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Permit No. 1209200135 4111 -erz 120 SAN BERNARDINO COUNTY—EPWA/LAND'AGEMEM1 DEPT OFFICE OF BUILDING AND SAFETY PERMIT APPLICAtION PERMIT NBR 120 92 00135 255A 01 I STATUS: ACTIV THIS IS NOT A PERMIT UNTIL ISSUED APP(_ DATE 02/04/92 I ISSUE DATE 02/04/92 I PG 1 OF 1 PARCEL NUMBER 1031-321-47-0000 V PROPOSED USE: ELECT. GARAGE/PATIO/DECK /D 3 / - 3 •. 1 - 7 CURRENT USE: RESIDENCE LOT SEC 12625TRACT 1000 ( 380 I SE29 I p S 108M I PRCL 0 P I PRCL ACTIVITY PLANL820 ZONE/LAND USE DISTRICT GENERAL PLAN SUBDIVISION NAME SUBDIVISION PARCEL NO CHINO HILLS I CH/PD,IL1,FR1, M—H LOT DIMENSION IRREGULAR CONST TYPE APPLICANT NAME, MAILING ADDRESS, AND PHONE NUMBER *BOGS ON LOT 1 (GROUP SPEAR, WILLIAM AND JANICE 3079 OAKCREEK RD *PLANS RECD 0 LAND USE PLOT 0 INDEX NBR 30-159 CHINO HILLS CA 91709-0000 STD PLAN/IGBO FHA (714) 597 — 5222 ' ITEM CNT DESCRIPTION DETAIL TOTALS OWNER NAME, MAILING ADDRESS, AND PHONE NUMBER 12 FIXTURES 11.56 SPEAR, WILLIAM AND JANICE 1 PLUG MOLD 7.00 3079 OAKCREEK RD ELEC SUB—TOTAL t18.56 CHINO HILLS CA 91709-0000 ISSUANCE FEE 50.44 (714) 597 — 5222 TOTAL AMOUNT 69.00 JOB SITE ADDRESS 3079 OAKCREEK RD CHINO HILLS CA 91709-0000 CROSS STREET OAK HILL DR. INSPECTN ACCESS ' CONTRACTOR NAME, ADDRESS LICENSE NUMBER . m.i 'DIV. "CIF IND. SAF71 V, PEPMIT:. _ - 1 MINIMUM SETBACK DISTANCES — 45eFRNT SETBACK%CENTRLINE OAKCREEK RD. R/W 50 20 REAR SETBACK/PROP LINE !s 10 SIDE SETBACK/PROP LINE N 5 SIDE SETBACK/PROP LINE S MECHANICAL EQUIP NOT PERMITTED IN REQUIRED SIDE SETBACKS - _ ' -^- -- , NO. STORIES I NO. DWELLING I NO. BEDROOMS 1 FLOOR UNITS NTARIO EXT. WALLS I INT. WALLS I CEILING COMPLE ED 61, ! ?, q 2.---- D AT E DATE ROOF I HEATINGI FIREPLACES METAL MASRY u _� 11.., :' I '.-.'w•wPt1?R`-. WATER I SEWER I MIN DEPTH( S.F./1001 SIZE! NEW/REPAIR 2 PUBLIC PUBLIC 000 000 0000 COMMENTS 02/04/92 ISSUE PERMIT PER DON BAKER. D.FLETES. i AMT WAIVED .0 AMT PAID 69.00 PAYOR NAME: JANICE SPEAR ' PAID 02/04/92 RECEIPT 313 E L: FLETS, DEBORAH ' PAID BY : CHECK NB : 1733 . g —a— -, •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 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 PE LTY OF NOT MORE THAN FIVE HUNDRED DOLLARS [S500] 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 R 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 9 NTRACTORIS) LICENSED PURSUANT TO THE CONTRACTORS LICENSE LAW) ❑ I AM,E EMPT NO R SEC` V.16g1A9 II B AND P C FOR THIS REASON �7 �,.L //WNFfl '1!iii/ DATE �r-.L.! 7/! � RKERS' COMPENSATION DECLARATION I HEREBY AlFF M 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 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 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 I LENDER'S NAMF 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 APPLICATIOI _ D STATE THAT THE(ABOVE INFOR ATION IS CORRECT, I AGREE TO COMPLY WITH ALL CITY AND COUNTY ORDINANCES AND STATE LAWS RELATIN' 0 BUIL• NG CON TRUCTION, AND HERE: AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO E TER UPON THE ABOVE-MENTIONED PROPERTY FOR ISECTION PUR•OSS��- IGNATURE OF APPLICANT OR AC NT ///J/ �i�C_1 '- / / DATE Q/1-/ 9' / / /-. - G•-•'" ",-/ / / EXPIRATION AND REPGND NOTICE APPLICATIONS FOR WHICH NO PERMIT IS ISSUE 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 '.> 12.17699.489 Rev 4/90 .., • • County of San B•rdino EPWA/Land Management Department ....0 LI,N OFFICE OF BUILDING AND SAFETY -0 00 0 --4 a -0 ••---. m x - z > %Pc' A- Region/3a -..)..----/- x ZZ H > m 3 m m c 0 0 0 ----. To 7? - XI 77 CP H H 3 r c.r) Address ?r-9 7 67 c,,7C (72-- - e 7?1") Date -0 ' ?--q - > a o > 0 > H Z - 0 0 -4 a -..._ 0 x 7J m m -1 ri m 0 co CORRECTION NOTICE 0 Cn V/ P1 X (/) Cf) 7 73 Permit No. m 0 > .-7 -7--4 /A) '4 "P / Z-- .. .. .. •• -.-'. - , ow. 0. - --4 NM =0-0 =0 N X 0 0 2i --.IM —4 a% > w --(7.-) TZ < / ,z 7- /e-4 '.0m zvi› % .. , 0 - N - 0 X Li' -1 ,._ . O H 0- 00 w i )-- C / C")71-c/ Z .. -1 / /) /----__c 0 0 => >> -X X X -a N N --4 r-o- C) 01 I -- • r Cn-4 r r vo 73 N 224 4e- fr) / > / / i 4 /-7 ,2-/77 /T C N 0 Cn rn r --,rl s p - -Jfl UI --.1 I > 0 r o 1_3 v ( .cL)r- G / A'', N c? cr r 7---)e>wi /7 -< . 1, 0 OX I:3 >77 70 00-4 0 i . ..... OX 0 0 • CO (4 /' '.C./e -C C- --/- C ' C ,c) m r co > tn ..... H 00 --7. .74 ;(--' (--, ,( ;>-.),7 /7 C (-) -I ---1 -1 > 0 > -I ‘0 0 , <- c d. - -- 7?----. :7_ ru S'7 '-(A-5' 4 , (/1 0 0 0 -n * Z L) /7 /I/4 -) ---47-17--r—r- X o * 3 -41 /.---,:- 8 0 -----7 /1 -7 4- :54-/S----' 0 (e -. rn xi r m d 1 /C:: _ 0 m -i 0. co Po 7_,Z) 7.--&(/ ' Te-- -(=3 u / T--- ,` 0 .- /( i .- 0 (..0 -4 7J Co 0 -I 0 0 . 0 * 0 * , . , . CA 4 - . . -1 ? if > H -I ;'40 CI) .. V - -0 rn • , X -,----r J Please make corrections and call for reinspection 5-•P 6,6. ......q-,3 _ „..., H ] Please make corrections and proceed with work. INSPECTOR'S O, FICE HOctie,j - 3-30-tcr-4--39-p.m. '')--,---tc?LA Inspector (:)Q -1347-469 Rev 7/87 _ _______ _____________________ — _ • Cl) 1---\ -I > C2) -T- ----- -I C C. .....-- e 0 n > € Z”- • 0 rn 0 t ' k ft) 1 1/1 Owner Name • Permit NumbO1a sOOR'ScSIaQ1 INSPECTION REC RD DATE I INSPECTOR I 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 Bord Beam Final Heating/A.C. � r. A Final Bond Beam Final Construction I g rJ Fireplace Bond Beam Final On Site Improvements t,�9i. v Roof Sheathing Final Off Site Improvements \ /7,7/ Framing and Ventilation Final Dedication A JJ /✓ Roof Covering Final Zoning no Rough Heating Final Electrical Electrical Service and Ground Final Gas A l , /I OP Rough Electrical Developer Fees Paid (\ ,' t .0 V-- WC (Y/N) Ind Saf (Y/N) Certificate of Occupancy t NLJ ►J SEPTIC TANK GALS SEEP PIT X LEACH LINF WIDF X LONG X DEPTH OF ROCK N. W E S Inspector's Signature and Initials 12-17889-489 Rev 3/88