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Permit No. 1058903077 •1T5 SAN BERNARDINO COUNTY-EPWA/LAND•AGEMENT DEPT - -- OFFICE OF BUILDING AND SAFETY P E RMI T APPLTCATION PERMIT NBR 105 89 03077 210A 01 I STATUS: ACTIV 1HIS IS NOT A PERMIT UNTIL ISSUED --- --- APPL DATE 09/33/89 I ISSUE DATE 09/13/89 I PG 1 OF 1 PARCEL NUMBER 1017-831-52-0000 PROPOSED USE: PATIO/DECK CURRENT USE: RESIDENCE 12625TRAC BLK LOT SEC 7 1 000 1 398 1 SE29 1 02S ( RNG81 PRCL 00AP 1 PRCL CCTOMIMUNITY PI_ANL820 ZONE/LAND USE QISTRICT GENERAL PLAN SUBDIVISION NAME SUBDIVISION PARCEL NO CH/PD LOT DIMENSION IRREGULAR CONST TYPE APPLICANT NAME, MAILING ADDRESS, AND PHONE NUMBER *SLOGS ON LOT 1 (GROUP PRACHT, ROBERT 3207 OAKCREEK RD *PLANS RECO 0 LAND USE PLOT 0 INDEX NBR 32-159 CHINO HILLS CA 91709-0000 STD PLAN/ICBG FHA N (714) 597 - 6903 TYPE I SQ FT I FACTOR/P.S.F. I ADJSTED AREA/VALUATN OWNER NAME, MAILING ADDRESS, AND PHONE NUMBER --- -- - '' PRACHT, ROBERT PORCH 108 20 22-.00 3207 OAKCREEK RD CHINO HILLS CA 91709-0000 CALC VALU 990.00 I ADJUSTED AREA 22 (714) 597 - 6903 • ITEM CNT DESCRIPTION DETAIL TOTALS JOB SITE ADDRESS RESIDENTIAL CONSTRU 35.45 3207 OAKCREEK RD, ISSUM')CE FEE 16.96 CHINO HILLS CA 91709-0000 TOTAL AMOUNT 52.41 CROSS STREET OAKCREST DRIVE INSPECTN ACCESS CONTRACTOR NAME, ADDRESS LICENSE NUMBER _ nTv_OF TND. SAFETY PERMIT: _ _ _ _ _ _ _ _ _ __ _ MINIMUM SETBACK DISTANCES 45 FRNT SETBACK/CENTRLINE OAKCRLEK RD. R/W 50 15 REAR SETBACK/PROP LINE 10 SIDE SETBACK/PROP LINE W 5 SIDE SETBACK/PROP LINE E MECHANICAL EQUIP NOT PERMITTED IN REQUIRED SIDE SETBACKS NO STORIES I NO. DWELLING 1 NO. BEDROOMS 1 FLOOR UNITS _ permit EXT. WALLS INT. WALLS CEILINR . Time lirnit expired on p Unable to obtain on per the work ROOF HEATING FIREPLACES _ NO visible ba sagded�inspeCtions wits METAL MASRY approve Y IMASRY erm expired. WATER ( SEWER PUBLIC 1 MIN0DEPTH1 S.F./1001000 0000E1 NEW/REPAIR _ b 22/2 -I,_ COMMENTS Date Inspector PRE-ALTER BY DON BAKER 5' AND 10' SIDE YARD SETBACK TO BE DETERMINED BY LOCATION OF EXISTING RESIDENCE AMT WAIVED .00 AMT PAID 52.41 PAYOR NAMF• ROBERT PRACHT PAID 09/13/89 RECEIPT 5261 EMPL: STACCATO-NYARI, M PAID BY CHECK NBR : 2362 . / 1111pICENSED CONTRACTORS DECLARATIONS ' • I HEREBY AFFIRM THAT I AM LICENSED UNDER THE PROVISIONS OF CHAPTER 9 (COMMENCING WITH SECTION 70001 OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE, AND MY LICENSE IS IN FULL FORCE AND EFFECT LICENSE 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 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 I,PENA TY OF NOT MORE THAN FIVE HUNDRED DOLLARS 1$500] 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 EXEMPT UNDER S•C � B AND P C FOR THIS REASON �T / / —' � G DATE /' r CS � i WNER ij —�� - l v ' / f 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 APPLICANT DATE CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATION INSURANCE(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [S100] 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 ISA 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 ND STATE LAWS RELATING TO BUILDING CONSTRUCTION, AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE- ZONED PROPERTY FOR INSPECTION PURPOSES' /f �j IGNATURE OF APPLICANT OR AGE •,i I _ -'I' _ �t_�/1 i-f DATE / "r F-,--C-1P 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 10/88 jos �?-- 77ioAd/ Owner Name �/tZ/0.k�� • rmit Numb a INSPECTION RECORD DATE INSPECTOR I DATE 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 C 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 Final Zoning Rough Heating Final Electrical Electrical Service and Ground Final Gas Rough Electrical Developer Fees Paid _ WC (Y/N) _ _ _ ___ - Ind Saf WINO_ - Certificate of Occupancy_ _ _ _ _ __ _ _ _ __ _ _ _ r1/4 , co- L `(--a a--e-r7-Aa, ac tic Cc' • I Time limit expired on per111i� I linable to obtain admission SEPTIC TANK GALS Mn vnclhle hazards Only me woc n SEEP PIT X ��.nrn�rAri by su2fled inspections Wlli LEACH LINE WIDF Iyrr X LONG X DEPTH OF ROCK I II • • --'! N Iof L'Li.' ►- 11n9pector Date_ W E S Inspector's Signature and Initials 12-17589-469 Rev 3/88 , ei _0307-7_,3,0 4-6 ( 105 SAN BERNARDINO COUNTY—EPWA/LAND AGEMENT DEPT OFFICE OF BUILDING AND SAFETY P E RMI T APPLICATION PERMIT NBR )05 89 03077 255A 01 I STATUS: ACTIV THIS IS NOT A PERMIT UNTIL ISSUED APPL DATE 09/13/89 I ISSUE DATE 09/13/89 I PG 1 OF 1 PARCEL NUMBER 1017-831-52-0000 PROPOSED USE: GAS/ELEC FOR SPA/ELEC FIXTURES CURRENT USF. RESIDENCE 12625TRAC BLK LOT SEC T 1000 1398 I SE29 102S 108W I PRCL 00AP I PRCLOCCTOMIMIVkIJiTY PLAN• l820 ZONE/LAND USE DISTRICT GENERAL E AL PLAN SUBDIVISION NAME SUBDIVISION PARCEL NO CH/PD LOT DIMENSION IRREGULAR CONST TYPE APPLICANT NAME, MAILING ADDRESS, AND PHONE NUMBER *SLOGS t LOT 1 (GROUP PRACHT, ROBERT 3207 OAKCREEK RD *PLANS RECD. 0 LAND USE PLOT 0 INDEX NBR 32-159 CHINO HILLS CA 91709-0000 STD PLAN/ICBO FHA (714) 597 — 6903 ITEM CNT DESCRIPTION DETAIL TOTALS OWNER NAME, MAILING ADDRESS, AND PHONE NUMBER 17 FIXTiES 10.76 PRACHT, ROBERT ELEC SUB—TOTAL 10.76 3207 OAKCREEK RD 1 GAS PIPING OUTLETS 13.80 CHIN HILLS CA 91709-0000 PLUM SUB—TOTAL 13.80 (714) 597 — 6903 ISUANCE FEE 27.85 TOfTAL AMOUNT 52.41 JOB SITE ADDRESS 3207 OAKCREEK RDe CHINO HILLS CA 91709-0000 CROSS STREET OAKCREST DRIVE INSPECTN ACCESS CONTRACTOR NAME, ADDRESS LICENSE NUMBER _ DIV. OF IND SAFETY PEPMIT: _ _ _ _ ,_ _ __ _ ._ __ MINIMUM SETBACK DISTANCES 45 FRNT SETBACK/CENTRLINE OAKCREEK'RD. R'W 50 15 REAR SETBACK/PROP LINE 10 SIDE SETBACK/PROP LINE W 5 SIDE SETBACK/PROP LINE E MECHANICAL EQUIP NOT PERMITTED IN REQUIRED SIDE SETBACKS NO. STORIES I NO. D I DWELLING I NO. BEDROOMS I FLOOR UNIT EXT. WALLS INT. WALLS CEILINGrksfl, k; ROOF HEATING FIREPLACES C O"r'' �LETED IMETAL IMASRY o 2"9/ WATER SEWER MIN DEPTH S.F./100 SIZE NEW/REPAIR DAT E PUBLIC (PUBLIC I 000 I 000 10000 I / �'�" COMMENTS ELECTRICAL FIXTURES IN GARAGE PRE—ALTER BY DON BAKER AMT NAIVEO .00 AMT PAID 52.4] PAYOR NAE ROBERT PRACHT PAID 09/13/89 RECEIPT • 5260 EMPL: STACCATO—NYARI, M ' tD BY • CHECK NBR : 2362 � y •ICENSED CONTRACTORS DECLARATIONS 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 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 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]>eil,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 EXEMPT UNDER SEC 1 B AND P C FOR THIS REASON �s c►� WNER ���� K__/I/C�!/v" DATF 4% / - C� 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 APPLICANT DATF 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 DATF 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 ISA 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 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 CONS CTION, AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOV NTIONED PROPERTY FOR INSPECTION PURPOSESll SIGNATURE OF APPLICANT OR AGEN 9- � �%�'�"� DATE 9/ SP. 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 489 Rev 10/88 /OS/g1— 03027 „2S-S—A, Owner Namer/ionefir, • Permit Numb! 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 yD*-24>"53�f 7de Water Service Fireplace Foundation Lath or Drywall Nailing Joists and Girders Gas Line Air Test 151 Electrical Ground Final Energy Mid-Height Bond Beam Final Plumbing 8-Foot Bond Beam Final Heating/A.C. Final Bond Beam Final Construction 4- - Fireplace Bond Beam Final On Site Improvements '-�--I}--� 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 1//) 7061 f ' Developer Fees Paid WC (YIN) Ind Saf (YIN) - Certificate of Occupancy __2��2 g1 I - _ 0 f - v CA) n .> .a..ic ‘71mit1 02- Z-S/ 0.g rSii ,,-seri%nom b SEPTIC TANK GALSy ._ _.. � ��- SEEP PIT X � q a LEACH LINE WIDE /0111 X LONG X DEPTH OF ROCK N • • • W E S Inspector's Signature and Initials V 12-17589-469 Rev 3/88 . . t 1110 105 SAN BERNARDINO COUNTY-EPWA/LAND AGEMENT DEPT OFFICE OF BUILDING AND SAFETY P E RMI T APPLICATION PERMIT NBR 105 89 03077 230A 01 I STATUS: ACTIV THIS IS NOT A PERMIT UNTIL ISSUED APPL DATE 09/13/89 I ISSUE DATE 09/13/89 I PG 1 OF 1 PARCEL NUMBER 1017-831-52-0000 PROPOSED USE: RETAINING WALL CURRENT (SSE: RESIDENCE TRAC BLK LOT SEC TY : 12625T 1 000 1 398 1 SE29 1 02S 1 R0t86W PRCL 00AP 1 ORCL CCTOMIMIRIJITY COMMUNITY PLAN ZONE/LAND USE DISTRICT GENERAL PLAN SUBDIVISION NAME SUBDIVISION PARCEL NO CH/PD LOT DIMENSjION IRREGULAR CONST TYPE APPLICANT NAME, MAILING ADDRESS, AND PHONE NUMBER *BLDGS ON LOT 1 (GROUP PRACHT, ROBERT 3207 OAKCREEK RD *PLANS RECD 0 LAND USE PLOT 0 (INDEX NBR 32-159 CHINO HILLS CA 91709-0000 STD PLAN/1'CBO FHA N (714) 597 - 6903 TYPE I SQ FT. I FACTOR/P.S.F. I ADJSTED AREA/VALUATN OWNER NAME, MAILING ADDRESS, AND PHONE NUMBER PRACHT, ROBERT FENCE 450 .20 90.00 3207 OAKCREEK RD CHINO HILLS CA 91709-0000 CALC. VALU 4,050.00 I ADJUSTED AREA 90 (714) 597 - 6903 ITEM CNT DESCRIPTION DETAIL TOTALS JOB SITE ADDRESS RESIDENTIAL CONSTRU 53.93 3207 OAKCREEK RD TOTAL AMOUNT 53.93 CHINO HILLS CA 91709-0000 CROSS STREET OAKCREST DRIVE INSPECTN ACCESS CONTRACTOR NAME, ADDRESS LICENSE NUMBER DIV. OF IND. SAFETY PERMTT• MINIMUM SETBACK DISTANCES 45 FRNT SETBACK/CENTRLINE OAKCREEK RD. R/W 50 15 REAR SETBACK/PROP LINE 10 SIDE SETBACK/PROP LINE W 5 SIDE SETBACK/PROP LINE E MECHANICAL EQUIP NOT PERMITTED IN REQUIRED SIDE SETBACKS NO. STORIES 1 NOITDWELLING 1 NO. BEDROOMS I FLOOR UN EXT. WALLS INT WALLS CEILING ONTARIO ROOF HEATING FIREPLACES CO P TED METAL IMASRY PUWATER BLIC 1 SEWERR 1 MINODEPTHI S.F./I0010SIZE1 NEW/REPAIR DATE: Z� COMMENTS ORE-ALTER BY DON BAKER AMT WAIVED .00 AMT PAID 53.93 PAYOR NAME• ROBERT PRACHT PAID 09/13/89 RECEtPT 5263 EMPL: STACCATO-NYARI, M PAID BY CHECK NBR : 2362 •ICENSED CONTRACTORS 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 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 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 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) ❑ 1,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 A EXEMPT UNDER B AND P C FOR THIS REASON NES v � � �F_.-'2-�f --- 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 1 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 1$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 DATF 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 CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT, I AGREE TO COMPLY WITH ALL CITY AND COUNTY ORDINANC S AND STATE LAWS RELATING TO BUILDING CONSTRUCTION, AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOV NTIONED PROPERTY FOR INSPECTION PURPOSES IGNATURE OF APPLICANT OR AGENT • ---��� DATF 9"— / d7, 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 17688-469 Rev 10/88 /0T-/?5,43677 a 3074 ©/ Owner Name T.e HTS Permum INSPECTION RECORD DATE I INSPECTOR I I DATE I INSPECTOR Setback Rough Plumbing Temporary Power Shower Pan Test Foundation Reinforcing Steel ja,iggyl Stucco Mesh or Exterior Siding Excavation and Forms et-1446,7 7 , Insulation F.H A Foundation Req r — 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 4-, >QP Final Plumbing 8-Foot Bond Beam Final Heating/A C. Final Bond Beam 6'Z T Final Construction G1Z4►¢!J Fireplace Bond Beam Final On Site Improvements itk( aD(/L .449' 2 Final Off Site Improvements Framing and Ventilation Final Dedication 1.. ,9� +4W *//IT 9 - - 'j,Zc•-g, ,zr Final Zoning Rough Heating Final Electrical Electrical Service and Ground Final Gas Rough Electrical Developer Fees Paid WC (Y/N) Ind Saf (Y/N) Certificate of Occupancy �'F►eis.FA Al Pt?.a =man SEPTIC TANK GALS T I- _ SEEP PIT X {� g��-•iI�'� LEACH LINE WIDE X LONG X DEPTH OF ROCK N • • • • W E I S Inspector's Signature and Initials _ i, _ 12-17589-469 Rev 3/88