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Permit No. 30105 BUILDING ADDRESS: 3542 VALLE VISTA DRIVE PERMIT NUMBER: 30105 � BUILDING INFORMATION APPLICANT INFORMATION ,� y� o>r� BUILDING PERMIT APPLICATION Address 3542 VALLE VISTA DRIVE tiName PAUL GARCIA ,,,, Community Development APN 1017-561-20-0000 Address 11565 E BENMORE LANE ''%°~`w, 2001 Grand Avenue '.-.1''' Lot 150 City,Zip Code 1ANAHEIM,CA 92802 Chino Hills,CA 91709 Cross Streets VALLE VISTA DRIVE&PEYTON Phone/Pager (714)774-9036 1 ext LICENSED CONTRACTOR DECLARATION Tract/Parcel 9231 City Bus Lic# 1NEW I hereby affirm that I'm licensed under the provisions of Chapter 9(commencing with Section Valuation 1$5,800 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 BOB1SCHOFIELD Address I hereby affirm that I'm exempt from the Contractor's License Law for the following reason Address 13542 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 O compensation,will do the work,and the structure is not intended or offered for sale Phone (909)597-7101 1 ext Lie# 0 I,as owner of the property,am exclusively contracting with licensed contractors to Bus Lic# 1 City Bus Lie# construct the project Bus Exp APPROVAL INFORMATION I am exempt under Section BPC for this reason I I WORKERS'COMPENSATION DECLARATION CONTRACTOR INFORMATION Issued By CARMEN FRUCTUOSOA , I hereby affirm under penalty of perjury one of the following declarations Contractor PAUL GARCIA Date Issued 19/25/02 A h Address 11565 E BENMORE LANE 1 Finance CodeIcAtr /� I have and will maintain a certificate of consent to self-insure for workers'compensation City,ZipCode ANAHEIM,CA 92802 � ` � as provided by Section 3700 of the Labor Code,for the performance of the work for y Census Code Ir which this permit is issued Phone or Pager 1(714)774-9036 ext 1 Final Date /0—.D,^d ., V Bus Lie# NEW Final I have and will maintain workers'compensation,as required by Section 3700 of the By O O Labor Code,for the performance of the work for which this permit is issued My Lic # 605061 Extension workers'compensation insurance earner and policy number are Exp Date 10-31-02 1 Reviewed By Lie Class 1C39 Approved By INSURANCE INFORMATION Insurance Company 1Exempt PROJECT INFORMATION Policy Number PROJECT DESCRIPTION LOCATION SQUARE FT. Expiration Date 11 1 Structure ® Section deed 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 any person in any manner so as to become subject to the Workers'Compensation Laws of Porch California and agree that if I should become subject to the workers'c pensation provisions of Other RE-ROOF ROOF 1 1900 Section 3700 of the Labo I shall comply with those proves s REMOVE EXISTING SHAKE,APPLY 7/16"OSB PLYWOOD,30 LB FELT DURALITE � PROPOSED USE VILLA Date. i , v _ZJ'dz_I Signature: i 777 // (/ 5 85 LBS/SQ FOOT CLASS A FIRE RATED ECBO#2651 I certify I have'lead this application and state that the above information is correct I agree to 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 purpose Date: i 9-l'.1-4 Z I Signature. i /v i OTHER FEES REQUIRED ZONING SETBACK S GRADING PRIOR TO ACTUAL PERMIT PERMIT FEE INFORMATION ISSUANCE Zoning IRS 1 Front Yard EXIST Over X 0 1 Issuance 1 $29 00 1 Electrical $0 00 Land Use FR-1 Side Yard Cut 0 School NO Permit Fees: $115.40 Plan 1RE-ROOF Rear Yard Fill 0 Development NO Plan Check $0 00 Plumbing $0 00 SMIP $0 00 occ R3 1 SSY Total o Sewer NO Mechanical $0 00 Structural $86 40 Total Fee Due $115.40 Type VN Water NO Geo Review $0 00 Grading $0 00 I itISPECTION 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 _ 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 ``dam ���"'b °� �� �a \�\�+� • • Exterior Walls • Interior Walls Hardware/Hold-Downs Rough Electnc Rough Mechanical Rough Plumbing/Topout Framing COVER NO WORK UNTIL ABOVE IS APPROVED " Insulation Drywall Interior/Extenor Lath Stucco Scratch Roof Covenng Block Wall Inspections : Footing,ReBar 1st Lift Bond Beam 2nd Lift Bond Beam 3rd Lift Bond Beam Drain/Seal SWIMMING POOLS: Location/Rebar/Bond ing/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