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Permit No. 2011-25497 City of Chino Hills BUILDING DIVISION OFCOMMUNITY DEVELOPMENT DEPARTME/� , / 14000 City Center Dr.,Chino Hills,CA91709 fila Counter Phone (909)364-2780 Vk . Building Permit 24-Hour Inspection Line (909)364-2790 — (NOTE:You must call before 3p.m.for a next business day inspection) City Hall Main Number (909)364-2600 NOTICE: THIS PERMIT BECOMES NULL AND VOID IF WORK IS NOT COMMENCED WITHIN PLEASE USE PERMIT NUMBER 180 DAYS FROM DATE OF ISSUANCE,OR IF WORK IS SUSPENDED AT ANY TIME FOR MORE BELOW WHEN MAKING INQUIRIES THAN 180 DAYS OR IF WORK IS DONE IN VIOLATION OF ANY CITY OR STATE LAWS OR REQUESTING INSPECTIONS RELATING THERETO. 1PROJECT DESCRIPTIONPROJECT No. PERMIT No. 50 GALLON WATER HEATER CHANGE OUT,SAME LOCATION. 12011-25497 133143 BUILDING ADDRESS IAPT./UNIT NO. 'ISSUED IS UED DATE I Wh ISSUED B Rosemary Y 16286 IVORY CT 0741204 ITR 1CT07 IL LOT 1FLOORS/UNITS PROJECT PERMITS IP.TYPE 434 Res Add/Alter12 / 1CONST. CTYPE 'ZONING TYPE IOCCUPANCY TYPE 1VALUATION R-3 $500.00'TOTAL SQFT 0.00 1 BLDG.SQFT B Current Owners: . . : Fees Name:SUSANA SAHAGUN Fee Group/ Fee Description Fee Amount Payments Address: 16286 IVORY CT CHINO HILLS CA 91709 Transaction Type Ph: 909393-2454 Water Heater 0/0 - _ -_ - _-__:$70.00-_-_ Email: m@ch.org Contractor. ALL STAR WATER HEATERS INC-ALL STAR WATER HEATERS 8001 Permit Issuance Fee $53.00 53.00 Address: 30300 PUERTO VALLARTA MENIFEE CA 92584 B141 Water Heater $16.00 16.00 Ph: 800-727-0977 Email: M@CH.ORG LIc.Information812894 Exp.Date:9/30/2012 SB1473 $1.00 1.00 LICENSED CONTRACTORS DECLARATIONLICENSED CONTRACTORS DECLARATION TOTAL FEES :- - $70.00 • I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9(commencing with Sec.7000)of Division 3 of the Business and Professions Code,and my license is in full force and AMOUNT PAID $70.00 effect In securing this permit I am acting with the knowledge of and on behalf of the owner of the property. .DUE $0.00 Date/2,0%q Contractor. /, • OWNER-BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's Licence Law for the following mason,(Sec,7031.5,Business and Profesional 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 Sec.7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more that five hundred dollars($500.00) I,as owner of the propterty,or my employees with wages as their sole compensation,will do the work,and the structure is not intended or offered for sale(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 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 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 Contractor's 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 article 3 of the Business and Professions Code. Date: Permittee: Print Full Name: x 'WORKERS COMPENSATION DECLARATION . .. 11 hereby 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 I certify that I have read this application and state that the above information is correct I agree to comply provided for y section 3700 of the Labor Code,for the performance of the work for which this permit is with all city and finances and state laws relating to building construction,and hereby authorize issued. representaf of this to upon the above-mentioned proptery for inspection purposes. I have and will maintain workers'compensation insurance,as required by Section 3700 of the / / /// Labor Code,for the performance of the work for ich this permit is issued. My workers compensation /�!r`—/- insurance carrier and policy numt ��� �2. J fx/ �/ 11 rer C ,� Policy ' (APP SIG RE DATE / �/_ 1CQe l`C/ AbdiEant: "KENNETH BLOCK. 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 worker's compensation laws of California,and Address: 30300 PUERTO VALLARTA MENIFEE CA 92584 agree that if I should become subject to the worker's compensation provisions of Section 3700 of the Ph: 800-727-0977 Email: • .. Labor Code,I shall forthwith comply with those provisions. L_` /� Lic.Information Exp.Date: Date- G U `� C . . Applicant: /7/"../ ......----7.----'' I certify that the user of this facility shall comply with sections 25506,25533 and 25534 of the Health and Safety Code,which regulate the storage,handling and use of hazardous materials WARNING ..,.;•re to se.. •=•orker's com.:- -.on coverage is unlawful,and shall subject an employ�/• min- :- a _ -•• nes up to one hundred thousand dollars($100,000),in addition • to the cost' pensation,damages as provided for in section 3706 of the Labor Code,interest,and attorney's fees. CITY OF CHINO HILLS COMMUNITY DEVELOP MENT—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. • Gradlig: Block WaII Inspections: Pregrade•Meeting Footing,Rebar Rough Grade 1 s'Lift Bond Beam Terraces 2^'Lift Bond Beam Sub Drains 3"'Lift Bond Beam Finish Grading Drain I 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 Swirmirrg Pools: Storm Drain.!Catch Basin Location I Rebar./Bonding I Light DO NOTBACKFILL 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 UIF Waste Plumbing UIF Water Fire Protection Equipment: UIF Mechanical UG Pipe UIF Electrical Thrust Blocks USF Framing Hydra UIF Insulation Flush Subfloor Weld Outlet Insp. ABOVE IS REQUIRED PRIOR TO FOUNDATION INSPECTION Overhead Hydra Foundation Inspection: Temp Power Pole Setback I Footing—OK to Pour Electric Release UFER Ground(Rebar/Copper) Gas Test Hardware I 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) Shea Inspection•(W4oad): Planning Dept.(364-2752) Roof Nailing Public Works (364-2774) Exterior Walls Fire (3933888) Interior Walls Landscape (364-2766x" Hardware/Hold-Downs ALL ABOVE MUST BEAPPROVED'BE FORE FINAL BLDG. Final Grade Combo inspection: • Final Electric Framing Final Plumbing (2, co/1—p Rough Electric Final Mechanical ( _ Rough Mechanical .Final Building/Construction ( Rough Plumbing 1 Topout Water Meter Number U COVER 110 WORK UNTIL ABOVE IS APPROVED Insulation CERTIFICATE OF OCCUPANCY OK TO ISSUE Drywall Inspection: OTHER: - Interior Exterior EXT LATH Stucco Scratch • Miscellaneous inspections: Masonry Fkeplace Plate Ties,Fire Block Patio I Deck: Footing Frame Access/Light/Swtch NOTICE TO OWNER:Call for FINAL INSPECTION on eery job. PatioFinal This penritwill expire if work is suspended or abandonedfor.a period of 180 days. •