Permit No. 18165 BUILDING ADDRESS: 5709 KNOLLSIDE WAY PERMIT NUMBER: 18165
BUILDING INFORMATION APPLICANT INFORMATION
BUILDING PERMIT APPLICATION Address: 5709 KNOLLSIDE WAY Name. PACIFIC CONSULTANTS 1
i5, , Community Development APN: �aa, . .5,3 2-7,r
�;. Address: 2399 CARLENE CIRCLE
2001 Grand Avenue
.-o Lot: 38 City,Zip Code. CORONA,CA 92882
--,.;, Chino Hills,CA 91709
M. Cross Streets: Phone/Pager: (909)372-0478 I ext.
CHINO HIL
CI
.r0....”s LICENSED CONTRACTOR DECLARATION Tract/Parcel 15751-1 City Bus Lic#: N/A
I hereby affirm that I'm licensed under the provisions of Chapter 9(commencing with Section Valuation: $175,000.00 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: 1THE WOODLEY ARCHITECTUAL GROUP 1
OWNER BUILDER DECLARATION Name: CENTEX HOMES Address: 151 KALMUS,SUITE#E230
I hereby affirm that I'm exempt from the Contractor's License Law for the following reason: Address: 7555 IRVINE CENTER DRIVECity,Zip Code:(COSTA MESA,CA 92626
I,as the owner of the roe Phone: (714)546-8919 1 ext.
O property,rty,or my employees with wages as their whole City,Zip Code: IRVINE,CA 92618
compensation,will do the work,and the structure is not intended or offered for sale. Phone: (949)453-01 13 ext. 1 Lic#: C24900
O I,as owner of the property,am exclusively contracting with licensed contractors to Bus Lie#: 02-04604 City Bus Lic#•
construct the project.
I 1 am exempt under Section I I BPC for this reason I
Bus Exp. 3/31/02 •
APPROVAL INFORMATION •
III WORKERS'COMPENSATION DECLARATION CONTRACTOR INFORMATION Issued By: YVETTE MARTINEZ
I hereby affirm under penalty of perjury one of the following declarations. Contractor. CENTEX HOMES 1 Date Issued• 14/30/01
p Address 7555 IRVINE CENTER DRIVEFinance Code C4-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 IRVINE,CA 92618 Census Code• 1101
which this permit is issued. Phone or Pager (949)453-0113 ext 1 Final Date.
Bus.Lic.#: 02-04604 Final B
I have and will maintain workers'compensation,as required by Section 3700 of the y
i j Labor Code,for the performance of the work for which this permit is issued My Lic.# 734094 I Extension:
workers'compensation insurance earner and policy number are Exp Date 3/31/02 Reviewed By: KEITH L.PRYOR
Lic.Cass• B&A Approved By: KEITH L.PRYOR
INSURANCE INFORMATION1
Insurance Company: 1AMERICAN GUARANTEE&LIABILITY PROJECT INFORMATION
Policy Number: 1WC 8322098 PROJECT DESCRIPTION LOCATION SQUARE FT.
Expiration Date: 110/01/01 1 1 1
Structure 2566
8 Section need not be completed if permit is for one hundred dollars($100)or less Garage 490
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• 42
California and agree that if I should become subject to the workers'compensation provisions of 1 1 1
•ection 3700 of the Labor Code. I shall comply with those provisions Other:
PROPOSED USE SINGLE FAMILY RESIDENCE
Date: i i Signature: I I
PLAN 3X-ALT STANDARD
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.
Date: I (3°h' I Signature: I L1 /' - I OTHER FEES REQUIRED (_,
ZONING [ SETBACKS GRADING PRIOR TO ACTUAL PERMIT PERMIT FEE INFORMATION
ISSUANCE
Zoning. 1PD 1 Front Yard• 10
Over X• 0 1 Issuance: $29.00 Electrical: $282.26
Land Use: 1 Side Yard• 5/5
School YES
Cut: 0 DevelopmentPlan Check- $120 45 Plumbing. $225 00 Permit Fees: $2,029.45
YES
Plan- 13X-ALT Rear Yard: 15 Fill 0 SMIP. $17 80
Occ- R3 SSY. Sewer. YES Mechanical: $93.24 Structural $1,204.50
Total 0
Type• VN Water. YES Geo Review $0 00 1 Grading: $75.00 Total Fee Due 1 $2,047.25
IN'ECTION RECORDO
Permit Number
Inspection Date Inspector Inspection Date Inspector
Grading:
Pregrade Meeting FINAL INSPECTIONS(Inspector verify following)
Rough Grade L/^/i-of I LP 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 A?z, Final Grade
Water Service (j- -o l 4 Final Electric
Storm Drain/Catch Basins
U/G Conduit/Electrical Final Plumbing
_
7
Final Mechanical
Compaction Report Final Building/Construction
ABOVE IS REQUIRED PRIOR TO FOUNDATION INSPECTION Water Meter Number S5M�/.51�
Footings _'
UFER Ground (Rebar/Copper) CERTIFICATE OF OCCUPANCY
Hardware/Hold-Downs
Piers/Caissons/Tendons
Slab Grade OTHER:
DO NOT POUR CONCRETE UNTIL ABOVEIS APPROVED Ulm PIt>rubi /1-•
Shear
Roof Nailing
Exterior Walls ' j'4-®( '4 v
Interior Walls mit- froom—Oi 2Z
Hardware/Hold-Downs I
Rough Electric ,,""%
Rough Mechanical r ��
Rough Plumbing/Topout
Framing
COVER NO WORK UNTIL ABOVE IS APPI OVED
Insulation '7 ._.oJ A_2,
Drywall
Interior
/Exterior
Lath
Stucco Scratch 7-6?.p/ ,4
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/Bond ing/Light
Gr Conduit
Ro Elect
POOL NOT TO BE FILLED UNTIL FENCING IS COMPLETE
Fence,Gate&Alarm
Final Pool
Temp Power Pole
' Electric Release 7-0/ /ie-
Gas Test 7 Lci
•