Loading...
Permit No. 16864 BUILDING ADDRESS: 16261 VAN GOGH COURT PERMIT NUMBER: 16864 BUILDING INFORMATION APPLICANT INFORMATION . �, . BUILDING PERMIT APPLICATION i;. Address 116261 VAN GOGH COURT I Name IiAN GRIFFIN --.:17/tie' Community Development APN 1 I Address 17145 MAGNOLIA AVENUE,SUITE 100 ""'^` 2001 Grand Avenue -�'r'•=�Lot 121 City,Zip Code (RIVERSIDE,CA 92504 : Chino Hills,CA 91709 ty:'.*-7. Cross Streets 1 1 Phone/Pager 1(909)328-0777 I ext 117 TV 0/CHINO ""'S LICENSED CONTRACTOR DECLARATION Tract/Parcel 114079 1 City Bus Lic# 101-04775 I hereby affirm that I'm licensed under the provisions of Chapter 9(commencing with Section Valuation 1$229,000 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 L D KING OWNER BUILDER DECLARATION Name !GRIFFIN COMMUNITIES Address 2151 CONVENTION CENTER WAY I hereby affirm that I'm exempt from the Contractor's License Law for the following reason Address 17145 MAGNOLIA AVENUE,SUITE 100 City,Zip Code ONTARIO,CA 91764-4464 I,as the owner of the property,or my employees with wages as their whole City,Zip Code RIVERSIDE,CA 92504 Phone (909)937-0200 1 ext 1 ® compensation,will do the work,and the structure is not intended or offered for sale Phone 1(909)328-0777 1 ext 117 Lie# (i‘) I,as owner of the property,am exclusively contracting with licensed contractors to Bus Lic# 10 1-0477 5 City Bus Lie# construct the project ® I am exempt under Section I i BPC for this reason I Bus Exp 6/3oro1 APPROVAL INFORMATION • ./ CONTRACTOR INFORMATION WORKERS'COMPENSATION DECLARATION Issued By 1YVETTE MARTINEZ Contractor GRIFFIN COMMUNITIESI herebyaffirm under penaltyof perjuryone of the followingdeclarations Date Issued 108/18/2000 Address 7145 MAGNOLIA AVENUE,SUITE 100 1 Finance Code 1C4-SM I have and will maintain a certificate of consent to self-insure for workers'compensation 0as provided by Section 3700 of the Labor Code,for the performance of the work for City,Zip Code RIVERSIDE,CA 92504 1 Census Code 1101 which this permit is issued Phone or Pager (909)328-0777 'ext 117 1 Final Date Bus Lic# 01-04775 Final I have and will maintain workers'compensation,as required by Section 3700 of the By 1 Qi Labor Code,for the performance of the work for which this permit is issued My Lie 4 638223 1 Extension 1 workers'compensation insurance carrier and policy number are Exp Date 4/30/01 Reviewed By !KEITH L PRYOR ass B I Approved By 'KEITH L PRYOR INSURANCE INFORMATION f/ Insurance Company !STATE FUND �( PROJECT INFORMATION Policy Number 1154080-99 ` PROJECT DESCRIPTION LOCATION SQUARE FT. Expiration Date 12/1/01 Structure ILIVIBLE I 1 3320 1 O Section need not be completed if permit is for one hundred dollars($100)or less Garage GARAGE 1 576 1 I certify that in the performance of the work for which this permit is issued I shall not employ Patio 1 I I I any person in any manner so as to become subject to the Workers'Compensation Laws of Porch 'PORCH I I 135 _fl* California and agree that if I should become subject to the workers'compensation provisions of Other Section 3700 of the Labor Code I shall comply with those provisions PROPOSED USE SINGLE FAMILY RESIDENCE Date: i i Signature: i i PLAN 4 STANDARD I certify I have read this application and state that the above information is correct I agree to comply with all City Ordinances and state laws and hereby authonze re resentatives of this City to COMMENTS )n enter upon the abovymen ed property for inspection purpose ,0"' Date: i gy z..„ I Signature: OTHER FEES REQUIRED • a8 ZONING SETBACKS GRADING PRIOR TO ACTUAL PERMIT PERMIT FEE INFORMATION Zoning PD Front Yard 28 ISSUANCE Over X 0 1 Issuance $29 00 I Electrical 1 $365 20 1 Land Use IFR-2 I Side Yard 5/5 Cut 0School I YES ' Permit Fees: I Plan PLAN 4 Rear Yard 15 I DevelopmentPlan Check $144 04 Plumbing $293 50 $2,455.64 I YES I Fill I 0 1 Sewer YES Mechanical $108 78 Structural $1,440 12 SMIP ' $22 90 ' Occ 1R3 SSY Total 0 'I Type 1" Water YES I Geo Review I $0 00 Grading I $75 00 I Total Fee Due I $2,478.54 t OINSPECTION RECORD 4 INSPECTION DATE INSPECTOR Grading INSPECTION DATE INSPECTOR Pregrade Meeting Block Wall Inspections . Rough Grade Footing, ReBar Terraces 1st Lift Bond Beam Sub Drains 2nd Lift Bond Beam Finish Grading 3rd Lift Bond Beam Soils Certification Drain/Seal Grading Certification ReRoof Rough Tear-off, Existing Conditions As Built Approved Sheath Nailing Underground Site Inspections Roof Final Building Sewer Line ` Swimming Pools Supply Water Line ' �' Location/Rebar/Bonding/Light Storm Drain/Catch Basins Gas Test U/G Conduit/Electrical Gr Conduit/Ro Elect DO NOT BACKFILL UNTIL ABOVE IS APPROVED Pre-Deck Verify Soils Engineering POOL NOT TO BE FILLED UNTIL FENCING IS COMPLETE Compaction, moisture,conditioning,etc Fence, Gate&Alarm Underfloor/Underslab Inspection Final Pool U/F Waste Plumbing ��-- Fire Protection Equipment U/F Water UG Pipe U/F Mechanical Thrust Blocks U/F Electrical Hydro U/F Framing Flush Insulation Weld Outlet Insp Subfloor �i Overhead Hydro ABOVE IS REQUIRED PRIOR TO FOUNDATION INS CTION Foundation Inspection _ Temp Power Pole Setback/Footing Electric Release -1W-5/er _y/ UFER Ground(Rebar/Copper) / / Gas Test &7(-' Hardware/Hold-Downs &Y/ Piers/Caissons/Tendons FINAL INSPECTIONS DO NOT POUR CONCRETE UNTIL ABOVE IS APPROVED NO OCCUPANCY PERMITTED WITHOUT FINAL I Shear Inspection(Wood) County Environmental Roof Nailing ,•,'/ /- Health Dept (391-7570) Exterior Walls , / / �— Planning Dept (364-2750) Intenor Walls ,,/ Public Works (364-2770) Hardware/Hold-Downs fes' Fire (393-3888) Combo Inspection Landscape (364-2797) Framing jiajO Trust Accounts (364-2769) Rough Electric // / ALL ABOVE MUST BE APPROVED BEFORE FINAL BLDG Rough Mechanical /j/ Final Electnc I Rough Plumbing/Topout / y Final Grade f d COVER NO WORK UNTIL ABOVE IS APPROVED/ / / / s/ Final Plumbing __701,.. // Insulation C" /� Final Mechanical Drywall Inspection Final Building/Construction ,/ Interior //=, �--- Water Meter Number - 5-'7s tel' Z�� Exterior Lath //3/trYCERTIFICATE OF OCCUPANCY -2,,Q-A7 Stucco Scratch ,4,------ OK TO ISSUE MISCELLANEOUS INSPECTIONS ' ' • ...2. --- Masonry Fireplace OTHER Plate Ties, Fire Block, Patio/Deck Footing Access/Light/Switch Patio Final oG - =�F')Ar - • • ZZ