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Permit No. 20003 BUILDING ADDRESS: 5440 KNIGHT COURT PERMIT NUMBER: 20003 BUILDING INFORMATION APPLICANT INFORMATION st BUILDING PERMIT APPLICATION Address: 5440 KNIGHT COURT Name ROLLINS CONSTRUCTION ' Community Development APN: 1028-601-6900 Address• 1252 MONTE VISTA#17 .,;. 2001 Grand Avenue Chino Hills,CA 91709 Lot 19 City,Zip Code: UPLAND CA 91786 l=airs''', Cross Streets: 1 Phone/Pager: (909)946-5189 I ext. CM °``"'NO HILLS .... LICENSED CONTRACTOR DECLARATION Tract/Parcel: 115748 City Bus Lic#• NEW I hereby affirm that I'm licensed under the provisions of Chapter 9(commencing with Section Valuation: 1$3,588.00 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: 1N/A OWNER BUILDER DECLARATION Name JAMES AND AMY GABLE Address: I hereby affirm that I'm exempt from the Contractor's License Law for the following reason: Address: 5440 KNIGHT COURT City,Zip Code. I,as the owner of theroePhone: ext. 0 p p rty,or my employees with wages as their whole City,Zip Code: CHINO HILLS,CA 91709 compensation,will do the work,and the structure is not intended or offered for sale. Phone: (909)606-0388 ext 1 Lic#. O I,as owner of the property,am exclusively contracting with licensed contractors to Bus Lic#: City Bus Lic#: IPconstruct the project I am exempt under Section i i BPC for this reason I I Bus Exp. APPROVAL INFORMATION WORKERS'COMPENSATION DECLARATION CONTRACTOR INFORMATION Issued By. 1CHRIS OBERLE I hereby affirm under penalty of perjury one of the following declarations: Contractor ROLLINS CONSTRUCTION 1 Date Issued: 15/9/02 Address: 11252 MONTE VISTA#17 Finance Code 1C4-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,Zip Code: (UPLAND CA.91786 Census Code. which this permit is issued. Phone or Pager: (909)946-5189 ext. 1 1 Final Date: 733 Geri, ) Bus.Lic.#: 1NEW Final ByLain I / / I have and will maintain workers'compensation,as required by Section 3700 of the �}c ClJ') /.4. X rr 0 Labor Code,for the performance of the work for which this permit is issued My Lic.#: 672452 Extension: / workers'compensation insurance carrier and policy number are• Exp Date. 6/03 Reviewed By 1CHRIS OBERLE V Lie Class: 1B Approved By. 1CHRIS OBERLE INSURANCE INFORMATION Insurance Company: Exempt PROJECT INFORMATION Policy Number: 110-4-_r PROJECT DESCRIPTION LOCATION SQUARE FT. Expiration Date. 1 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. 1PATIO COVER 1REAR 299 my 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: Section 3700 of the Labor Code. I shall comply with those provisions /� / / f /1 _ /®/ /.1 PROPOSED USE I.C.B 0 PATIO COVER Date: i.579/0 �I Signature: ✓ i 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 inspection purposes I Date: i 5/9/i Z i Signature: iii OTHER FEES REQUIRED ZONING SETBACKS GRADING PRIOR TO ACTUAL PERMIT PERMIT FEE INFORMATION ISSUANCE Zoning: 1PD Front Yard 18 Over X• 0 Issuance $29.00 Electrical $0 00 Land Use: 1FR-1 Side Yard: 5/5 Cut: 0 School. 1 N Permit Fees: $153.74 Plan PATIO COVER Rear Yard: 15 Development. 1 N Plan Check: 1 $49 14 Plumbing 1 $0.00 Fill 0 SMIP: 1 $0 50 Occ: 1R3 SSY Total. 0 Sewer N Mechanical. $0 00 Structural. $75 60 Type: 1VN Water: N Geo Review- $0 00 Grading $0 00 Total Fee Due $154.24 NSPECTION RECORD rr 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 WaterFinal Electric Service Storm Drain/Catch Basins Final MechanicalPluming U/G Conduit/Electrical Final � U/GCopaction Report Final Building/Construction c7 i)/y (_(1(j 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: . / I Slab Grade 4[ U/C 7/5/0 2, 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 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