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Permit No. 18166 BUILDING ADDRESS: 5678 KNOLLSIDE WAY PERMIT NUMBER: 18166 / BUILDING INFORMATION APPLICANT INFORMATION BUILDING PERMIT APPLICATION Address: 5678 KNOLLSIDE WAY Name: PACIFIC CONSULTANTS ` .. Community Development APN: 11021-— .&9.--.3 Address: 2399 CARLENE CIRCLE 2001 Grand Avenue Lot: 34 I City,Zip Code: (CORONA,CA 92882 l,- Chino Hills,CA 91709 Cross Streets: Phone/Pager 1(909)372-0478 I ext I ll'!".l. LICENSED CONTRACTOR DECLARATION Tract/Parcel. 15751-1 City Bus Lic#: 1N/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: (THE WOODLEY ARCHITECTUAL GROUP 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: 17555 IRVINE CENTER DRIVE City,Zip Code COSTA MESA,CA 92626 I,as the owner of theroe Phone: (714)546-8919 ext. p p rty,or my employees with wages as their whole City,Zip Code. 1RVINE,CA 92618 0 compensation,will do the work,and the structure is not intended or offered for sale. Phone. 1(949)453-0113 ext. Lie#: 1C24900 01 I,as owner of the property,am exclusively contracting with licensed contractors to Bus Lic#. 102-04604 City Bus Lic#: 1 construct the project. 4 I am exempt under Section BPC for this reason Bus Exp 3/31/02 I APPROVAL INFORMATION • WORKERS'COMPENSATION DECLARATION CONTRACTOR INFORMATION Issued By: YVETTE MARTINEZ • I hereby affirm under penalty of perjury one of the following declarations Contractor: CENTEX HOMES I Date Issued• 4/30/01 Address: 17555 IRVINE CENTER DRIVE Finance Code. C4-SM I have and will maintain a certificate of consent to self-insure for workers'compensation C) as provided by Section 3700 of the Labor Code,for the performance of the work for City,Zip Code: IRVINE,CA 92618 Census Code: 101 which this permit is issued Phone or Pager: 1(949)453-0113 1 ext. 1 Final Date. Bus Lic.#. 02-04604 Final By: I have and will maintain workers'compensation,as required by Section 3700 of the (i Labor Code,for the performance of the work for which this permit is issued. My Lie #: 734094 Extension. workers'compensation insurance carrier and policy number are: Exp Date: 3/31/02 Reviewed By KEITH L.PRYOR ' INSURANCE INFORMATION Lie Class: B&A Approved By. KEITH L.PRYOR Insurance Company: AMERICAN GUARANTEE&LIABILITY 1 PROJECT INFORMATION Policy Number: WC 8322098 1 PROJECT DESCRIPTION LOCATION SQUARE FT. Expiration Date: 10/01/01 Structure• 1 2566 0 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 I I 42 4, 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. 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 authonze representatives of this City to COMMENTS enter upon the above mentioned property for inspection purposes. Date: mg,t1ti- Signature: I•� --J2-----'` i OTHER FEES REQUIRED iti— ZONING SETBACK S GRADING PRIOR TO ACTUAL PERMIT PERMIT FEE INFORMATION ISSUANCE Zoning: PD Front Yard: 10 Over X 0Issuance: $29 00 Electrical: $282.26 Land Use. 1 Side Yard 5/5 Cut: 0 School. 1 YES 1 Permit Fees: $2,029.45 Plan: 3X-ALT Rear Yard 15 Development YES Plan Check: $120.45 Plumbing $225.00 Fill 0 SMIP: $17 80 Occ. R3 SSY. Total 0 Sewer. 1 YES 1 Mechanical. $93.24 Structural. $1,204.50 1 Type: VN 1 Water 1 YES I Geo Review- $0.00 Grading• $75.00 Total Fee Due $2,047.25 • • INSPECTION RECORD Permit Number Inspection Date Inspector Inspection Date Inspector Grading: Pregrade Meeting FINAL INSPECTIONS(Inspector verify following) Rough Grade GJ--/f-c! K'LJ 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 �j�-6) Final Grade ^/ Water Service K/9-0/ Final Electric Storm Drain/Catch Basins Final Plumbing • " U/G Conduit/Electrical Final Mechanical ! /1 — Compaction Report Final Building/Construction ABOVE IS REQUIRED PRIOR TO FOUNDATION INSPECTION 7 Water Meter Number 5$3.a.( 53. Footings / UFER Ground,(Rebar/Copper) qx�� CERTIFICATE OF OCCUPANCY Hardware/Hold-Downs --_ � i Piers/Caissons/Tendons Slab Grade % OTHER: DO NOT POUR CONCRETE UNTIL ABOVE)APPROVED GI Shear Roof Nailing _.1 — of 4 U�i=(270,W.-- -c,1 Exterior Walls V u Interior Walls r4 Hardware/Hold-Downs Rough Electric Rough Mechanical Rough Plumbing/Topout Framing COVER NO WORK UNTIL ABOVE IS APP VED Insulation ----Ac"---e21 44E-- Drywall Interior/Exterior Lath AR- Stucco Scratch 7-q-a/ Z 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 , , n • Electric Release 0c. A ✓��'� Gas Test '' -p'I' ,lkr-- • • ��