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Permit No. 17057 BUILDING ADDRESS: 2143 OAK CANYON LANE PERMIT NUMBER: 17057 ,- / BUILDING INFORMATION APPLICANT INFORMATION \ BUILDING PERMIT APPLICATION Address: 2143 OAK CANYON LANE Name ' (MOHAMMED MAHMOOD ; :*s'. Community Development APN: 11031-061-01 I Address 12143 OAK CANYON LANE `="` `, —1`;;?..., 2001 Gd Aranvenue Lot 138 City,Zip Code 1CHINO HILLS,CA 91709 ;. .� Chino Hills,CA 91709 Cross Streets (OAK CAYNON LANE/PROMONTORY I Phone/Pager 1(909)606-2990 I ext 1 an UMW HILLSLICENSED CONTRACTOR DECLARATION Tract/Parcel 110379-1 I City Bus Lic# IN/A I hereby affirm that I'm licensed under the provisions of Chapter 9(commencing with Section Valuation 1$4,416 00 I ENGINEER/ARCHITECT INFORMATION 7000 of Division 3 of the Business and Professions Code)and my license is in full force and effect OWNER INFORMATION Name 1N/A OWNER BUILDER DECLARATION MOHAMMED MAHMOOD 1 Address 1 I hereby affirm that I'm exempt from the Contractor's License Law for the following reasonAddress 2143 OAK CANYON LANE 1 City,Zip Code 1 I,as the owner of the property,or my employees with wages as their whole City,Zip Code CHINO HILLS,CA 91709 Phone I 1 ext 1 O • compensation,will do the work,and the structure is not intended or offered for sale Phone (909)606-2990 1 ext I 1 Lic# I 1 © I,as owner of the property,am exclusively contracting with licensed contractors to Bus Lie# N/A City Bus Lic# ilkJ construct the project lir © I am exempt under Section 1 I BPC for this reason I IBus Exp. APPROVAL INFORMATION WORKERS'COMPENSATION DECLARATION CONTRACTOR INFORMATION Issued By YVETTE MARTINEZ I hereby affirm under penalty of perjury one of the following declarations Contractor TOWNER BUILDER I Date Issued 9/21/00 Address Finance Code C4-SM I have and will maintain a certificate of consent to self-insure for workers'compensation © as provided by Section 3700 of the Labor Code,for the performance of the work for City,Zip Co. 1 Census Code which this permit is issued Phone o ' :er 1 , 1 ext Final Date ., Bus •• Final By have and will maintain workers'compensation,as required by Section 3700 of the © Labor Code,for the performance of the work for which this permit is issued My Lic # Extension workers'compensation insurance carrier and policy number are Exp 'late 1YReviewed By LAURO BUGARIN Lie , lass I Approved By LAURO BUGARIN '— INSURANCE INFORMATION Insurance Company I EXEMPT PROJECT INFORMATION Policy Number' I PROJECT DESCRIPTION LOCATION SQUARE FT. Expiration Date I 1 I Structure © Section need not be completed if permit is for one hundred dollars($100)or lessGarage I I I certify that in the performance of the work for which this permit is issued i shall not employ Patio 1LATTICE (REAR I I 368 any person in any manner so as to become subject to the Workers'Compensation Laws of Porch I I I California and agree that if I should become subject to the workers'compensation provisions of Other Section 3700 of the Labor Code I shall comply with those provisions LATTICE PATIO COVER WITH(4)LIGHTS PROPOSED USE Date: 1 I Signature: i i I certify I have read this application and state that the above information is correct I agree to L. ' comply with all City Ordinances and state laws and hereby authorize representatives of this City to COMMENTS enter upon the above mentioned property for inspection purposes, Date: 1 4/24 Oti i Signature: I • ^" = i ' i OTHER FEES REQUIRED ZONING SETBACKS GRADING PRIOR TO ACTUAL PERMIT ISSUANCE PERMIT FEE INFORMATION` Zoning 1PD 1 Front Yard 25 Over X 1 0 Issuance 1 $29 00 1 Electrical 1 $9 00 1 Land Use FR-1 1 Side Yard 15/10 Cut 0 School 1 NO I Permit Fees: $180.56 Plan ACCESSORY Rear Yard 15Development 1 NO Plan Check $56 16 Plumbing $0 00 Fill I 0 Sewer NO Mechanical. $0 00 Structural $86 40 SMIP 1 $0 50 Occ 1R3 SSY Total- 0 1 I I I 1 I Type 1VN I Water 1 NO 1 Geo Review 1 $0 00 1 Grading 1 $0 00 1 Total Fee Due I $181.06 1 INSPECTION RECORD 1 INSPECTION DATE INSPECTOR Grading: INSPECTION DATE INSPECTOR Pregrade Meeting Block Wall Inspections . Rough Grade Footing, ReBar Terraces 1st Lift Bond Beam Sub Drains 2nd Lift Bond Beam Finish Grading 3rd Lift Bond Beam Soils Certification Drain/Seal Grading Certification ReRoof: Rough Tear-off, Existing Conditions As Built Approved Sheath Nailing Underground Site Inspections: Roof Final Building Sewer LineSwimming Pools : Supply Water Line Location/Rebar/Bonding/Light Storm Drain/Catch Basins Gas Test U/G Conduit/Electrical Gr Conduit/Ro Elect DO NOT BACKFILL UNTIL ABOVE IS APPROVED Pre-Deck Verify Soils Engineering: POOL NOT TO BE FILLED UNTIL FENCING IS COMPLETE, Compaction, moisture,conditioning,etc Fence,Gate&Alarm Underfloor/Underslab Inspection: Final Pool U/F Waste Plumbing Fire Protection Equipment: U/F Water UG Pipe U/F Mechanical Thrust Blocks U/F Electrical Hydro U/F Framing Flush Insulation Weld Outlet Insp Subfloor Overhead Hydro ABOVE IS REQUIRED PRIOR TO FOUNDATION INSPECTION, Foundation Inspection: Temp Power Pole Setback/Footing Electric Release UFER Ground(Rebar/Copper) Gas Test Hardware/Hold-Downs Piers/Caissons/Tendons FINAL INSPECTIONS DO NOT POUR CONCRETE UNTIL ABOVE IS APPROVED NO OCCUPANCY PERMITTED WITHOUT FINAL,! Shear Inspection(Wood): County Environmental Roof Nailing Health Dept (391-7570) Extenor Walls Planning Dept (364-2750 ) Intenor Walls Public Works (364-2770) Hardware/Hold-Downs Fire (393-3888) Combo Inspection: Landscape (364-2797) Framing Trust Accounts (364-2769) Rough Electric ALL ABOVE MUST BE APPROVED BEFORE FINAL BLDG Rough Mechanical Final Electric Rough Plumbing/Topout Final Grade COVER NO WORK UNTIL ABOVE IS APPROVED Final Plumbing Insulation Final Mechanical _ Drywall Inspection: Final Building/Construction /7,, /1:443)_. .....0",--------/ Interior Water Meter Number Exterior Lath CERTIFICATE OF OCCUPANCY Stucco Scratch OK TO ISSUE MISCELLANEOUS INSPECTIONS Masonry Fireplace ETHER: Plate Ties, Fire Block, 't-CAra►vs►+ o1L tp`b—0O 011 -, J Patio/Deck : Footing alc-00 lef Access/Light/Switch Patio Final __ __ _ /...""1/4._ 0 0