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Permit No. 17417 BUILDING ADDRESS: 5533 VERONESE DRIVE 1 PERMIT NUMBER: 17417 1 �� BUILDING INFORMATION APPLICANT INFORMATION •�...: of BUILDING PERMIT APPLICATION Address 15533 VERONESE DRIVE Name IAN GRIFFIN ;g�s+;� Community Development APN Address 17145 MAGNOLIA AVENUE,SUITE 100 r.,� 2001 GrandAvenue` LotI 21 City,Zip Code IRNERSIDE,CA 92504 Chino Hills,CA 91709 Cross Streets Phone/Pager (909)328-0777 1 ext 117 ""°`."°"' LICENSED CONTRACTOR DECLARATION Tract/Parcel 114079-3 City Bus Lic# 101-04775 I hereby affirm that I'm licensed under the provisions of Chapter 9(commencing with Section Valuation $167,000 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,as owner of the property,am exclusively contracting with licensed contractors to Bus Lic# 101-04775 City Bus Lie# construct the project • 4 Bus Exp 16/30/01 APPROVAL INFORMATION I am exempt under Section I I BPC for this reason I WORKERS'COMPENSATION DECLARATION CONTRACTOR INFORMATION Issued By 1YVETTE MARTINEZ I hereby affirm under penalty of perjury one of the following declarations Contractor GRIFFIN COMMUNITIES I Date Issued 11/10/01 Address 7145 MAGNOLIA AVENUE,SUITE 100 I Finance Code 1C4-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 City,Zip Code RIVERSIDE,CA 92504 I Census Code 1101 which this permit is issued Phone or Pager (909)328-0777 1 ext 17 I Final Date Bus Lie# 01-04775 Final By I have and will maintain workers'compensation,as required by Section 3700 of the Lie # 638223 ® Labor Code,for the performance of the work for which this permit is issued My I Extension workers'compensation insurance earner and policy number are Exp Date 4/30/01 I Reviewed By 1KEiTH L PRYOR Lie Class B INSURANCE INFORMATION Approved By (KEITH L PRYOR Insurance Company 1STATE FUND I PROJECT INFORMATION Policy Number 1154080-99 I PROJECT DESCRIPTION LOCATION SQUARE FT. Expiration Date 12/1/01 I Structure ILNIBLE 1 I 1 1 2337 © Section need not be completed if permit is for one hundred dollars($100)or less Garage 1GARAGE 1 578 I certify that in the performance of the work for which this permit is issued I shall not employ Patio I I any person in any manner so as to become subject to the Workers'Compensation Laws of Porch 1PORCH I 1 I 151 50 California and agree that if I should become subject to the workers'compensation provisions of Other aakkSection 3700 of the Labor Code I shall comply with those provisions SINGLE FAMILY RESIDENCE PROPOSED USE Date: 1 i Signature I i PLAN 1 STANDARD-30'-37'REAR LANDSCAPE AND DRAINAGE EASEMENT 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 representatives of this City to enter upon the aboveyenticyed property for inspection purposes 2 COMMENTS Date I /VGII Signature ' OTHER FEES REQUIRED UI_ �� l.—J.,0 V PRIOR TO ACTUAL PERMIT ZONING SETBACKS GRADING ISSUANCE PERMIT FEE INFORMATION Zoning 1PD I Front Yard 16 5 Over X 1 0 Issuance 1 $29 00 1 Electrical 1 $257 07 1 Land Use IFR-2 Side Yard 5/5 Cut 0 School I YES Permit Fees: $2,064.91 Plan (PLAN 1 Development YES Plan Check 1 $115 37 Plumbing $246 00 I I Rear Yard 15 Fill I 0SMIP 1 $16 70 1 Occ IR3 1 SSY Total 1 0 Sewer YES Mechanical 1 $98 79 Structural 1 $1,153 68 1 Type IVN Water 1 YES Geo Review 1 $0 00 Grading 1 $165 00 I Total Fee Due I $2,081.61 I 4 INSPECTION RECORD Permit Number nspection Date Inspector Inspection Date Inspector 3rading: 3regrade Meeting FINAL INSPECTIONS(Inspector verify following) sough 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 Alf Rough Landscape CIF / As Built Approved Underground Site Inspections: ALL ABOVE MUST BE APPROVED BEFORE FINAL BLDG Building Sewer /tom Final Grade Water Service Storm Drain/Catch Basins Final Electnc U/G Conduit/Electncal Final Plumbing Final Mechanical Compaction Report Final Building/Construction/ ABOVE IS REQUIRED PRIOR TO FOUNDATION INSPECTION, Water Meter Number /,rJoFf Footings UFER Ground(Rebar/Copper) j CERTIFICATE OF OCCUPANCY Hardware/Hold-Downs Piers/Caissons/Tendons +/ Slab Grade 7./, d/7)i /.7.- **-- OTHER: DO NOT POUR CONCRETE UNTIL ABOVE IS AO OVtD - ` tz_d4 P Shear , 5a60 Roof Nailing Exterior Walls ;,AKA/ Interior Walls Hardware/Hold-Downs �. Rough Electnc -9 Rough Mechanical - Rough Plumbing/Topout �- Framing / COVER NO WORK UNTIL ABOVE IS APPROVED Insulation Af, Drywall Intenor/Extenor c.. Lath h.—l�L 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 COMPLETE Fence,Gate&Alarm Final Pool Temp Power Pole Electric Release MJjf Gas Test lad f/�