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Permit No. 19257 BUILDING ADDRESS: 5424 KNIGHT COURT PERMIT NUMBER: 19257 • BUILDING INFORMATION APPLICANT INFORMATION � BUILDING PERMIT APPLICATION Address: 15424 KNIGHT COURT Name: MICHAEL AND PATRICIA BRADY ,` Community Development APN: 11028-601-67 Address. 5424 KNIGHT COURT e; , 2001 Grand Avenue Lot• 17 City,Zip Code- CHINO HILLS,CA 91709 ,, Chino Hills,CA 91709 Cross Streets: Phone/Pager 1(909)606-0824 1 ext I .c!!!?;!-VM TT. LICENSED CONTRACTOR DECLARATION Tract/Parcel: 115748 1 City Bus Lic#- 1N/A I hereby affirm that I'm licensed under the provisions of Chapter 9(commencing with Section Valuation• 1$6,006 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. MICHAEL AND PATRICIA BRADY Address: I hereby affirm that I'm exempt from the Contractor's License Law for the following reason: Address. 5424 KNIGHT COURT City,Zip Code 1 I,as the owner of the property,or my employees with wages as their whole City,Zip Code: 1CHINO HILLS,CA 91709 Phone. 1I ext I 0 compensation,will do the work,and the structure is not Intended or offered for sale Phone: 1(909)606-0824 1 ext. Lic#: 1 I,as owner of the property,am exclusively contracting with licensed contractors to0 Bus Lic# N/A City Bus Lic 4 construct the project. I am exempt under Section I BPC for this reason I Bus Exp. APPROVAL INFORMATION WORKERS'COMPENSATION DECLARATION CONTRACTOR INFORMATION Issued By IYVETTE MARTINEZ I hereby affirm under penalty of perjury one of the following declarations. Contractor. (OWNER BUILDER 1 Date Issued: 11/20/01 Address Finance Code C4 I have and will maintain a certificate of consent to self-insure for workers'compensation O as provided by Section 3700 of the Labor Code,for the performance of the work for City,Zip Code Census Code• ` which this permit is issued Phone or Pager. I ext. 1 Final Date o?/5/off _ Bus Lic# Final By. � /c(�, I have and will maintainworkers'compensation,as required by Section 3700 of the E 0 Labor Code,for the performance of the work for which this permit is issued. My Lie.#: 1 Extension workers'compensation insurance carrier and policy number are. Exp Date. Reviewed By. CHRIS OBERLE Lic. ass Approved By: CHRIS OBERLE INSURANCE INFORMATION Insurance Company: EXEMPT PROJECT INFORMATION Policy Number: PROJECT DESCRIPTION LOCATION SQUARE FT. Expiration Date: Structure: GARAGE CONVERSION (GARAGE 155 0 Section need not be completed if permit is for one hundred dollars($100)or less Garage. (INTERIOR IMPROVEMENT 1 (GARAGE 27 ALI certify that in the performance of the work for which this permit is issued. I shall not employ Patio. I I I any person in any manner so as to become subject to the Workers'Compensation Laws of Porch 1 1 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: PROPOSED USE GARAGE CONVERSION TO LIVIBLE AND IMPROVEMENTS Date: I i Signature: i 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 authorize representatives of this City to COMMENTS enter upon the above mentioned property for inspectionourposgs1 , Date: I 1) 20/0/ I Signature: / /aim T t. L~_ / OTHER FEES REQUIRED ZONING SETBACKS GRADIN I i PRIOR TO ACTUAL PERMIT PERMIT FEE INFORMATION ISSUANCE Zoning: 1PD Front Yard: 18 Over X• 0 Issuance $29 00 Electrical $17.05 Land Use: FR-2 Side Yard. 5/5 Cut. 0 School: NO Permit Fees: $244.23 Development NO Plan Check $70.20 Plumbing. $0 00 Plan: CONVERSION Rear Yard. 15 Fill 0 SMIP: $0.00 Occ. R3 SSY Total: 0 Sewer: 1 NO Mechanical: $19 98 1 Structural 1 $108 00 Type: IVN Water: NO Geo Review I $0 00 I Grading: $0.00 I Total Fee Due $244.23 • INSPECTION RECORD Permit Number Inspection Date Inspector Inspection Date Inspector Grading: Pregrade Meeting FINAL INSPECTIONS(Inspector verify following) Rough Grade NO OCCUPANCY PERMITTED WITHOUT FINAL I 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 /570,-2. 225 C`a/A;...1: Water Service Final Plumbing Storm Drain/Catch Basins Final Mechanical U/G Conduit/Electrical • " . Final Building/Construction ,,,,//c4,2 (9" Compaction Report Water Meter Number ABOVE IS REQUIRED PRIOR TO FOUNDATION INSPECTION Footings CERTIFICATE OF OCCUPANCY UFER Ground(Rebar/Copper) Hardware/Hold-Downs Piers/Caissons/Tendons OTHER: Slab Grade DO NOT POUR CONCRETE UNTIL ABOVE IS APPROVED Shear Roof Nailing Exterior Walls Interior Walls Hardware/Hold-Downs Rough Electric Rough Mechanical Rough Plumbing/Topout Framing /7 Po 4, 4911 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 Electric Release Gas Test