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Permit No. 18248 BUILDING ADDRESS: 5569 VERONESE DRIVE PERMIT NUMBER: 18248 BUILDING INFORMATION APPLICANT INFORMATION . eaP BUILDING PERMIT APPLICATION Address 15569 VERONESE DRIVE Name IAN GRIFFIN -;'$'1,,6S, Community Development APN 1 Address 7145 MAGNOLIA AVENUE,SUITE 100 'I� ' 2001 Grand Avenue•�+ Lot 115 City,Zip Code RIVERSIDE,CA 92504 Hills,CA 91709 . ` 1 ;r `=fi : Phone/Pager 1(909)328-0777 I ext 117 `.1n '1°.rid. LICENSED CONTRACTOR DECLARATION Tract/Parcel 14079-3 City Bus Lic# 10 1-0477 5 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 IL 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 reasonAddress 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 1RIVERSIDE,CA 92504 Phone 1(909)937-0200 1 ext 1 0 compensation,will do the work,and the structure is not intended or offered for sale Phone 1(909)328-0777 1 ext 17 1 Lie# 1 ® I,as owner of the property,am exclusively contracting with licensed contractors to Bus Lie 4 01-04775 City Bus Lie 4 construct the project li Bus Exp 6/30/01 I am exempt under Section I I BPC for this reason APPROVAL INFORMATION WORKERS'COMPENSATION DECLARATION I CONTRACTOR INFORMATION Issued By IYVETTE MARTINEZ I hereby affirm under penalty of perjury one of the following declarations Contractor GRIFFIN COMMUNITIES Date Issued 15/11/01 Address i 17145 MAGNOLIA AVENUE,SUITE 100 Finance Code 1C4-SM I have and will maintain a certificate of consent to self-insure for workers'compensation O as provided by Section 3700 of the Labor Code,for the performance of the work for City,Zip Code RIVERSIDE,CA 92504 Census Code 1101 which this permit is issued Phone or Pager (909)328-0777 1 ext 117 Final Date /A- 2.--, A, Bus Lic# , I01-04775 , , Final By II � -- �� I have and will maintain workers'compensation,as required by Section 3700 of the ®i Labor Code,for the performance of the work for which this permit is Issued My Lie # f 638223 - 1 Extension workers'compensation insurance earner and policy number are Exp Date 4/30/03 1 Reviewed By KEITH L PRYOR INSURANCE INFORMATION Lie Class B Approved By KEITH L PRYOR Insurance Company 1STATE FUND PROJECT INFORMATION Policy Number 11545080 PROJECT DESCRIPTION LOCATION SQUARE FT. Expiration Date 2/9/02 Structure LIVIBLE 2337 Section need not be completed if permit is for one hundred dollars($100)or less Garage GARAGE 1 1 1 578 I certify that in the performance of the work for which this permit is issued I shall not employ Patio 1 1 any person in any manner so as to become subject to the Workers'Compensation Laws of Porch 1PORCH 1 151 50 •alifomia and agree that if I should become subject to the workers'compensation provisions of Other ection 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-36 99'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 / 7 1. Date: IS////©/I Signature: f/L�� ` / OTHER FEES REQUIRED ZONING SETBACKS GRADING PRIOR TO ACTUAL PERMIT PERMIT FEE INFORMATION ISSUANCE Zoning PD Front Yard 16 5 Over X 1 0 Issuance $29 00 Electncal $257 07 Land Use FR-2 Side Yard 5/5 School YES Plan PLAN 1 Rear Yard 15 Cut 0 Development YES Plan Check $115 37 Plumbing $246 00 Permit Fees: $1,974.91 Fill 0 SMiP $16 70 Occ 1R3 SSY Total 1 0 Sewer YES Mechanical 1 $98 79 Structural $1,153 68 1 Type 1VN Water YES I Geo Review 1 $0 00 Grading $75 00 I Total Fee Due 1 $1,991.61 • IN ECTION RECORD Permit Number 7:ee Y� Inspection Date Inspector Inspection Date Inspector Grading: Pregrade Meeting FINAL INSPECTIONS(Inspector verify following) Rough Grade NO OCCUPANCY PERMITTED WITHOUT FINAL! Terraces County Environmental Sub Drains Health Dept /2 Finish Grading Planning Dept 21.14_4 _ A,(..../17,7" Soils Certification Public Works / Grading Certification Fire /ti// Rough Landscape As Built Approved Underground Site Inspections: ALL ABOVE MUST BE APPROVED BEFORE FINAL BLDlki Budding Sewer G� A. "74— Final Grade /%GAv Water Service Final Electric Storm Drain/Catch Basins Final Plumbing U/G Conduit/Electncal i Final Mechanical , /9/-7_ Compaction Report ABOVE IS REQUIRED PRIOR TO FOUNDATION INSPECTION Final Building/Construction f//(�/� L Water Meter Number Voj yp 7 v Footings a)�' UFER Ground (Rebar/Copper) CERTIFICATE OF OCCUPANCY Hardware/Hold-Downs Piers/Caissons/Tendons Slab Grade ,(r/-f (' OTHER: DO NOT POUR CONCRETE UNTIL ABOVE IS APPROVED (/F' Pia.4 c^a,9—Ng( /41,L Shear _ Roof Nailing �' . d Exterior Walls Interior Walls Hardware/Hold-Downs Rough Electric Rough Mechanical Rough Plumbing/Topout Framing COVER NO WORK UNTIL ABOVE IS APPROVED / Insulation / _ h ✓ Drywall Intenor/Exterior Lath /'//:4/ Stucco Scratch Roof Covenng 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 ElectrGas Te Release /� u4-r`, Gas Test