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Permit No. 1059000016 4 r ^�r�i .__ . 105 SAN BERNARDINO COUNTY-EPWA/LANDWAGEMENT DEPT • OFFICE OF BUILDING AND SAFETY P E RMI T APPLICATION PERMIT NBR 105 90 00016 225A 01 I STATUS: ACTIV THIS IS NOT A PERMIT UNTIL ISSUED APPL DATE 01/04/90 I ISSUE DATE 01/11/90 I PG 1 OF 1 PARCEL NUMBER 1025-411-11-0000 PROPOSED USE: SWIMMING POOL AND SPA CURRENT USE: RESIDENCE WITH GARAGE 7046CT I BIK I 181LOT I SE21SEC I p N USW PRCL MMAP I PRCL ACTIVITY : L821 000COMMUNITY PLAN ZONE/LAND USE DISTRICT GENERAL PLAN SUBDIVISION NAME SUBDIVISION PARCEL NO CH/RS,IL1,FR1 LOT DIMENSION IRREGULAR CONST TYPE APPLICANT NAME, MAILING ADDRESS, AND PHONE NUMBER *BOGS ON LOT 1 (GROUP MALINS POOLS INC. 12345 MILLS AVE 31 #PLANS RECD 0 LAND USE PLOT 0 INDEX NBR 39-149 CHINO CA 91710-0000 STD PLAN/ICBO FHA s (714) 628 - 8734 r ITEM CNT DESCRIPTION DETAIL TOTALS OWNER NAME, MAILING ADDRESS, AND PHONE NUMBER POOL PRIVATE /�251.68 BOGLE, BOB MISC SUB-TOTAL 251.68 14999 SANDALWOOD LN TOTAL AMOUNT 251.68 CHINO HILLS CA 91709-0000 (714) 597 - 2368 JOB SITE ADDRESS 15019 SANDALWOOD LN HINO HILLS CA 91709-0000 CR SS STREET ROSEWOOD WAY I ECTN ACCESS r /CONTRACTOR NAME, ADDRESS LICENSE NUMBER / MALINS POOL CONST CONT000438874 12345 MILLS #31VE UNIT #C CHINO CA 91710-0000 (000) 000 - 0000 OiV._ nF TNO _ SAF�71! PFRNTT• _ � .. -- - _ - - - �- - '--- -�.�N , ., .._ „�:_ .�--...._- __-- -� -_ ---- -- MINIMUM SETBACK DISTANCES 55 FRNT SETBACK/CENTRLINE SANDALWOOD LANE R/W 60 15 REAR SETBACK/PROP LINE 5 SIDE SETBACK/PROP LINE 10 SIDE SETBACK/PROP LINE MECHANICAL EQUIP NOT PERMITTED IN REQUIRED SIDE SETBACKS a9 NO. STORIES 1 NO. DWELLING 1 NO. BEDROOMS 1 FLOOR UNITS EXT. WALLS I INT. WALLS I CEILING ROOF - HEATING FIREPLACES METAL IMASRY PUWATER ATIR I SEWER I MIN NODEPTH! S 000 DEPTH! SIZE( NEW/REPAIR 0000 COMMENTS 01/04/90 LOW TO MODERATE LANDSLIDE SUSCEPTIBILITY. D.FLETES AMT WAIVED .00 AMT PAID 251.68 PAYOR NAME: MALINS POOL CONST. INC. PAID 01/04/90 RECEIPT . 40 EMPL: FLETS, DEBORAH PAID BY CHECK NBR : 19330 1 OICENSED CONTRACTORS DECLARATION. v- I HEREBY AFFIRM THAT I AM _ICENSED UNDER THE PROVISIONS OF CHAPTER 9 (COMMENCING WITH SECTION 7000) OF DIVISION 3 0= THE BUSINESS AND PROFESSIONS CODE AND MY LICENSE IS IN PULL FORCE AND EFFECT /� � �J LICENSE CLASS ( 7- -53 LICENSE NUMBER 7_S OCJ 7 CONTRACTOR MQ/ liS ,DATE 7- �o 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 E 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 OWNERDATE WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM THAT I HAVE A CERTIFICATE OF CONSENT TO SELF-INSURE OR ERTIFICATE OF WORKERS COMPENSATION INSURANCE OR A CERTIFIED COPY THEREOF (SEC 380 1, LAB CI POLICY NO b ---- ..( 5.-‘,.1, T COMPANY ` ❑ CERTIFIEbiPY IS HEREBY FURNISHED CE D COPY IS FIL WITH T OUNTY BUILDING INSPECTION DEPARTMENT APPLICANT `---- , DATE 7-/- 9 0 CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATION INSURANCE(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [5100)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 IS A 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 AND STATE LAWS RELATING TO BUILDING C RUCTION AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY ENTER UPON THE ABOVE MENTIONED PROPERTY FOR INSPECTIO OSES / c SIGNATURE OF APPLICANT OR AGENT ��-� DATE V / 7 EXPIRATI6N 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,A-0-EPTANCE WHICH MAY BE REFUNDABLE UP TO ONE YEAR FROM DATE OF PAYMENT ALL FEES PAID MAY NOT BE REFUNDABLE ..., , y A/�S' 9a - c -o/6 & zc b/ Owener Namj L.� - 4it___ Per it Num. INSPECTION RECORD DATE I INSPECTOR DATE INSPECTOR Setback /%42 -7 &be Rough Plumbing I Temporary Power r Shower Pan Test Foundation Reinforcing Steel , O___&p,"( Stucco Mesh or Exterior Siding Excavation and Forms /' Insulation` — I J 1/ -e F H A Foundation Req er ,%e_c.c � pr�fM r✓' ' ?"ZD-Per s:=_: L/6i4/T"eti!!Zi/T1" 1-2Z70 2 G° o a,, 'i 3-�0-P ve_.. Ground Plumbing _ A berets.. Tank Underslab G A 5 / 'Z 3.Q Q (I Leach Line or Seep Pit I _ Underslab Conduit ,?-9-q ' el Water Service I /°.,52-Y04-69c Fireplace Foundation I Lath or Drywall Nailing I — s Joists and Girders Gas Line Air Test i •. r Electrical Ground �� /-2 2-90 k Final Energy I ear Mid-Height Bond Beam / Final Plumbing 8-Foot Bond Beam Final Heating/02.v t. 4e i La Final Bond Beam Final Construction Fireplace Bond Beam Final On Site Improvements I7.--2$.rle 4,010 Roof Sheathing Final Off Site Improvements I Framing and Ventilation Final Dedication I Roof Covering Final Zoning I Rough Heating Final Electrical 11"Z.0.41-111) 4110-0 Electrical Service and GroundFinal Gas *42 p lo I ILP3 Rough Electrical 2.-1.-�'c OAK/ Developer Fees Paid 1- WC WC (Y/N1 - Ind Saf (YM)\ Certificate of Occupancy I - I - - I-r5;"?V cM]",EGGA/Z7 ONThrn SEPTIC TANK GALS ,ft.. 04 y fR SEEP PIT X ° --�+� rS 7e LEACH LINF WIDF XLONG X DEPTH OF ROCK � /i N W E SInspector's Signature --' Initials (It d s a-i re i -A" 2'.- --- 12-17589-469 Rev 3/88 -