAL AMOUNT 227.00 CHINO HILLS CA 91709-0000 (714) 597 - 1533 JOB SITE ADDRESS 6220 FLEETWOOD LN CHINO HILLS CA 91709-0000 CROSS STREET SEVENOAKS INSPECTN ACCESS CONTRACTOR NAME, ADDRESS LICENSE NUMBER DIV. OF IND. SAFETY PERMIT: MINIMUM SETBACK DISTANCES 43 FRNT SETBACK/CENTRLINE FLEETWOOD R/W 50 15 REAR SETBACK/PROP LINE 5 SIDE SETBACK/PROP LINE 10 SIDE SETBACK/PROP LINE MECHANICAL EQUIP NOT PERMITTED IN REQUIRED SIDE SETBACKS NO. STORIES I NO. OITDWELLING I NO. BEDROOMS I FLOOR UNEXT. WALLS INT. WALLS I CEILING ROOF HEATING FIREPLACES METAL IMASRY PUWATER BLIC (PUSEWER BLIC I MIN DEPTH( S.0000/100I SIZE( NEW/REPAIR 000 COMMENTS 06/14/89 DEVIATION APPROVED. JUSTIFICATION: ARCHWAY DOES N PROJECT BEYOND GARAGE EAVE OVERHANG G1763. AMT WAIVED .00 AMT PAID 227.00 PAYOR NAME: COURTENAY F. WROTH PAID 06/05/89 RECEIPT 3157 EMPL: STACCATO-NYARI, M PAID BY : CHECK NBR : 1014 *LICENSED CONTRACTORS DECLARATION* I HEREBY AFFIRM THAT I AM LICENSED UNDER THE PROVISIONS OF CHAPTER 9 (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 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 [55001.1' ❑ 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.0 I 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 [$1001 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 DATE 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 AND REFUND NOTICE APPLICATIONS FOR WHICH NO PERMIT IS ISSUED WITHIN 180 DAYS FROM THE DATE OF APPLICATION SHALL EXPIRE.PERMITS 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 180 DAYS FROM DATE OF PAYMENT, EXCEPT FOR ERRORS IN ACCEPTANCE WHICH MAY BE REFUNDABLE UP TO ONE YEAR FROM DATE OF PAYMENT. ALL FEES PAID MAY NOT BE REFUNDABLE 12-17588-469 Rev. 10/88 • County of San Bernardino OFFICE OF BUILDING AND SAFETY APPLICATION FOR A MINOR DEVIATION RESIDENTIAL/COMMERCIAL/INDUSTRIAL AND SIGNS 1. Owner ' s Name //'' Telephone No. .-c.e f--re,d 4-5e F i�� ��t Lei)M ( w) C7 Mailing Addkess / C' y State Zip 2- F-( 4,;C I Chao Wk. TI 7D 2. Person To Be Notified Other Than Owner Telephone No. Mailing Address City State Zip 3. Location of Property ( Example : Street number at site , street name , distance from nearest intersection, community or township) : ar,o r .. 6 23 U F/e wo Lane. /55 P. fry rn i() -r -- 0-P Wood hr ido+estt ctn d Fl eefw000l La-ne. 4. Describe the Minor/ Deviation .Re_ uested J�° // �/ / ,Q/�'<'!?�4/.!2S.T7�d�`IO�iYY77 SSS/o h!r `et. elY;;T'diwQy teAlGA(,sheen hu;? gr) /...7e-/e-6/7% M e arl of fhe house and does e:xSenG/ het/and e house , rhes Arai MPS'z v-es a. h e/9o' $ / 1/. ,deD/A 07' 3" Zra LA)/d77 O7e' 174 ' S:� 5 . ssessor ' s ParceL_Ntra>er( s) and Complete Legal Description of Property 'Tract # or Metes and Bounds)MSS SCA--Ae`t (1rr4ne i iC733Z6 7i'nao(=> I CERTIFY UNDER PENALTY OF PERJURY that the foregoing is true and correct, and that I am the (check one) : Legal Owner(s) (All individuals must sign their names as they appear on the deed to the land, OR (-1 Owner's Legal Agent 6l A;43/F9 s2s L-a,z G< 13/�i Signature Date ` Si'gnature Date' (FOR OFFICE USE ONLY) ZONE GENERAL PLAN INDEX PANEL FILING DATE FEE $ RECEIPT # RECEIVED BY BRANCH FORM MD-1 • • COUNTY OF SAN BERNARDINO LAID MANAGEMENT DEPARTMENT �`��III�'''% PUBENVIRONMENTAL LIC WORKS AGENCY 320 East "D" Street • Ontario, CA 91764 //// ` \ JOHN N. JAQUESS - / I \ Land Management Director June 14, 1989 OFFICE OF PLANNING Sharon W. Hightower County Planning Officer COFFICE OF SURVEYOR 614 COURTENAY WROTH EXPIRATION DATE: 06/14/92 laude D. Tomlinson, L.S.. County Surveyor 6220 FLEETWOOD LANE A PN : 1033-262-74 OFFICE OF BUILDING AND SAFETY .44 CHINO CA 91709 INDEX: 62-177 Larry L. Schoelkopf, P.E. ZONE/GP: PUD/RES 6 County Building Official - • PMT. NO. : 105 89 01814 80 A 01 This is to advise you of the action on your application for modification involving Minor Deviations under Title 8 , Division 11444 4 , of the County Code , to locate a structure contrary to said Code on property described as: 6220 Fleetwood Lane. Lot 117, Tr. No. 13401; CHINO HILLS The following request was Approved on June 14, 1989 to : construct archway eight feet one inch high to be located seventeen feet six inches from front property line instead of required eighteen feet setback. Conditions of Approval : 14 THE FOLLOWING CONDITIONS ARE PART OF THE ACTION ON THIS APPLICATION UNLESS OTHERWISE SPECIFIED UNTIL ALL CONDITIONS ARE MET: 1. This action is subject to appeal within 10 days of the date on which the decision becomes effective . The filing of an appeal SUSPENDS the action taken by the Building Official until such time as a decision is rendered on the appeal . 2. Appeals to the action of the Building Official must be filed within 10 calendar days after the written notice of action has been made. The appeal forms can be obtained from the Office of Building and Safety , and must be accompanied by the appropriate filing fee. Thank you , BRUNO GUTIERREZ, Regional Building Inspector Supervisor t9 Land Use Section `G 10-Office of Building and SafetyQ • EPWA/Land Management Department -• BG:df cc : File f\ii MAYS ..i' ,� _. ,u ;,j=i�3�.. ' ,;(1*-Nv JC7Yruc.. �`: :t'� .. '.;;°3t..F.« :`.• g _ iNGRr"M, ";t ;s_ri:_f>r �� .;7` 1'u',rr: =:1�':t `i C.3tS 'ry� t�si!,3:'?;,j';,;,. . . r COUNTY OF SAN BERNARDINO LAND MANAGEMENT DE ARTMENT ENVIRONMENTAL PUBLIC WORKS AGENCY NOTIFICATION LETTER: MINOR DEVIATION / /4I \ Date: June 7, 1989 TO: CONTIGUOUS PROPERTY OWNERS RE: MINOR DEVIATION REQUEST OF Courtenav F. Wroth Owner's Name The San Bernardino County Development Code requires that all contiguous property owners (those whose properties touch and those across streets or road easements) abutting the site listed below be notified of the proposed deviation in order to allow them an opportunity to voice their concerns. If you have any questions regarding this deviation application, contact the indicated office below.* This MINOR DEVIATION REQUEST for the site listed below is to modify the minimum County regula- tions and/or standards as follows: construct archway eight feet one inch high to be located seventeen feet six inches from front property line instead of required eighteen feet setback. Site Address 6220 Fleetwood Lane Site Location Chino Hills Legal Description 117 13401 Lot Blk Tract OR Metes and Bounds File/Index 62-177 Zone PUD APN 1033-262-74 Please check here ❑ if you wish to receive a copy of the DEVIATION DECISION and return this letter along with a stamped self-addressed envelope to the office indicated below.* *OFFICE OF BUILDING AND SAFETY ❑ P.O. Box 2835, Big Bear Lake, CA 92315 — (714) 866-4115 ❑ Star Route 1, Box 60, Joshua Tree, CA 92252 — (619) 366-3751 ❑ 385 North Arrowhead Avenue, San Bernardino, CA 92415-0181 — (714) 387-4225 ❑ P.O. Box 185, Twin Peaks, CA 92391 — (714) 337-2405 ❑ 15505 Civic Drive, Victorville, CA 92392 — (619) 243-8127 X 320 East "D" Street Ontario, CA 91764 (714) 391-7500 ANY APPEAL of an approval, denial or modification of the deviation request MUST be filed with the Office of Building and Safety within ten (10) calendar days after the MAILING DATE of the deviation decision. The appropriate fee must accompany any appeal. If no appeal is filed within the above time period, the deviation ecision will become effective. ® regional Supervisor ❑ Land Use Plans Examiner 12-18521-489 Rev.4/87 y 'l [ . FINDINGS NEASARY FOR THE GRANTING OF fINOR DEVIATION Prior to approving a request for a deviation, the reviewing authority shall find that the following are true [Section 84.0340( f) - Development Code] : It is the applicant ' s responsibility to provide specific justification for each of the four (4) following findings . An approval of the requested deviation ( justification) should include specific evidence, details and/or qualities of the proposed use, structure or other project. Additional pages or supporting documentation (photographs , previous deviation approvals, etc. ) may be attached. 1. The granting of such deviation will not be materially detrimental to other properties/ /orr, land uses in the area, because: /1" ,C-v .s', to/ '4-ke_ �h'�c/5(Z, /di l:iY_ 'F�tJ /4¢e! T"CQ,.7 A-d o 54—(]~ias It 1rb Lt/�it oa T S1 no r G oc% / C ,0,14. 5- : Z4' 6Gl� /pain-6/4a/ i& I!via/ ®led,1€d- it e4". .S/I/�n4 i1 Leniel our I 2. There are exceptional or extraordinary circumstances or conditions (size, shape, topography, location or surroundings) applicable to the property or to the intended use that do not apply to other properties in the same District or •vicinity, because: 2-7n ;14 y `�2,c/1.6': 4; ) )11,,0l e vY?- -1/(6?- c)`‘ fits/ riaCli&alL- _ 3. The strict application of the Land Use District deprives such property of priveleges enjoyed by other properties in the same Land Use District. /(Stat the specific right or rights. ) / / Ako.e a �,f7ai 4. That the granting of the deviation is compatible with the objectives, policies, general land uses and programs specified in the adopted General Plan and/or any applicable Community Plan or Specific � Plan, because: !4 !y'( l'� t�iA�l J,, /Vfrzrive ��z 41./A) �i,,JhGG /cr `1/L,p 1cir�J 1v�5%Y' GSC l e_c .�)' rl`f'l� E%�.��i ce/�'.� j roc yet.{ ,1n h /t a y�s ,.904- A tori/�-.� 1-GSA-1 [�L� A A 1J i s V,'`��>1--0r4Gh 4. i,•1 to d e lkaa,...(4 Se lr9-40 . yo6.0_ 4-17,o e.4-( 4-0 1 o f t `, !lS l0:165 gNC74.6)11- 1,7 p c. u,Afo frfJY 414V � � ®tea FORM MD-3 • 0 •* CERTIFIED PROPERTY OWNER'S LIST DECLARATION . I CERTIFY UNDER THE PENALTY OF PERJURY that to the best of my knowledge, the list below contains the names and address of all contiguous property owners* as they appear on the latest available County asses- sment role. *Those properties which touch property lines at any parcel involved with a Minor Deviation, including those properties which touch the prop ty lines o the subject parcel when projected across roads or stree s. ----4 / —1(2— / Sicha€ure Date APN: 0235-091-25 NAME: John Doe SAMPLE: ADDRESS: 1653 Outside Lane CITY: San Bernardino STATE:CA ZIP: 92400 1 APN: APN: /03 2.6 2j o ,c -- NAME: ` - l 'r ' . NAME:L//Z/,'M) L. {l�I.o&Jr/r4 L., 661CS' i ADDRESS:f ADDRESS:g=:22 S r/e'r cx2P 1�„A) CITY: STATE:// lab./ ZIP: CITY: I�li 4O%t�`LSTATE:erIZIP:`r/ 205' APN: / 0-3 -S zC, 2,`f73 0000 APN : jgc.�3 3 2 2J2 wo NAME: M/e-hoc-G IP Gj4 5S-100a-i4 NAME:�/� wee. di .�©/0 �2� r' � � i� ADDRESS:6 i/1( fll��, G )00r, ADDRESS:.&-• .C1 f eei`i" 44) I-51 CITY:('/j1)U/V IL C1T STATEC/(ZIErL 7 ait$0 CITY1�/`/SSTATE: ZIP: /7i, APN: 1 C�3 Z427 APN : //p 33 - Cm J/ - /c, NAME: , 1-4,1 j .19 / AK,A.,,j4 72 el NAME: /P/f.A2I� C)U��►-��/ l/. ADDRESS: (22,.2.6 //"/2.4 �(, c.��� LA/0.e... ADDRESS: „;90 2.9 CeNTUR/ pA EA' � � '/556 CITY: C/14./00 G i / STATEel ZIP:?7ZO /may CITY: oveDS A.N&f" I : C'AZIP: 7 APN: APN: NAME: NAME: ADDRESS: ADDRESS: CITY: STATE: ZIP: CITY: STATE: ZIP: APN: APN: NAME: NAME: ADDRESS: ADDRESS: CITY: STATE: ZIP: CITY: STATE: ZIP: (ADDITIONAL SPACES ON REVERSE SIDE OF THIS PAGE) FORM MD-2 CERTIFIED PROPERTY OWNER'S LIST APN: APN: ;. NAME: NAME: ADDRESS: ADDRESS : CITY: STATE: ZIP: CITY: STATE: ZIP: APN: APN: NAME: NAME: ADDRESS: ADDRESS: CITY: STATE: ZIP: CITY: STATE: ZIP: APN: APN: NAME: NAME: ADDRESS: ADDRESS: CITY: STATE: ZIP: CITY: STATE: ZIP: APN: APN: NAME: NAME: ADDRESS: ADDRESS: CITY: STATE: ZIP: CITY: STATE: ZIP: APN: APN: NAME: NAME: ADDRESS : ADDRESS: CITY: STATE: ZIP: CITY: STATE: ZIP: APN: APN: NAME: NAME: ADDRESS: ADDRESS: CITY: STATE: ZIP: CITY: STATE: ZIP: APN: APN: NAME: NAME: ADDRESS: ADDRESS: CITY: STATE: ZIP: CITY: STATE: ZIP: APN: APN: NAME: NAME: ADDRESS: ADDRESS: CITY: STATE: ZIP: CITY: STATE: ZIP: