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Permit No. 18478 BUILDING ADDRESS: 3435 VALLE VISTA DRIVE PERMIT NUMBER: 18478 BUILDING INFORMATION APPLICANT INFORMATION s-- BUILDING PERMIT APPLICATION Address 3435 VALLE VISTA DRIVE Name (ISLAND PACIFIC ROOFING -,s's' Community Development APN 11017-541-22 Address 118193 MUIRWOODS COURT •""�'^ 2001 Grand Avenue Lot 175 City,Zip Code 1FOUNTAiN VALLEY,CA 92708 Chino Hills,CA 91709 :.Vy::'•• Cross Streets 1 Phone/Pager I(714)579-7663 1 ext 1 ".......T1 010.0 LICENSED CONTRACTOR DECLARATION Tract/Parcel 19231 City Bus Lic# 102-05368 I hereby affirm that I'm licensed under the provisions of Chapter 9(commencing with Section Valuation 1$4,000 00 ENGINEER/ARCHITECT INFORMATION 7000 of Division 3 of the Business and Professions Code)and my license is in full force and effect OWNER INFORMATION Name N/A OWNER BUILDER DECLARATION Name KOOK Address I hereby affirm that I'm exempt from the Contractor's License Law for the following reason Address 3435 VALLE VISTA DRIVE City,Zip Code I,as the owner of the property,or my employees with wages as their whole City,Zip Code CHINO HiLLS,CA 91709 Phone 1 ext 1 © O compensation,will do the work,and the structure is not intended or offered for sale Phone 1(909)563-2421 1 ext 1 Lie# 4), I,as owner of the property,am exclusively contracting with licensed contractors to Bus Lie# City Bus Lic# construct the project ® I am exempt under Section I I BPC for this reason I i Bus Exp I APPROVAL INFORMATION sill WORKERS'COMPENSATION DECLARATION CONTRACTOR INFORMATION Issued By 1YVETTE MARTINEZ i hereby affirm under penalty of perjury one of the following declarations Contractor (ISLAND PACIFIC ROOFING 1 Date Issued 16/20/01 Address 18193 MUIRWOODS COURT Finance Code IC4 I have and will maintain a certificate of consent to self-insure for workers'compensation ©p as provided by Section 3700 of the Labor Code,for the performance of the work for City,Zip Code (FOUNTAIN VALLEY,CA 92708 Census Code 1 which this permit is issued Phone or Pager (714)579-7663 1 ext Final Date O Oi Bus Lie# 102-05368 Final I have and will maintain workers'compensation,as required by Section 3700 of the By ®i Labor Code,for the performance of the work for which this permit is issued My Lie # 1631472 Extension workers'compensation insurance carrier and policy number are Exp Date 110-31-01 Reviewed By 1 `, Lie Class 1C39 ^ Approved By INSURANCE INFORMATION Insurance Company 1STATE FUND 05 PROJECT INFORMATION Policy Number 11576654-01 PROJECT DESCRIPTION LOCATION SQUARE FT. Expiration Date 110/01/01 1I I I 1 Structure © Section need not be completed if permit is for one hundred dollars($100)or less Garage I certify that in the performance of the work for which this permit is issued I shall not employ Patio 1 I any person in any manner so as to become subject to the Workers'Compensation Laws of Porch 1 California and agree that if I should become subject to the workers'compensation provisions of Other IRE-ROOF ICB0#2093 (ROOF 1900 1111 Section 3700 of the Labor Code I shall comply with those provisions RE-ROOF CLASS A PROPOSED USE Date. I i Signature: I i TEAR OFF EXISTING SHAKE AND INSTALL 1/2 PLYWOOD,#40 ASTM FELT,MONIER I certify I have read this application and state that the above information is correct I agree to DURALITE 5-8 PSF ICBG#2093 comply with all City Ordinances and state laws and hereby authonze representatives of this City to COMMENTS enter upon the above mentioned property for inspection purposes i n i Date: 11.124/01 i Signature V.If0� (��� `b �t� OTHER FEES REQUIRED ZONING SETBACKS GRADING PRIOR TO ACTUAL PERMIT PERMIT FEE INFORMATION ISSUANCE Zoning IRS I Front Yard "XISTINC Over X I 0 Issuance1 1 $29 00 1 Electrical 1 $0 00 Land Use 1FR-1 Side Yard Cut 0 School I NOPermit Fees: $104.60 NO Plan Check $0 00 1 Plumbing 1 $0 00 Plan Rear Yard Development I Fill 0 1 SMTP 1 $0 00 1 Occ IR3 SSY Total 1 0 Sewer 1 NO 1 Mechanical 1 $0 00 1 Structural 1 $75 60 1 Type IVN Water 1 NO Geo Review $0 00 1 Grading 1 $0 00 1 Total Fee Due 1 $104.60 INSPECTION RECORD Permit Number Inspection Date Inspector Inspection Date Inspector Grading: Pregrade Meeting FINAL INSPECTIONS (Inspector verify following) Rough Grade NO OCCUPANCY PERMITTED WITHOUT FINAL I Terraces County Environmental Sub Drains Health Dept Finish Grading Planning Dept Soils Certification Public Works Grading Certification Fire Rough Landscape As Built Approved Underground Site Inspections: ALL ABOVE MUST BE APPROVED BEFORE FINAL BLDG Building Sewer Final Grade U G Waste Plumbing Final Electric Water Service Final Plumbing Storm Drain/Catch Basins Final Mechanical U/G Conduit/Electrical Final Building/Construction -7//© ©r �= Compaction Report Water Meter Number '�/' ABOVE IS REQUIRED PRIOR TO FOUNDATION INSPECTION Footings CERTIFICATE OF OCCUPANCY UFER Ground(Rebar/Copper) Hardware/Hold-Downs Piers/Caissons/Tendons OTHER: Slab Grade DO NOT POUR CONCRETE UNTIL ABOVE IS APPROVED Shear Roof Nailing Q/2. Exterior Walls Intenor Walls Hardware/Hold-Downs Rough Electnc Rough Mechanical Rough Plumbing/Topout Framing COVER NO WORK UNTIL ABOVE IS APPROVED Insulation Drywall Intenor/Exterior Lath Stucco Scratch Roof Covering Block Wail Inspections : Footing, ReBar 1st Lift Bond Beam 2nd Lift Bond Beam 3rd Lift Bond Beam Drain/Seal SWIMMING POOLS : Location/Rebar/Bonding/Light Gr Conduit Ro Elect POOL NOT TO BE FILLED UNTIL FENCING IS COMPLETE Fence, Gate&Alarm Final Pool Temp Power Pole Electric Release Gas Test • •