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Permit No. 1058801987 ee I itiAfr 105 SAN BERNARDINO COUNTY-EPWA/LAND AGEMENT DEPT • OFFICE OF BUILDING AND SAFETY P E RMI T APPLICATION PERMIT NBR 105 88 01987 225A 01 I PAGE 1 OF 1 THIS IS NOT A PERMIT UNTIL ISSUED APPL DATE 06/02/88 ISSUE DATE 06/09/88 PARCEL NUMBER 1017-841-21-0000 PROPOSED USE: SWIMMING POOL AND SPA CURRENT USE: RESIDENCE TRACT IBIKI LOT I SEC ITJ N I PRCL MAP I PRCL OU PLAN ZONE/LAND D E DISTRICT GENERALPLAN 12625 000 321SE29 O0 CHINO HILLS DUA SUBDIVISION NAME SUBDIVISION PARCFL NO LOT DIMENSION IRREGULAR (CONST TYPE VN JFBLDGS ON LOT 1 GROUP R3 APPLICANT NAME, MAILING ADDRESS, AND PHONE NUMBER *PLANS RECD 2 LAND USE PLOT 0 (INDEX NBR 30-159 MALINS POOLS INC STD PLAN/ICBO FHA 12345 MILLS AVE *31 CHINO CA 91710-0000 GRADING INITIAL ACTUAL (714) 628 - 8734 CU.YDS. EXC. CU.YDS. FILL OWNER NAME, MAILING ADDRESS, AND PHONE NUMBER STANLEY, LEWIS ITEM CNT DESCRIPTION DETAIL TOTALS 15937 OAK CANYON DR POOL PRIVATE 198.80 CHINO HILLS CA 91709-0000 MISC SUB-TOTAL 198.80 (714) 597 - 5646 TOTAL AMOUNT 198.80 JOB SITE ADDRESS 15937 OAK CANYON DR - CHINO HILLS CA 91709-0000 CROSS STREET OAKCREEK RD INSPECTN ACCESS CONTRACTOR NAME LICENSE NUMBER MALINS POOL CONST C0NT000438874 MAILING ADDRESS, PHONE NUMBER 3857 SCHAEFER AVE UNIT IFC CHINO CA 91710-0000 _ nen) nnn 7_11n(10_ -- • -- w _ - - MINIMUM SETBACK DISTANCES 45 FRNT SETBACK/CENTRLINE OAK CANYON DR R/P) SO 20 REAR SETBACK/PROP LINE _ 40 S1DE'SETBACK/CENTRLINE OAKCREEK RD R/W SO 5 SIDE SETBACK/PROP LINE MECHANICAL EQUIP NOT PERMITTED IN REQUIRED SIDE SETBACKS NO. STORIES I NO. DWELLING I NO. BEDROOMS I FLOORUNITONTARIO EXT. WALLS INT. WALLS ( CEILING rit L E ROOF HEATING FIREPLACES DATE: 9 -I (METAL (MASRY PWWATER ATIR I SEWER I MINODEPTH' S•OOO100IOOOOEI NEW/REPAIR COMMENTS II STD POOL PLAN NO. 86-30088-225A. PRE-CONSTRUCTION INSPECTION REQUESTED 6/2/88. ------------ AMr WAIVED .00 AMT PAID 198.80 PAYOR NAME: MALINS POOLS INC. PAID 06/02/88 RECEIPT 1654 EMPL: RICHARDS, GARY ICENSED CONTRACTORS DECLARATION I HEREBY AFFIRM THAT I AM LICENSED UNDER T PROVISIONS OF CHAPTER 9 (COMMENCING WITH SE ON 7000) OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE,E, AND MY LICENSE IS IN FULL FORCE AND lEEFFFECTT /� / 9 LICENSE CLASS l 3 LICENSE NUMBER 13 d 7`-/ CONTRACTOR "� `rN5 DATF v - / ' C5' OWNER-BUILDER DECLARATION I HEREBY AFFIRM THAT I AM EXEMPT FROM THE CONTRACTORS LICENSE LAW FOR THE FOLLOWING REASON(SECTION 7031 5,BUSINESS AND PROFESSIONS 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 SECTION 7031 5 BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO A CIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS [8500] 1 ❑ I,AS OWNER OF THE PROPERTY,OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION,WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SECTION 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 OR 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 CONTRACTORS 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 SEC B AND P C FOR THIS REASON OWNER DATF WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM THAT I HAVE A CERTIFICATE OF CONSENT TO SELF-INSURE OR A CERTIFICATE OF WORKERS'COMPENSATION INSURANCE OR A CERTIFIED COPY THEREOF (SEC 800, LAB C I { POLICY NO \ -CD'SI. -6\ COMPANY A k O N k ❑ CERTIFIED COPY IS HEREBY FURNISHED r�E„TIFIED COPYIS ILED�Wg-H-THE COUNTY BUIL¢ IN + SPECTION DEPARTMENT APPLICANT , /"� '7 ---)-7-'N DATF / ` 9 P g5"-- , " / // i CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATION INSURANCE(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [5100] OR LESS) I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I SHALL NOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBJECT TO THE WORKERS' COMPENSATION LAWS OF CALIFORNIA APPLICANT DATF NOTICE TO APPLICANT IF,AFTER MAKING THIS CERTIFICATE OF EXEMPTION,YOU SHOULD BECOME SUBJECT TO THE WORKERS'COMPENSATION PROVISIONS OF THE LABOR CODE, YOU MUST FORTHWITH COMPLY WITH SUCH PROVISIONS OR THIS PERMIT SHALL BE DEEMED REVOKED CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM THAT THERE ISA CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC 3097,CIV C) LENDER'S NAME - LENDER'S ADDRESS DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION THE CALIFORNIA HEALTH AND SAFETY CODE REQUIRES A DIVISION OF INDUSTRIAL SAFETY PERMIT AS A PREREQUISITE TO PERMIT ISSUANCE UNLESS THE APPLICANT SIGNS ONE OF THE CERTIFICATES BELOW ❑ I CERTIFY THAT NO EXCAVATION 5 FEET OR MORE FEET IN DEPTH,INTO WHICH A PERSON IS REQUIRED TO DESCEND,WILL BE MADE IN CONNECTION WITH WORK AUTHORIZED BY THIS PERMIT,AND THAT NO BUILDING,STRUCTURE,SCAFFOLDING, FALSEWORK,OR DEMOLITION OR DISMANTLING THEREOF,WILL BE MORE THAN 36 FEET HIGH ❑ AS OWNER/BUILDER I WILL NOT EMPLOY ANYONE TO DO WORK WHICH WOULD REQUIRE A PERMIT FROM THE DIVISION OF INDUSTRIAL SAFETY,AS NOTED ABOVE UNLESS SUCH PERSON HAS A PERMIT FROM THAT DIVISION DIVISION OF INDUSTRIAL SAFETY PERMIT NUMBER I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT, I AGREE TO COMPLY WITH ALL CITY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION, AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE-MENTIONED PROPERTY FOR INSPECTION PURPOS SIGNATURE OF APPLICANT OR AGENT ///iti / -c--- DATE v I D / - / / / EXPIRATION NOTICE APPLICATIONS FOR WHICH NO PERMIT IS ISSUED WITHIN 180 DAYS FOLLOWING THE DATE OF APPLICATION SHALL EXPIRE,EVERY PERMIT SHALL EXPIRE IF WORK DOES NOT COMMENCE WITHIN 180 DAYS OF ISSUANCE OF SUCH PERMIT OR IF THE WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS, FEES PAID ARE NOT REFUNDABLE AFTER ONE YEAR FROM DATE OF PAYMENT, ALL FEES PAID MAY NOT BE REFUNDABLE 12-17588-469 Owner Name sz Permit Numb Ckr----p -Otgi7•ZZr-P -a/ INSPECTION RECORD DATE INSPECTOR I I DATE INSPECTOR Setback l WIC A-/N- 1 4,0 Rough Plumbing Temporary Power I Shower Pan Test Foundation Reinforcing Steel Stucco Mesh or Exterior Siding Excavation and Forms I�-� Insulation F H A Foundation Req. Sewer Slab Grade I Interceptor Ground Plumbing 4 /SI f rib Septic Tank Underslab Ducts I Leach Line or Seep Pit Underslab Conduit Water Service Fireplace Foundation Lath or Drywall Nailing Joists and Girders Gas Line Air Test j EIectnca 416•40 4? 401 Final Energy Mid-Height Bond Beam Final Plumbing 8-Foot Bond Beam Final Heatin*A.C. 7,. t 3-IV Si Final Bond Beam Final Construction r?-13-seL�f/�fJ„ Fireplace Bond Beam Final On Site Improvements I Roof Sheathing Final Off Site Improvements I Framing and Ventilation Final Dedication I Roof Covering Final Zoning I Rough Heating /�• s ( r 7 Final Electrical 7-13-E e � Electrical Service and Ground ��'g Final Gas I '77.411- frir Rough Electrical fo .gr{ f Developer Fees Paid WC (YIN) --Ind Saf (YIN) Certificate of Occupancy • I • • • • _ 'i1; 1 • e SEPTIC TANK GALS SEEP PIT X LEACH LINF WIDF X LONG X DEPTH OF ROCK N W E S Inspector's Signature and Initials ab /0`ve 12-17589.489 Rev 3/88