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Permit No. 7044 7 City of Cao Hills APPLIC4N FOR BUILDING PERMIT Community Development 7//—e—/ 2001 Chino rand Avenue FSIs,CA 917004 Building Address: Proposed Use - 6t No 3102 Street OAKCREEK RD - ROOM ADDITION/DECK APN 1031-311-13 THE FOLLOWING WORK IS AUTHORIZED BY THIS PERMIT Lot 340 Block Tract 12625 ® Struct ❑ Plumb Applicant BRIAN MORALES r- ❑ Mech ®Elect L Gfadina St No. 5761 Street E LA PALMA AVE STE 206 Type of Project ❑New ❑Alter ®Addition City ANAHEIM HILLS Zip 92807 Phone 714-294-0395 ❑ Repair ❑ Convert ❑ Demo ❑Occupancy Permit Owner CHRIS BERNSTEIN Project Location on Size 3102 OAKCREEK RD Description I Property in Sq. Feet St No. Street City (;HINO HILLS Zip 91709 Phone 1 ADDITION I I 126 Engr/Arch Lic No. 2 DECK I I 154 St No. Street 3 I I City Zip Phone 4 I I Contractor BRIAN MORALES Lic No. 667658 REMARKS/SPECIAL CONDITIONS/PROJECT DESCRIPTION Sewer I Min Depth I S/F/100 I Size St No. 5761 Street E LA PALMA AVE STE 206 City ANAHEIM HILLS Zip 92807 Phone 714-294-0395 Cubic Yards Excavation Fill Over Excavation City Business License License No NEWExpiration Date Licensed Contractor's Declaration I hereby atfirm that I am licensed under the provisions of Chapter 9 (commencing with Section - 1 7000 of Division 3 of the Business and Professions Code) and my license is in full force and • 1,,, .`f. . .+.r�>^,Aktogk'ifs�ii;.:11 s,''- ` effect _s_.•,.'.—:: ' i ,— •>•--:.Ull':�tw-'License Class Class B License Number 667658 / - 3/31/97 SAME AS ABOVE s ec'. 4 ;' ^¢,-:•r... Date Contractor , --- ;-.7 t-E'., -'s }'' Address .,, •_ {,`d i' i tni. , /a,,,r ,, , '•-". ICS City and Zip Phone _ .. _ _. .:. _ _ ..:....,.iw NUM w., v:;;,. '/11111111L11111111111'a•i'iii r: Owner Builder Declaration I hereby affirm that I am exempt from the Contractor's License Law for the following r son ❑ I, as the owner of the property, my employees with wages as their whole compensation, will do the work, and the structure is not intended or offered le e ❑ I, as owner of the property, am exclusively contracting with licensed contractors to Q construct the project w ^` m�� r ❑ I am exempt under Sec__—,B&PC for this reason Date Initial Workers' Compensation Declaration l I hereby affirm under penalty of perjury one of the following declarations Zoning I Land Use Da 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 Setbacks Model/Plan work for which this permit is issued I 11N 0 b I have and will maintain worker's compensation, as required by Secticn 3700 of the FY 20' I SY 10-W,5-E I LaborCode, for the performance of the work for which this permit is issued My worker's RY 20 I SSY I compensation insurance carrier and policy number are Ins. Co.: Group/Division/Type Policy No: Exp Date: VALUATION ((Thisdee need not be completed if the permit is for one hundred doolars(S100)or less) $9,305 00 Li c I certify that in the performance of the work for which this permit is issued I shall PERMIT FEES not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California and agree that if I should become subject to the workers' compensation provisions ection 3700 of the Labor C shall forthwith comply with those Electrical $1386 Structural $15444 pro ns (( G 1 —1�n'//�' �y�� •/ Date C I i b I —Signature—k �'"-^ V I' td.:1 Warning Failure to secure workers' compensation coverage is unlawful, and shall subject an Plumbing Grading -rip'-,• < tr rm. I p.,_Ities -Ind civil fines up to one hundred thousand dJle, iC 000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest, and attorney's fees Mechanical Issuance $29.00 I certify that I have read this application and state that the above Geo Review Plan Check information is correct I agree to comply with all City Ordinances and state la and hereby authonze representatives of this City Issuance Approved Total Permit Fee - - - upon the above mentioned property for inspection Dom_ I X197 1n .u.:i tes. I A _ `�j�1-_ ry Date Issued Permit Number ure of Applicant or Agent Date 9/16/96 7044 Ct Q'''‘ ifll��tlP FINANCE CODE CENSUS CODE Print Applicant's/Agent's Name/ C4 434 V ONSTRUCTION LENDING AGENC ' • I HEREBY AFFIRM THAT THERE IS A CONSTRUC iLENDING AGENCY FOR THE PERFORMANCE 0 WORK FOR WHICH THIS PERMIT IS ISSU (SEC 3097,CIV C) LENDER'S NAME LENDER'S ADDRESF 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 'i THEREOF,WILL BE MORE THAN 38 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 DIS ❑IS'NOT SUBJECT TO THE APPLICABLE REQUIREMENTS OF THE HEALTH AND SAFETY CODE AND THE LOCAL AIR QUALITY AGENCY , _ BUILDING INSPECTIONS RECORD . DATE INSPECTOR DATE INSPECTOR Setback/Location w�0,,--.j G Azycv Roug) Jpa Temporary Power I Stigt6 0r(Test / l Foundation Reinforcing Steel 61,..-74.,1--96, / l/ > Stucco Mesh or Exterior Siding ./)/2--„,- '9 / Excavation and Forms 4,----2„.0- h p„ / Insulation �//-2/J& /- 7-1/Slab Grade e:32--0(71--1/7 / V V Sewer Ground Plumbing Soil Interceptor •, Ground Plumbing Water Septic Tank Underslab Ducts Leach Line or Seep Pit Underslab Conduit Water Service , Underslab Gas - ,.y sem,,.,_ -L�th _ rywall ihng /// 3��� Fireplace Foundation 4 Gas Line Air Test ” / Joists and Girders ' ; t.t'•i •nj,•• r-. ,--‘....-,4-i...,;• t Final Energy , i7/ ,. (.4;r`'4 `.v., s.,n " k Final Plumbing _ • /�� Electrical'Ground r ,� !VvI Mid-Height Bond Beam r Final Heating/A C , /') (-.V 8-Foot Band Beam _ Final Construction X Gal V Final Bond Beam_- tw4wi,��.,m,„ _ 1. '? ,. -•- ° Final On Site Improvements \ \ 7, Fireplace Bond Beam , / / Final Off Site Improvements -\ %\ v Roof Sheathing 5 4/7‘.042._- jO/?797„I ' / Final Dedication 'L1r Z Framing and Ventilation ,, 46/y,/ !a,/ Final Zoning a'� Roof Covering / Final Electrical A Rough Heating `pi(p/g,E, /1?.-"/ Final Gas 4- 1 I _ Service and Ground , / Developer Fees Paid I Rough Electrical ji0//1o/' /'51-v")/ Fire Dept Approval Verified < I Bonding Certificate of Occupancy I Over Head Electrical I 1 1 Fence Height I 1 / Gates I V Heater I • Pool Drainage J , / /4fV. , `7V/�/9 ' / , `, /4/ vri Qs- ' 7 , /3/gC. fir./ C//V Stci c c h/4i'Zi /4'// '/ '7 /- 1 /3 _ _–tel y / Y C . -) ' .,. % ti c, /'- 7/ 7.7,-- Al 6 i, ,d4 of , - --Al,*//L Jo --419 y A/i 77c.4_, SEPTIC TANK GALS Ta O w��)? .4-tvd Ga A/ ,i Pail. SEEP PIT X LEACH LINE WIDE i LONG X ' DEPTH OF ROCK N - W E • S. Inspector's Signature and Initials ��� e..,,-6, -fL'L .--Z- � DATE OF ISSUANCE PERMIT NUMBER