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Permit No. 1058801126 1110 �L h 105 SAN BERNARDINO COUNTY-EPWA/LAND t AGEMENT DEPT OFFICE OF BUILDING AND SAFETY P E RMI T APPLICATION PERMIT NBR 105 88 01126 225A 01 I PAGE 1 OF 1 THIS IS NOT A PERMIT UNTIL ISSUED APPL DATE 02/17/88 ISSUE DATE 02/26/88 PARCEL NUMBER 1000-191-08-0000 PROPOSED USE: POOL AND SPA CURRENT USE: RESIDENCE AND GARAGE 9781TCT I BLK000 I 039 LOT I NE36 SEC 1033 RNG PRCL MAP I PRCL 0 0 CHINO ITYLPLAN ZONE/LLANND USE DISTRICTIGENERAL PLAN SUBDIVISION NAME SUBDIVISION PARCEL NO LOT DIMENSION IRREGULAR (CONST TYPE #BLDGS ON LOT 1 GROUP APPLICANT NAME, MAILING ADDRESS, AND PHONE NUMBER #PLANS RECD 2 LAND USE PLOT 0 (INDEX NBR 13-161 POOL PLANS INC STD PLAN/ICBO 8630088225A FHA 11022 E ACAICA PKWY GARDEN GROVE CA 92640 GRADING INITIAL ACTUAL (714) 636 - 0294 CU.YDS. EXC. CU.YDS. FILL OWNER NAME, MAILING ADDRESS, AND PHONE NUMBER POST, ED AND REIDEL ITEM CNT DESCRIPTION DETAIL TOTALS 1359 OAK TREE CIR PRIVATE POOL STD PL 165.80 CHINO HILLS CA 91709-0000 MISC SUB-TOTAL 165.80 ( ) - TOTAL AMOUNT 165.80 JOB SITE ADDRESS 1359 OAK TREE CIR CHINO HILLS CA 91709-0000 CROSS STREET OAK TREE CROSSING INSPECTN ACCESS CONTRACTOR NAME LICENSE NUMBER MATLING ADDRESS, PHONE NUMBER MINIMUM SETBACK DISTANCES ?2 rRNT SETBACK/_CFNTRLINE P/L OAK TRE_F CROS'NG R:11_50 _ _ _ 5 REAR SETBACK/PROP LINK= 10 SIDE SETBACK/PROP LINE 10 SIDE SETBACK/PROP LINE MECHANICAL EQUIP NOT PERMITTED IN REQUIRED SIDE SETBACKS NO. STORIES 1 NO. DWELLINGNO. BEDROOMS FLOOR Tai .�»h" � '�`?i1 > UNITS I . :'",_ CEILINGhazards. Only the work EXT. WALLS INT. WALLS No visible approved by signed inspections will ROOF I HEATING FIREPLACES METAL IMASRY be rt ted. Permit expired. / Zr 3 -WATER PUBLIC (PUBLIC SEWER I NIH 000EPTHI s 000100I0000EI NEW/REPAIR Spector Date COMMENTS 5' REAR P/L SETBACK FOR POOL AND SPA ONLY POOL VALUATION IS $22,500 AMT WAIVED .00 AMT PAID 165.80 PAYOR NAME: CURCIE POOLS PAID 02/17/88 RECEIPT • 296 EMPL: STACCATO-NYARI, M OICENSEDCONTRACTORS DECLARATION. I HEREBY IRM THAT I AM LICENSED UNDER THE PROVISIONS OF CHAPTER 9 (COMMENCING WITH SECTION 7000) OF DIVISION 3 OF THE BUSINESS AND PROFS ONS CODE, AND MY LICENS S IN FULL FORCE AND EFFECT CENSE CLASS 31.25 7 'Zs C aLICENSE NUMBER 3 / Q173 CONTRACTORas DATE 1-3 /- Q / 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 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) POLICY NO I(7�� - 1/3-7 7 COMPANY 57-41-Er Dunaj" ❑ CERTIFIE -COPY IS HEREBY FURNISHED ❑ IFIED CMY'1NFILLE.D'WITH THE OUNTPBUILDING INSPECTION DEPARTMENT PPLICANT V�' w '�I� DATF CERTIFICATE OF EXEMPTION ryROM WORKERS'COMPENSATION INSURANCE(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100)OR LESS) I I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,I SHALL NOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBJECT TO THE WORKERS' COMPENSATION LAWS OF CALIFORNIA APPLICANT DATE NOTICE TO APPLICANT IF,AFTER MAKING THIS CERTIFICATE OF EXEMPTION,YOU SHOULD BECOME SUBJECT TO THE WORKERS'COMPENSATION PROVISIONS OF THE LABOR CODE, YOU MUST FORTHWITH COMPLY WITH SUCH PROVISIONS OR THIS PERMIT SHALL BE DEEMED REVOKED CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC 3097,CIV C) LENDER'S NAMF LENDER'S ADDRESS DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION THE CALIFORNIA HEALTH AND SAFETY CODE REQUIRES A DIVISION OF INDUSTRIAL SAFETY PERMIT AS A PREREQUISITE TO PERMIT ISSUANCE UNLESS THE APPLICANT SIGNS ONE OF_THE CERTIFICATES BELOW ❑ I CERTIFY THAT NO EXCAVATION 5 FEET OR MORE FEET IN DEPTH,INTO WHICH A PERSON IS REQUIRED TO DESCEND,WILL BE MADE IN CONNECTION WITH WORK AUTHORIZED BY THIS PERMIT,AND THAT NO BUILDING,STRUCTURE,SCAFFOLDING,FALSEWORK,OR DEMOLITION OR DISMANTLING THEREOF,WILL BE MORE THAN 36 FEET HIGH ❑ AS OWNER/BUILDER I WILL NOT EMPLOY ANYONE TO DO WORK WHICH WOULD REQUIRE A PERMIT FROM THE DIVISION OF INDUSTRIAL SAFETY,AS NOTED ABOVE UNLESS SUCH PERSON HAS A PERMIT FROM THAT DIVISION DIVISION OF INDUSTRIAL SAFETY PERMIT NUMBER I CERTIFY THAT I E READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT, I AGREE TO COMPLY WITH ALL CITY AND COUNTY ORDINANCES STATE LAWS RELATING T UILDG CONSTRU TION,eAND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE-M IONED PROPERTY FOR INSPECT (PURP SES A,/�Io �,��/ S ATURE OF APPLICANT OR AGENT / / {Il 41'$(O . DATE___27/a6 /9� r , 1 . . 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 12-17588-469 los T? a - /�2,� azsA 0 l ! • INSPECTION RECORD Permit Number DATE 1 I1 CTOR I I DATE INSPECTOR Setback 3'-141111: Rough Plumbing Temporary Power Shower Pan Test Foundation Reinforcing Steel 1 *1 4'cii I fit.v Stucco Mesh or Exterior Siding Excavation and Forms r Insulation F H A Foundation Req I Sewer Slab Grade I Interceptor Ground Plumbing I Septic Tank Underslap Ducts I „ Leach Line or Seep Pit Underslab Conduit ”Z7' . ¢._ Water Service Fireplace Foundation f I Lath or Drywall Nailing Joists and Girders I/7/1 . Gas Line Air Test Electrical Ground /50•44 1102--- Y'tiZ--ef n t�, Final Energy Mid-Height Bond Beam, Final Plumbing 8-Foot Bond Beam I Final Heating/A.0 Final Bond Beam I Final Construction Fireplace Bond Beam I Final On Site Improvements Roof Sheathing I ya Final Off Site Improvements Framing and Ventilation I Final Dedication Roof Covering I/j (1 Final Zoning Rough Heating -->A -Q7' x.ig4, Final Electrical n/.7 Electrical Service and Ground r( Final Gas F'2-? -71"") Rough Electrical 3 ).-73 '-ey A.... Developer Fees Paid • Ui. e fes . y)- -re—y". Certificate of Occupancy WORKERS' COMPENSATION INSURANCE (YIN) DIVISION OF INDUSTRIAL SAFETY PERMIT (YIN) ` / W e J Zd PO 0/ "9"r Aa. lir/ 7 6.97V fav 7-- i-/ %r/!, e./i trJ?/-e 9-40 Z_4vd ;c s.10-�,✓,,e. J �,►�ev.,r ,. ,,r o y ...„-,,-,_,...,_,......r. 1. Tw c f 9; t0 :rte_ va: f SEPTIC TANK GALS I No visible nazaras. uniy erne work I SEEP PIT x I approved by signed inspections wiii I LEACH LINE WIDE I h- - .=d. Permit expired. 1 X LONG X DEPTH OF ROCK INII I '7-'—VII N I Awn- '- . , — ' I L inspector LJaLc sd W E • • • • • S Inspector's Signature and Initials 12 17589.489 County of San ardino — EPWA/Land Management D ment ICE OF BUILDING AND SAFETY ENGINEERED GRADING INSPECTION REPORT Owner U lhCeN7L Sa/74ar Index No. Job Address 13 59 047kiree /r'C�e Permit No. ry 8894 Tract No. 9751 ❑ ROUGH GRADING INSPECTION ❑ BY SOILS ENGINEER Fills were installed upon properly prepared base material and compacted in compliance with Section 7010, U.B.C. and where the report of an engineering geologist has recommended the installation of buttress fills or other measures, such work has been completed in accordance with the approved design. Lot Nos See attached report for compaction test data, recommended allowable soil bearing values and other special recommendations. EXPANSIVE SOILS 0 Yes ❑No Lot Nos. Remarks Engineer Reg. No. Phone No. Date Signature ❑ BY GRADING ENGINEER The rough grading has been completed in accordance with the approved plans including: grading to approximate final elevations; property lines staked; swales and terraces ready for paving; berms installed; and required drainage slopes provided; and where reports of an engineering geologist and/or soils engineer have been prepared, the recommendations contained therein have been followed. Lot Nos. Remarks Engineer i Reg. No Phone No, DatP Signature © FINAL GRADING INSPECTION The grading has been satisfactorily completed in accordance with the approved plans. All required drainage devices have been installed, slope planting established and adequate provisions have been made for drainage of surface waters from each building site. The recommendations of the soils engineer and/or engineering geologist (if such persons were employed) have been incorporated in the work. V, C1v/� Lot No,. 3 9 ,kQ` (c'( Remarks r r �GEORGE BANo.11092CH) 71 Engineer .b t 4 L 9Ten A Q. eI/ii)9Z Phone No.6Sta 7274 Date /VO!/,/3, /107 of Signature DEPARTMENT USE ONLY: Report approved by Date Remarks 0411-111311-441 0« MA