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Permit No. (7) 105 • 'SAN BERNARDINO COUNTY-EPWA/LAND AGEMENT iJEPT • OFFICE OF BUILDING AND SAFETY PERMIT APPLICATTnN PERMIT NBR t05 89 02820 225A 01 I STATUS: ACTIV THIS IS NOT A PERMIT UNTIL ISSUED !' ---- APPL DATE 08/16/89 I ISSUE DATE 09/07/89 I PG 1 OF 1 PARCEL NUMBER 1031-281-38-0000 PROPOSED USE: SWIMMING POOL AND SPA e, 3 I .— 4 V / - .. CURRENT USE: RESIDENCE TRAC BLK SEC AC IVITY : 133137 1 000 096 I LOT I NW29 102S 108W I PRCL 00AP I PRCL COTMMUNITY PLANL821 ZONE/LAND USE DISTRICT GENERAL PLAN SUBDIVISION NAME SUBDIVISION PARCEL NO CHINO HILLS CH/PD LOT DIMENSION IRREGULAR CONST TYPE APPLICANT NAME, MAILING ADDRESS, AND PHONE NUMBER *BOGS ON LOT 1 GROUP MALINS POOLS INC. 12345 MILLS AVE #31 *PLANS RECD 2 LAND USE PLOT 0 INDEX NBR 26-156 CHINO CA 91710-0000 STD PLAN/ICBO 8630088225A FHA (714) 628 - 8734 ITEM CNT DESCRIPTION DETAIL TOTALS OWNER NAME, MAILING ADDRESS, AND PHONE NUMBER POOL PRIVATE 251.68 WATSON, RON MISC SUB-TOTAL 251.68 2670 HACKBERRY CIR TOTAL AMOUNT 251.68 CHINO HILLS CA 91709-0000 (714) 597 - 0256 , JOB SITE ADDRESS 2670 HACKBERRY CIR CHINO HILLS CA 91709-0000 CROSS STREET PISTACHIO STREET INSPECTN ACCESS CONTRACTOR NAME, ADDRESS LICENSE NUMBER MALINS POOL CONST CONT000438874 12345 MILLS *31VE UNIT *C CHINO CA 91710-0000 (000) 000 - 0000 DIV. OF ]NO. SAFETY PERMIT: P e'14J tt A 4° * 9 11 MINIMUM SETBACK DISTANCES 43 FRNT SETBACK/CENTRLINE HACKBERRY CIR R/W 50 At *-t '- 15 REAR SETBACK/PROP LINE 40 SIDE SETBACK/CENTRLINE PISTACHIO STREET R/W 50 5 SIDE SETBACK/PROP LINE MECHANICAL EQUIP NOT PERMITTED IN REQUIRED SIDE SETBACKS NO. STORIES IINOTDWELLING NO. BEDROOMS FLOOR UNS EXT. WALLS I INT. WALLS CEILING ROOF I HEATING FIREPLACES METAL IMASRY PUWATER ATIR I SEWER I MIN NODEPTHI S.000 100I0000EI NEW/REPAIR COMMENTS ADDITIONAL ZONING INFO:IMPROVEMENT LEVEL 1 / FR 1 / MOD TO HIGH LANDSLIDE SUSCEPTIBTLFY MINOR EROSION CONTROL REPORT SUBMITTED. AMT WAIVED .00 AMT PAID 251.68 PAYOR NAME: MALINS POOL CONSTRUCTION, INC. PAID 08/16/89 RECEIPT 4721 EMPL: RICHARDS, GARY PAID BY : CHECK NBR : 17942 • •LICENSED CONTRACTORS DECLARATIO• 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 4 LICENSE CLASS �'- LICENSE NUMBER �l� 3 7 f: • CONTRACTOR On 11.A N S DATE i - / - 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 [$500].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 DATE 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. 380, LA`B�C I ... --1-(•-_____POLICY NO.2� `V� ✓2 ` COMPANY • ❑ CERTIFIED COPY IS HEREBY FURNISHED c'TIFIED(COPY ISFILEDWITH E COUNTY BUILDING INSPECTION DEPARTMENT �/ APPLICANT \ A ) c ~ `� DATE I ` CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATION INSURANCE(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1$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 0 B LDINCONSTRUCTION, AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE-MENTIONED PROPERTY FOR INSPEC ION URPO9-- �' .5- '� SIGNATURE OF APPLICANT OR AGENT `l 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 ()Wrier Name )AJC ©A.) , < OPermit Numb s � -0,2 55.20 -, ,)574 INSPECTION RECORD r DATE "PECTOR I DATE INSPECTOR Setback 09/0/p Rough Plumbing Temporary Power j I i Shower Pan Test Foundation Reinforcing Steel 0//+/V \/ I Stucco Mesh or Exterior Siding Excavation and Forms Uv Insulation F.H.A. Foundation Req. Sewer Slab Grade Interceptor Ground Plumbing r),11141 N VII Septic Tank Underslab Ducts ' r ' v Leach Line or Seep Pit Underslab Conduit Water Service Fireplace Foundation _ Lath or Drywall Nailing () Joists and Girders ( ) Gas Line Air Test cqJ/488 1 A� Electrical Ground Sart/r6 07//f/f! WI Final Energy Mid-Height Bond Beam Final Plumbing 8-Foot Bond Beam Final Heating/A.C. Final Bond Beam .Hi. Final Construction Fireplace Bond Beam -f Final On Site Improvements Roof Sheathing I Final Off Site Improvements Framing and Ventilatiqp‘ Final Dedication Q.9.2.1.-C" CIPPel 4r4A ti,e3; // / 7 Final Zoning Rough Heating Final Electrical & .�ja Electrical Service and Ground I I Final Gas Rough Electrical I '"/f.-49 r I •431VDeveloper Fees Paid I WC (Y/N) Ind Saf (YIN) _ Certificate of Occupancy Et-6-g® 1-1,044- i-- - c+. It.). /—4( r,%.0104------Ar- o'C /.4'r%.� - / • SEPTIC TANK GALS SEEP. PIT X LEACH LINE WIDF X LONG X DEPTH OF ROCK N. W. E. — ., 44 n S. Inspector's Signature and Initials d 12-17589-469 Rev.3/88