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Permit No. 1058803384 3 k 105 SAN BERNARDINO COUNTY-EPWA/LAND MANAGEMENT DEPT • 't' OFFICE OF BUILDING AND SAFETY P E RMI T APPLICATION PERMIT NBR 105 88 03384 225A 01 I PAGE 1 OF 1 THIS IS NOT A PERMIT UNTIL ISSUED APPL DATE 10/27/88 ISSUE DATE 10/31/88 PARCEL NUMBER 1017-831-46-0000 PROPOSED USE: POOL AND SPA CURRENT USE: RESIDENCE W/GARAGE TRACT 1000 13LOT 92 I SEC SE29 102S 08W PRCL MAP I PW 0ORCI ACTIVITY : L821 COMMUNITY PLAN ZONE/LAND USE DISTRICT( GENERAL PLAN SUBDIVISION NAME SUBDIVISION PARCEL NO CHINO HILLS CH/PUD LOT DIMENSION IRREGULAR (CONST TYPE APPLICANT NAME, MAILING ADDRESS, AND PHONE NUMBER *BLDGS ON LOT 1 GROUP MALINS POOLS INC. 12345 MILLS AVE 31 *PLANS RECD 0 LAND USE PLOT 0 INDEX NBR 31-159 CHINO CA 91710-0000 STD PLAN/ICBO 8630088225A FHA (714) 628 - 8734 GRADING INITIAL ACTUAL OWNER NAME, MAILING ADDRESS, AND PHONE NUMBER CU.YDS. EXC. HOCH, MARK T CATHY CU YDS. FILL 3165 OAKCREEK ROAD CHINO HILLS CA 91709-0000 ITEM CNT DESCRIPTION DETAIL TOTALS (714) 597 - 4343 POOL PRIVATE 251.68 MISC SUB-TOTAL- 251.68 JOB SITE ADDRESS TOTAL AMOUNT 251.68 3165 OAKCREEK ROAD CHINO HILLS CA 91709-0000 CROSS STREET OAKCREST DRIVE INSPECTN ACCESS CONTRACTOR NAME LICENSE NUMBER MALINS POOL CONST CONT000438874 MAILING ADDRESS, PHONE NUMBER 3857 SCHAEFER AVE UNIT *C CHINO CA 91710-0000 t-nn';l_pnn _ -�n^n - - — - --- -- - MINIMUM SETBACK DISTANCES 47 FRNT SETBACK/CENTRLINE OAKCREEK ROAD R/W 50 20 REAR SETBACK/PROP LINE 5 SIDE SETBACK/PROP LINE 10 SIDE SETBACK/PROP LINE MECHANICAL EQUIP NOT PERMITTED IN REQUIRED SIDE SETBACKS NO. STORIES I NO. DWELLING I NO. BEDROOMS I FLOOR UNITS COIV1PL ' ED EXT WALLS INT. WALLS CEILING r i if GATE • ROOF HEATING FIREPLACES METAL IMASRY N.PWAATER TIR I SEWER I MIN DEPTH! S.F./100IOSIZE! NEW/REPAIR 000COMMENTS 'AMT WAIVED .00 AMT PAID 251.68 PAYOR NAME. MALINS POOL CONSTRUCTION INC. PAID 10/27/88 RECEIPT • 4356 EMPL: STACCATO-NYARI, M s IP LICENSED CONTRACTORS DECLARATION I HEREBY AFFIRM THAT I AM LICENSED UNDER E PROVISIONS OF CHAPTER 9 (COMMENCING WITH S TION 7000) OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE, AND MY LICENSE IS IN FULL FORCE AND EFFECT CENSE CLASS LICENSE NUMBER CONTRACTOR DATE 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 CODE1 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 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 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 COPY IS FILED WITH THE COUNTY BUILDING INSPECTION DEPARTMENT PPLICANT DATE 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 SUB IECT 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 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 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 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 489 /oS7 -- 033?,/ o?aS`74 01 Owner Name NOc ( ) M Permi NumbeO INSPECTION RECORD DATE INSPECTOR I DATE INSPECTOR Setback /2.7-7 Y d Rough Plumbing Temporary Power .1Shower Pan Test Foundation Reinforcing Steel /2-7-6Y _ CDV71 Stucco Mesh or Exterior Siding Excavation and Forms /7 -7-I V Q Insulation F H A Foundation Req Sewer Slab Grade Interceptor Ground PlumbingSeptic Tank Underslab awes C lOrtS 7 _ ' ( 4- Leach Line or Seep Pit Underslab Conduit i °4-- �rj Water Service Fireplace Foundation Lath or Drywall Nailing Joists and Girders Gas Line Air Test V2-7.- t ( Electrical Ground lep41/4442) (7.-7.4"6- d' Final Energy Mid-Height Bond Beam Final Plumbing 8-Foot Bond Beam Final Heating/A.0 Final Bond Beam Final Construction Fireplace Bond Beam Final On Site Improvements Roof Sheathing Final Off Site Improvements Framing and Ventilation Final Dedication Roof Covering J Final Zoning Qeagh-Heating L4964/749"/ /2.-/e--r% C(c<- Final Electrical Electrical Service and Ground Final Gas Rough Electrical Developer Fees Paid WC (Y/N) Ind Saf (Y/N) Certificate of Occupancy '-iv- S7 /=Eivc a anr3 0.#Q',C -_ 2-I P/AdG Vie,," -- n _. ( n '..// SEPTIC TANK GALS ..K N.1 .11 SEEP PIT X .,.N._`LI/1 / LEACH LINE WIDE . I'4/ X LONG X DEPTH OF ROCK eO ' ��I N .'e% -I l C- I W E S Inspector's Signature and Initials 7/ (Y/Wt.-C4• .C.c'T /3 12-17589-469 Rev 3/88