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Permit No. 2003-1907 • BUILDING DIVISION OF COM TY DEVELOPMENT IMPARTMENT f` City2001 Grand Avenue,Chino Hills,CA 91709 ,,� of Chino Hills Counter Phone (909)364-2780 k Building Permit 24-Hour Inspection Line -(909)364-2790 '�;'. // (NOTE You mustucalle before 3p m a next6business day inspection) ` � �" City Hall Main Number (909)364-2600 cH,i of:m,V,VIII: NOTICE THIS PP R 'f BECOMES NULL AND VOID IF WORK IS NOT COMMENCED PLEASE USE PERMIT NUMBER WITHIN 180 DA ROM DATE OF ISSUANCE, OR IF WORK IS SUSPENDED AT ANY BELOW WHEN MAKING TIME FOR MORE THAN 180 DAYS OR IF WORK IS DONE IN VIOLATION OF ANY CITY INQUIRIES OR REQUESTING OR STATE LAWS RELATING THERETO: INSPECTIONS PROJECT DESCRIPTIONPERMIT No 520 SO FT ICB0#222PP I 2003-1907 0 BUILDING ADDRESSDATE ISSUED BY 4988 HERITAGE DR 0 I I APT/UNIT No ISSUED 11/17/2003 I LLAPORT APN PARCEL MAP# TRACT LOT/PARCEL BLOCKCONST TYPE ZONE OCC LAND USE 1028-521-54 I CR 15769 115 V-N UN I R-3 I Residential CENSUS CDIES I OVERLAY FR1 DIST I BLDGO SOFT I P TYPE I PROBJECT PL PEERMITS I SETBACK FY I SETBACKC RY I SETBACK SSY I SETBACK SY unkn5/5 FEES CL Description Calc. Paid w GOROSPE,GERRY & ZENALDA Structural $108.00 $108.00 O 4988 HERITAGE DR Plan Check PC $70.20 $70.20 CHINO HILLS CA 91709 Issuance/Suppl F $29.00 $29.00 SNIP $0.70 $0.70 L J HAUSNER CONST CO Total Paid 11/17/2003: $207.90 505 W FIRST STREET TUSTIN, CA 92780 ct Grand Total: $207.90 $207.90 0 H (719) 544-3100 U g Z Contr Lic: 326317 o Expiration: 1/31/2005 License Type:B00 Workers Comp:229-0024835 Expiration: 6/23/2004 Bus. License:NEEDED Expiration: - LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury 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 is in full force and effect In securing this permit I am acting with the knowledge of and on the behalf of the owner of the property I� PROJECT DESCRIPTION Daj l''-('')'-' 3 Contractor ...e.. �r(1/��'1 I /' OWNER-BUILDER DECLARATION v 520 SQ FT ICB0#222PP ❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason (Sec 7031 5 Business and Professional 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 there from 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) ' ❑ 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 safe (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 does such work himself or herself or through his or her i own employees, provided that such improvements are not intended or offered for sale If however,the building or improvements 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 I PROJECT INFORMATION 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 I Desc I Location I Sq Foot I Valuation projects with a contractor(s)licensed pursuant to the Contractors License Law) I PATIO ICBG REAR 520 $6,240.00 ❑ I am Exempt under Article 3 of the Business and Professions Code Date Owner WORKERS COMPENSATION DECLARATION I iereby affirm under penalty of perjury one of the following declarations (❑ I have and will maintain a certificate of consent to self-insure for workers' compensation, as provided for by Section 3700 of the Labor Code,for the performance of the work for which this Total Valuation S6.240.00 permit is issued. I certify that I have read this application and state that the above information -- iCC-"I have and will maintain workers' compensation insurance, as required by Section 3700 the is correct I agree to comply with all city and county ordinances and state — Labor Code,for the performance of the work for which this permit is issued laws relating to building construction,and hereby authorize representatives of this county to enter upon the above-mentioned property for inspection ❑ I certify that in the performance of the work for which this permit is issued,I shall not employ purposes any person in any manner soIhaulto becoeme subject tot the 's compensation laws of / C��N�i v`►✓ r California,and agree that if I should become subject to the worker's compensation provisions I/ x of Section 3700 of the Labor Code,I shall forthwith comply with those provisions "--APFCLICANT SIGNATURE t GATE ) APPLICANT INFORMATION L J HAUSNER CONST CO ( 505 W FIRST STREET 0Date ((,-(7--- .3 Applicant AA " ITUSTIN, CA 92780 WARNING Failure to secure worker's compensation coverage is unlawful,and shall subjedUan 1(714) 594 3100 employer to criminal penalties and civil fines up to one hundred thousand dollars($100,000),in I certify that the use of this facility shall comply with sections 25505,25533, addition to the cost of compensation,damages as provided for in Section 3706 of the Labor Code, and 25534 of the Health and Safety Code,which regulate the storage, interest,and attorney's fees handling and use of hazardous materials • CITY OF CHINO HILLS COMMUNITY DEVELOPMENT—BUILDING&SAFETY DIVISION Call (909)364-2790 before 3:00 p.m.for next day inspection Post in a safe, conspicuous place at front of job. Provide permit number when calling for inspection. Have approved plans on job at time of inspection. NO WORK SHALL BE COVERED WITHOUT INSPECTION File this permit with your permanent records when job is complete. INSPECTION RECORD INSPECTION DATE INSPECTOR INSPECTION DATE INSPECTOR Grading: Block Wall Inspections: Pregrade Meeting Footing, Rebar Rough Grade 1s'Lift Bond Beam Terraces 2nd Lift Bond Beam Sub Drains 3`d Lift Bond Beam Finish Grading Drain/Seal Soils Certification Grading Certification Rough ReRoof: Tear-off,Existing Conditions Underground Site Inspections: Sheath Nailing Building Sewer Line Roof Final Water Supply Line U/G Electrical Service Conduit Swimming Pools: Storm Drain/Catch Basin Location/Rebar/Bonding/Light DO NOT BACKFILL UNTIL ABOVE IS APPROVED Gas Test Gr Conduit Verify Soils Engineering: Ro Elect Compaction,moisture,conditioning,etc POOL NOT TO BE FILLED UNTIL FENCING IS COMPLETE Fence,Gate&Alarm Underfloor/Underslab Inspection: Final Pool U/F Waste Plumbing U/F Water Fire Protection Equipment: U/F Mechanical UG Pipe U/F Electrical Thrust Blocks U/F Framing Hydro U/F Insulation Flush Subfloor Weld Outlet lnsp ABOVE IS REQUIRED PRIOR TO FOUNDATION INSPECTION Overhead Hydro Foundation Inspection: Temp Power Pole Setback/Footing—OK to Pour Electric Release UFER Ground(Rebar/Copper) Gas Test Hardware/Hold-Downs Piers/Caissons/Tendons FINAL INSPECTIONS Slab Grade—OK to Pour NO OCCUPANCY PERMITTED WITHOUT FINAL DO NOT POUR CONCRETE UNTIL ABOVE IS APPROVED County Environmental Health Dept (391-7570) Shear Inspection(Wood): Planning Dept. (364-2752) Roof Nailing - Public Works (364-2774) Exterior Walls Fire (393-3888) Interior Walls Landscape (364-2766) Hardware/Hold-Downs ALL ABOVE MUST BE APPROVED BEFORE FINAL BLDG. Final Grade Combo inspection: Final Electric Framing Final Plumbing Rough Electric Final Mechanical Rough Mechanical Final Building/Construction Rough Plumbing/Topout Water Meter Number COVER NO WORK UNTIL ABOVE IS APPROVED CERTIFICATE OF OCCUPANCY Insulation OK TO ISSUE Drywall Inspection: OTHER: Interior Exterior // EXT LATH rc xlc . 1 G> t — /.2,4/3 Stucco Scratch Miscellaneous Inspections: Masonry Fireplace Plate Ties,Fire Block Patio/Deck: Footing Frame Access/Light/Switch / NOTICE TO OWNER.Call for FINAL INSPECTION on every job This permit will expire if work is suspended or abandoned for a period of Patio Final - 180 days