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Permit No. 18247 BUILDING ADDRESS: 5545 VERONESE DRIVE PERMIT NUMBER: 18247 1.--- 4' � BUILDING INFORMATION APPLICANT INFORMATION / oto BUILDING PERMIT APPLICATION Address 5545 VERONESE DRIVE Name IAN GRIFFIN -:17.3`; y Community Development APN Address 17145 MAGNOLIA AVENUE,SUITE 100 It '""' r 2001 Grand Avenue �I•=�' Lot 119 � City,Zip Code RIVERSIDE,CA 92504 '^• Chino Hills,CA 91709 Cross Streets Phone/Pager (909)328-0777 1 ext 17 4' J. ::' n 0/CIIINO "' LICENSED CONTRACTOR DECLARATION TracUParcel 114079-3 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 k 7000 of Division 3 of the Business and Professions Code)and my license is in full force and ENGINEER/ARCHITECT INFORMATION effect OWNER INFORMATION Name L D KING OWNER BUILDER DECLARATION Name GRIFFIN COMMUNITIES Address 12151 CONVENTION CENTER WAY `I , I hereby affirm that I'm exempt from the Contractor's License Law for the following reason Address 7145 MAGNOLIA AVENUE,SUITE 100 City,Zip Code (ONTARIO,CA 91764-4464 1 I,as the owner of the property,or my employees with wages as their whole City,Zip Code 1RIVERSIDE,CA 92504 Phone 1(909)937-0200 1 ext O compensation,will do the work,and the structure is not intended or offered for sale Phone 1(909)328-0777 ext 117 1 Lic# 1 O I,as owner of the property,am exclusively contracting with licensed contractors to Bus Lic# 10 1-0477 5 City Bus Lic# 1 construct the project iiiI am exempt under Section BPC for this reason I Bus Exp 6/30/01 APPROVAL INFORMATION WORKERS'COMPENSATION DECLARATION • CONTRACTOR INFORMATION Issued By YVETTE MARTINEZ I hereby affirm under penalty of perjury one of the following declarations Contractor GRIFFIN COMMUNITIES Date Issued 5/11/01 Address 17145 MAGNOLIA AVENUE,SUITE 100 1 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 City,Zip Code RIVERSIDE,CA 92504 Census Code 101 which this permit is issued Phone or Pager (909)328-0777 ext 17 Final Date / //o�r_ ,- Bus Lic# 10 1-0477 5 Finae....... ..: ' l By "4!r I have and will maintainworkers'compensation,as required by Section 3700 of the CI Labor Code,for the performance of the work for which this permit is issued My Lic # 638223 1 Extension workers'compensation insurance carrier and policy number are Exp Date 14/30/03 1 Reviewed By 1KEITH L PRYOR INSURANCE INFORMATION Lic Class 1B Approved By 1KEITH L PRYOR Insurance Company 1STATE FUND 1 PROJECT INFORMATION Policy Number 11545080 PROJECT DESCRIPTION LOCATION SQUARE FT. Expiration Date 12/9/02 Structure 1LIVIBLE 2337 O 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 1 any person in any manner so as to become subject to the Workers'Compensation Laws of Porch 1PORCH 1 1 151 50 person 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 PLAN 1 STANDARD-33 49'REAR LANDSCAPE 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 mentioned property for inspection purposes i i Date: I.S////0/ I Signature: 1 `f y �,�17.( i r / OTHER FEES REQUIRED ZONING SETBACK S GRADING PRIOR TO ACTUAL PERMIT PERMIT FEE INFORMATION ISSUANCE Zoning 1PD Front Yard 17 Over x 1 0 1Issuance 1 $29 00 Electncal 1 $257 07 1 Land Use 1FR-2 Side Yard 5/5 Cut 1 0 1 School 1 YES 1 Development YES Plan Check 1 $115 37 Plumbing 1 $246 00 Permit Fees: $1,974.91 Plan PLAN 1 Rear Yard 15 Fill 0 p SMIP $16 70 Occ R3 SSY Total 1 0 1 Sewer YES 1 Mechanical $98 79 Structural 1 $1,153 68 Total Fee Due $1 991.61 Type VN 1 Water 1 YES 1 Geo Review $0 00 Grading $75 00 1 1 IN ECTION RECORD • Permit Number //-2 V7 Inspection Date Inspector Inspection Date Inspector Grading: Pregrade Meeting FINAL INSPECTIONS(Inspector verify following) Rough Grade NO OCCUPANCY PERMITTED WITHOUT FINAL 1 Terraces County Environmental Sub Drains Health Dept Finish Grading Planning Dept /1-(5144-/ Soils Certification Public Works Grading Certification Fire /t, iI Rough Landscape /t--P/ As Built Approved Underground Site Inspections: ALL ABOVE MUST BE APPROVED BEFORE FINAL BLDG Building Sewer y /4 `�� � AFinal Grade � Water Service Final Electnc Storm Drain/Catch Basins Final Plumbing U/G Conduit/Electrical Final Mechanical / <� Compaction Report Final Building/Construction ABOVE IS REQUIRED PRIOR TO FOUNDATION INSPECTION Water Meter Number Yo/ro 9G Footings _-r-O , UFER Ground (Rebar/Copper) _04e CERTIFICATE OF OCCUPANCY Hardware/Hold-Downs Piers/Caissons/Tendons �✓' Slab Grade �J ' i / " OTHER: DO NOT POUR CONCRETE UNTIL ABOVE IS APPROVED iLenb/ A. S"o73—01 ,4 — Shear � Roof Nailing Extenor Walls Interior Walls ;fes•J k Hardware/Hold-Downs i Rough Electric Rough Mechanical Rough Plumbing/Topout Framing COVER NO WORK UNTIL ABOVE IS APPROVED Insulation 1,,41..1 Drywall Interior/Extenor , o Lath j"'(��`( h -I Stucco Scratch Roof Covering Block Wall Inspections : Footing, ReBar 1st Lift Bond Beam 2nd Lift Bond Beam 3rd Lift Bond Beam Drain/Seal SWIMMING POOLS : Location/Rebar/Bonding/Light Gr Conduit Ro Elect POOL NOT TO BE FILLED UNTIL FENCING IS COMPLETE Fence,Gate&Alarm Final Pool Temp Power Pole Electric Release IO2 •/ d Gas Test /'2 J$ 6( —�e