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Permit No. 2005-1939 .ir • BUILDING DIVISION OF CO 'TY DEVELOPMENT DEPARTMENT : N. 2001 Grand Avenue,Chino Hills,t .-41709. ,,. City of Chino Hills Counter Phone (909)364-2780 •• t = 24-Hour Inspection Line (909)364-2790 Building Permit A ti (NOTE You must call before 3p m for a next business day inspection) ''� City Hall Main Number (909)364-2600 CIINOFF CHINO HILLS .-tr. NOTICE' THIS PERMIT BECOMES NULL AND VOID IF WORK IS NOT COMMENCED PLEASE USE PERMIT NUMBER WITHIN 180 DAYS FROM 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 PROJEt,i uta,nir HON I PERMIT No INTERIOR LOFT ADDITION (335 SQ FT) 2005-1939 0 BUILDING ADD RESS APT/UNIT No ISSUED DATE 12/14/2005 ISSUED 14817KELTY CT 0 SCOPE APN PARCEL MAP# TRACT LOT/PARCELBLOCK CONST TYPE ZONE OCC LAND USE 1032-592-05 1743 TR 15723 13 1 592 UN R-3 Residential CENSUSCODES OVERLAY DIST BLDG SQFT TYPE IPROJECT PL PC PERMITS SETBACK FY SETBACK RY SETBACK SSY SETBACK SY S9 0 SAL FEES Description Calc. Paid w• NALBANDIAN, SARKIS A Plan Check PC $200.77 $200.77 14817 KELTY CT CHINO HILLS, CA 91709 Total Paid 12/12/2005: $200.77 Issuance/Suppl F $29.00 $29.00 OWNER / BUILDER Structural $308.88 $308.88 Mechanical $44.40 $44.•40 CHINO HILLS, CA 91709 Electrical S $73.70 $73.70 Plumbing $90.00 $90.00 0 I- U Total Paid 12/14/2005: $545.98 Contr Lic: p Expiration: O License Type: Grand Total: $746.75 $746.75 Workers Comp: Expiration: Bus. License: 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 PROJECT DESCRIPTION Date Contractor' • OWNER-BUILDER DECLARATION INTERIOR LOFT ADDITION (335 SQ FT) ❑ 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 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 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 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 Desc I Location I Sq Foot I Valuation projects with a contractor(s)licensed pursuant to the Contractors License Law) INTERIOR LOFT 000000000 335 $22,545.50 ❑ I am Exempt under Article 3 of the Business and Pr ofessions Code Date — —0/ Owner 7-C—\--D - WORKERS COMPENSATION DECLARATION • I 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 provided for by Section 3700 of the Labor Code,for the performance of the work for which this Total Valuation $,22,545.50 permit is issued I certify that I have read this application and state that the above information ❑ 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 so as to become subject to the worker's compensation laws of \/ ��i`j- f California,and agree that if I should become subject to the worker's compensation provisions x- / of Section 3700 of the Labor Code,I shall forthwith comply with those provisions / APPLICANT SIGNATURE DATE APPLICANT INFORMATION FRANK MARTINEZ 719 W. FRONT ST COVINA, CA 91722 Date Applicant 626-339-1364 WARNING Failure to secure worker's compensation coverage is unlawful,and shall subject an 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 At > • CITY OF CHINO HILLS COM UNITY 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 15`Lift Bond Beam Terraces 2nd Lift Bond Beam Sub Drains 3rd 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 (l Combo inspection: Final Electric n� •' Framing / Final Plumbing Rough Electric /,/lO nit? Final Mechanical Rough Mechanical Final Building/Construction �Q v Rough Plumbing/Topout Water Meter Number COVER NO WORK UNTIL ABOVE IS APPROVED Insulation /� CERTIFICATE OF OCCUPANCY // , OK TO ISSUE Drywall Inspection: OTHER: Interior a.a?•O(o 14)4V/Q. - Exterior EXT LATH Stucco Scratch 4-c4.0 6 /1 iK• - 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.