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Permit No. 18675 BUILDING ADDRESS: 5407 KNIGHT COURT PERMIT NUMBER: 18675 -� BUILDING INFORMATION APPLICANT INFORMATION + y.•n� BUILDING PERMIT APPLICATION Address: 5407 KNIGHT COURT Name: (JAIME&FRANCISCA BALTAZAR Community Development APN 11028-601-64 Address: 15407 KNIGHT COURT f" 21 2001 Grand Avenue '�,��•�� Lot: 114 City,Zip Code: (CHINO HILLS,CA 91709 --I- Chino Hills,CA 91709 `' Cross Streets: 1 Phone/Pager: 1(909)606-6543 I ext. 1 °'`"•"O HILLS —.. LICENSED CONTRACTOR DECLARATION Tract/Parcel. 115748 City Bus Lic#: 1 I hereby affirm that I'm licensed under the provisions of Chapter 9(commencing with Section Valuation 1$5,000.00 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: JAIME&FRANCISCA BALTAZAR Address: I hereby affirm that I'm exempt from the Contractor's License Law for the following reason• Address 5407 KNIGHT COURT City,Zip Code: I,as the owner of the property,or my employees with wages as their whole City,Zip Code. 1CHINO HILLS,CA 91709 Phone: I ext I 0 compensation,will do the work,and the structure is not intended or offered for sale. Phone. 1(909)606-6543 1 ext. 1 Lic#: O Bus Lic#:I,as owner of the property,am exclusively contracting with licensed contractors to 1 1 City Bus Lic 4. •l construct the project. 0 I am exempt under Section i i BPC for this reason I Bus Exp: APPROVAL INFORMATION WORKERS'COMPENSATION DECLARATION I CONTRACTOR INFORMATION Issued By. ILAURO BUGARIN I hereby affirm under penalty of perjury one of the following declarations: Contractor: JAiME&FRANCISCA BALTAZAR I Date Issued. 17/31/01 Address• 5407 KNIGHT COURT Finance Code. 1C4-SM 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)606-6543 1 ext 1 I Final Date 77/0/41 Bus.Lic#: 1 Final By. / Poi 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 Lie.# Extension: K workers'compensation insurance carrier and policy number are Exp Date: Reviewed By. LAURO BUGARIN b Lie Class I Approved By: ILAURO BUGARIN INSURANCE INFORMATION Insurance Company: 1Exempt 1 PROJECT INFORMATION Policy Number: 1 1 PROJECT DESCRIPTION LOCATION SQUARE FT. Expiration Date: 1 1 1 I 1 1 Structure. 0 Section need not be completed if permit is for one hundred dollars($100)or less Garage: I I I certify that in the performance of the work for which this permit is issued. I shall not employ Patio. 1 I III.- 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 Other 1PATIO 1 REAR 1 360 Section 3700 of the Labor Code. I shall comply with those provisions. (v 1 PROPOSED USE REAR PATIO 360 SF Date: 17-3 1—o( I Signature: CiIbJa......`' .0p t 1\ I - i certify i have read this application and state that the.bove information is corect. gree to comply with all City Ordinances and state'awl..: ereby authonze representatives of this City to COMMENTS enter upon the above mentioned property for inspection purposes /' Date: i-7-3I. Gl i i Signature: I / , / OTHER FEES REQUIRED V�d ZONING SETBACK GRADIN PRIOR TO ACTUAL PERMIT PERMIT FEE INFORMATION ISSUANCE Zoning: 1PD Front Yard. 18 Over X. 0 Issuance. 1 $29 00 Electrical: $0 00 Land Use: FR-1 Side Yard. 5/5 School: 1 N 1 $171.76 I 1 1 Cut• I 0 1 Plan Check. $56 16 Plumbing: $0 00 Permit Fees: Plan. Rear Yard: 15 Development. N 1 I Fill 0 SMIP: 1 $0 50 I Occ: 1R3 SSY: Total. 0 1 Sewer: 1 N I Mechanical: I $0.00 1 Structural. $86.60 Type: 1VN I Water. 1 N 1 Geo Review: 1 $0 00 1 Grading: I $0.00 Total Fee Due I $172.26 1 INSPECTION ������������� N��������Q�^�� Permit Number Inspection Date Inspector Inspection Date Inspector Grading: Pregrade Meeting FINAL INSPECTIONS (Inspector 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 BEFORE FINAL BLDG Building Sewer Final Grade U.G.Waste Plumbing Final Electric Water Service Storm Drain/Catch Basins Final Plumbing U/� Condui�Boo�rica| Final Mechanical � o ~ . Compaction Report Rna| Bui|ding/ConstruoVon ‘tivoldP ,��*°.���~ ABOVE IS REQUIRED PRIOR TO FOUNDATION INSPECTION Water Meter Number Footings CERTIFICATE OF OCCUPANCY UFER Ground (Rebar/Copper) Hardware/Hold-Downs Piers/Caissons/Tendons ��' OTHER Slab Grade ' � ' • — e,/���' �����^~,^�� DO NOT POUR CONCRETE UNTIL ABOVE IS APPROVE ^��c�� �� ' =~ Shear r� �� ~' w^ � �� ,�*� .� Roof Nailing ` ��- Exterior Walls Interior Walls ` ' Hardware/Hold-Downs Rough Electric Rough Mechanica 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/Light Gr Conduit Ro Elect POOL NOT TO BE FILLED UNTIL FENCING IS COMPLETE Fence, Gate&Alarm Final Pool Temp Power Pole Eleutri' Release Gas Test 41111 •