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Permit No. 18246 BUILDING ADDRESS: 2104 VISTA DEL SOL PERMIT NUMBER: 1 18246 BUILDING INFORMATION APPLICANT INFORMATION BUILDING PERMIT APPLICATION Address: 21041VISTA DEL SOL Name: (MICHAEL ORDUNO ,. r+ Community Development APN: 11032-561-01 Address: 12104 VISTA DEL SOL "" 2001 Grand Avenue -1.";",� Lot: 164 City,Zip Code: 'CHINO HILLS,CA 91709 ;y•;..r' Chino Hills,CA 91709 Cross Streets: IEUCALYTUS Phone/Pager: 1(909)606-7950 I ext. I nrrornnxomus LICENSED CONTRACTOR DECLARATION Tract/Parcel: 113906-5 City Bus Lic#: 1 I hereby affirm that I'm licensed under the provisions of Chapter 9(commencing with Section Valuation: I$5,000.00 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: OWNER BUILDER DECLARATION 'MICHAEL ORDUNO Address: I hereby affirm that I'm exempt from the Contractor's License Law for the following reason: Address: 12104 VISTA DEL SOL 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. 1 ® compensation,will do the work,and the structure is not intended or offered for sale. Phone: (909)606-7950 1 ext. 1 I Lic#: ® I,as owner of the property,am exclusively contracting with licensed contractors to Bus Lic#: 1 City Bus Lic#: J construct the project. Bus Exp: APPROVAL INFORMATION ©c', I am exempt under Section I I BPC for this reason I WORKERS'COMPENSATION DECLARATION CONTRACTOR INFORMATION Issued By: LAURO BUGARIN I hereby affirm under penalty of perjury one of the following declarations: Contractor: MICHAEL ORDUNO 1 Date Issued: 5/17/01 Address: 2104 VISTA DEL SOL Finance Code: C4 I have and will maintain a certificate of consent to self-insure for workers'compensation I Q as provided by Section 3700 of the Labor Code,for the performance of the work for City,Zip Code: CHINO HILLS,CA 91709 Census Code: which this permit is issued. Phone or Pager: (909)606-7950 1 ext. I Final Date: -W.-)//9 Bus.Lic.#: / ` �� I have and will maintain workers'compensation,as required by Section 3700 of the Final By: ti� �, Q Labor Code,for the performance of the work for which this permit is issued. My Lic.#: Extension: workers'compensation insurance carrier and policy number are: Exp Date: 1 Reviewed By: LAURO BUGARIN Lic.Class: I Approved By: LAURO BUGARIN INSURANCE INFORMATION Insurance Company: (EXEMPT I X PROJECT INFORMATION Policy Number: I I PROJECT DESCRIPTION LOCATION SQUARE FT. Expiration Date: I Structure: ' I I I © Section need not be completed if permit is for one hundred dollars($100)or less Garage: 1 1I 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: I I [ California and agree that if I should become subject to the workers'compensation provisions of Other: 'RET.WALL (REAR ' 430 Section 3700 of the Labor Code. I shall comply with those provisions. 7-) PROPOSED USE RET.WALL REAR 430 SF Date: Ili;0 I 0 ' I Signature: I C-3,4,4 c,t,,) ,----- I 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 authorize representatives of this City to COMMENTS enter upon the above mentioned property for inspection purposes. Date: I I Signature: I OTHER FEES REQUIRED ZONING SETBACKS GRADING PRIOR TO ACTUAL PERMIT PERMIT FEE INFORMATION ISSUANCE Zoning: 1PD I Front Yard: 50 Over X: 1 0 1 Issuance: 1 $29.00 1 Electrical: 1 $0.00 1 Land Use: IFR-1 1 Side Yard: 5 Cut: 0 School: I N Permit Fees: I .,115.40 I 1 1 Development: 1 N Plan Check: 1 $0.00 1 Plumbing: 1 $0.00 1 Plan: ' I Rear Yard: 20 Fill: 0 1 SMIP: $0.00 1 Occ: 1R3 SSY: Sewer: N Mechanical: 1 $0.00 1 Structural: 1 $86.40 1 Type: VN Total: I 0 1 Water: 1 N Geo Review: 1 $0.00 1 Grading: 1 $0.00 I Total Fee Due I $115.40 I 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! 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 Water Service Electric Storm Drain/Catch Basins Final c Final Plumbing Final U/G Conduit/Electrical Mechanical Compaction Report Final Building/Construction /,//y ABOVE IS REQUIRED PRIOR TO FOUNDATION INSPECTION A 4 Water Meter Number Footings l',(•—/:#•–•--- UFER Ground(Rebar/Copper) CERTIFICATE OF OCCUPANCY Hardware/Hold-Downs A\ Piers/Caissons/Tendons / I Slab Grade I/ OTHER: DO NOT POUR CONCRETE UNTIL ABOVE(IS APPROVED( Shear Roof Nailing Exterior Walls Interior Walls Hardware/Hold-Downs Rough Electric Rough Mechanical Rough Plumbing/Topout Framing COVER NO WORK UNTIL ABOVE IS APPROVED Insulation Drywall Interior/Exterior Lath Stucco Scratch Roof Covering Block Wall Inspections: .14Footing, ReBar 1i v 1st Lift Bond Beam , cif, ,(„Z/�,( 2nd Lift Bond Beam 3rd Lift Bond Beam ./94, Drain/Seal aTtv 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 -