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Permit No. 2003-0620 IP SBUILDING DIVISION OF COMM'DEVELOPMENT DEPARTMENT w� .H 2001 Grand Avenue,Chino Hills,CA 91709 City of Chino Hills Counter Phone (909)364-2780 ^tBuilding Perlin24-Hour Inspection Line (909)364-2790 `"� (NOTE You must call before 3p m for a next business day inspection) City Hall Main Number (909)364-2600 i'MTY!QtfOFORATt4LO tI fl 1111 NOTICE THIS PERMIT BECOMES NULL AND VOID IF WORK IS NOT COMMENCED PLEASE USE PERMIT WITHIN 180 DAYS FROM DATE OF ISSUANCE, OR IF WORK IS SUSPENDED AT NUMBER BELOW WHEN ANY TIME FOR MORE THAN 180 DAYS OR IF WORK IS DONE IN VIOLATION OF MAKING INQUIRIES OR ANY CITY OR STATE LAWS RELATING THERETO REQUESTING INSPECTIONS PROJECT DESCRIPTIONPERMIT No RE-ROOF - REMOVE EXISTING COMP SHINGLES AND REPLACE W/CLASS I 2003-0620 0 BUILDING ADDRESS APT/UNIT No ISSUED DATE ISSUED BY 14929 SANDALWOOD LN 0 04/07/2003 YMARTI APNTRACT LOT/PARCEL BLOCK CONST TYPE ZONE I OCC LA USE 1\ I 1025-411-18 I PARCEL MAP# ITR 7046 1174 V-N UN I R-3 Residelitial CENSUS CODES OVERLAYOFR DIST BLDG SSOFT PROJ TYPE PROJECTBPERMITS SETBACK FY SETBACK RY SETBACK ES1� I SETBPJ.K SY FEES 1\b // Description Calc. Paid w CASARUBIAS, ADRIAN Structural $75.60 $75 60 14929 SANDALWOOD LANE Issuance/Suppl F $29.00 $29 00 CHINO HILLS, CA 91709 Total Paid 4/7/2003 $104 60 OWNER BUILDER N/A Grand Total $104 60 $104 60 N/A, CA N/A 1_ N/A 0 Z Contractor License 0 Expiration License Type Workers Comp Expiration City Business License Expiration LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect In secunng this permit I am acting with the knowledge of and on the behalf of the owner of the property Date Contractor OWNER-BUILDER DECLARATION ❑ I hereby affirm under penalty of penury that I am exempt from the Contractors License Law for the following reason(Sec 7031 5 Business and Professional Code Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, pnor 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 there from 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($500) ❑ 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 (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 does such work himself or herself or through his or her PROJECT INFORMATION own employees, provided that such improvements are not intended or offered for sale If Desc I Location I Sq Foot I Valuation however,the building or improvements 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 RE ROOF ROOF 1600 $3,200 0 0 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 Article 3 of the Business and Professions Code , � v Date r9//— Pl1-O 0 Owner __ i-_-_ / WORKERS COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations ❑ I have and will maintain a certificate of consent to self-insure for workers' compensation, as provided for by Section 3700 of the Labor Code,for the performance of the work for which this Total Valuation permit is issued I certify that I have read this application and state that the above ❑ I have and will maintain workers' compensation insurance, as required by Section 3700 the information is correct I agree to comply with all city and county Labor Code,for the performance of the work for which this permit is issued __ _ __ _ _ ordinances and state_laws_relating to building_construction and hereby authonze representatives of this city to enter upon the above- ❑ I certify that in the performance of the work for which this permit is issued,I shall not employ mentioned property for inspection purposes any person in any manner so as to become subject to the worker's compensation laws of California,and agree that if I should become subject to the worker's compensation provisions �4 h 1/ D -00 of Section 3700 of the Labor Code,I shall forthwith comply with those provisions APPLICANT SIGNATURE DATE APPLICANT NAME CASARUBIAS, ADRIAN ADDRESS 14929 SANDALWOOD LANE Date Applicant CHINO HILLS, CA 91709 WARNING Failure to secure worker's compensation coverage is unlawful,and shall subject an TELEPHONE 909-597-1894 employer to criminal penalties and civil fines up to one hundred thousand dollars($100,000),in addition to the cost of compensation,damages as provided for in Section 3706 of the Labor Code, interest,and attorney's fees I certify that the use of this facility shall comply with sections 25505, 25533,and 25534 of the Health and Safety Code,which regulate the storage,handling and use of hazardous materials CITY OF CHINO HILLS COMMUNITY DEVELOPMENT—BUILDING&SAFETY DIVISION Call (909)364-2790 before 3.00 p.m.for next day inspection Post in a safe, conspicuous place at front of job Provide permit number when calling for inspection Have approved plans on job at time of inspection NO WORK SHALL BE COVERED WITHOUT INSPECTION File this permit with your permanent records when job is complete INSPECTION RECORD INSPECTION DATE INSPECTOR INSPECTION DATE INSPECTOR Grading' Block Wall Inspections Pregrade Meeting Footing, Rebar Rough Grade 1st Lift Bond Beam Terraces 2n'Lift Bond Beam Sub Drains 3`"Lift Bond Beam Finish Grading Drain/Seal Soils Certification Grading Certification Rough ReRoof Tear-off,Existing Conditions / , ^� Underground Site Inspections Sheath Nailing ///-q_ Building Sewer Line Roof Final Water Supply Line U/G Electrical Service Conduit Swimming Pools. Storm Drain/Catch Basin Location/Rebar/Bonding/Light DO NOT BACKFILL UNTIL ABOVE IS APPROVED Gas Test Gr Conduit Verify Soils Engineering Ro Elect Compaction,moisture,conditioning,etc POOL NOT TO BE FILLED UNTIL FENCING IS COMPLETE Fence,Gate&Alarm Underfloor/Underslab Inspection Final Pool U/F Waste Plumbing U/F Water Fire Protection Equipment U/F Mechanical UG Pipe U/F Electrical Thrust Blocks U/F Framing Hydro U/F Insulation Flush Subfloor Weld Outlet Insp ABOVE IS REQUIRED PRIOR TO FOUNDATION INSPECTION Overhead Hydro Foundation Inspection: Temp Power Pole Setback/Footing-OK to Pour Electric Release UFER Ground(Rebar/Copper) Gas Test Hardware/Hold-Downs Piers/Caissons/Tendons FINAL INSPECTIONS Slab Grade-OK to Pour NO OCCUPANCY PERMITTED WITHOUT FINAL DO NOT POUR CONCRETE UNTIL ABOVE IS APPROVED County Environmental Health Dept (391-7570) Shear Inspection(Wood): Planning Dept (364-2752) Roof Nailing Public Works (364-2774) Exterior Walls Fire (393-3888) Interior Walls Landscape (364-2766) Hardware/Hold-Downs ALL ABOVE MUST BE APPROVED BEFORE FINAL BLDG Final Grade Combo inspection: Final Electric Framing Final Plumbing Rough Electric Final Mechanical Rough Mechanical Final Building/Construction Rough Plumbing/Topout Water Meter Number COVER NO WORK UNTIL ABOVE IS APPROVED Insulation CERTIFICATE OF OCCUPANCY OK TO ISSUE Drywall Inspection OTHER Intenor Exterior EXT LATH Stucco Scratch Miscellaneous Inspections* Masonry Fireplace Plate Ties, Fire Block Patio/Deck: Footing Frame Access/Light/Switch NOTICE TO OWNER Call for FINAL INSPECTION on every job This permit will expire if work is suspended or abandoned for a period of Patio Final 180 days