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Permit No. 19051 BUILDING ADDRESS: 5004 HERITAGE DRIVE PERMIT NUMBER: 19051 . .z BUILDING INFORMATION APPLICANT INFORMATION Vi$ BUILDING PERMIT APPLICATION Address: 15004 HERITAGE DRIVE Name: 1WEST COAST CUSTOM ROOMS ;' 4 Community Development APN: 1028-521-56 Address 1786 PiNEFALLS AVE ",•• „irk, 2001 Grand Avenue Lot 1117 City,Zip Code: 1WALNUT,CA.91789 Chino Hills,CA 91709 : : `• Cross Streets. 1 Phone/Pager. (909)594-7547 I ext `"° "'� wLICENSED CONTRACTOR DECLARATION Tract/Parcel: 115769 I City Bus Lic#. I I hereby affirm that I'm licensed under the provisions of Chapter 9(commencing with Section Valuation: $2,304.00 ENGINEER/ARCHITECT INFORMATION 7000 of Division 3 of the Business and Professions Code)and my license is in full force and effect. OWNER INFORMATION Name: 1N/A OWNER BUILDER DECLARATION Address Name: 1PETER PAPPAS 1 I hereby affirm that I'm exempt from the Contractor's License Law for the following reason: Address: 15004 HERITAGE DRIVE 1 City,Zip Code O I,as the owner of the property,or my employees with wages as their whole City,Zip Code 1CHINO HILLS,CA 91709 Phone. I ext I compensation,will do the work,and the structure is not intended or offered for sale. Phone. (909)606-8969 1 ext. 1 Lie# I,as owner of the property,am exclusively contracting with licensed contractors tomo Bus Lic# City Bus Lie# construct the project. I am exempt under Section BPC for this reason I Bus Exp APPROVAL INFORMATION WORKERS'COMPENSATION DECLARATION CONTRACTOR INFORMATION Issued By 1YVETTE MARTINEZ I hereby affirm under penalty of perjury one of the following declarations. Contractor. WEST COAST CUSTOM ROOMS 1 Date Issued: 110/3/01 1 Address• 1786 PINEFALLS AVE Finance Code C4-SM I I have and will maintain a certificate of consent to self-insure for workers'compensation O as provided by Section 3700 of the Labor Code,for the performance of the work for City,Zip Code: WALNUT,CA 91789 Census Code• which this permit is issued Phone or Pager: 1(909)594-7547 I ext I Final Date. i d— Bus Lic#: 101-05750 Final By ' I have and will maintain workers'compensation,as required by Section 3700 of the ® Labor Code,for the performance of the work for which this permit is issued My Lic.#: 1471619 I Extension workers'compensation insurance earner and policy number are: Exp Date. 4/30/02 Reviewed By: LAURO BUGARIN Lie Class: IB,HIC Approved By: ILAURO BUGARIN INSURANCE INFORMATION inA:ranee Company: 1STATE FUND 1 PROJECT INFORMATION Policy Number: 11620269 PROJECT DESCRIPTION LOCATION SQUARE FT. Expiration Date. 1/1/02 Structure: 0 Section need not be completed if permit is for one hundred dollars($100)or less Garage: • 1 certify that in the performance of the work for which this permit is issued I shall not employ Patio: 11CBO#2228P 1REAR 1 I 192 any person in any manner so as to become subject to the Workers'Compensation Laws of Porch 1 1 California and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code. I shall comply with those provisions. Other: SOLID PATiO COVER PROPOSED USE Date: I I Signature: I i LEDGF,R INSPECTION REQUIRED I certify i have read this application and state that the above information is corre . I agree to p 4/� !✓/?e'oA G<Ce"" At --- comply with all City Ordinances and state laws and hereby aut represejtati es of this City to COMMENTS enter upon the above mentioned property for inspection p oses. 4 Date: a Signature: i( _-.5r.' tNL OTHER FEES REQUIRED ZONING SETBACKS G ING PRIOR TO ACTUAL PERMIT PERMIT FEE INFORMATION ISSUANCE Zoning- PD Front Yard• 23 Over X• 0 Issuance• 1 $29 00 1 Electrical: 1 $0.00 I Land Use: IFR-1 Side Yard. 5/5 Cut 0 School NO Permit Fees: I $135.92 Plan. ACCESSORY Rear Yard• 15 Development. NO Plan Check• 1 $42.12 Plumbing $0 00 Fill: 0 SMiP: 1 $0.50 1 Occ• 1R3 I SSY Total. 0 Sewer I NO Mechanical I $0.00 Structural: $$640.0800 64.80 1 Type. VN Water. NO Geo Review 1 $0 00 Grading $0 00 1 Total Fee Due I $136.42 • • INSPECTION RECORD Permit Number Inspection Date Inspector Inspection Date Inspector Grading: Pregrade Meeting FINAL INSPECTIONS(Inspector verify following) Rough Grade NO OCCUPANCY PERMITTED WITHOUT FINAL I Terraces County Environmental Sub Drains Health Dept Finish Grading Planning Dept Soils Certification Public Works Grading Certification Fire Rough Landscape As Built Approved Underground Site Inspections: ALL ABOVE MUST BE APPROVED BEFORE FINAL BLDG Building Sewer Final Grade U.G.Waste Plumbing Final Electric Water Service Final Plumbing Storm Drain/Catch Basins Final Mechanical U/G Conduit/Electrical Final Building/Construction /fl- .9C/ _ z Compaction Report Water Meter Number ABOVE IS REQUIRED PRIOR TO FOUNDATION INSPECTION, Footings CERTIFICATE OF OCCUPANCY UFER Ground(Rebar/Copper) Hardware/Hold-Downs Piers/Caissons/Tendons OT ER Slab Grade ^P .__�Z Ok /�Jt-/7- Zf DO NOT POUR CONCRETE UNTIL ABOVE IS APPROVED Shear Roof Nailing 425' Y++�( el<- /0---',;12g-a 7 Exterior Walls Interior Walls Hardware/Hold-Downs Rough Electric Rough Mechanical Rough Plumbing/Topout Framing COVER NO WORK UNTIL ABOVE IS APPROVED Insulation Drywall Interior/Exterior Lath Stucco Scratch Roof Covering Block Wall Inspections : Footing, ReBar 1st Lift Bond Beam 2nd Lift Bond Beam 3rd Lift Bond Beam Drain/Seal SWIMMING POOLS: • Location/Rebar/Bonding/Light Gr Conduit Ro Elect POOL NOT TO BE FILLED UNTIL FENCING IS COMPLETE •, Fence,Gate&Alarm • Final Pool Temp Power Pole Electric Release Gas Test