Loading...
Permit No. 18733 BUILDING ADDRESS: 16257 VAN GOGH COURT PERMIT NUMBER: 18733 � \ BUILDING INFORMATION APPLICANT INFORMATION , ..11e�\ BUILDING PERMIT APPLICATION Address: 16257 VAN GOGH COURT Name BELL-AIRF ~ ",t.f tk Community Development APN 11017-703-35 I Address 112356 OLEANDER -.1.•;i:5 :�` .•;i: 2001 Grand Avenue •-+ Lot 120 City,Zip Code (CHINO,CA 91710 _'+i._ Chino Hills,CA 91709 Cross Streets I Phone/Pager.� t. g (090)265-5962 I ext CITY°'C"°"" LICENSED CONTRACTOR DECLARATION Tract/Parcel 114079 I City Bus Lic# I I I hereby affirm that Cm licensed under the provisions of Chapter 9(commencing with Section Valuation $5,000 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 ICBO STANDARD OWNER BUILDER DECLARATION Name IMiKE&DEANNA ROBLES Address I hereby intra hat I'm exempt from the Contractor's License Law for the following reason Address 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 ICHINO HILLS,CA Phone. I ext O O compensation,will do the work,and the structure is not intended or offered for sale Phone 0909)597-6422 I ext I Lic# i I,as owner of the property,am exclusively contracting with licensed contractors to Bus Lic# City Bus Lie# construct the project i am exempt under ll Section BPC for this reason I I Bus Exp 1 APPROVAL INFORMATION WORKERS'COMPENSATION DECLARATION 1 CONTRACTOR INFORMATION Issued By LAURO BUGARIN I hereby affirm under penalty of perjury one of the following declarations Contractor BELL-AIRF I Date Issued 8/9/01 Address 12356 OLEANDER Finance Code C4-SM 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 Ctty,Zip Code CHINO,CA 91710 I Census Code n which this permit is issued Phone or Pager (090)265-5962 I ext I I Final Date '(/a� /p}, ZZ2JA e 2i Bus Lie# 01-05589 I Final By l ` C ' PQ, I have and will maintain workers'compensation,as required by Section 3700 of the ® Labor Code,for the performance of the work for which this permit is issued My Lie # 354170 I Extension workers'compensation insurance carnet and policy number are Exp Date 2/28/02 I Reviewed By LAURO BUGARIN Lie ss B I Approved By LAURO BUGAR1N INSURANCE INFORMATION Insurance Company 'EXEMPT . I ( PROJECT INFORMATION Policy Number I I 1 PROJECT DESCRIPTION LOCATION SQUARE FT. Expiration Date 1 I Structure I I ' ® Section need not be completed if permit is for one hundred dollars($100)or less Garage I I certify that in the performance of the work for which this permit is issued I shall not employ � Patio ' ny person in any manner so as to become subject to the Workers'Compensation Laws of Porch ' alifomia and agree that if I should become subject to the workers'compensation provisions of Other IICBG PATIO REAR I I 371 Section 3700 of the Labor Code I shall comply with those provisions n /// ICBO PATiO REAR 371 SF � / �� PROPOSED USE Date: ix''*% 6/I Signature: I (-..,V�%�� ije,(, I certify I have read this application and state that the above information is correc I a ree to IJd t/c �61C �Gf��/�L�� comply with all City Ordinances and state laws and hereby authonze representatives this City to COMMENTS enter upon the above mentioned property for inspection purposes I �/ ,c'i1/.,�. - � � Date: v�d_0/ 1 Signature: V '� W'4/.. '� i i OTHER FEES REQUIRED ZONING SETBACKS GRADING PRIOR TO ACTUAL PERMIT PERMIT FEE INFORMATION ISSUANCE Zoning IPD Front Yard 21 Over X 0I Issuance 1 $29 00 I Electrical $0 00 I Land Use IFR-1 Side Yard 5/5 Cut 0 School I N ' Permit Fees: $171.56 DevelopmentN Plan Check I $56 16 I Plumbing $0 00 1 Plan Rear Yard I S Fill 0 I SMTP 1 $0 50 I Occ IR3 SSYTotal 0 I Sewer I N I Mechanical I $0 00 I Structural $86 40 I Type IVN I Water I N I Geo Review I $0 00 I Grading. I $0 00 1 Total Fee Due I $172.06 INSPECTION 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 LI Keuivte-c( F- ?/- / 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 : .• Location/Rebar/Bonding/Light Gr Conduit Ro Elect POOL NOT TO BE FILLED UNTIL FENCING IS COMPLE' Fence,Gate&Alarm _ Final Pool Temp Power Pole Electric Release Gas Test •