Loading...
Permit No. 1058801083 3.,05 SAN BERNARDINO COUNTY-EPWA/LAND�AGEMENT DEPT - OFFICE OF BUILDING AND SAFETY P E R I T APPLICATION PERMIT NBR 105 88 083 2101 01 I PAGE 1 OF 1 THIS IS NOT A PERMIT UNTIL ISSUED APPL DATE 02/05/88 ISSUE DATE 02/05/88 PARCEL NUMBER 1017-831-35-0000 PROPOSED USE: FIELD INVESTIGATION FOR PATIO CURRENT USE: RESIDENCE AND GARAGE TRACT 1000 1 342 SE29 I TOWN I 2S RONW PRCL MAP 10RCL CCOMMUNITY PHINO HILLSLAN ( ZONE/LAND USE DISTRICT( GENERPUDRESPLAN SUBDIVISION NAME SUBDIVISION PARCEL NO LOT DIMENSION 50 X 100 (CONST TYPE 1BLDGS ON LOT 1 GROUP APPLICANT NAME, MAILING ADDRESS, AND PHONE NUMBER PLANS RECD 0 LAND USE PLOT 0 (INDEX NBR 31-160 JONES, WILLIAM E. STD PLAN/ICBO FHA 3126 OAKCREEK RD CHINO HILLS CA 91709-0000 GRADING INITIAL ACTUAL 1 1 - CU.YDS. EXC. CU.YDS. FILL OWNER NAME. MAILING ADDRESS, AND PHONE NUMBER JONES, WILLIAM E. ITEM CNT DESCRIPTION DETAIL TOTALS 3126 OAKCREEK RD FIELD INVESTIGATION 65.80 CHINO HILLS CA 91709-0000 MISC SUB-TOTAL 65.80 ( ) - TOTAL AP ����® 65.80 JOB SITE ADDRESS 3126 OHILLSEK,RD COMPLETED CHINO HILLS CA 91709-0000 CROSS STREET OAK HILL DRIVE INSPECTN ACCESS DATE: zees CONTRACTOR NAME LICENSE NUMBER MAILING ADDRESS, PHONE NUMBER MINIMUM SETBACK DISTANCES 20 FRNT SETBACK/CENTRLINE P/L OAKCREEK ROAD R/W 50 5 REAR SETBACK/PROP LINE 35 SIDE SFTBACK/CENTRLINE P/L OAK HILL DRIVE R/W 50 5 SIDE SFTBACK/PROP LINE MECHANICAL EQUIP NOT PERMITTED IN REQUIRED SIDE SETBACKS NO. STORIES I NO. DHELLING I NO. BEDROOMS I FLOOR UNITS CO EXT. WALLS I INT. WALLS I CEILING ROOF 1 HEATING FIREPLACES WO (METAL IMASRY PUWATER BLIC IPUSEWER BLIC I MIN DEPTH' S•F./1001 SIZE( NEW/REPAIR 00 000 00 COMMENTS AMT WAIVED .00 AMT PAID 65.80 PAYOR NAME: WILLIAM E. JONES PAID 02/05/88 RECEIPT 233 EMPL: FLETS, DEBORAH eICENSED CONTRLCTORS DECLARATION• I HEREBY AFFIRM THAT I AM LICENSED UNDER THE PROVISIONS OF CHAPTER 9 (COMMENCING WITH SECTION 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 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 PENA Y OF NOT MORE THAN FIVE HUNDRED DOLLARS [8500]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 CONTRACTORISI LICENSED PURSUANT TO THE CONTRACTORS LICENSE LAW) ❑ IAMEXEMPTUNDRSE ' B AND P C FOR THIS REASON /� OWNER V w ' e_ DATF 2-S-�F i 1, vi' II // 101ORKERS' 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 COPY IS FILED WITH THE COUNTY BUILDING INSPECTION DEPARTMENT APPLICANT DATF CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATION INSURANCE(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [S1001 OR LESS) I CERTIFY THAT IN THE PERFORMAN F THE WORK FOR WHICH THIS PERMIT IS ISSUED,I SHALL NOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBJECT TO THE WORKER ' COM ION LAWS OF LIF IA J -FF .t DATF L '� N CE TO APPLICANT IF,AFTER MAKING THIS CERTIFICAT/fi0 XEMPTION,YOU SHOULD BECOME SUBJECT TO THE WORKERS'COMPENSATION PROVISIONS F THE LABOR CODE, YOU MUST FORTHWITH COMPLY WI UCH 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 I 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 STAT THAT THE ABOVE INFORMATION IS CORRECT, I AGREE TO COMPLY WITH ALL CITY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING C STRUCTION, AND HER UTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE-M TIONED PROPERTY FOR INSPECTION PURPOSE NATURE OF APPLICANT OR AGENT (� , DATE 2*$"' / / , EXPIRATI f6I4IOTICE 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 /o.S/fg o /o S'3 a/o 6/ • INSPECTION RECORD Permit Number DATE INSPECTOR I DATE I INSPECTOR Setback I,ZS b8 4/7o Rough Plumbing Temporary Power I Shower Pan Test Foundation Reinforcing Steel I Stucco Mesh or Exterior Siding Excavation and Forms,rpor/ 288 L)/ Insulation F.H A. Foundation Req _ Sewer Slab Grade 12063€663 �/s Interceptor Ground Plumbing I Septic Tank Underslap 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 teeel A/ Fireplace Bond Beam Final On Site Improvements Roof Sheathing Final Off Site Improvements Framing aodVentilauon 2 888 .4_Q/ Final Dedication Roof Covering Z,a > g 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 (YIN) Z88 ' /G, . Q 4c%dC JCRaNrE z7C•T/O w/ Til .� is TT/ G ,Ge z7."_ /2 " G?EAI. 1 c A to + /p`• Lt l./E- [_o,a p x G, 7S ' x // # acPsic/o/G.S/ Pa,¢ G�EoL,av/ - _ .g�P'oRr f."5 v e -r Ln(A/. 2:70-5.6-roJ 'SET 'SQu.o.,QE TD r T/AIG $ . /7'' w- u //„ " �c�7./4/c5es .C)e c/BLC 2'x.6. !Pads-rEA's 3 " O. . /1E,a1=3EAe w/ v*a5c . -5' /..1 o (Q. 5 / O.,fl. Pc:)--,fir-1/ R..c►�T�,4S Qac tL� ssiE A, Sbi 6•1-1,./.4.A.//2 En . }zvL,TE LZ 722 uci f-5.= /6, " O. C, u//Txf d R4,Fr R' FREs5 L/T•Z&. Gsi P'r ec-.zQrs� SEPTIC TANK GALS TL/.resDM 44-! /A/God, /. SEEP PIT X EE.V T.c1p,1/24.aai/4 d/GY w4-.44.7"WP-4C7 - LEACH LINE WIDE TlrE47 D. th C.L / AI /Z C-c) C. 0_ ;SE T X LONG X DEPTH OF ROCK 7 # i0 r.5 N. 16 xxa Perna W E G7pwc,tEFE{� p Signature -� / 1 /1 Inspector's and Initials ( 2( 12-17589-469