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Permit No. 17418 BUILDING ADDRESS: 5521 VERONESE DRIVE , PERMIT NUMBER: 17418 BUILDING INFORMATION APPLICANT INFORMATION 477-- net BUILDING PERMIT APPLICATION Address 15521 VERONESE DRIVE Name IAN GRIFFIN �"""`.' CommunityDevelopment APN I 1 Address 7145 MAGNOLIA AVENUE,SUITE 100 •��t° P 1 I ^i- 2001 Grand Avenue Lot 123 City,Zip Code IRNERSIDE,CA 92504 AI., Chino Hills,CA 91709 :'. Cross Streets 1 1 Phone/Pager 1(909)328-0777 1 ext 17 . cm°'° °' I LICENSED CONTRACTOR DECLARATION Tract/Parcel 114079-3 1 City Bus Lic# 101-04775 I hereby affirm that I'm licensed under the provisions of Chapter 9(commencing with Section Valuation 1$167,000 00 1 ENGINEER/ARCHITECT INFORMATION 7000 of Division 3 of the Business and Professions Code)and my license is in full force and OWNER INFORMATION Name IL D KING effect OWNER BUILDER DECLARATIONName GRIFFIN COMMUNITIES I Address 2151 CONVENTION CENTER WAY I hereby affirm that I'm exempt from the Contractor's License Law for the following reason Address 7145 MAGNOLIA AVENUE,SUITE 100 1 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 (909)328-0777 1 ext 117 1 Lic# I © I,as owner of the property,am exclusively contracting with licensed contractors to Bus Lic# 01-04775 1 City Bus Lic# 1 construct the project • I Bus Exp 6/30/01 APPROVAL INFORMATION, I am exempt under Section i i BPC for this reason 110 WORKERS'COMPENSATION DECLARATION CONTRACTOR INFORMATION Issued By 1YVEFIE MARTINEZ I hereby affirm under penalty of perjury one of the following declarations Contractor 'GRIFFIN COMMUNITIES 1 Date Issued 11/10/01 Address 17145 MAGNOLIA AVENUE,SUITE 100 1 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 IRNERSIDE,CA 92504 Census Code 1101 / / which this permit is issued Phone or Pager 1(909)328-0777 1 ext 117 1 Final Date Bus Lic# 01-04775 Final By I have and will maintain workers'compensation,as required by Section 3700 of the Di Labor Code,for the performance of the work for which this permit is issued My Lie # 1638223 Extension workers'compensation insurance earner and policy number are Exp Date 14/30/01 1 Reviewed By 'KEITH L PRYOR Lie Class 1B Approved By 'KEITH L PRYOR INSURANCE INFORMATION Insurance Company 'STATE FUND I PROJECT INFORMATION Policy Number 1154080-99 I PROJECT DESCRI ON LOCATION SQUARE FT. Expiration Date 2/1/01 1 Structure ILIVIBLE I 1 1 I 2337 © Section need not be completed if permit is for one hundred dollars($100)or less Garage (GARAGE I I 578 I certify that in the performance of the work for which this permit is issued I shall not employ Patio I any person in any manner so as to become subject to the Workers'Compensation Laws of Porch 'PORCH 151 50 California and agree that if I should become subject to the workers'compensation provisions of Other I 1 'Section 3700 of the Labor Code I shall comply with those provisions PROPOSED USE SINGLE FAMILY RESIDENCE Date. i i Signature: I I PLAN 1 STANDARD - 35'-40'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 COMMENTS enter upon the above mentiosied property for inspection purposes / / Date. , PRIOR TO ACTUAL PERMIT Signature: i , ,..-- }"9"- )/Y OTHER FEES REQUIRED C v � y ZO IN SETBACKS GRADING ISSUANCE PERMIT FEE INFORMATION Zoning 1PD i Front Yard 16 5 Over X 1 0 1 Issuance 1 $29 00 i Electrical 1 $257 07 1 Land Use IFR-2 ' Side Yard 5/5Cut 0School 1 YES I Permit Fees: I $2,064.91 1 I Plan Check $115 37 Plumbing $246 00 Plan 'PLAN 1 Rear Yard 15 Fill 0 Development YES 1SMIP I $16 70 1 Occ 1R3 1 SSY Total 1 0 1 Sewer 1 YES 1 Mechanical 1 $98 79 Structural 1 $1,153 68 1 Type VN I Water 1 YES 1 Geo Review 1 $0 00 I Grading 1 $165 00 1 Total Fee Due I $2,081.61 I f 0 INSPECTION RECORD Permit Number,/ 'f nspection Date Inspector Inspection Date Inspector 3rading: regrade Meeting FINAL INSPECTIONS(Inspector verify following) dough Grade NO OCCUPANCY PERMITTED WITHOUT FINAL I rerraces County Environmental Sub Drains Health Dept r / a-- Finish Grading Planning Dept 1✓ ✓,��/ Soils Certification Public Works Grading Certification Fire 4 7 Rough Landscape die As Built Approved Underground Site Inspections: ALL ABOVE MUST BE APPROVED BEFORE FINAL BLDG/ BuiSewer -7"4Final Grade Water Waterer Service Final Electnc Storm Drain/Catch Basins Final Plumbing U/G Conduit/Electrical Final Mechanical Compaction Report Final Budding/Constructio►j /f ABOVE IS REQUIRED PRIOR TO FOUNDATION INSPECTION Water Meter Number 24,13 cm, ,t, Footings 1% UFER Ground(Rebar/Copper) CERTIFICATE OF OCCUPANCY Hardware/Hold-Downs ,r Piers/Caissons/Tendons Slab Grade / / d OTHER: DO NOT POUR CONCRETE UNTIL ABOVE IS •PP'OM- - -Z Shear /J� .,.as — Roof Nailing Y Exterior Walls id,;/.'� Interior Walls Hardware/Hold-Downs Rough Electnc � Rough Mechanical � Rough Plumbing/Topout Framing V COVER NO WORK UNTIL ABOVE IS APPROVED Insulation (oz �L <de Drywall Intenor/Extenor 6/17 t L /ak >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 �'�i/ / z Gas Test 111 ,