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Permit No. 2009-22991 ' .., City of Chino Hills BUILDING DIVISION OF COMMUNITY DEVELOPMENT DEPARTME f- ) 14000 City Center Dr.,Chino Hills,CA91709 Counter Phone (909)364-2780 `' 0 BuildingPermit 24-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 NOTICE: THIS PERMIT BECOMES NULL AND VOID IF WORK IS NOT COMMENCED WITHIN PLEASE USE PERMIT NUMBER 180 DAYS FROM DATE OF ISSUANCE,OR IF WORK IS SUSPENDED AT ANY TIME FOR BELOW WHEN MAKING INQUIRIES MORE THAN 180 DAYS OR IF WORK IS DONE IN VIOLATION OF ANY CITY OR STATE LAWS OR REQUESTING INSPECTIONS RELATING THERETO. PROJECT DESCRIPTION PROJECT No. PERMIT No. HVAC C/O 2009-22991 30677 B ADDRESS UED ED BY 3525 VALGLE VISTA DR,Apt.0 I APT./UNIT NO. I SS5 2 09 DATE I Castro,Monica AO N56104 ITRAC TRACT I L6OT !FLOORS/UNITS PROJECT PERMITS IP.TYPE CENCUAdd ACODES Sr 1CONST. CB TYPE I TYPE IOCCUPANCY O3TYPE 1VALUATION $5,000.001 TOTAL SQFT 0.00 1 BLDG.SQFT 434_Res Current Owners: KEITH&KATHLEEN MORRIS- Fees Address: 3525 VALLE VISTA DR CHINO HILLS,CA 91709 Fee Group/ Fee Description Fee Amount Payments Ph: 909-661-1101 Transaction Type "" Email: Mechanical 0/0 $88.75 Contractor. SERVICE CHAMPIONS-SERVICE CHAMPIONS • - Address: 22911 SAVI RANCH PKWY YORBA LINDA CA 92887 B001 Permit Issuance Fee $52.00 52.00 Ph: 714-692-7977 Email: 8110 FAU/A-C=<100;000BTU 20.75ea $20.75 20.75 LIc.Information799170 . Exp.Date:9/30/2011 LICENSED CONTRACTORS DECLARATIONLICENSED CONTRACTORS DECLARATION B121 Air-handling unit up to10,000 cfm 15.00ea $15.00 15.00 I hereby affirm under penalty of perjury that I am license der provisions of Chapter 9(commencing with SB1473 $1.00 1.00 Sec.7000)of Division 3 of the Business and Professi s Co and my license Is in full force and effect. In securing this permit I am acting with the knowledg of an n beha f the owner of the property. TOTAL FEES �p/�,y 1 $88.75 Date:(1- 5 1!�✓y Contractor. / AMOUNT PAID $88.75 BALANCE DUE $0.00 OWNER-BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's Licence Law for the following reason,(Sec,7031.5,Business and Profesional 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 Sec.7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more that five hundred dollars($500.00) I,as owner of the propterty,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 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 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 Contractor's 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. Date: Owner. •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 I certify that I have read lication and state that the above information is correct. I agree to comply provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is with all city and co y ordinan and ws relating to building construction,and hereby authorize issued. representatives this city to enter on the a ve-mentioned proptery for inspection purposes. -k- I have and will maintain workers'compensation insurance,as required by Section 3700 of the Labor / // Code,for the performance f the work for which this permit is issued. My workers compensation I 1 J / Z�6 insurance carrier and policynumber are: Carrier._ rel//...€4-c( _ Policy#:. -2 OC,E3 `T vK SGZ APPLICANT�SIGNATURE DATE I certify that in 4he performance of the work for which this permit is issued,I shall not employ any Applicant: .CARbQS ZAMOR� ' . person in any manner so as to become subject to the worker's co nsa' n laws of California,and agree Address: 5858 DOVETAIL DR AGOURA HILLS CA 91301 that if I should become subject to the worker's compensation p isions ec I 700 of the Labor Code, I shall forthwith comply with those provisions. Ph: 818-735-7876 Email: Date: W Lie.Information Exp.Date: WARNING: Failure to secure workers compensation coverage is u I�ltfi�hall subject an employer I certify that the user of this facility shall comply with sections 25506,25533 and 25534 of the Health and to criminal penalities and civil fines up to one hundred thousand dollars($100,000),in addition to the cost Safety Coda,which regulate the storage,handling and use of hazardous materials of compensation,damages as provided for in section 3706 of the Labor Code,interest,and attorney's fees. CITY OF CHINO HILLS COM MUNITY DEVELOP MENT—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 callincl 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 wtien job is complete. INSPECTION RECORD INSPECTION DATE INSPECTOR INSPECTION DATE INSPECTOR Grading: Block Wall Inspections: Pregrade Meeting Footing,Rebar Rough Grade 151 Lift Bond Beam Terraces 2m Lift Bond Beam Sub Drains 3"Lift Bond Beam Finish Grading Drain 1 Seal Soils Certification Grading Certification Rough ReRoof: Tear-off,Existing Conditions Undergrornd Site Inspections: Sheath Nailing 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 UndertloorlUnderslab Inspection: Final Pool UF Waste Plumbing OF Water Fire Protection Equipment: UiF Mechanical UG Pipe U/F Electrical Thrust Blocks OF Framing Hydro OF 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 Hardwere/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 (393-3688) 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 ElectricFinal Mechanical r-f; Rough Mechanical Final Building/Construction Rough Plumbing/TopoutWater Meter Number • COVER HO WORK UNTIL ABOVE IS APPROVED CERTIFICATE OF OCCUPANCY Insulation OK TO ISSUE Drywall Inspection: OTHER: Interior /111��� SiYtO`Q A _ A Exterior EXT LATH Stucco Scratch Miscellaneous Inspections: Masonry Fieplace Plate Ties,Fire Block Patio/Deck: Footing Frame Access/Light/Swtch NOTICE TO OWNER:Call for FINAL INSPECTION on every job. Patio Final This pemitwill expie if work is suspended or abandoned for a period of 180 days. i; �, x / 12.-e i ct G e wI h-f L �5�("1 i bGGL-ttb� 3J- A-6 �3 Seems Q / 2 �) / 10 ' 12; 352-5- Val(. APPROVED CHINO HILLS -� PL/,N1\IINf __ BY DATF v//� �d -