Loading...
Permit No. 2010-23933 ""'t.'y BUILDING DIVISION OF COMMUNITY DEVELOPMENT DEPARTME City of Chino Hills 1 14000 City Center Or,Chino Hills,CA91709 / Counter Phone (909)364-2780 Building Permit 24-Hour Inspection Line (909)364-2790 (NOTE You must call before 3p m_for a next business day inspection) City Has Main Number (909)364-2600 NOTICE:THIS PERMIT BECOMES NULL AND VOID IF WORK IS NOT COMMENCED WITHIN PLEASE USE PERMIT NUMBER 180 DAYS FROM DATE OF ISSUANCE,OR IF WORK IS SUSPENDED AT ANY TIME FOR BELOW WHEN MAKING INQUIRIES MORE THAN 180 DAYS OR IF WORK IS DONE IN VIOLATION OF ANY CITY OR STATE LAWS OR REQUESTING INSPECTIONS RELATING THERETO. PROJECT DESCRIPTION PROJECT No. I PERMIT No. WATER HEATER CIO,SAME LOCATION 2010-23933 31590 BUILDING ADDRESS I APT./UNIT NO. I ISSUED DATE ISSUED BY 2544 LA SALLE POINTE—,Apt.0 0 8/25/2010 Heredia,Monica 103217131APN I TRACT M13AWS LOT I FLOORS I UNITS I PROJECT PERMITS I P.TYPE CENCUS Res CODES ICONST.TYPE (ZONING TYPE I OCCUPANCY TYPE IVALUATION $50000 I TOTAL SQFT O�I BLDG.SOFT Add/Aft VB Current Owners: GREGORY BLACKFELNER- Fees Address: 2544 LA SALLE POINT CHINO HILLS CA 91709 Fee Group/ Fee Description Fee Amount Payments Ph- 909-982-8488 Transaction Type Email- Water Heater C/O $69.75 Contractor AFFORDABLE WATER HEATERS-AFFORDABLE WATER HEATERS Address. 24663 RAILROAD AVENUE SANTA CLARITA CA 91321 6001 Permit Issuance Fee $53.00 53 00 Ph- 661-259-7131 Email' 8141 Water Heater $15.75 1575 LIc.Information627366 _ Exp.Date:9/30/2010 LICENSED CONTRACTORS DECLARATIONLICENSED CONTRACTORS DECLARATION SB1473 $7.00 1.00 I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9(commencing with TOTAL FEES $69.75 Sec.7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. - , In securing this permit I am acting with the knowledge of and on behalf of the owner of the properly AMOUNT PAID _ $89.75 -tL� Date. D'3-5-.1 0 Contractor AWL BALANCE DUE _ M.00 V ✓ OWNER-BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors Licence Law for the following reason,(Sec,7031.5,Business and Profesional Code. Any city or county which requires a permit to construct,alter,improve,demolish or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9 commencing with Section 7000 of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption Any violation of Sec.7031.5 by any applicant for a permit subjects the applicant to a awl penalty of not more that five hundred dollars($500.00) I,as owner of the propterty,or my employees with wages as their sole compensation,will do the work,and the structure is not intended or offered for sale(Sec.7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale. If however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he she did not build or improve for the purpose of sale) I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors License Law) I am exempt under article 3 of the Business and Professions Code Date: Owner WORKERS COMPENSATION DECLARATION • I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self-insure for workers'compensation,as I certify that I have read this application and state that the above information is correct. I agree to comply provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is with all city and county ordinances and state laws relating to building construction,and hereby authorize issued representatives of this city to enter upon the above-mentioned proptery for inspection purposes I have and will maintain workers'compensation insurance,as required by Section 3700 of the La or ode,for the performance of the work for which this permit is issued My worker's compensation eag F- 2c.1 8 insurance camererannd�poliicyy number are: ( ('may" 4 ,/ Gamer 242.4E` Policy it2tr1 (t< <a 7 o APPLICAFST SIGNATURE DATE • I certify that in the performance of the work for which this peril is issued,I shall not employ any Applicant SCOTT LITTLEFIELD- - person in any manner so as to become subject to the workers compensation laws of California,and agree Address: 24663 RAILROAD AVE NEWHALL CA 91321 that if I should become subject to the workers compensation provisions of Section 3700 of the Labor Code, (�� I shall forthwith comply with those provisions. 4 Ph- 661-259-7131 Email. Date' k-'2S`C" Applicant- //--Cert- l i Lie.Information _ Exp.Date: s..../✓C WARNING: Failure to secure worker's compensation coverage is unlawful,and shall subject an employer I certify that the user of this facility shall comply with sections 25506,25533 and 25534 of the Health end to criminal penalities and civil fines up to one hundred thousand dollars($100,000),in addition to the cost Safety Code,which regulate the storage,handling and use of hazardous materials of compensation,damages as provided for in section 3705 of the Labor Code,interest,and attorney's fees.