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Permit No. 2012-25712 , `. City of Chino Hills BUILDING DIVISION OF COMMUNITY DEVELOPMENT DEPAR 14000 City Center Dr.,Chino Hills,CA91709 Counter Phone (909)364-2780 -. . -.-. E Building Permit 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 MORE BELOW WHEN MAKING INQUIRIES 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. RE-ROOF:TEAR OFF&REPLACE W/CLASS"A"30 YEAR COMPOSITE SHINGLES;21 SQUARES(ALTERNATIVE TO COOL ROOF REQUIREMENT: 2012-25712 33357 ExISmNG DUCTS IN THE ATTIC ARE INSULATED AND SEALED) I3 533DVALGLEV VISTA DR,Apt 0 SS I APT./UNIT NO. !ISSUED/012 ATE I ISSUED BY Heredia,Monica APN 21303 ITR C MAIN/ 1LOT 363 ILOORS/UNITS 1PROJECT PERMITS I P.TYPE 1 41 / 1 CENCUS Res CODES OD Sr 1CONST. CB TYPE (ZONING TYPE I OCCUPANCY TYPE 1VALUATION $7,000.001 TOTAL SQFT 0.001 BLDG.SOFT 434_ Add/ Current Owners: Fees • Name:VICTOR L BOISELLE JR Fee Group/ Fee Description Fee Amount Payments Address: 3953 VALLE VISTA DR CHINO HILLS CA 91709 Transaction Type Ph: 951-204-0718 Re-Roof $166.25 Email: M@CH.ORG Contractor. OWNER BUILDER-OWNER/BUILDER B001 Permit Issuance Fee $53.00 53.00 Address: N/A CHINO HILLS CA 91709 B39-B53 Residential Structural Fee $112.25 112.25 Ph: N/A Email: Lie.Information Ey.Date: 581473 $1.00 1.00 LICENSED CONTRACTORS DECLARATIONLICENSED CONTRACTORS DECLARATION TOTAL FEES $166.25 I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9(commencing with Sec.7000)of Division 3 of the Business and Professions Code,and my license is in full force and AMOUNT PAID $166.25 effect In securing this permit 1 am acting with the knowledge of and on behalf of the owner of the property. BALANCE DUE $0.00 • Date: Contractor. / 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) 4r I,as owner of the propterty,or my employees with wages as their sole compensation,will do the •rk,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. /� Pi'Date:Z I Z 1I Permittee: � �_ /moi—,—P rint Full Name: VI�� eo i5 E )E �1- 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 this application 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 county ordinances and state laws relating to building construction,and hereby authorize issued. representatives of this city to enter upon the above-mentioned proptery for inspection purposes. I have,and will maintain workers'compensation isinsurance,permit i as required. by Section 3700 of the /' Z. � i Z/G Labor Code,for the performance of the work for which this permit is issued. My worker's compensation s (` insurance carrier and policy number are: v Cartier. Policy /APPLICANT SIGNATURE DATE # Applicant VICTOR L BOISELLE JR • 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 worker's compensation laws of California,and Address: 3953 VALLE VISTA DR CHINO HILLS CA 91709 agree that if I should become subject to the worker's compensation provisions of Section 3700 of the Ph: 951-204-0718 Email: M@CH.ORG Labor Code,I shall forthwith comply with those provisions. Lic.Information ` ` . Exp.Date: ' Date: Applicant: I certify that the user of this facility shall comply with sections 25506,25533 and 25534 of the Health and Safety Code,which regulate the storage,handling and use of hazardous materials WARNING: Failure to secure worker's compensation coverage is unlawful,and shall subject an employer to criminal penalities 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. CITY OF CHINO HILLS COMMUNITY DEVELOPMENT—BUILDING & SAFETY DIVISION Call(909)364-2790 before 3:00 p.m.for next clay inspection Post in a safe, conspicuous place at front ofjob. 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\M yen job is complete. INSPECTION RECORD INSPECTION DATE INSPECTOR INSPECTION DATE INSPECTOR Gradlig: Block Wall Inspections: Pregrade Meeting Footing,Rebar Rough Grade 151 Lift Bond Beam Terraces 2^'Lift Bond-Beam Sub Drains 3n1 Lift Bond Beam Finish Grading Drain/Seal Soils Certification Grading Certification Rough ReRoof: Tear-off,Existing Conditions „t�� Z et0_ Underground Site Inspections: Sheath Nailing Building Sewer Line Roof Final Water Supply Line UAG Electrical Service Conduit Swimming Pools: Storm Drain.!Catch Basin Location I Rebar/Bonding I Light DO NOT BACKFILL UNTIL ABOVE IS APPROVED Gas Test Or Conduit Verify Soils Engineering: Ro Elect Compaction,moisture,conditioning,etc. POOL NOT TO BE FILLED UNTIL FENCING IS COMPLETE Fence,Gate&Alarm UnderfloorlUnderslab inspection: Final Pool UIF Waste Plumbing UIF Water Fire Protection Equipment: UIF Mechanical UG Pipe UT Electrical Thrust Blocks UIF Framing Hydro UIF Insulation Flush Subfloor Weld Outlet Insp. ABOVE IS REQUIRED PRIOR TO FOUNDATION INSPECTION Overhead Hydro Foundation Inspection: Temp Power Pole Setback 1 Footing—OK to Pour Electric Release UFER Ground(Reber/Copper) Gas Teat • Harctwere I Hold-Downs Piers/Caissons/Tendons FINAL INSPECTIONS Slab Grade—OK to Pour 110 OCCUPANCY PERMITTED WITHOUT FINAL DO NOT POUR CONCRETE UNTIL ABOVE IS APPROVED County Environmental Health Dept. (391-7570) • Shear Inspection(1Nood): Planning Dept.(364-2752) Roof Nailing Public Works (364-2774) Exterior Walls Fire (393-3888) Interior Walls Landscape (364-2766) Harciwere/Hold-Downs ALL ABOVE MUST BE APPROVED BEFORE FINAL BLDG. Final Grade Combo mspectron: Final Electric Framing Final Plumbing Rough Electric Final Mechanical Rough Mechanical Final Building/Construction 3r l ,1 Rough Plumbing/Topout Water.Meter Number �t L COVER 110 WORK UNTIL ABOVE IS APPROVED Insulation OK OF OCCUPANCY OK TO ISSUE Drywall inspection: OTHER: Interior ..16t( (2— ( n�dl�yvc - /�A /Y 6)L - Ci 7v 4 Exterior EXT LATH \� Stucco Scratch Miscellaneous Inspections: Masonry Fireplace Plate Ties,Fire Block Patio!Deck: Footing Frame Access/Light I Swtch NOTICE TO OWNER:Call for FINAL INSPECTION on every job. This pemitwill ergrie if work is suspended or abandoned for a Patio Final period of 180 days.