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Permit No. 19215 BUILDING ADDRESS: 5515 VERONESE DRIVE PERMIT NUMBER: 19215 BUILDING INFORMATION APPLICANT INFORMATION r ,et BUILDING PERMIT APPLICATION Address 5515 VERONESE DRIVE Name ARTHUR HOWELL -;:5,;;+ Community Development APN 1017-693-24 Address 5515 VERONESE DRIVE r)u'- `, 2001 Grand Avenue . � 3 Lot 24 City,Zip Code CHINO HILLS,CA 91709 Chino Hills,CA 91709 x ..: air.••..: Cross Streets Phone/Pager (909)606-6815 I ext "Or CHINO,,.„,'L„ LICENSED CONTRACTOR DECLARATION Tract/Parcel 14079-3 City Bus Lic# I hereby affirm that I'm licensed under the provisions of Chapter 9(commencing with Section Valuation $5,100 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 OWNER BUILDER DECLARATION Name ARTHUR HOWELL Address I hereby affirm that I'm exempt from the Contractor's License Law for the following reason Address 5515 VERONESE DRIVE City,Zip Code I,as the owner of the property,or my employees with wages as their whole City,Zip Code CHINO HILLS,CA 91709 Phone 1 ext O compensation,will do the work,and the structure is not intended or offered for sale Phone (909)606-6815 1 ext I Lie# I,as owner of the property,am exclusively contracting with licensed contractors to 0Bus Lic# City Bus Lic# �y_ construct the project ,. I am exempt under Section BPC for this reason I Bus Exp APPROVAL INFORMATION WORKERS'COMPENSATION DECLARATION CONTRACTOR INFORMATION Issued By 1DORIS CARPENTER i I hereby affirm under penalty of perjury one of the following declarations Contractor OWNER/BUILDER Date Issued 111/7/01 Address 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 Census Code which this permit is issued Phone or Pager 1 ext 1 Final Date H '�/` / ' Bus Lic# I have and will maintain workers'compensation,as required by Section 3700 of the Final By �� 1� O Labor Code,for the performance of the work for which this permit is issued My Lic # Extension workers'compensation insurance carner and policy number are Ex ate Reviewed By LAURO BUGARIN Li lass Approved By LAURO BUGARIN INSURANCE INFORMATION Insurance Company Exempt PROJECT INFORMATION Policy Number PROJECT DESCRIPTION LOCATION SQUARE FT. Expiration Date Structure 0 Section need not be completed if permit is for one hundred dollars($100)or less Garage • 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 1LATTICE 1 425 California and agree that if I should become subject to the workers'compensation provisions of Other 1 Section 3700 of the Labor Code I shall comply with those provisions �1 — PROPOSED USE LATTICE PATIO WITH ELECTRICAL FOR FUTURE SPA Date: {V l 7—C / i Signature. i yge , 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 Date: I I Signature i i OTHER FEES REQUIRED ZONING SETBACKS GRADING PRIOR TO ACTUAL PERMIT PERMIT FEE INFORMATION ISSUANCE Zoning 1PD 1 Front Yard 20 Over X 0 1 Issuance 1 $29 00 1 Electrical 1 $33 00 Land Use FR-1 Side Yard 5/5 Cut 0 School N Plan Check $63 18 Plumbing $0 00 Permit Fees: $222.38 Plan 1 Rear Yard 15 Fill 0 Development N SMIP 1 $0 60 Occ 1R-3 SSY Total 0 Sewer N Mechanical 1 $0 00 Structural $97 20 Type 1VN Water N Geo Review 1 $0 00 Grading $0 00 Total Fee Due 1 $222.98 S • INSPECTION RECORD Permit Number Inspection Date Inspector Inspection Date Inspector Grading: Pregrade Meeting FINAL INSPECTIONS(Inspector verify following) Rough Grade NO OCCUPANCY PERMITTED WITHOUT FINAL I Terraces County Environmental Sub Drains Health Dept Finish Grading Planning Dept 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 Final Grade U.G.Waste Plumbing Final Electric Water Service Final Plumbing Storm Drain/Catch Basins Final Mechanical U/G Conduit/Electrical Final Building/Construction Compaction Report Water Meter Number ABOVE IS REQUIRED PRIOR TO FOUNDATION INSPECTION Footings CERTIFICATE OF OCCUPANCY UFER Ground(Rebar/Copper) Hardware/Hold-Downs Piers/Caissons/Tendons OTHER: Slab Grade DO NOT POUR CONCRETE UNTIL ABOVE IS APPROVED f k Shear et/6 C`,-.4.-Aci yr Roof Nailing n f", 4 Exterior Walls A , Interior Walls b107,415 01471--/t3 Ok 774/0 Hardware/Hold-Downs / Rough Electric Rough Mechanical Rough Plumbing/Topout Framing COVER NO WORK UNTIL ABOVE IS APPROVED Insulation Drywall Interior/Extenor Lath 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 Electric Release Gas Test