Loading...
Permit No. 17578 BUILDING ADDRESS: 5089 JADE TERRACE PERMIT NUMBER: 17578 �— BUILDING INFORMATION APPLICANT INFORMATION ,t�, BUILDING PERMIT APPLICATION •` ; Address: 5089 JADE TERRACEAName: SPLASH POOLS `,. Community Development APN: 1013-- �1- 19 Address: 12505 YORBA 1 ? ,,,: 2001 Grand Avenue� Lot. 119 City,Zip Code. CHINO HILLS,CA 91709 -..: Chino Hills,C.Z�917.(.:-`;, .: � .��._.,.. Cross Streets: 1 Phone/Pager: (909)548-6177 I ext. ? "°':";: LICENSED CONTRACTOR DECLARATION Tract/Parcel. 114285 City Bus Lic#: NEW 1 hereby affirm that I'm licensed under the provisions of Chapter 9(commencing with Section Valuation: 1525,000 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. OWNER BUILDER DECLARATION Name: 1GREG WILBER Address: I hereby affirm that I'm exempt from the Contractor's License Law for the following reason: Address: 5089 JADE TERRACE City,Zip Code:1 I,as the owner of the property,or my employees with wages as their whole City,Zip Code. CHINO HILLS,CA 91709 Phone: 1 ext. 0 compensation,will do the work,and the structure is not intended or offered for sale Phone (909)606-5654 1 ext. - Lie#: I,as owner of the property,am exclusively contracting with licensed contractors to CityBus Lie#• J t` Bus Lic#. construct the project. 0 I am exempt under Section i i BPC for this reason i i Bus Exp: APPROVAL INFORMATION WORKERS'COMPENSATION DECLARATION CONTRACTOR INFORMATION Issued By: 1LAURO BUGARIN I hereby affirm under penalty of perjury one of the following declarations: Contractor: SPLASH POOLS 1 Date Issued: 1/25/01 Address: 12505 YORBA Finance Code: C4 I have and will maintain a certificate of consent to self-insure for workers'compensation as provided by Section 3700 of the Labor Code,for the performance of the work for City,Zip Code: CHINO HILLS,CA 91709 Census Code: which this permit is issued Phone or Pager: (909)548-6177 ext. 1 Final Date: Bus.Lic.#. NEW I-11/(X,, I have and will maintain workers'compensation,as required by Section 3700 of the Final By: Lic.#: 784292 0 Labor Code,for the performance of the work for which this permit is issued. My _ Extension: workers'compensation insurance carrier and policy number are• Exp Date: 9/02 Reviewed By: LAURO BUGARIN INSURANCE INFORMATION Lic.Class: C53 Approved By: LAURO BUGARIN Insurance Company: '1STATE FUND INS. PROJECT INFORMATION Policy Number: 11613386 PROJECT DESC ION LOCATION SQUARE FT. Expiration Date. 11-1-01 • Structure• 0 Section need not be completed if permit is for one hundred dollars($100)or less Garage. I certify that in the performance of the work for which this permit is issued. I shall not employ Patio: • any person in any manner so as to become subject to the Workers'Compensation Laws of Porch: 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 provision Other: POOL/SPA REAR POOL ANS SPA �—....., PROPOSED USE Date: Il/ It I Signature: I h�, I certify I have read this application and state that the above information is correct. I agree to comply with all City Ordinances and state laws and hereby thorize r r nt tives City to COMMENTS enter upon the above mentioned property for inspection rposes. f ) Date: k r?/C-O` i Signature: j LAA. l\ / OTHER FEES REQUIRED 03 SETBACK S GI4 PRIOR TO ACTUAL PERMIT PERMIT FEE INFORMATION ISSUANCE .- Zoning. PD Front Yard: 18 Over X: 0 Issuance: $29 00 1 Electrical. $90.00 Land Use: FR-1 Side Yard: 5/5 Cut. 0 School. N Plan Check. $0 00 Plumbin $0.00 Permit Fees: $421.40 1 Plan. POOL Rear Yard 20 Fill• 0 Development: N g - Sewer: N Mechanical. $0.00 Structural $302.40 SMIP. $0 00 Occ• R3 55y. Total: 0 Type VN Water: 1N Geo Review: $0.00 Grading. $0.00 Total Fee Due 1 $421.40 1 INSPECTION RECORD Permit Number spection Date Inspector Inspection Date Inspector -ading: egrade Meeting FINAL INSPECTIONS (Inspector verify following) Dugh Grade NO OCCUPANCY PERMITTED WITHOUT FINAL ;maces County Environmental ib Drains Health Dept nish Grading Planning Dept oils Certification Public Works rading Certification Fire Rough Landscape s Built Approved nderground Site Inspections: ALL ABOVE MUST BE APPROVED BEFORE FINAL BLDG uilding Sewer Final Grade later Service Final Electric torm Drain/Catch Basins Final Plumbing I/G Conduit/Electrical Final Mechanical :ompaction Report Final Building/Construction 117771;77 PLAI lc. (41-hi-e--- 1BOVE IS REQUIRED PRIOR TO FOUNDATION INSPECTION Water Meter Number 'ootings JFER Ground(Rebar/Copper) CERTIFICATE OF OCCUPANCY iardware/Hold-Downs Ners/Caissonsfrendons 3Iab Grade OTHER: )O NOT POUR CONCRETE UNTIL ABOVE IS APPROVED 4/ Xe, — 3hear Roof Nailing Exterior Walls nterior Walls -lardware/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/Ught / A <-----.4e/ Gr ConduitX Ro Elect Z:72X •- A POOL NOT TO BE FILLED UNTIL ENCING ISCOMPLETE — Fence, Gate&Alarm /,/ Final Pool -- Temp Power Pole Electric Release Gas Test 4111