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Permit No. 5878 City of cino Hills APPLI•ION FOR BUILDING PERMIT Community Development 2001 Grand Avenue Chino Hills,CA 91709 ` Building Address: Proposed Use - St No 1393 StreetHEATHER RIDGE ELECT OUTLETS/2 SWITCHES APN 1000-451-04 THE FOLLOWING WORK IS AUTHORIZED BY THIS PERMIT Lot Block Tract ❑ Struct. ❑ Plumb. Applicant PHIL MAY LANDSCAPE ARCHITECT I Mech. Elect. ❑Gradina St No.636 StreetW ALLEN AVE Type of Project®New p Alter Q Addition CitySAN DIMAS Zip91773 Phone 592_1959 –1 Repair fl Convert. El Demo f1 Occupancy Permit OwnedOHN HUNT Project Location on Size — — ---- - Description I Property in Sq.Feet St Nal 393 StreetIEATHER RIDGE 1ELECT Cit}CHINO HILLS Zii91709 Phone 606-0538 Engr/Arch Lic No. 2. I I St No. Street 3 I City Zip Phone 4 I I REMARKS/SPECIAL CONDITIONS/PROJECT DESCRIPTION ContractorpHlL MAY LANDSCAPE Lic N0691184 Sewer I Min. Depth I S/F/100 I Size St No636 StreetW ALLEN AVE CittAN DIMAS ZipJ1773 Phone 592-1959 nitric Yards Excavation Fill Over Excavation City Business License U" License No2348 Expiration Dat5/31/97 �0 Licensed Contractor's 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 PIufessrons Code)and my hr.ense is in full for and effect License Class C_27 - License Number691184--- - - Date ContractorsAMe ncARn\g Address City and Zip Phone \Ns t\ Owner Builder Declaration I hereby affirm that I am exempt from the Contractor's License Law for the following reason: I, as the ownerwill of thedothe property, or my employees with wages as theel!r whole ----P ---EXPIB--B-LIMITION '" compensation, work, and the structure rs not mended offered for sale ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. uI am exempt under Sec. , B&PC for this reason ---- Dat$ IMttat . . - ._._., Date Initial b Workers' Compensation Declaration G. EIhereby affirm under penalty of perjury one of the following declarations. Zoning I Land Use a. I have and will maintain a certificate of consent to self-insure for workers' PD compensation as tided by Section 3700 of the Labor Code, for the performance of the work for wh is permit is issued. Setbacks 1 Model/Plan ID— b. I have and will maintain worker's compensation, as required by Section 3700 of the FY I SY I LaborCode, for the performance of the work for which this permit is issued My worker's RY I ss' compensation insurance carrier and policy number arc: • Group/Division/Type Ins. Co.: S o,0c-ro% r- _UJ4 c,-.A� ")S• C0 • . Policy No: WPC 1 1184 Exp Date: q• ( . 1(o VALUATION (Ihiis dection Treed not be completed it the permit is for one hundred doolars($Ion) or less) $'00.00 IJ c. I certify that in the performance of the work for which this permit is issued I shall PERMIT [TES not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code. I shall forthwith comply with those provisions $9.00 Electrical Structural xj. h C - to _—_Z 1kure q_ Srgnatur Warning: Failure to se workers' compensation coverage is unlawful, and shall subject an Plumbing Grading employer to criminal penalties 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 attunney's fees. Mechanical Issuance $45.00 I certify that I have read this application and state that the above information is correct. I agree to comply with all City Ordinances Geo Review Plan Check and state laws and hereby authorize representatives of this City Issuance Approved Total Permit Fee to enter upon the above mentioned property for inspection DC $54.00 purposes i I I,"1 2 ► A. Date Issued Permit Number Signature tit Applicant or Agent Da e 02/28/96 5878 FINANCE CODE CENSUS CODE,/ \, Print Applicant's/Agent's Name C4 0/S 'SONSTRUCTION LENDING AGENCI• I HEREBY AFFIRM THAT THERE IS A 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. O I CERTIFY THAT NO EXCAVATIONS 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. O 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 HAVE READ THE HAZARDOUS MATERIALS QUESTIONNAIRE AND THE WORK APPLIED FOR ON THIS PERMIT OIS OIS NOT SUBJECT TO THE APPLICABLE REQUIREMENTS OF THE HEALTH AND SAFETY CODE AND THE LOCAL AIR QUALITY AGENCY. BUILDING INSPECTIONS RECORD DATE INSPECTOR DATE I INSPECTOR Setback/Location Rough Plumbing Temporary Power Shower Pan Test Foundation Reinforcing Steel Stucco Mesh or Exterior Siding Excavation and Forms Insulation Slab Grade Sewer Ground Plumbing Soil Interceptor Ground Plumbing Water I Septic Tank Underslab Ducts Leach Line or Seep Pit Underslab Conduit Water Service Underslab Gas Lath or Drywall Nailing Fireplace Foundation I Gas Line Air Test Joists and Girders I Final Energy I Electrical Ground I Final Plumbing I Mid-Height Bond Beam I Final Heating/A C. I 8-Foot Bond Beam Final Construction Final Bond Beam Final On Site Improvements Fireplace Bond Beam Final Off Site Improvements Roof Sheathing Final Dedication Framing and Ventilation I Final Zoning Roof Covering I Final Electrical I Rough Heating li Final Gas • Service and Ground I - Developer Fees Paid Rough Electrical . //a/e7. CJ_ Fire Dept. Approval Verified Bonding ` I Certificate of Occupancy I Over Head Electrical Fence Height I Gates Heater Pool Drainage J/ 0-57Led----ZO—C&y S/g-6 1 � _ccrn r • SEPTIC TANK GALS. I SEEP. PIT X I PPR T FxpJRED_BY_LIMITATION LEACH LINE WIDE LONG X DEPTH OF ROCK N. 7\111 I Dat . ._-_-- Initial _-- ---� • W E. S. Inspector's Signature and Initials • DATE OF ISSUANCE PERMIT NUMBER ...1,''T?:,, ' • CITY OF CHINO HILLS 0 CITY COUNCIL: ED M. GRAHAM s t' ; , 2001 GRAND AVENUE GARY G. CARSON CHINO HILLS, CALIFORNIA 91709-4869 GWENN E. NORTON-PERRY (909) 590-1511 • (909) 590-5646 FAx JAMES S. THALMAN MICHAEL G. WICKMAN CITY OF CHINO HILLS 1 N C C)R PC,R AT1'.1)1901 EXPIRATION DATE: 6-28-97 APN: 1000-451-004 ZONE/GP:CH/PD MINOR VAR NO. :B20778 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 : ,14&48 HEATHERIDGE LANE, Tract 13915-9 Lot 20 43 .3 The following request was : APPROVED To construct a single family residence with a reduction in the required 20 foot rear yard setback. Proposed rear yard setback is 14 feet . 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 20 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 20 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, Winston Ward Building Official