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Permit No. 0250 s APPLICATION F•BUILDING PERMIT AND A CERTIFICATE OF UIII OCCUPANCY ,474..�s,„ -i - CITY OF CHINO HILLS / 3 / - D (- /( ADDRE S 20 C l 0 AK x~11 '' l-^ ' d"i•••-C3 c"'I I t-t-S CLEARED BY APPLICATION TYPE NO ‘6j F LOT 4 4 BLOCK TRACT 1 0'3'79 _ I C /c0( Tv L I re ( oz o C t > OWNERA1-L. �� `� ' 1 L I THE FOLLOWING WORK IS AUTHORIZED BY THIS PERMIT 0 K Qr P w. r _..,( o ADDRESS 6C Ar-1-6 6COt01C , I'�; TRUCT O PLUMB ❑MECH 0 ELECT R, In Cl) CITY Ce\;v,I, h ZIP qG',^7 f V PH(g r8)3 35 -‘16/6) TYPE OF PROJECT XALEW_ ❑ALTER ❑ADDITION ENGIN IEER/ / ' A. PQKk I SS LIC NO S `3,2 91 1 0 REPAIR 0 CONVERT0 DEMO IDOCCUPANCY PMT • ADDRESS 5.2.....9 A.�..gi�g CT�S� 1-/W T PROJECT LOCATION ON SIZE CITY La. ( j✓,QCT( "- ZIP S')h/1 PH lbw) 9s2-ZQ7� DESCRIPTION I PROPERTY I IN SO FEET P CONTRACTOR LIC NO 1 I - 1.2.els-s ADDRESS 2 I I.�l�/J �3 Z_ �// CITY ZIP PH 3 /'''./,'(,4't-a- I .s 71i /I • c CITY BUSINESS LICENSE ESS LICENSE MARKS/SkCIAL CONDITIONS PROJECT DESCRIPTIONZNS LICENSE NO EXPIRATION DATE /. e._.6._ / LICENSED CONTRACTOR S DECLARATION /`b r 61 C I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000 of Division 3 of the Business and Professions Code,and my license is in lull force and effect . a // A•US C- Wc.c n-•-+� - License Class License Numb., C/N�-/ Dal. Contractor CO / p ADDRFCo ' CITY AND ZIP PHONF /�� / �- ,/— /J ' CONSTRUCTION LENDING AGENCY '_,5--e_,:( L,���^^n IF \ /,r i w/'�" I"/L e.CI hereby affirm that there is a construction lending agency for the performance of the work for which � /`--f/� /4"4-- 1 this permit is issued(Sec 1097,Civ C)Lender's Name Lender's Address /C-/ .c/Cjf r/L- .J,.- OWNER BUILDER DECLARATION /J/gyp I hereby�r�i that 18rti exempt from the Contractor's License Law for the following reason . - - `� ���L' LN'l as owner of the property,or my employees with wages as their sole compensation,will do the ()(9._(,-..-c r o ie..- CSL CF--p/ ,O rTM-C3 work,ar�p,the structure is not intended or offered for sale din o t ` �� /f C ' R1 as/owner of the property am exclusively contracting with licensed contractors to construct the 1 L-"_--"`- 'v -S L S J"t -pro>ect 1--bi , (o 4 'k<ir641p � 5'-3Q) 0 I am exempt under Sec B&PC for this reason t//7 4,7 A. . _ , Date INITIAL /� _ 1 // WORKERS COMPENSATION DECLARATION 7- / ::‘.,11..41..' U -7"' • . •. • •`. '..>C", .'` / 1 I hereby affirm that I have a certificate of.._ ., ,,, ., - ) Compensation Insurance or a certified copy hereof POI �L�_ I • r •` . \ N. \ COMPANY �� R//U �,_n__n�__{�y — U_` �_ \ t 0 Certified copy rs hereby furnished t1 •ofl _iai�s, I A `'\\ too �` 0 Certified copy is filed with the city - GRr rpt, ` DIVISIONIVCTYPE Data APPLICANT _. J V /U CERTIFICATE OF EXEMPTION FF DM •- E': •. PPPi fitTION - URANC��E-+�2'7/J �1UATION I certify that in the performance of the work r,wfi ' •=int ItL15�i � �(1 ,6^all not emp�/a � � person in any manner so as to become sub)... . . �i.' . . t ,. _.'...n ...I, . / Date •APPLICANT (n`+ DT,,,,,r1e PERMIT FEES NOTICE TO APPLICANT If after making this Certificate of Exemption,you should become subject / v'"' to the Workers Compensation provisions of the Labor Code,you must forthwith comply with such ELECTRICAL I STRUCTURAL /7(p��' provision or this permit shall be deemed revoked PLUMBING I GRADING I CERTIFY HAT I H• u 1111J APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORR •' r.REE TO COMPLY WITH ALL CITY ORDINANCES AND STATE LAWS AND MECHANICAL ISSUANCE FEES H,-• : • ••r E REPRESENTATIVES'OF THIS CITY TO ENTER UPON THE ABOVE GEO REVIEW 7 -) I PLAN CHECK /MENTIO t Jr.• ; FOR INSPECTION PURPOSES ( / 2ISSUAN PPROVE� TOTAL PERMIT FEE do Sig •tine ot-Applicant-or-Age eetZ,0/9‘ A.,��\ I a, 7 iv /'/ /l t*, K 1 o! p-,.? 1, D OF S9SUsA,NCr/r PERMIT NUMBER /� Print Applicant's'` /Agent s Name T/r•6'- vi;>/ ' � I (�� cls i 1 1 I , • .y a • t • . ///q. / � x ..,../Pi . .i - i f r 1 t, t .--.i s L .1 a , r5 • .rr . 1 t b P . r . wa,rwe.ca.4..oc i r beirwatirmos v.60 11012 Ma AZ I Ilrl r• 1,Ml lwhn, Y, N•-,,,,,,,,m--.--,,.-1. ` 4`�' 1 r 4 ', C 'b taw...*am.I.www...........4.. ..r,-i wok.n..o.........,•, CITY, OF- CHINO ALLS._ _ , . I BDDRE S / _ �( /"� ,, ^� 1 ADDRESS \�D �lC//(„) /...) . -QT / BLOCK TRACT/6.1 7 cj,_J BUILDING INSPECTIONS RECORD OrdNER }�,,_L NX POST IN CONSPICUOUS 'vL/ r� e � PLACE ON THE JOB ADDRESS 6,6- ` n �r G CITY C NCI ZIPCl(7( PHI 1R I,3J S_ , 6I1 PLUMBING DATE APPROVEDANSPR'S • SIGNATURE i GROUND SOIL P1 I /41. —k3 I ' GROUND WATER P2 I 1 TOP I P3 REMARKS rt SEWEERT I PS I A __ `-\`'' " 2 /-2.1-1/T<- �,`IG / IGAS TEST P6 I I I 'fes �'c ' -2I-7SGw3 IFINAL PLUMBING P72 I I MECHANICAL DATE APP SIGNAT NSPR S r7/°/ ..5 ,./p J`'e�?,� 5 rvu SIGNATURE /' ROvED UNDERGROUNDIFLOOR Mt I I ? Y/9 c..40 OEpig I) c7>7o1f T 1 ROUGH M2 II AIR GOND M/ I - I I I , FINAL MECHANICAL M12 I I ELECTRICAL DATE APPRO✓EDANSPR S SIGNATURE I TEMP CONSTN POWER E3 12 hf 4/13 II..-J , UNDERGROUND I I PVC METAL•D B a El ROUGH WIRING RECEPT SPACING- SERVICE-CIRCUIT E2 I I a . FINAL ELECTRICAL E12 I I I PERMIpXPIRED BY LIMITATION STRUCTURAL DATE APPROVEDANSPR S SIGNATURE FOUNDATION LO,SION S7 9��i�'/ Ibi/k III���" ' � I REINFORCED �D LIFE R I J \7 �/ I !�►w� SLAB REINF C/EMBRANE VS3 13/2/'/5 I j/ L 7�i� , UNDERPINNING Sa I I 4 MASONRY Sil I I FIREPLACE $11 I ROOSHEATHING S5 I 7//6/�y I FRAMING I I — i INSULATION I I SOUND/ENERGY S7 LATH EXTERIOR S8 I I LATH INTERIOR/GYPBOARD S9 I I I I I APPRO✓EDANSPR S SIGNATURE PATE OF ISSU CE PERMIT NUMBER BUILDING FINAL Si2 I I 97 872-t .// (1 ,2•5--° F I