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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 •