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2014-29414 10-9-2014 2526 LA SALLE POINTE HVAC C/OCity of Chino Hills Building Permit BUILDING DIVISION OF COMMUNITY DEVELOPMENT DEPARTMENT 14000 City Center Dr., Chino Hills, CA91709 Counter Phone (909) 364-2780 24 -Hour Inspection Line (909) 364-2790 N 4� Date: Permittee: Print Full Name: WORKERS COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations. 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 "ounty ordinances and state laws relating to building construction, and hereby authorize issued. representati oaf 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 Labor Code, for the performance oft work for which this permit is issued. My workers compensation insurance carrier a olicy numb y _ SIGNATURE Y DATE —�' Car,�er: f �_ Policy A ; PLICANT SIGNA . ~� Applicant: pp DAN STINSON I certify that in the performance of the work for which this permit is issued, I shall not employ any YY person in any manner so as to become subject to the workers compensation laws of California, and Address: 4375 PRADO RD, STE 108 CORONA CA 92880 a agree 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. Ph: 909-824-6240 Email - Labor ETSCAPE. .i, NET Date:.� l . r Applicatt n::/ Lic. Information e. I certify that the user of this facility shall comply with sections 25506, 25533 and 25534 of the Health and WARNING: Failure to secure work �Sco�pp nsation coverage is unlawful, and shall subject an Safety Code, which regulate the storage, handling and use of hazardous materials employer to criminal penalities and civil fines up to one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in section 3706 of the Labor Code, interest, and attorney's fees. (NOTE: You must call before 3p.m. for a next business day inspection) 'y City Hall 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 MORE BELOW WHEN MAKING INQUIRIES 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. PERMIT No. HVAC CHANGE OUT 2014-29414 BUILDING ADDRESS APT. / UNIT NO. ISSUED DATE ,��'' ISSUED BY 2526 LA SALLE POINTE — 10/9/2014 Whiteman, Rosemary APN TRACT MAP# LOT FLOORS / UNITS PROJECT PERMITS P. TYPE 103217134 TR 13792 107 / CENCUS CODES CONST. TYPE ZONING TYPE OCCUPANCY TYPE VALUATION TOTAL SQFT BLDG. SQFT 434 Res Add/Alter VB R-3 $7,000.00 0.00 Current Owners: Fees Name: CHINA IIAMS Fee Group / Fee Description Fee Amount Payments Address.- 2562 LA SALLE POINTE CHINO HILLS CA 91709 Transaction Type Ph: 909-994-6112 Mechanical C/O $423.40 Email: M@CH.ORG Contractor. CYPRESS HEATING AND AIR CONDITIONING - CYPRESS HEATING AND AIR 38 HVAC change out - Split System w/Energy $422.40 422.40 Address: 547 SOUTH LORAINE GLENDORA CA 91741 SB1473 $1.00 1.00 Ph: 626-963-9810 Email: GARYALDERETE@HOTMAIL.CO TOTAL FEES $423.40 M Lic. Information302865 Exp. Date: 9/30/2014 AMOUNT PAID $423.40 LICENSED CONTRACTORS DECLARATION LICENSED CONTRACTORS DECLARATION BALANCE DUE $0.00 � I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with 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 and on behalf of the owner of the property. ,. Date: Contractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's 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 civil 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: Permittee: Print Full Name: WORKERS COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations. 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 "ounty ordinances and state laws relating to building construction, and hereby authorize issued. representati oaf 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 Labor Code, for the performance oft work for which this permit is issued. My workers compensation insurance carrier a olicy numb y _ SIGNATURE Y DATE —�' Car,�er: f �_ Policy A ; PLICANT SIGNA . ~� Applicant: pp DAN STINSON I certify that in the performance of the work for which this permit is issued, I shall not employ any YY person in any manner so as to become subject to the workers compensation laws of California, and Address: 4375 PRADO RD, STE 108 CORONA CA 92880 a agree 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. Ph: 909-824-6240 Email - Labor ETSCAPE. .i, NET Date:.� l . r Applicatt n::/ Lic. Information e. I certify that the user of this facility shall comply with sections 25506, 25533 and 25534 of the Health and WARNING: Failure to secure work �Sco�pp nsation coverage is unlawful, and shall subject an Safety Code, which regulate the storage, handling and use of hazardous materials employer to criminal penalities and civil fines up to one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in section 3706 of the Labor Code, interest, and attorney's fees. I y, = e EVIE w +F @ Q i 4 A"s 1 F w.w. ..,� n.. 's �,»,� £.b ,o... F .p P. e��. n§ 8 ��."s° R ie' _ {{ °P1 F L' £PP IE � .- w � P C 4 ; D .-.� I L D 1 � 13 ¢�: ° S ,�.:tl � � � � :� Y 16 11' J Post in : sa��', €vooll'_IS¢ OCA OI °I; Place front of & ob. P r o e► de pert -,,,it $dui-rlbe1 ,Ps hUl 11A:> l eng for inspection. l .1aaPve a .fpr oP'b ed plans on job at 4 _0 ' _ aI44 ¢R '► L F nm y- m fry ,_ ;_ T I .IS S � �. � I iF F 1Ie�;wiea-n!. 'vvithPY,o� �r pewnar',eaft a°ecoacis §Y==Yhen job icn C 01-1-1 pi e e. I �: �'e. �xo>4 8"�" ° '� R r'a'b ia�".x asy „x s, �p4rr II it i q:, m � � � �u � ' �x d« ' 4 �aa � INSPECTION DATE INSPECTOR Grading: Pregrade Meeting Rough Grade Terraces Sulo Drains Finish Grading Soils Certification Grading Certification Rough UnderUrom d Site Inspections: Building Sewer Line Fater Supply Line N Electrical Service Conduit Storm Drain f Catch Fusin DO NOT HACK FILL UNTIL ABOVE IS APPROVED Verify Soils Engineering: Compaction, moisture, conditioning, oto. UnderfloorMnduslab list ticmi: UF Waste P lu mbing UF 'mater UF Mechanical t fF Electrical UF Framing t )F Insulation Suhtloor ABOVE IS REQ DIRE D H RIO R TO F OU N DATION I NSP ECTION Foundation Inspectim: Setback, f Footing — OK to Pour t IF E R Ground (Rebar!Copper) Hardware f Hold -Downs Piersaissons I Tendons Slab Grade — OK to Pour DO NOT PO UFS CO NCRET E U NTIL ABOVE E IS AdPPROV EU Shear ape tion (Wood): Foot Nailing Exterior Walls Interior Walls Hardware f Hold -Gowns Combo inspection: Framing Rough Electric Rough Mechanical Rough Plumbing I Topout COVER NO WO RK U HTIL ABOVE IS APP ROVE D Insulation Drywall kispection: Interior Exterior EXT LATH Stucco Scratch Miscellaneous asp ections: Masonry Fireplace Plate Ties, Fire Block, Patio I Deck: Footing Frame Access I Light i Switch Patio Final INSPECTION DATE INSPECTOR Block 'Fall pecti : Footing, Rebar 1 " Litt Blond Beam 2r4 Litt Bond Beam Litt Bond Beam Drain f Seal ReRoof: Tear -off , Existing Conditions Sheath Nailing Foot Final Swinw Virg Fools: Location f Rebar f Bonding f Light Gas Test Gr Conduit fro Elect POOL NOT TO H E FILLE D U NTIL F ENCI NG IS COMPLETE Fence, Gate & Alarm Final Pool Fire Protection Equiprriert: UG Pipe Thrust Blocks Hydro Flush Veld Outlet Insp . Overhead Hydro Temp Povwff Pole Electric Release Gas Tet. FINAL INSPECTIONS NO OCCU PNCY P E RMITTED VATHO UT FINAL Counter Environmental Health Crept. (391-7570) Planning Crept. (004-2752) Pupil is '4'Vorks (004-2774) Fire (000-3300) Landscape (004-270 ALL ABOVE MUST H E APPROVE D H E FO RE FI NAIL BLD G. Final Grade Final E lectric Final P lump ing . Final Mechanical, Final F u ildingf Construction Water Meter Number CERTIFICATE OF OCCUPANCY OK TO ISSUE OTHER: NOTICE TO OWN E Ft: Call for FINAL INSP ECTION on every jobb This permitgill expire if work is suspended or abandoned for a period of 180 days. S PLAN CA. E SITE ADDRESS S pARCEL NUMBER ASSESSO Provide North Arrow s I D P R 0 P E. R L I N E 284-199 (Rev. 06/2009) REAR PROPERTY LINE FRONT PROpERTy LIME I - s I D E P R 0 p E R L N E