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Permit No. 18250 BUILDING ADDRESS: 5557 VERONESE DRIVE PERMIT NUMBER: 18250 `t BUILDING INFORMATION APPLICANT INFORMATION st BUILDING PERMIT APPLICATION ?. Address 55571VERONESE DRIVE .,,,,,;, ,� Name IAN GRIFFIN , ;i ,,; Community Development APN Address 17145 MAGNOLIA AVENUE,SUITE 100 -IN-, 2001 Grand Avenue l~ � Lot 17 City,Zip Code RIVERSIDE,CA 92504 .fv%k.• Chino Hills,CA 91709 Cross Streets Phone/Pager (909)328-0777 I ext 117 CT °.°"°" . LICENSED CONTRACTOR DECLARATION Tract/Parcel 14079-3 City Bus Lic# 01-04775 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 1L D KING OWNER BUILDER DECLARATION Name GRIFFIN COMMUNITIES Address 12151 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 1RIVERSIDE,CA 92504 Phone 1(909)937-0200 1 ext 0 compensation,will do the work,and the structure is not intended or offered for sale Phone (909)328-0777 1 ext 117 Lic 4 1 0 I,as owner of the property,am exclusively contracting with licensed contractors to Bus Lic 4 01-04775 City Bus Lie 4 1 construct the project I 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 0 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 ext 17 Final Date / //>/.4/...... Bus Lic 4 101-04775 /1 I have and will maintain workers'compensation,as required by Section 3700 of the Final By A. ter 0 Labor Code,for the performance of the work for which this permit is issued My Lic # 638223 /' Extension workers'compensation insurance carrier and policy number are Exp Date 4/30/03 Reviewed By 1KEITH L PRYOR INSURANCE INFORMATION Lic Class 1B Approved By 1KEITH L PRYOR Insurance Company 1STATE FUND 1PROJECT INFORMATION Policy Number 1545080 1 PROJECT DESCRIPTION LOCATION SQUARE FT. Expiration Date 2/9/02 Structure ILIVIBLE 1 2337 0 Section need not be completed if permit is for one hundred dollars($100)or less Garage GARAGE 1 578 I certify that in the performance of the work for which this permit is issued i shall not employ Patio any person in any manner so as to become subject to the Workers'Compensation Laws of Porch PORCH 81 62 isCalifomia 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 W/PORCH-33 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 J - / Date: I�/f/ay I Signature: J ���' i OTHER FEES REQUIRED ZONING SETBACKS GRADING PRIOR TO ACTUAL PERMIT PERMIT FEE INFORMATION ISSUANCE Zoning PD Front Yard 16 5 Over X 0 Issuance $29 00 Electrical $257 07 Land Use FR-2 Side Yard 5/5 Cut 0 1 School YES I Plan Check $115 37 Plumbing $246 00 Permit Fees: 1 $1,974.91 Plan PLAN 1 Rear Yard 15 Fill 0 1 Development YES SMIP 1 $16 70 Occ R3 SSY Total 0 1 1 Sewer YES 1 Mechanical $98 79 Structural $1,153 68 Type VN T e Water YES Geo Review $0 00 Grading $75 00 Total Fee Due 1 $1,991.61 INIPPECTION RECOORD Permit Number Z"--��4>c� 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 ? Qrre 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 a' -/� A e---de Final Grade //y4Z A Water Service Final Electnc Storm Drain/Catch Basins Final Plumbing / U/G Conduit/Electrical Final Mechanical Compaction Report Final Building/Construction /Arc_ ABOVE IS REQUIRED PRIOR TO FOUNDATION INSPECTION - Water Meter Number �o� //� i / Footings „4;4/ UFER Ground(Rebar/Copper) s�� CERTIFICATE OF OCCUPANCY Hardware/Hold-Downs Piers/Caissons/Tendons _ Slab Grade r6' /•, �—I ' OTHER: DO NOT POUR CONCRETE UNTIL ABOV IES APPROVED ((Aja' 131 ji/v1 g— 19-41 4' Shear Roof Nailing Exterior Walls Intenor Walls -� Hardware/Hold-Downs Rough Electric / Rough Mechanical Rough Plumbing/Topout Framing COVER NO WORK UNTIL ABOVE IS APPROVER Insulation Drywall Interior/Exterior _ Q Lath /v/1�7/( 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 / c; or Gas Test Airy vi M (�