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Permit No. 17377 BUILDING ADDRESS: 5040 JADE TERRACE PERMIT NUMBER: 17377 BUILDING INFORMATION APPLICANT INFORMATION rot BUILDING PERMIT APPLICATION Address: 5040 JADE TERRACE I Name: (RICHMOND AMERICAN HOMES Community Development APN: IAddress. 16845 VON KARMAN,SUITE#100 •ate 2001 Grand Avenue Lot: 130 City,Zip Code IRVINE,CA 92606 ^':•• Chino Hills,CA 91709 Cross Streets. Phone/Pager: i(949)756-7373 I ext. CTTY OP CIANO HS ...„„ LICENSED CONTRACTOR DECLARATION Tract/Parcel: 14285 City Bus Lic#. 101-03571 I hereby affirm that I'm licensed under the provisions of Chapter 9(commencing with Section Valuation: $197,000.00 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. N/A OWNER BUILDER DECLARATION Name: RICHMOND AMERICAN HOMES Address: I hereby affirm that I'm exempt from the Contractor's License Law for the following reason: Address: 16845 VON KARMAN,SUITE#100 City,Zip Code: I,as the owner of the property,or my employees with wages as their whole City,Zip Code: IRVINE,CA 92606 Phone: 1 ext. 1 0 compensation,will do the work,and the structure is not intended or offered for sale. Phone: 1(949)756-7373 ext. I Lie#: O I,as owner of the property,am exclusively contracting with licensed contractors to Bus Lic#: 101-03571 /., t/. City Bus Lic#- construct the project. Bus Exp: 17/31/01 I am exempt under Section BPC for this reason APPROVAL INFORMATION � CONTRACTOR INFORMATION WORKERS'COMPENSATION DECLARffTION Issued By: IYVETTE MARTINEZ I hereby affirm under penalty of perjury one of the following declarations• Contractor. RICHMOND AMERICAN HOMES Date Issued• 112/4/00 Address• 116845 VON KARMAN,SUITE#100 Finance Code: C4-SM I have and will maintain a certificate of consent to self-insure for workers'compensation 0 as provided by Section 3700 of the Labor Code,for the performance of the work for City,Ztp Code: IRVINE,CA 92606 / Census Code: 101 which this permit is issued. Phone or Pager 1(949)756-7373 ext. I Final Date: Bus Lic.#• 101-03571 1 Final By. • I have and will maintain workers'compensation,as required by Section 3700 of the 0 Labor Code,for the performance of the work for which this permit is issued My Lic # 487535 Extension: workers'compensation insurance carrier and policy number are: Exp te: 2-01 Reviewed By: (KEITH L PRYOR INSURANCE INFORMATION Lic. lash/ IB I Approved By: KEITH L.PRYOR Insurance Company: AON RISK SERVICES PROJECT INFORMATION Policy Number: 610 29-78-876-00 PROJECT DESCRIPTION LOCATION SQUARE FT. Expiration Date: (07/01/01 Structure: 2788 1 0 Section need not be completed if permit is for one hundred dollars($100)or less Garage: 636 1 I certify that in the performance of the work for which this permit is issued. I shall not employ Patio. 1 1 1 54 any person in any manner so as to become subject to the Workers'Compensation Laws of Porch: I I I I I s • 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: DECK 60 PROPOSED USE SINGLE FAMILY RESIDENCE Date: I i Signature: PLAN 2 I certify I have read this application and state that the above information effect I agree to comply with all City Ordinances and state laws and her-by onze re. �t. -s of this City to enter upon the above mentioned property for inspection . l S. COMMENTS r i Date: 11141'1 DUI Signature: / V Vf �J�- OTHER FEES REQUIRED IA ZONING SETBACKS GRADING PRIOR TO ACTUAL PERMIT PERMIT FEE INFORMATION ISSUANCE Zoning: 1PD Front Yard: 18 Over X: 0 Issuance: I $29.00 Electrical: I $306.68 I Land Use: IFR2 Side Yard: 5/5 Cut 0 School. I YES Plan Check: $129 23 Plumbing: $258 00 Permit Fees: 1 $2,188.98 1 Plan• PLAN 2 Rear Yard. 20 Development: YES 1 Fill: 1 0 SMIP: I $19.70 1 Sewer: YES Mechanical. $98.79 Structural: $1,292.28 Occ: R3 SSY: Total. 1 0 Type• VN I Water: I YES Geo Review: $0.00 Grading: $75.00 1 Total Fee Due 1 $2,208.68 • • INSPECTION RECORD Permit Number /,77-7 Inspection Date Inspector Inspection Date Inspector Grading: Pregrade Meeting FINAL INSPECTIONS(lnspector verify following) Rough Grade NO OCCUPANCY PERMITTED WITHOUT FINAL | 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 BEFOm6 LBLOG Building Sewer Fino| Water Service Grade �� f��'^, Storm Drain/Catch Basins .^~-�^^�^ ~ Final Electric U/G Conduit/ElectricalFino| Plumbing / �~ Compaction Repo rtFina} Mechanical ^� ABOVE IS REQUIRED PRIOR TO FOUNDATION INSPECTION Final Building/Construction ^� Water Meter Number —�� ���v FooUngu UFER Ground(Rebar/Copper) / CERTIFICATE 0FOCCUPANCY Hardware/Hold-Downs Piers/Caissons/Tendons y�~ � / Slab Grade ' �� OTHER: DONOT POUR CONCRETE UNTIL ABOVE|SAPProcrvEQ � Shear . — —�x� �1 � ~- _�-- - ..—_ '-_ '-.- Roof Nailing Exterior Walls _ ~� Interior Walls Hardware/Hold-Downs / Rough Electric A / Rough Mechanical Rough Plumbing/Topuut �` Framing �^ //./ COVER NO��QRKUNTIL ABOVE)SAPPROVED � Insulation Drywall Interior/Exterior W24, 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 Elec POOL NOT TO BE FILLED UNTIL FENCING IS COMPLETE Fence,Gate&Alarm Final Pool Temp Power Pole Electric Release _- GnsTest 410 4110