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Permit No. 1058700250 (2) -45 SAN , ERNARDINO COUN1Y-EPWA/LAND III GEMENT DEPT • t OFFICE OF BUILDING AND SAFET' P E RMI T APPLICATION PERMIT NBR 105 87 00250 2010 01 I PAGE 1 OF 1 THIS IS NOT A PERMIT UNTIL ISSUED APPL DATE 02/08/88 ISSUE DATE 02/08/88 PARCEL NUMBER 1017-881-22-0000 PROPOSED USE: GTE UTILITY BLDG CURRENT USE: VACANT TRACT 1 BLKI 000LOT I NE29SEC I TWN 0210NG I PRCL M8WMAP I PRCL 0COOIrMuNO IIYLPLAN ZONE/LAD USE DISTRICT( GENERALPLAN 000SUBDIVISION NAME SUBDIVISION PARCEL NO LOT DIMENSION 7.14 ACRES (CONST TYPE IIIN #BLDGS ON LOT GROUP B4 APPLICANT NAME, MAILING ADDRESS, AND PHONE NUMBER ;PLANS RECD 2 LAND USE PLOT 0 INDEX NBR 32-156 SALTS, TROUTMAN AND KANESHIRO STD PLAN/ICBO FHA ► 1600 E FLORIDA AVE 320 HEMET CA 92344-0000 GRADING INITIAL ACTUAL (714) 925 - 2504 CU.YDS. EXC. CU.YDS. FILL OWNER NAME, MAILING ADDRESS, AND PHONE NUMBER GENERAL TELEPHONE OF CALIFORNIA TYPE I SQ. FT. I FACTOR/P.S.F. I ADJSTED AREA/VALUATN 1 GTE PL THOUSAND OAKS CA 91362-0000 01 690 28.00 19320.00 (213) 451 - 7080 CALC. VALU 19,320.00 I ADJUSTED AREA 690 JOB SITE ADDRESS • 3230 PAISLEY DR ITEM CNT DESCRIPTION DETAIL TOTALS CHINO CA 91710-0000 COMMER/INDUST CONST 243.20 CROSS STREET PEYTON 1 TO 600V/1000AMP SER 41.40 INSPECTN ACCESS 690 WAREHOUSE/GARAGE EL 6.21 ELEC SUB-TOTAL 47.61 1 VACCUM BREAKERS 10.Q0 CONTRACTOR NAME LICENSE NUMBER PLUM SUB-TOTAL 10.90 2 FORCED AIR/GRAVITY 24.40 MECH SUB-TOTAL 24.40 MAILING ADDRESS, PHONE NUMBER ISSUANCE FEE 17.00 SMIP SURCHARGE 2.90 TOTAL AMOUNT 346 01 MINIMUM SETBACK DISTANCES *** PER PLOT *** MECHANICAL EQUIP NOT PERMITTED IN REQUIRED SIDE SETBACKC1 FT E DS NO. STORIESNO. DWELLING NO. BEDROOMS FLOOR AI, _ 1 I UNITS I CO 0 e t < EXT WALLS INT. WALLS CEILING `l r MA ST IMA OP /- ROOF HEATING FIREPLACES C•� TI TEL METAL IMASRY PUWATER ATIR I SEWER I MIN NODEPTH) S•000 100I0000EI NEW/REPAIR COMMENTS SCHOOL FEES PAID. CONTRACTORS LICENSE ON FILE. CERTIFICATE OF SELF-INSURANCE FOR WORKERS COMP ON FILE. AMT WAIVED .00 AMT PAID 346.01 PAYOR NAME• SHARPE, KEITH PAID 02/08/88 RECEIPT : 05281 EMPL: CASTRO, K *LICENSED 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 ANO 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 [5500]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 CONTRACTORIS) 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 1 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 [$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 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) 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 469 • • INSPECTION RECORD Permit Number AS87045 dSO d0(Qo DATE I INSPECTOR I DATE I INSPECTOR Setback I // 68 I ,,U/L Rough Plumbing I ‘—/-S- 4 404 Temporary Power I Shower Pan Test I Foundation Reinforcing Steel I'1 // 8a oC/4 Stucco Mesh or Exterior Siding I Excavation and Forms 3 // 68 _A.2n6 Insulation I F H A Foundation Req Sewer Slab Grade Interceptor I Ground Plumbing Septic Tank I Underslap Ducts Leach Line or Seep Pit Underslab Conduit Water Service Fireplace Foundation Lath or Drywall Nailing Joists and Girders Gas Line Air Test I I . Electrical Ground 1 // Bg " Final Energy I I Mid-Height Bond Beam Final Plumbing 8-Foot Bond Beam I Final Heating/A.0 4/ �/ _t /�- Final Bond Beam I Final Construction .0,,,,/, I: 7 Fireplace Bond Beam I Final On Site Improvements ,! r Zi_ Tj,. Roof Sheathing Final Off Site Improvements � Framing ew•'R�F. `3 22 f?IR � Final Dedication Roof Covering - Final Zoning Rough Heating k r I5 /4,'' Final Electrical I4.••--/A.-"eSj 44442 sn? Electrical Service and Ground I Final Gas I f Rough Electricalratncid9.1I 4.4A23° Developer Fees Paid Certificate of Occupancy WORKERS' COMPENSATION INSURANCE (YIN/ DIVISION OF INDUSTRIAL SAFETY PERMIT (YIN) I 1 f SEPTIC TANK GALS ro m C7.._a SEEP PIT X LAP fell 11 ^..",p LEACH LINE WIDE riti 01'17'c'° X LONG X DEPTH OF ROCK int -� N "n• _ !‘44J W E ..,/1 /9� .If S Inspector's Signature and Initials rU/,�S 6‘,..."— j 7". 7 12-17589-469 I