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Permit No. 18261 BUILDING ADDRESS: 5563 VERONESE DRIVE PERMIT NUMBER: 18261 ! � BUILDING INFORMATION APPLICANT INFORMATION " x.4;,�,e$� BUILDING PERMIT APPLICATION Address 5563 VERONESE DRIVE Name IAN GRIFFIN .A .,,v,, Community Development APN I Address 17145 MAGNOLIA AVENUE,SUITE 100 ?..f"^ 2001 Grand Avenue • Lot 116 I City,Zip Code (RIVERSIDE,CA 92504 ... . Chino Hills,CA 91709 Cross Streets 1 Phone/Pager 1(909)328-0777 I ext 117 CITY°'°"°HILLS LICENSED CONTRACTOR DECLARATION Tract/Parcel 114079-3 City Bus Lic# 101-04775 1 I hereby affirm that I'm licensed under the provisions of Chapter 9(commencing with Section Valuation $208,000 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 1ONTARIO,CA 91764-4464 1,as the owner of theroe Phone (909)937-0200 ext © p p rty,or my employees with wages as their whole City,Zip Code RIVERSIDE,CA 92504 compensation,will do the work,and the structure is not intended or offered for sale Phone 1(909)328-0777 1 ext 117 Lie 4 I (i-,) I,as owner of the property,am exclusively contracting with licensed contractors to Bus Lie 4 101-04775 -, City Bus Lie# 1 construct the project Bus Exp 16/30/01 1 APPROVAL INFORMATION I am exempt under Section i I BPC for this reason i WORKERS'COMPENSATION DECLARATION CONTRACTOR INFORMATION issued By IYVETTE MARTINEZ i hereby affirm under penalty of perjury one of the following declarations Contractor GRIFFIN COMMUNITIES 1 Date Issued 15/11/01 Address 7145 MAGNOLIA AVENUE,SUITE 100 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 Census Code 1101 I e which this permit is issued Phone of Pagei (909)328-0777 1 ext 117/, Final Date 7 7firj.. Bus Lic# 01-04775 Final By I have and will maintain workers'compensation,as required by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued My Lie # 638223 Extension workers'compensation insurance carrier and policy number are Exp Date 4/30/03 Reviewed By 1KEITH L PRYOR Lie Class B Approved By 1KEITH L PRYOR INSURANCE INFORMATION Insurance Company 1STATE FUND 1 PROJECT INFORMATION Policy Number 11545080 PROJECT DESCRIPTION LOCATION SQUARE FT. Expiration Date 12/9/02 Structure 1LIVIBLE 1 3010 © Section need not be completed if permit is for one hundred dollars($100)or less Garage 1GARAGE 563 I certify that in the performance of the work for which this permit is issued i shall not employ Patio 1 I I any person in any manner so as to become subject to the Workers'Compensation Laws of Porch PORCH 1 I I 52 SCalifomia 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 3 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 enter upon the above mentioned property for inspection purposes COMMENTS / / ---, Date• i 5—•///,i I Signature: i _ /L/�'// T3 OTHER FEES REQUIRED / r PRIOR TO ACTUAL PERMIT ZONING SETBACKS GRADING ISSUANCE PERMIT FEE INFORMATION Zoning 1PD Front Yard 17 Over X 1 0 1 Issuance $29 00 I Electrical $331 10 1 Land Use 1FR-2 Side Yard 5/5 CutSchool I YES Permit Fees: $2,258.80 1 0 Plan Check $134 31 Plumbing $247 50 Plan 1PLAN 3 Rear Yard 15Development I YES Fill 0 SMTP I $20 80 1 Occ IR3 SSY Total 1 0 Sewer YES Mechanical $98 79 I Structural I $1,343 10 Type VN Water YES Geo Review 1 $0 00 I Grading $75 00 I Total Fee Due I $2,279.60 I • IN'ECTION RECORD - Permit Number 7/2 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 . , Finish Grading Planning Dept n_70-(,-/ •A i Sods Certification Public Works ;`/{ Grading Certification Fire Rough Landscape As Built Approved Underground Site Inspections: ALL ABOVE MUST BE APPROVED BEFORE FINAL BLDG Building Sewer Water Service Final Grade , Storm Drain/Catch Basins Final Electric U/G Conduit/Electrical Final Plumbing ✓ Final Mechanical , / / � Compaction Report Final Building/Construction `// 7-' - fir" ABOVE IS REQUIRED PRIOR TO FOUNDATION INSPECTION Water Meter Number Jo 3 c(66i- - Footings UFER Ground(Rebar/Copper) CERTIFICATE OF OCCUPANCY Hardware/Hold-Downs Piers/Caissons/Tendons 7/,��i Slab Grade - 4 /vim_4 F OTHER: DO NOT POUR CONCRETE UNTIL ABOVE I APPROVED C)- f U 1 , .g-.a9--o f fiFZ, Shear ', 6 )A — 7/J./ri Roof Nailing Exterior Walls �•1'`'�' Interior Walls �� ., Hardware/Hold-Downs Rough Electric / / Rough Mechanical / / Rough Plumbing/Topout / / Framing COVER NO WORK UNTIL ABOVE IS APPROVED Insulation 111 Drywall Intenor/Exteriori „ , .� Lath f A •�-�/,0'' 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 /d b Gas Test ,.1