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Permit No. 11076 �� APPLICATION FOR BUILDING PERMIT BUILDING INFORMATION / \ Address: 2604 LA SALLE POINTE Permit Number: 111076 :..a, Community Development "S ' 2001 Grand Avenue APN: �'- '0�,� I u32-14'(-Z 1 PERMIT FEES Chino Hills CA 91709 Lot: 94 X/ Electrical: $0.00 CITY OF CHINO IIILLS NST , “.....,.,,.., :. Geo Review: $0.00 LICENSED CONTRACTOR'S DECLARATION Tract: 13792 I hereby affirm that I am licensed under the provisions of Chapter 9(commencing with Valuation: $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 A/C Name: WEST PAC HEATING AND NC Plan Check: $0.00 Address: 601 S. MILIKEN AVE. STE. R Address: 601 S.MILIKEN AVE.,STE.R Plumbing: $0 00 City,State Zip: ONTARIO,CA 91761 City,State Zip: ONTARIO,CA. 91761 Structural: $0.00 Phone: (909)605-6955 Phone: (909)605-6955 Total Permit Fee: $53.28 License Class: C-20 City Bus Lic#: 9702995 License#: 585972 City Bus Exp: rip 1-1-98 OWNER INFORMATION SMIP: $0.00 OWNER BUILDER DECLARATION Name: CHEN Total with SMIP: $53.28 I hereby affirm that I am exempt from the Contractor's License Law for the following reason: Address: 2604LA SALLE POINTE yI City,State Zip: CHINO HILLS,CA 91709 I,as the owner of the property,or my employees wits - !._ it , ,, , compensation,will do the work,and the str t -%� r•-1. ••j?°•t-• for sale. Phone: (909)597-1351 APPROVAL INFORMATION I-1 I,as owner of the property,am exclusively( . , licensed co tract City Bus Lic#: Approved by: DEBY CONRAD construct the project 1 ,�' City Bus Exp: 5/ Date Issued: n I am exempt under Section 114 , -^C foytlI ENGINEER/ARCHITECT INFORMATION Finance Code: C-4 , Va�� ! / Name: I Census Code: 0/S WORKERS'COMPEIiS ., - ARATION Address: I hereby affirm under penalty of perj4 ► • the following declarations: Comments: City,State Zip: ElI have and will maintain a certificate of consent to self-insure for workers' Phone: Cy - -6-7y compensation as provided by Section 3700 of the Labor Code,for the performance City Bus Lic#: of the work for which this permit is issued. City Bus Exp: •' r /L d �•� 1,440 nI have and will maintain workers'compensation,as required by Section 3700 of the Eng/Arc Lic#: ? c Cd I, Labor Code,for the performance of the work for which this permit is issued. My r •workers'compensation insurance carrier and policy number are: Proposed Use: /. Insurance Company: (CALIF COMPENSATION INS. HVAC CHANGEOUT Policy Number: 1G971117248 Expiration Date: 11/1/98 n Section need not be completed if the permit is for one hundred dollars($100)or less. Project Description: Location on Prop: Square Feet: Setbacks: Livable: 0 FY I certify that in the performance of the work for which this permit is issued. I shall not employ Garage: SY: any person in any manner so as to become subject to the Workers'Compensation Laws of Patio RY California and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code. I shall comply with those provisions. Porch: // Other: Date: I I,Ll k-i —) 1 Signature: I y 1�//� ....\r7-/ I 9� �/ Grading: I I certify I have read this application and state that the above information is correct. I agree to Zoning: comply with all City Ordinances and state laws and hereby authorize representatives of this Land Use: I Cut: 0 City to enter upon the above mentioned property for inspection purposes. Plan: Fill: 0 Occ: Total: 0 Date: I , 2.-1 -7 I Signature: I 1'- 1,.V� Type: v v ( • • 'i INSPECTION RECORD INSPECTION DATE INSPECTOR INSPECTION DATE INSPECTOR Grading: }} •, Miscellaneous Inspections: Pregrade Meeting Masonry Fireplace Rough Grade (if applicable) Terraces P Plate Ties Throat Damper Sub Drains Shower Pan Temp Power Pole Finish Grading Electric Green Tag(wiring to be protected) Soils Certification Ground Rod Grading Certification Gas Test(after drywall) Rough a Gas Yellow Tag Final Other As Built Approved Reroof: Underground Site Inspections: :,;•. ; Tearoff Building Sewer Line Roof Nail/Existing Conditions Supply Water Line Swimming Pools: Storm Drain/Catch Basins ' °f Location on Site U/G Conduit/Electrical • Rebar : . Bonding DO NOT BACK FILL UNTIL ABOVE IS APPROVED Gas Piping/Test Verify Soils Engineering: 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 Electrical 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 Perimeter Footings Alarm Interior Footings Test/Final UFER Ground(Rebar/Copper) Hardware/Hold-Downs FINAL INSPECTIONS Piers/Caissons/Tendons (NO OCCUPANCY PERMITTED WITHOUT FINAL) OK to Pour Concrete County Environmental Health(if required) DO NOT POUR CONCRETE UNTIL ABOVE IS APPROVED Public Works Shear Inspection(Wood): Fire Exterior Walls Landscape Interior Walls Building Hardware/Hold-Downs OK to Install Lath CERTIFICATE OF OCCUPANCY Connection to Roof(if required) Roof Nail Inspection: Frame Inspection: OK TO SUPPLY Framing Lath OTHER: Plumbing Topout • Rough Mechanical Multi-Story Waste Test OK to Insulate OK to Place Drywall COVER NO WORK UNTIL ABOVE IS APPROVED Drywall Inspection: Nail/Screw Drywall Shear Nailing OK to Tape Drywall OK to Stucco J�