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Permit No. 11058 APPLICATION FOR BUILDING PERMIT BUILDING INFORMATION Address 12526 LA SALLE POINTE Permit Number 111058 "`.'t"�?w Community Development 1-111‘,..r. 2001 Grand Avenue APN 1143 -11-I-'hl-{ tr.? e� PERMIT FEES !�" Chino Hills, CA 91709 Lot 1107 - wsr1Electrical $0 00 LICENSED CONTRACTORS DECLARATION Tract 13792 Geo Revie $0 00 R' I hereby affirm that I am licensed under the provisions of Chapter 9(commencing with Valuation I$0 00 Grading $0 00 Section 7000 of Division 3 of the Business and Professions Code)and my license is in Issuance $33 30 full force and effect APPLICANT INFORMATION Mechanical $19 98 Contractor 'WEST PAC HEATING AND NC I Name (WEST PAC HEATING AND NC Plan Check $0 00 Address 1601 S MILIKEN AVE STE R I Address 1601 S MILIKEN AVE, STE R Plumbing $0 00 City,State Zip 'ONTARIO,CA 91761 1 City,State Zip 'ONTARIO,CA 91761 Structural $0 00 Phone 1(909)605-6955 I Phone 1(909)605-6955 Total Permit Fee $53 28 License Class 1C-20 I City Bus Lic# 9702995 License# 1585972 I City Bus Exp r• 1-1-98 OWNER INFORMATION SMIP $000 OWNER BUILDER DECLARATION Name GARCIA Total with SMIP S53 28 I hereby affirm that I am exempt from the Contractor's License Law for the following reason Address 2526 LA SALLE POINTE I l J I,as the owner of the property,or my employees with wages as their whole City,State Zip ICHINO HILLS,CA 91709 compensation,will do the work,and the structure is not intended or offered for sale Phone 1(909)3936GG�� APPROVAL INFORMATION 111I,as owner of the property, City Bus Lic# ' 'lo bel 1 am exclusively contracting with licensed contractors to City Bus Exp Approved by IDEBY CONRAD construct the project Date Issued 1 ❑ I am exempt under Section I I BPC for this reason I I ENGINEER/ARCHITECT INFORMATION Finance Code IC-4 WORKERS'COMPENSATION DECLARATION Name Census Code 10IS Address I hereby affirm under penalty of perjury one of the following declarations Comments City,State Zip ❑ I have and will maintain a certificate of consent to self-insure for workers' Phone I _ compensation as provided by Section 3700 of the Labor Code,for the performance City Bus Lic# 1 /"SI-10 ( CC79 , of the work for which this permit is issued City Bus Exp ' 1 c\a E I have and will maintain workers compensation,as required by Section 3700 of the Eng/Arc Lic# 1 ILabor Code,for the performance of the work for which this permit is issued My 6 g •workers'compensation insurance camer and policy number are Proposed Use Insurance Company CALIF COMPENSATION INS HVAC CHANGEOUT _ Policy Number IG971117248 - Expiration Date 11/1/98 , El Section need not be completed if the permit is for one hundred dollars($100)or less Project Descnption Location on Prop Square Feet Setbacks Livable 10 1 FY I. I certify that in the performance of the work for which this permit is issued I shall not employ Garage - I SY any person in any manner so as to become subject to the Workers'Compensation Laws of Patio 1 1 RY California and agree that if I should become subject to the workers'compensation provisions Porch I 1 �� of Section 3700 of the Labor Code I shall comply with those provisions i ,-, Other - I V Date I tZl Zld1 I Signature I ([ L/ I / Grading f Zoning 1 I certify I have read this application and state that the above information is correct I agree to Land Use 1 Cut 0 comply with all City Ordinances and state laws and hereby authonze representatives of this - City to enter upon the above mentioned property for inspection pu oses Plan 1 Fill — 0 / Occ "Total 0 Date I ., I Signature � ' I / �, / `1�k1 I I F^ v l� Type 1 • • INSPECTION RECORD INSPECTION DATE INSPECTOR INSPECTION DATE INSPECTOR Grading Miscellaneous Inspections Pregrade Meeting Masonry Fireplace Rough Grade (if applicable) Terraces Plate Ties Throat Damper Sub Drains Shower Pan Temp Power Pole Finish Grading Electnc Green Tag(winng to be protected) Soils Certification Ground Rod Grading Certification Gas Test(after drywall) Rough Gas Yellow Tag Final Other As Built Approved Reroof Underground Site Inspections Tearoff Building Sewer Line Roof NaiVExisting Conditions Supply Water Line Swimming Pools Storm Drain/Catch Basins Location on Site U/G Condurt/Electncal Rebar Bonding DO NOT BACK FILL UNTIL ABOVE IS APPROVED Gas Piping/Test Venfy Soils Engineenng Predeck Compaction,moisture,conditioning,etc Final Underfloor/Undersalb Inspection U/F Waste Plumbing FINAL REQUIRED-POOL NOT TO BE FILLED U/F Water UNTIL FENCING IS COMPLETE U/F Mechanical Fire Protection Equipment U/F Electncal UG Pipe U/F Framing Thrust Blocks OK to Install Insulation Hydro OK to Install Subfloor Flush Weld Outlet Insp ABOVE IS REQUIRED PRIOR TO FOUNDATION INSP Overhead Hydro Foundation Inspection Other Setback Fence&Gate Penmeter Footings Alarm Interior Footings Test/Final UFER Ground(Rebar/Copper) Hardware/Hold-Downs FINAL INSPECTIONS Piers/Caissons/Tendons (NO OCCUPANCY PER ' ED WITHOU NAL) OK to Pour Concrete County Environmental _\1 Health(if required) • DO NOT POUR CONCRETE UNTIL ABOVE IS APPROVED Public Works ` \ A Shear Inspection(Wood) Fire Extenor Walls Landscape Interior Walls Building m\! . \\ OK Hardware/Hold-Downs nset Install Lath CERTIFICATE OF OCCUPANC \ / Connection to Roof(rf required) Roof Nail Inspection \1 Frame Inspection OK TO SUPPLY Framing Lath OTHER Plumbing Topout � 1 i Rough Mechanical C Multi-Story Waste Test I1. OK to Insulate \MaVLI 0V ( 1 Cur &.- ktk OK to Place Drywall k • L r 01 't C6ZIn.61 COVER NO WORK UNTIL ABOVE IS APPROVED Drywall Inspection C-iieskst Pl.P1�1n,. Nail/Screw r Drywall Shear Nailing 24.-r.L/U•2 l La•J' OK to Tape Drywall OK to Stucco 1 Ort