Loading...
Permit No. 12694 BUILDING PE PLICATION PERMI MBER: k12694 �:tea t PERMW. ' ;t Community uvelopment Ilir St:I.' 2001 Grand Avenue ':n1. r.0 Chino Hills,CA 91709 4 "+:.;, BUILDING INFORMATION CRY°" °°` LICENSED CONTRACTOR DECLARATION Address 14999 SANDLEWOOD I hereby affirm that I'm licensed under the provisions of Chapter 9(commencing with Section APN 1025-411-11 7000 of Division 3 of the Business and Professions Code)and my license is in full force and effect Lot 181 Cross Streets 1 OWNER BUILDER DECLARATION Tract/Parcel 17046 I hereby affirm that I'm exempt from the Contractor's License Law for the following reason Valuation 1$2,000 00 1 I,as the owner of the property,or my employees with wages as their whole APPLICANT INFORMATION • compensation,will do the work,and the structure is not intended or offered for sale Name 1MLW HOME IMPROVEMENTS ® I,as owner of the property,am exclusively contracting with licensed contractors to Address 13600 SUNRISE BLVD construct the project City,Zip Code 1RANCHO CORDOVA,CA 95742 ® I am exempt under Section I i BPC for this reason I i Phone or Pager 1(916)638-2455 City Bus Lic# WORKERS'COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations OWNER INFORMATION I have and will maintain a certificate of consent to self-insure for workers'compensation Name BOBLE,M 1 ® as provided by Section 3700 of the Labor Code,for the performance of the work for Address 14999 SANDLEWOOD which this permit is issued City,Zip Code CHINO HILLS,CA 91709 I have and will maintain workers'compensation,as required by Section 3700 of the Phone (909)597-2368 ® Labor Code,for the performance of the work for which this permit is issued My Bus Lie# 1 workers'compensation insurance earner and policy number are Bus Exp INSURANCE INFORMATION ENGINEER/ARCHITECT INFORMATION Insurance Company State Fund Name Policy Number 144900-97 1 Address Expiration Date 10-31-98 1 City,Zip Code ® Section need not be completed if permit is for one hundred dollars($100)or less Phone Lic# 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 City Bus Lie# California and agree that if I should become subject to the workers'compensation provisions of CONTRACTOR INFORMATION Section 3700 of the Labor Code I shall comply with those provisions Contractor MLW HOME IMPROVEMENTS Date: I i Signature: I I Address 3600 SUNRISE BLVD City,Zip Code RANCHO CORDOVA,CA 95742 I certify I have read this application and state that the above information is correct I agree to Phone or Pager (916)638-2455 comply with all City Ordinances and state laws and hereby authonze representatives of this City to enter upon the above mentioned property for inspection purposes Bus Lic# . /2 ..-.11 Lic # 731771 Date: I 7,27/76 I Signature: �d r/ �kate 10-31-98 PROJECT INFORMATION r Lic Class C20 PROJECT DESCRIPTION LOCATION SQUARE FT. PERMIT FEE INFORMATION Structure 1 1 1 Issuance 1 $33 30 Mechanical 1 $39 96 Garage 1 1 Plan Check $0 00 1 Geo Review 1 $0 00 Patio Electrical $22 50 Permit Fees: 1 $95.76 Porch Other Structural $0 00 SMIP 1 $0 00 Plumbing $0 00 PROPOSED US 1-3-1/2 TON A/C, 1-80,000 BTU FURNACE, 1-3 HP MOTOR Gradin $0 00 Total Fee Du $95.76 COMMENTS g APPROVAL INFORMATION Approved By 1DORIS CARPENTER Date Issued 17/27/98 ZONING SETBACK S GRADING Finance Code 1C-4 Census Code Zoning Front Yard Over X 1 0 Final Date Land Use Side Yard Cut1 0 Final Plan Rear Yard Fill 0 xBy Extension Occ SSY Total 0 Reviewed By 1KEITH L PRYOR Type CITY OF CHINO HILLS COMMUNI•VELOPMENT DEPARTMENT-BUIDLING &SAE/1)Y DIVISION Permit # Call(909)-764.2790 before 3 00 p m for next day Inspection Post In a safo,conspicuous place at front of Job Provide permit number when call for Inspection Have approved plans on job at time of Inspection. Owner Date Location INSPECTION RECORD INSPECTION DATE INSPECTOR INSPECTION DATE INSPECTOR Grading: Patio/Deck. Pregrade Meeting Footing Rough Grade Access/Light/Switch Terraces Temp Power Pole Sub Drains Ground Rcd Finish Grading Electric Release Soils Certification Gas Test(after drywall) Grading Certification Reroof: . Rough Tearoff Final Roof Nail/Existing Conditions As Built Approved Swimming Pools Underground Site Inspections: Location/Rebar/Bonding/Lite Building Sewer Line Gas Test Supply Water Line Electric Ground Conduit/Pipes Storm Drain/Catch Basins Fence&Gate/Alarms U/G Conduit/Electrical Final DO NOT BACK FILL UNTIL ABOVE IS APPROVED FINAL REQUIRED-POOL NOT TO BE FILLED Verify Soils Engineenng. UNTIL FENCING IS COMPLETE Compaction,moisture,conditioning,etc Fire Protection Equipment. Underfloor/Underslab Inspection. UG Pipe Waste Plumbing Thrust Blocks Ground Copper Hydro Mechanical Flush Electncal Weld Outlet Insp Framing Overhead Hydro Insulation FINAL INSPECTIONS Subfloor (NO OCCUPANCY PERMITTED WITHOUT FINAL) ABOVE IS REQUIRED PRIOR TO FOUNDATION INSPECTION County Environmental Foundation Inspection: Health(if required) Setback Fire Footings Landscaoe UFER Ground(Rebar/Copper) Public Works Hardware/Hold-Downs Final Electric Piers/Caissonsfrendons Final Plumbing OK to Pour Concrete Final Mechanical DO NOT POUR CONCRETE UNTIL ABOVE IS APPROVED Final Building/Construction Shear Inspection(Wood) CERTIFICATE OF OCCUPANCY Extenor Walls OK TO SUPPLY Interior Walls Hardware/Hold-Downs OTHER: Rcof Nail ,Sr. qg 1,,v4C /-/c/a < /..-.0.77 c4T" Combo Inspection: Framing Rough Electric Rough Plumbing Rough Mechanical Lath Insulation COVER NO WORK UNTIL ABOVE IS APPROVED Drywall Inspection. - Na l/Screw Scratch Coat(Extenor/Showers) NOTICE TO OWNER! Miscellaneous Inspections. Call for FINAL inspection on every job This permit will expire if — Masonry Fireplace work is suspended or abandoned for a period of 180 days Call for Block Wall inspection every 180 days to help keep permit active Footing/Rebar 1st Lift Bond Beam 2nd Lrft Bond Beam Drain/Seal NO WORK SHALL BE COVERED WITHOUT INSPECTION File this card with your permanent records when job is completed.