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Permit No. 18471 BUILDING ADDRESS: 2104 VISTA DEL SOL PERMIT NUMBER: 18471 BUILDING INFORMATION APPLICANT INFORMATION BUILDING PERMIT APPLICATION Address: 12104 VISTA DEL SOL I Name: (ALPINE CUSTOM POOLS ? y*5, Community Development APN: 11032-561-01 I Address: 11232 N.MONTE VISTA#8 2001 Grand Avenue '�,17':' Lot: 164 I City,Zip Code: 1UPLAND CA.91786 Y ;., ,, Chino Hills,CA 91709 Cross Streets: I 1 Phone/Pager: 1(909)982-2165 1 ext. ""°`°""°""LS LICENSED CONTRACTOR DECLARATION Tract/Parcel: 113906 City Bus Lic#: 1 I hereby affirm that I'm licensed under the provisions of Chapter 9(commencing with Section Valuation: 1$2,000.00 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: 1N/A OWNER BUILDER DECLARATIONName: MIKE ORDUNIO Address: I hereby affirm that I'm exempt from the Contractor's License Law for the following reason: Address: 2104 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. I Lic#: I,as owner of the property,am exclusively contracting with licensed contractors to Bus Lic#: City Bus Lic#: j construct the project. ® I am exempt under Section I I BPC for this reason I I Bus Exp: APPROVAL INFORMATION WORKERS'COMPENSATION DECLARATION CONTRACTOR INFORMATION Issued By: 1LAURO BUGARIN I hereby affirm under penalty of perjury one of the following declarations: Contractor: ALPINE CUSTOM POOLS Date Issued: 16/18/01 Address: 1232 N.MONTE VISTA#8 Finance Code: 1C4 I have and will maintain a certificate of consent to self-insure for workers'compensation Q as provided by Section 3700 of the Labor Code,for the performance of the work for City,Zip Code: UPLAND CA.91786 Census Code: 1 i i which this permit is issued. Phone or Pager: (909)982-2165 1 ext. I Final Date: 1 J-�J 7 h/. Bus.Lic.#: 99-0278 Final By: 6 C.--, Z I have and will maintain workers'compensation,as required by Section 3700 of the C) Labor Code,for the performance of the work for which this permit is issued. My Extension: Lic.#: workers'compensation insurance carrier and policy number are: Exp Date: Reviewed By: LAURO BUGARIN 1 Lic.Class: Approved By: ILAURO BUGARIN I INSURANCE INFORMATION Insurance Company: IFAIRFILED INS.CO. 1 e — PROJECT INFORMATION Policy Number: IAM00002048 1 PROJECT DESCRIPTION LOCATION SQUARE FT. Expiration Date: 111-1-01 1 1 1 I I Structure: Section need not be completed if permit is for one hundred dollars($100)or less Garage: 1 I 1 I I I certify that in the performance of the work for which this permit is issued. I shall not employ Patio: 1 1 1 1 I ( any person in any manner so as to become subject to the Workers'Compensation Laws of Porch: 1 1 I I California and agree that if I should become subject to the workers'compensation provisions of Other: 1RET.WALL 1REAR 165 SF Section 3700 of the Labor Code. I shall comply with those provisions. `ifi/�s PROPOSED USE j RETAINING WALL 165 SF //// Date: 14,..../rd( I Signature: f`(/P") / `�j`._, I I v10," 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 representative of this City to COMMENTS enter upon the above mentioned property for inspection purposes. mol Date: I���1—(}/ I Signature: �// l��il y `/� Q . C...i�re��f/ OTHER FEES REQUIRED ZONING SETBACKS GR.> ING PRIOR TO ACTUAL PERMIT PERMIT FEE INFORMATION ISSUANCE Zoning: 1PD 1 Front Yard: 20 Over X: 1 0 Issuance: 1 $29.00 I Electrical: 1 $0.00 Land Use: IFR-1 1 Side Yard: 5 Cut: 0 School: 1 N 1 Permit Fees: I $118.10 1 1 Development: N 1 Plan Check: 1 $35.10 1 Plumbing: 1 $0.00 Plan: 1 Rear Yard: 20 Fill: 0 SMIP: 1 $0.00 I Occ: 1R3 SSY: Total: 1 0 Sewer: 1 N 1 Mechanical: 1 $0.00 I Structural: 1 $54.00 I Type: IvN Water: 1 N 1 Geo Review: 1 $0.00 1 Grading: 1 $0.00 1 Total Fee Due I $118.10 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 U.G.Waste Plumbing Final Electric Water Service Final Plumbing Storm Drain/Catch Basins Final Mechanical U/G Conduit/Electrical Final Building/Construction oy/ 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 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 : 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