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Permit No. 18428 • BUILDING ADDRESS: 16257 VAN GOGH COURT PERMIT NUMBER: 18428 BUILDING INFORMATION APPLICANT INFORMATION 4 e� BUILDING PERMIT APPLICATION Address 116257 VAN GOGH COURT Name (DIAMOND CREEK POOLS •'!-�"5,;,ti., Community Development APN 1017-703-35 1 Address 12965 CENTRAL AVE "4'w` 2001 Grand Avenue Lot 120 I City,Zip Code ICHINO,CA 91710 Chino Hills,CA 91709 ,z.,'i:I": . Cross Streets 1 I Phone/Pager 1(909)590-2425 I ext "•°' 1)XP"•. , LICENSED CONTRACTOR DECLARATION Tract/Parcel 114079 City Bus Lic# 1 I hereby affirm that I'm licensed under the provisions of Chapter 9(commencing with Section Valuation ($25,000 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 DAWN M PASOL OWNER BUILDER DECLARATION MIKE&DEANNA ROBLES Address I hereby affirm that I'm exempt from the Contractor's License Law for the following reasonAddress 116257 VAN GOGH COURT City,Zip Code I,as the owner of the property,or my employees with wages as their whole City,Zip Code 1CHINO HILLS,CA 1 Phone 1 ext 1 0 compensation,will do the work,and the structure is not intended or offered for sale Phone 1(909)597-6422 1 ext I I Lic 4 I,as owner of the property,am exclusively contracting with licensed contractors toI City Bus Lie 4 •J onstruct the project Bus Exp APPROVAL INFORMATION I am exempt under SectionQinkr BPC for this reason Bus Lie# WORKERS'COMPENSATION DECLARATION CONTRACTOR INFORMATION Issued By ILAURO BUGARIN I hereby affirm under penalty of perjury one of the following declarations Contractor DIAMOND CREEK POOLS Date Issued 6/14/01 Address 12965 CENTRAL AVE Finance Code IC4 I have and will maintain a certificate of consent to self-insure for workers'compensation ® as provided by Section 3700 of the Labor Code,for the performance of the work for City,Zip Code CHINO,CA 91710 Census Code 1 which this permit is issued Phone or Pager (909)590-2425 ext I Final Date 1 W�3/OI w Bus Lie# ON FILE Final By ` �� ��6 / I have and will maintain workers'compensation,as required by Section 3700 of the I// 0 Labor Code,for the performance of the work for which this permit is issued My Lie 4 585287 Extension workers'compensation insurance carrier and policy number are Exp Date 1/31/02 Reviewed By ILAURO BUGARIN INSURANCE INFORMATION Lie Class B Approved By ILAURO BUGARIN Insurance Company (LEGION INS COMPANY f PROJECT INFORMATION Policy Number 1WC40987381 I PROJECT DESCRIPTION LOCATION SQUARE FT. Expiration Date 12/10/02 I I 1 Structure O Section need not be completed if permit is for one hundred dollars($100)or less Garage I I I certify that in the performance of the work for which this permit is issued I shall not employ Patio 1 I I I . 111! ,ny person in any manner so as to become subject to the Workers'Compensation Laws of Porch 1 I I California and agree that if I should become subject to the workers'compensation provisions of Other (POOL/SPA 1REAR Section 3700 of the Labor Code I shall comply with those provisions -0' PROPOSED USE POOL/SPA Date: IC,7_` "-c( I Signature: I certify I have read this application and state th the above info anon icorrect I agree to comply with all City Ordinances and state laws and hereby authorize representatives of this City to COMMENTS enter upon the aboveo e mentioned property for inspection purps l s_� Date: 6-1f-a( i Signature: i 7/�._ OTHER FEES REQUIRED [AI // \PRIOR TO ACTUAL PERMIT ONING SETBACII`S /GRADING ISSUANCE PERMIT FEE INFORMATION Zoning 1PD 1 Front Yard 21 Over X I 0 IIssuance I $29 00 1 Electrical I $90 00 I Land Use FR-1 I Side Yard 5/5 0 School N Permit Fees: $421.40 CutI Development I N Plan Check 1 $0 00 I Plumbing 1 $0 00 SMTP $0 00 Occ 1R3 Plan I Rear Yard 15 Fill 0 1 SSY Total I 0 I Sewer N Mechanical I $0 00 1 Structural I $302 40 I N Total Fee Due I $421.40 I Type VN I WaterI Geo Review $0 00 I Grading I $0 00 I I PECTION R ECORIP 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/ElectncalFinal Building/Construction )1/Z3/e1 `KV l Y 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 Exterior Walls Interior Walls Hardware/Hold-Downs Rough Electric Rough Mechanical Rough Plumbing/Topout Framing COVER NO WORK UNTIL ABOVE IS APPROVED Insulation • Drywall Interior/Exterior • Lath Stucco Scratch Roof Covering Block Wall Inspections : Footing, ReBar • 1st Lift Bond Beam 2nd Lift Bond Beam 3rd Lift Bond Beam Drain/Seal • SWIMMING POOLS • • ...A._4_77/11 Location/Rebar/Bonding/Light /��q Gr Conduit e/I Ro Elect 'O / 4 � POOL NOT TO BE FILLED UNTIL FENCING IS.CQMPLETE Fence, Gate&Alarm Final Pool Temp Power Pole Electric Release Gas Test 'J7//l dI k '%/ • • • • 113g AP9inEEring and TEstiing, Inc . 2603 Pomona Boulevard,Pomona,CA 91768 • (909)869-6316 • Fax(909)869-6318 GEOTECHNICAL INSPECTION REPORT Report No. DATE: `�,2- 7/O/CLIENT: P ' P 8 r R-Pietas PROJECT NO. TIME: 12. 10 OB ADRESSf!'�� V°� !'�s*.--, SOILS REPORT DATED /one S_ �a 1 TYPE OF WORK: i2-- 116 Pei@V tO INSPECTION REPORT LEFT AT: ************************************************************************************* A REPRESENTATIVE OF THIS FIRM HAS INSPECTED THE ABOVE WORK ITEMNAT THE SUBJECT SITE. APPROVED PER THE PLANS DISAPPROVED SEE BELOW GENERAL COMMENTS AND CONDITIONS OF APPROVAL: fekGeaAt' oN spa ao � 1,40/4 4. 0..r tW j' ? . xN rr+'1 veasc> c T7 7( -a1,.itfst4 F.b ] —,f`1 046 > tTP tISO A'Rxrr' (.0t411.ctJ wacAS * 516;4 ACTION ITEMS: Wtror/N ¢-z ¢s- fT,taM. , 7 - INSPECTED BY: %-,(e � SIGNATU