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Permit No. 105903452 Ot.U01 6013I 3a-• ( h 4.9-o F 105 SAN BERNARDINO COUNTY-EPWA/LANDOAGEMENT DEPT - OFFICE OF BUILDING AND SAFETY P E RMI T APPLICATION PERMIT NBR 105 90 03452 211A 01 I STATUS: ACTIV THIS IS NOT A PERMIT UNTIL ISSUED APPL DATE 12/28/90 I ISSUE DATE 12/28/90 I PG 1 OF 1 PARCEL NUMBER 1031-321-01-0000 PROPOSED USE: ALUM.PATIO ENCLOSER 2ND STORY / -3 0-1 -d ) CURRENT USE: RESIDENCE W/ GARAGE 1TRACT I BLK000 I 301LOT I SE29SEC I p N RN I PRCL MMAP I PRCL ACTIVITY : L820 62COMMUNITY PLAN ZONE/LAND USE DISTRICT GENERAL PLAN SUBDIVISION NAME SUBDIVISION PARCEL NO PD 12625 LOT 301 1017-841-01-0000 LOT DIMENSION 50X110 CONST TYPE VN APPLICANT NAME, MAILING ADDRESS, AND PHONE NUMBER SBLDGS ON LOT 1 GROUP R3 STURGIS, TODD/ SUNLIGHT SOLARIUMS 976 W FOOTHILL BLVD 384 *PLANS RECD 2 LAND USE PLOT 0 (INDEX NBR 30-159 CLAREMONT CA 91711-0000 STD PLAN/ICBO 4383P FHA (714) 593 - 3029 ITEM CNT DESCRIPTION DETAIL TOTALS OWNER NAME, MAILING ADDRESS, AND PHONE NUMBER 1 ALUM PATIO COV STD 74.00 ALTO, JOHN `fr MISC SUB-TOTAL 74.00 15934 OAK CANYON DR / TOTAL AMOUNT 74.00 CHINO HILLS CA 91709-0000 (714) 597 - 6182 JOB SITE ADDRESS 15934 OAK CANYON DR COMP :!' F�:' I E CHINO HILLS CA 91709-0000 CROSS STREET BAYBERRY DRIVE a INSPECTN ACCESS niy1J `/ CONTRACTOR NAME, ADDRESS LICENSE NUMBER DIV. OF IND. SAFETY PERMIT: MINIMUM SETBACK DISTANCES 20 FRNT SETBACK/PROP LINE 15 REAR SETBACK/PROP LINE 5 SIDE SETBACK/PROP LINE 5 SIDE SETBACK/PROP LINE MECHANICAL EQUIP NOT PERMITTED IN REQUIRED SIDE SETBACKS NO. STORIES I NO. DWELLING I NO. BEDROOMS I FLOORL UNITEXT. WALLS INT. WALLS I CEILING OTHER OTHER ROOF HEATING FIREPLACES OTHER SOLAR METAL IMASRY WATER PUBLIC (PUBLIC SEWER I MIN 000EPTHI S.F./100I 0000000EI NEW/REPAIR COMMENTS PRE ALT COMPLETED BY MARK HOUSTON CONT. LI. # 606995/EXPIRES 11/21/92 COPY SENT TO KAREN AMT WAIVED .00 AMT PAID 74.00 PAYOR NAME: SUNLIGHT SOLARIUMS PAID 12/28/90 RECEIPT 5185 EMPL: HALL, S PAID BY : CHECK NBR : 609 0ICENSED CONTRACTORS DECLARATION -. I HEREBY AFFIRM THAT I AM LICENSED UNDER T ROVISIONS OF CHAPTER 9 (COMMENCING WITH SE N 7000) OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE, AND MY LICENSE IS IN FULL FORCE AND EFFECT LICENSE CLASS LICENSE NUMBER CONTRACTOR DATF 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 70001 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 [$500]I ❑ 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 3800, LAB C I POLICY NO y ' COMPANY 1 ❑ CERTIFIED COPY IS HEREBY FURNISHED ❑ CERTIFIED COPY IS FILED WITH THE COUNTY BUILDING INSPECTION DEPARTMENT APPLICANT DATF ADDITIONAL REVISION CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATION INSURANCE(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100) 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 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 HAVE READ THE HAZARDOUS MATERIALS QUESTIONNAIRE AND THE WORK APPLIED FOR ON THIS PERMIT ❑ IS ❑ IS NOT SUBJECT TO THE APPLICABLE REQUIREMENTS OF THE HEALTH AND SAFETY CODE AND THE LOCAL AIR QUALITY AGENCY 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 PURPOSES SIGNATURE OF APPLICANT OR AGENT DATE EXPIRATION AND REFUND NOTICE APPLICATIONS FOR WHICH NO PERMIT IS ISSUED WITHIN 180 DAYS FROM THE DATE OF APPLICATION SHALL EXPIRE PERMITS 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 180 DAYS FROM DATE OF PAYMENT, EXCEPT FOR ERRORS IN ACCEPTANCE WHICH MAY BE REFUNDABLE UP TO ONE YEAR FROM DATE OF PAYMENT ALL FEES PAID MAY NOT BE REFUNDABLE 12 17588-469 Rev 4/90 Owner Name A ("4/) Permit Numl.o S''D 03v5-0„911,901 INSPECTION RECORD DATE INSPECTOR I I DATE I INSPECTOR Setback Rough Plumbing Temporary Power Shower Pan Test Foundation Reinforcing Steel Stucco Mesh or Exterior Siding Excavation and Forms Insulation F H A Foundation Req Sewer Slab Grade Interceptor Ground Plumbing Septic Tank Underslab Ducts Leach Line or Seep Pit Underslab Conduit Water Service Fireplace Foundation Lath or Drywall Nailing Joists and Girders Gas Line Air Test Electrical Ground Final Energy Mid-Height Bond Beam Final Plumbing 8-Foot Bond Beam Final Heating/A.0 Final Bond Beam Final Construction /.12 Fireplace Bond Beam Final On Site Improvements Roof Sheathing Final Off Site Improvements Arh Framing and Ventilation red /—eV q l Final Dedication Roof Covering Final Zoning I e Rough Heating Final Electrical • ( Electrical Service and Ground Final Gas Rough Electrical a3.-9 ( T1- - Developer Fees Paid WC (YIN) Ind Saf (Y/N) Certificate of Occupancy F1 SEPTIC TANK GALS SEEP PIT X LEACH LINF WIDE X LONG X DEPTH OF ROCK N W E S Inspector's Signature and Initialsv`v /l 12-17589-469 Rev 3/88