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Permit No. 18969 1JILDING ADDRESS: 1 2112 VISTA DEL SOL PERMIT NUMBER: 18969 BUILDING INFORMATION APPLICANT INFORMATION ,ate v�� BUILDING PERMIT APPLICATION Address: 21121VISTA DEL SOL; Name: (ALPINE POOLS -,�. ','...r.... Community Development APN: 11032-482-29 Address: 11232 N.MONTE VISTA "' I2001 Grand Avenue �.,;,� Lot: 163 City,Zip Code: (CHINO HILLS,CA 91709 .,A1..r'i+ Chino Hills,CA 91709 Cross Streets: 1 Phone/Pager: 1(909)982-2165 1 ext. I nrvornnnoHILLS LICENSED CONTRACTOR DECLARATION Tract/Parcel: 113906-5 City Bus Lic#: I I hereby affirm that I'm licensed under the provisions of Chapter 9(commencing with Section Valuation: 1$25,000.00 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 MARK NEGAST Address: I hereby affirm that I'm exempt from the Contractor's License Law for the following reason: Address: 2112 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 1 Phone: 1 ext. 1 l� =' compensation,will do the work,and the structure is not intended or offered for sale. Phone: (909)606-9744 I ext. 1 1 Lic#: (,-- I,as owner of the property,am exclusively contracting with licensed contractors to Bus Lic#: 1 City Bus Lic#: construct the project. I am exempt under Section I I BPC for this reason I I Bus Exp: I APPROVAL INFORMATION WORKERS'COMPENSATION DECLARATION CONTRACTOR INFORMATION Issued By: YVETTE MARTINEZ I hereby affirm under penalty of perjury one of the following declarations: Contractor: ALPINE POOLS Date Issued: 9/27/01 Address: 1232 N.MONTE VISTA Finance Code: C4 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: CHINO HILLS,CA 91709 Census Code: • which this permit is issued. Phone or Pa• ger: (909)982-2165 I ext. 1 1 Final Date: i.-2•411-0L---- p,, Bus.Lic.#: ON FILE 1 Final By: '(�..C1y7 � ,C2/1._'t c I have and will maintain workers'compensation,as required by Section 3700 of the Lic.#: 711711 1 ® Labor Code,for the performance of the work for which this permit is issued. My Extension: 1.---- ' i' workers'compensation insurance carrier and policy number are: Exp Date: 1-31-02 1 Reviewed By: LAURO BUGARIN 0 Lic.Class: C-53 Approved By: LAURO BUGARIN INSURANCE INFORMATION Insurance Company: 1FARFIELD I PROJECT INFORMATION Policy Number: 14M00002048 PROJECT DESCRIPTION LOCATION SQUARE FT.Expiration Date: 111-1-01 1 1 1 Structure: @ Section need not be completed if permit is for one hundred dollars($100)or less Garage: 1 1 } I certify that in the performance of the work for which this permit is issued. I shall not employ Patio: 1 1 1 any person in any manner so as to become subject to the Workers'Compensation Laws of Porch: 1 1 1 California and agree that if I should become subject to the workers'compensation provisions of Other: (POOL/SPA 1 1 1 1 Section 3700 of the Labor Code. I shall comply with those provisions. B PROPOSED USE POOL/SPA Date: x''27--p/ I Signature: t.c /�j-' / ,- I I certify I have read this application and state that the above information is correct. .1 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 purges. //, Date: I .2 .d/ I Signature: I/Gc- /v��./t Y OTHER FEES REQUIRED ZONING SETBACKS GRADING PRIOR TO ACTUAL PERMIT PERMIT FEE INFORMATION ISSUANCE Zoning: IPD Front Yard: 25 Over X: 1 0 1 Issuance: 1 $29.00 1 Electrical: 1 $90.00 I Land Use: FR-1 Side Yard: 5/10 School: 1 N 1 Permit Fees: I $421.40 1 Cut: 1 0 1 Development: 1 N I Plan Check: 1 $0.00 1 Plumbing: $0.00 1 Plan: Rear Yard: 20 Fill: 0 1 SMTP: $0.00 1 Occ: 1R3 SSY: Sewer: 1 N 1 Mechanical: I $0.00 I Structural: 1 $302.40 1 Type: 1VN Total: 0 1 1Grading: 1 1 Total Fee Due 1 $421.40 I Water: N 1 Geo Review: $0.00 $0.00 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 //z# — /Yom►' 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: JJ Location/Rebar/Bonding/Light i� 0 IOd Gr Conduit Ro Elect POOL NOT TO BE FILLED UNTIL FENCING IS COMPLETE Fence,Gate&Alarm / /l Final Pool Temp Power Pole Electric Release _ Gas Test MVO/ IV