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Permit No. 1056 CIT jY OF CHINO HULLS 0 COMMUNITY DEVELOPMENT I 2001 Grand Avenue APPLICATION FOR A BUILDING PERMIT AND A CERTIFICATE OF USE &OCCUPANCY Chino Hills, CA 91709 BUILDING / �/c��j �]�� CLEARED BV APPLICATION TYPE NO co ADDRESS c7� IC /�/ I, l Cc�'!V/ C APN /�4A GL / Z0 I` L �"I 1— 61 THE FOLLOWING WORK IS AUTHORIZED BY THIS ERMIT D LOT I '''77 //// TRUCT 1MB CH ELECT 0 �l� BLOCK TRACT f� 0 ✓✓UUUU TYPE OF PROJECTEW ❑ ALTER ❑ ADDITION m JJJ fn OWNER a )/`��r,�/? n .-0),...w // 1] REPAIR ❑ CONVERT ❑ DEMO ❑ OCCUPANCY PMT /W` �jt I ---��� PROJECT LOCATION ON 1`SIZE ADDRESS (f�j► n` l, ,/ / y�-� DESCRIPTION I PROPERTY / J� IN SO FEET �. CITY? II b f,� n ZIP�(i�Y lVg PH �lN 1/o t4/a�I U"/ I //. .-;. q ' 1 , ,, . ENGINARCHEER ( LIC NO 46144:4 I t/V / I O',A04� ,..-"..7ADDRESS • 3�� V I /0,0 CITY ZIP PH REMARKS/SPECIAL CONDITIONS/PROJECT DESCRIPTION 1 • _._ . .t, � CONTRACTOR 6.1/!y`��J� LIC NO 6 ADDRESS CITY ZIP PH • ..---766:3 / ///777 , i I.. _ /,11,i CITY BUSINESS I LICENSE NO / J� EXPIRATION DATE LICENSE / r�/,s/ �� /�//4 3 (/ ---- LICENSE ` r LICENSED CONTRACTORS DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000 of Division 3 of the Business and Professions Code,and my license full fgrce,and el; 53 License Class !_yL) License Number,�f y��(~�(-//'�[/'fel r/�)j�jy��/� Date / Contractor)t`�`,' cv-N-f SJ7 z:ccr\ ADDRESS /c 1--) %;t()/ i)I .r 3 )c���c( 1.,,)-- -Frac( CITY AND ZIP V/ 1 / PHONESr16 63 () uv ----.\ 1 OWNER-BUILDING DECLARATION /in' / I hereby affirm that I am exempt from the Contractor's License Law for the following reason CI /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 1// t t•1/�/ / ❑ I.as owner of the property,am exclusively contracting with licensed contractors to construct the project ❑ I am exempt under Sec B&PC for the reason \ u Date INITIAI / /� i WORKERS'COMPENSATION DECLARATION �i��/ /1 r . MIA A / 77_s"--- Insurance, I hereby affirm that I have a certificate of consent to sell insure,or a certificate of Workers'Compensation �'// /'� Insurance,or a certified copy thereof L�i / - ^ - slii / .1' ' "`di� 41.��J17 LtM-'rll COMPAN I�L� � � OLICY NO , GROUP DIVISION e' TYPE I� ❑ Certified copy is hereby furnished DATE EXPIRES C�� l K r Certified copy is filed with the city CITY VERR�IFII,_pc�n VALUATION 47449124/g 7 !`J3�/ Date APPLICANT. / t t /) r / / o — PERMIT FEES CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATION INSURANCE I certify that in the performance of the work for which this permit is issued,I shall not employ any person in ELECTRICAL • I STRUCTURAL /1/-12-1-) any manner so as to become subject to the Workers'Compensation Laws of California ' Date APPLICANT PLUMBING I GRADING NOTICE TO APPLICANT If,after making the 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 MECHANICAL ISSUANCE FEES I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT I AGREE TO COMPLY WITH ALL CITY ORDINANCES AND STATE LAWS,AND HEREBY GEO REVIEW —I PLAN CHECK AUTHORIZE REPRESENTATIVES.OF THIS CITY TO ENTER UPON THE ABOVE MENTIONED . PROPERTY Oq SP GT tN P+'POSES ��, ISSU PROVED TOTAL PERMIT FC�f///3 3 3.A'3 .- , '-S'gnat$re of plx; o Agent Date / ✓ /ff/!l / ,—)yJ lg. DATE OF ISSUANCE' PERMIT NUMBER Priri Applicant's/Agent's Name 2J ✓ -qI / ///��� 7. Operator: DINN Check R: 000000000 Date: 3/23/93 00 Receipt ll:: 0000708 WHITE-INSPECTOR/GREEN-FILE/YELLOW-FILE/PINK-OWNER/GOLD-ASSESSOR CHECK $1113.00 BUILDING ADDRESS LOT BLOCK TRACT BUILDING INSPECTIONS RECORD OWNER ADDRESS CITY ZIP PH /PL ING _57SPRS GROUND SOP1 2 3 43� Z TOP OUT T P2 / I , SHOWER PAN P3 REMARKS SEWER P5 cr..)a- .5 k -4/,e5/./› GAS TEST P6 I I .C./l )(� -9:1 (14 4/1,FINAL PLUMBING P12 MECHANICAL DATE APPROVED/INSPR'S SIGNATURE UNDERGROUND FLOOR M1 ROUGH M2 I FAU/AC M4 FINAL MECHANICAL M12 ELECTRICAL DATE APPROVED/INSPR'S SIGNATURE TEMP CONSTN.POWER E3 UNDERGROUND ' PVC-METAL-D.B C El ROUGH WIRING RECEPT.SPACING- SERVICE-CIRCUIT E2 FINAL ELECTRICAL E12 STRUCTURAL DATE APPROVED/INSPR'S SIGNATURE • FOUNDATION.LO TION -S1 REINFORCED UFER``� ``JJ • SLAB REINFORCEDI/MEMBRANE(i63 rl/ f FLOOR FRAME/INSUL S4 MASONRY .. S:11. I. - __ FIREPLACE S11 I I ROOF FRAMING • • �jf nSS ROOF SHEATHING �/ �� S FRAMING "'. - - S6 I • INSULATION I I SOUND ENERGY S7 LATH EXTERIOR SB LATH INTERIOR/GYPBOARD S9 - n i / �_`/7 `'A APPROVED/INSPR'S 71�I�T� �/1- -ceti .SIGNATURE /ATE OF ISSUANCE PERMITAIUMBER BUILDING FINAL - S12 . . • CZEY OF CHINO HILLS . • COMMUNITY DEVELOPMENT 2001 Grand Avenue Chino Hills,CA 91709 - BUILDING ADDRRESSEBS / 3 y5/ `/&=/,e,H+�/ /v- /x% LOT ``+� BLOCK TRACT BUILDING INSPECTIONS RECORD OWNER POST IN CONSPICUOUS ADDRESS PLACE ON THE JOB CITY ZIP PH AP ROVED/INSPR'S FOR NEXT DAY INSPECTION CALL PLUMBING D -15,-" ; 590-1511 EXT.282 BEFORE 4:00 P.M. GROUND OIL P1 I d 43 -7/-- - GIVE AND OB ADDRESS,PERMIT TY E OF INSPECTION. BER, TOP OUT P2 I / •0!?i -1 r_ SHOWER PAN P3 I REMARKS SEWER P5 I a-2-2. 7 q -.oce.;a0A ,3/.36/27 /< -7/ GAS TEST PBI /7.,y' eLle I/7" ‘' ' ,2 7'' / .3 7y FINAL PLUMBING P12 / I f MECHANICAL DATE APPROVED/INSPR'S E, T 9---(5 '95'�5 ^9 �)a'--t.- -� SIGNATURE / UNDERGROUND FLOOR M1 ROUGH M2 ,-, f_ FAU/AC M4 I • FINAL MECHANICAL M12 I ELECTRICAL DATE APPROVED/INSPR'S SIGNATURE TEMP.CONSTN.POWER E3 I UNDERGROUND PVC-METAL-D.B.C. El ROUGH WIRING RECEPT.SPACING- / - ,_; SERVICE-CIRCUIT E2 I I FINAL ELECTRICAL E12 I STRUCTURAL DATE APPROVED/INSPRS SIGNATURE FOUNDATION:LOC/510N S '' I /REINFORCED Po'' SLAB REFORCED�WIEMBRANEIP/I FLOOR FRAME/INSUL. S4 1 MASONRY S11 FIREPLACE S11 I I ROOF FRAMING I /'"«I 74-4 ROOF SHEATHING _-- S5 . -----/cre,r FRAMING S6 I j /"•1 "7-- I `�-:) - / INSULATION SOUND ENERGY S7 I 214�-- LATH EXTERIOR SB I ‘/s I •==7 e-- LATH INTERIOR/GYPBOARD SB I /$ I ' APPROVED/INSPR'S SIGNATURE DATE OF ISSUANCE PERMIT NUMBER BUILDING FINAL S12 VZ'//13 L� C. t o t5 TY OF CHINO HIL BUILNG AND SAFETY DEPARTMENT EXPIRATION DATE: 1/12/96 APN:LOTS; 1, 22, 26, 41, 43 , 51, 109 & 138 ( 39 ) TRACT 13651-16 INDEX: ZONE/GP:CH/PD FR1 PMT. NO. : 20247 This is to advise you of the action on your application for modification involving minor variances under Title 8, Division 4 , of the City Code, to locate a structure contrary to said Code on property describe as : LOT 1 , 14015 COUNTRY WALK LANE; LOT 22 , 14115 SWEET GRASS LANE; LOT 26 , 14106 SWEET GRASS LANE; LOT 41 , 1731 MILL STREAM; LOT 43 , 1711 MILL STREAM; LOT 51 , 1631 MILL STREAM; LOT 109 , 13923 WEATHER VANE COURT; LOT 138 , 13731 HEARTH STONE LANE. ( LOT 39 , 1751 MILL STREAM ) The following request was APPROVED ON 1-12-93 to: REDUCE REAR SETBACKS ON LOT 1 TO 18 ' ; LOT 26 TO 18 ' ; LOT 41 TO 18 ' ; LOT 51 TO 18 ' ; LOT 109 TO 14 ' ; LOT 138 TO 18 ' ; AND TO REDUCE THE FRONT YARD SETBACK ON LOT 22 TO 15 ' . The following request was DENIED ON 1-12-93 to: REDUCE REAR SETBACK ON LOT 39 TO 14 ' . Conditions of approval: THE FOLLOWING CONDITIONS ARE PART OF THE ACTION ON THIS APPLICATION UNLESS OTHERWISE SPECIFIED UNTIL CONDITIONS ARE MET: 1. This action is subject to appeal within 10 days of the date on which the decision becomes effective. The filling 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 Community Development Department, and must be accompanied by the appropriate filing fee. THANK YOU, 'E T L.PRYOR .B .