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Permit No. 1058802324 (2) • • s • '105' RSAN BERNARDINO COUNTY-EPWA/LANG AGEMENT DEPT (32-Y--- OFFICE OF BUILDING AND SAFETY P E R MSI T APPLICATION PERMIT NBR 105 88 02324 225A 01 I PAGE 1 OF 1 THIS IS NOT A PERMIT UNTIL ISSUED APP( DATE 07/07/88 ISSUE DATE 07/15/88 PARCEL NUMBER 1017-841-01-0000 PROPOSED USE: SWIMMING POOL Aft CURRENT USE: RESIDENCE W/ GARAGE 1TRACT I BLK I 301LOT I SE29 SEC I T' I RNG08W ITItt MAP I PRCL ACTIVITY : L821 oonCOMMUNITY PLAN ZONE/LAND USE DISTRICT GENERAL PLAN SUBDIVISION NAME SUBDIVISION PARCEL NO PUD RES 2 LOT DIMENSION 50X110 CONST TYPE VN APPLICANT NAME, MAILING ADDRESS, AND PHONE NUMBER *BLDGS ON LOT 1 GROUP R3 CENTURY 21 POOLS 8608 HICKORY ST *PLANS RECD 2 LAND USE PLOT 0 INDEX NBR 30-159 CUCAMONGA CA 91729-0000 STD PLAN/ICBO FHA (714) 899 - 2515 GRADING INITIAL ACTUAL OWNER NAME, MAILING ADDRESS, AND PHONE NUMBER CU.YDS. EXC. ALTO, JOHN CU.YDS. FILL 15934 OAK CANYON DR CHINO HILLS CA 91709-0000 ITEM CNT DESCRIPTION DETAIL - TOTALS (714) 597 - 6182 POOL PRIVATE 198.80 MISC SUB-TOTAL 198.80 JOB SITE ADDRESS TOTAL AMOUNT198.80 15934 OAK CANYON DR COMPLETED CHINO HILLS CA 91709-0000 CROSS STREET BAYBERRY DRIVE INSPECTN ACCESS DATE '1-13-89 CONTRACTOR NAME LICENSE NUMBER CENTURY 21 POOLS INC CONT000316680 MAILING ADDRESS, PHONE NUMBER 8608 HICKORYE AYE RANCHO CUCAMONGA CA 91734-0000 _ - _'^io 1 !lfl .„---__1_1000 --- -- - - _ _' - '- - - ' - ' -- -- '- - - -' - -- MINIMUM SETBACK DISTANCES 20 FRNT SETBACK/PROP LINE 15 REAR SETBACK/PROP-LINE- ' 5 SIDE SETBACK/PROPLINE , 5 SIDE SETBACK/PROP LINE MECHANICAL EQUIP NOT PERMITTED IN REQUIRED SIDE SETBACKS NO. STORIES NO. DWELLING NO. BEDROOMS FLOOR UNITEXT WALLS I INT. WALLS CEILING ROOF 1 HEATING FIREPLACES METAL IMASRY WATER PUBLIC (PUBLIC SEWER I MI0000EPTHI S OOOl0010000E1 NEW/REPAIR COMMENTS PRE-CONSTRUCTION PERMIT WRITTEN AMT WAIVED .00 AMT PAID 198.80 PAYOR NAME. CENTURY 21 POOLS PAID 07/07/88 RECEIPT 2267 EMPL: GUTIERREZ, BRUNO &LICENSED CONTRACWORS D CLARATION • HEREBY AFFIRM THAT I AM LICENSED UNDER MrPROVISIONS OF CHAPTER 9 (COMMENCING WITH SE ION 7000) OF DIVISION 3 OF THE BUSINESS AND" PROFESSIONS CO /E�AND MY LICENSE IS IN FULL FORCE AND EFFECT U /-"I �� w�� /LI ENSE CLAS 1 �-1U-1�- ICSE NUMBER �/ CONTRACTOR� `�' �`� DNi /i 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 [$5001 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 DATE 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 3800, LAB C I ' POLICY NO COMPANY ❑ CERTIFIED COPY IS HEREBY FURNISHED ❑ CERTIFIED COPYLED WI H THEGJmTYUILSPECTION DEPARTMENT _I r /�� �gPPLICANT V DATE �r/ r CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATION INSURANCE(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$1001 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 DATE 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 IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC 3097,CIV C) LENDER'S NAMF 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 ST TE AT THE AB E INF fiMATION IS CORRECT, I AGREE TO COMPLY WITH ALL CITY AND COUNTY DINANCES AND STATE LAWS RELATING TO BUILDING 0 STRUCTIO AND H EBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE AB -MENTIONED PROPERTY FOR INSPECTION PUURPOS / SIGNATURE OF APPLICANT OR AGENT /I i-�I2.i✓ ii7,YYY , /L/--) DATE ---/ I�' t7 \__/ 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 ?Kra • • INSPECTION RECORD Permit Number/°54#42.32-(7-2?-14-0/ DATE INSPECTOR I DATE INSPECTOR Setback c - c.( _ I Rough Plumbing Temporary Power Shower Pan Test Foundation Reinforcing Steel $ Z s- r c. (_ Stucco Mesh or Exterior Siding Excavation and Forms C. . 4 . Insulation F H A Foundation Req. Sewer Slab Grade Interceptor Ground Plumbing Septic Tank Underslap Ducts Leach Line or Seep Pit Underslab Conduit i/,3 � Water Service Fireplace Foundation Lath or Drywall Nailing • Joists and Girders Gas Line Air Test � ��� J Electrical Ground Final Energy Mid-Height Bond Beam Final Plumbing 8-Foot Bond Beam Final Heating/A.C. Final Bond Beam Final Construction 4/-/3--K9 etz Fireplace Bond Beam Final On Site Improvements Roof Sheathing Final Off Site Improvements Framing and Ventilation Final Dedication Roof Covering Final Zoning • Rough Heating Final Electrical Electrical Service and Ground Final Gas Rough Electrical Developer Fees Paid Certificate of Occupancy WORKERS' COMPENSATION INSURANCE (Y/N) DIVISION OF INDUSTRIAL SAFETY PERMIT (Y/N) Gc0AT I UM vCMPLETED ^ATE q-/3- 'q SEPTIC TANK GALS SEEP PIT X LEACH LINE WIDE X LONG X DEPTH OF ROCK N W E S Inspector's Signature and Initials 12-17589-469