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Permit No. 2005-0701 / "* est\ -- BUILDING DIVISION OF COMA._,JITY DEVELOPMENT DEPARTMENT , 2001 Grand Avenue,Chino Hills,CA 91709. ',.1 ' City of Chino Hills Counter Phone (909)364-2780 1. �, 24-Hour Inspection Line ..1-.4-- Building Permit p (909)364-2790 •-"2-i7.-. (NOTE:You must call before 3p.m.for a next business day inspection) City Hall Main Number (909)364-2600 NOTICE: THIS PERMIT BECOMES NULL AND VOID IF WORK IS NOT COMMENCED PLEASE USE PERMIT NUMBER WITHIN 180 DAYS FROM DATE OF ISSUANCE, OR IF WORK IS SUSPENDED AT ANY BELOW WHEN MAKING TIME FOR MORE THAN 180 DAYS OR IF WORK IS DONE IN VIOLATION OF ANY CITY INQUIRIES OR REQUESTING OR STATE LAWS RELATING THERETO: INSPECTIONS PROJECT DESCRIPTION I PERMIT No. WATER HEATER CHANGE OUT 2005-0701 0 BUILDING ADDRESS APT/UNIT No. ISSUED DATE ISSUED BY 1981 VISTA DEL SOL -- 0 I I 05/12/2005 I SJENKINS APNPARCEL MAP# TRACT LOT/PARCEL BLOCK CONST.TYPE ZONE OCC. LAND USE 1032-561-27 12451 le R 13906-5 1 90 1561 I V-N I UN I R-3 I Residential ' CEN9S9U9S CODES I OVERLAY DIST. IO BLDG.SOFT. b P.PE LPROJECT PERMITS I SETBACK FY SETBACK RY I SETBACK SSY I SETBACK SY h FEES • Description Calc. Paid ce Z SMITH, HERBERT JR Plumbing $15.00 $15.00 0 0001174DIAMOND Issuance/Suppl F $30.00 $30.00 • BAR BLVDSCADIAMOND BAR #228 91765 • Total Paid 5/12/2005: $45.00 • H. B. COVEY 309 E. COMMERCIAL STREET Grand Total: $45.00 $45.00 POMONA, CA 91767 ir O 909-623-2502 U Contr Lic: 269354 p Expiration: 2/28/2006 License Type:C36 Workers Comp:1755312 Expiration: 10/22/2005 Bus. License:TO PURCHASE • Expiration: 5/10/2005 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. In securing this permit I am acting with the knowledge of and on the behalf of the owner of the property. // n I PROJECT DESCRIPTION Date:` /2.–p 5' Contractor( OWNER-BUILDER DECLARATION WATER HEATER CHANGE OUT ❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason(Sec.7031.5 Business and Professional Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9 commencing with Section 7000 of Division 3 of the Business and Professions Code)or that he or she is exempt there from and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500) ❑ I, as owner of the property,or my employees with wages as their sole compensation,will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however,the building or improvements is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct PROJECT INFORMATION the project(Sec.7044, Business and Professions Code. The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who.contracts for such I Desc. I Location I Sq.Foot I Valuation projects with a contractor(s)licensed pursuant to the Contractors License Law.) I ❑ I am Exempt under Article 3 of the Business and Professions Code Date: Owner: 1 • WORKERS COMPENSATION DECLARATION I I hereby affirm under penalty of perjury one of the following declarations: 1 Q I have and will maintain a certificate of consent to self-insure for workers'compensation, as provided for by Section 3700 of the Labor Code,for the performance of the work for which this Total Valuation $500.00 permit is issued. I certify that I have read this application and state that the above information I have and will maintain workers' compensation insurance, as required by Section 3700 the is correct. I agree to comply with all city and county ordinances and state Labor Code,for the performance of the work for which this permit is issued. laws relating to buildin constructs and hereby authorize representatives of this county to ent pon th a ove-mentioned property for inspection 0 I certify that in the performance of the work for which this permit is issued,I shall not employ purpose's.,..---, any person in any manner so as to become subject to the worker's compensation laws of //��//(� / California,and agree that if I should become subject to the worker's compensation provisions / K yU 111) V,/ .5=/2-03"--- of Section 3700 of the Labor Code,I shall forthwith comply with those provisions. AF,CICANT SIGNATME DATE APPLICANT INFORMATION: H. B. COVEY 1309 E. COMMERCIAL STREET POMONA, CA 91767 Date:/ 12- ' Applicant: (A_......—.--- 1909-623-2502 WARNING: Failure to secure worker's compensation coverage is unlawful,and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars($100,000),in I certify that the use of this facility shall comply with sections 25505,25533, addition to the cost of compensation,damages as provided for in Section 3706 of the Labor Code, and 25534 of the Health and Safety Code,which regulate the storage, interest,and attorney's fees. handling and use of hazardous materials. CITY OF CHINO HILLS COMMUNITY DEVELOPMENT—BUILDING&SAFETY DIVISION Call (909)364-2790 before 3:00 p.m.for next day inspection Post in a safe, conspicuous place at front of job. Provide permit number when calling for inspection. Have approved plans on job at time of inspection. NO WORK SHALL BE COVERED WITHOUT INSPECTION File this permit with your permanent records when job is complete. INSPECTION RECORD INSPECTION DATE INSPECTOR INSPECTION DATE INSPECTOR Grading: Block Wall Inspections: Pregrade Meeting Footing,Rebar Rough Grade 151 Lift Bond Beam Terraces 2n°Lift Bond Beam Sub Drains 3ni Lift Bond Beam Finish Grading Drain/Seal Soils Certification Grading Certification Rough ReRoof: Tear-off,Existing Conditions Underground Site Inspections: Sheath Nailing Building Sewer Line Roof Final Water Supply Line U/G Electrical Service Conduit Swimming Pools: Storm Drain/Catch Basin Location/Rebar/Bonding/Light DO NOT BACKFILL UNTIL ABOVE IS APPROVED Gas Test Gr Conduit Verify Soils Engineering: Ro Elect Compaction,moisture,conditioning,etc. POOL NOT TO BE FILLED UNTIL FENCING IS COMPLETE Fence,Gate&Alarm Underfloor/Underslab Inspection: Final Pool U/F Waste Plumbing U/F Water Fire Protection Equipment: U/F Mechanical UG Pipe U/F Electrical Thrust Blocks U/F Framing Hydro U/F Insulation Flush Subfloor . Weld Outlet Insp. ABOVE IS REQUIRED PRIOR TO FOUNDATION INSPECTION Overhead Hydro Foundation Inspection: Temp Power Pole Setback/Footing—OK to Pour Electric Release UFER Ground(Rebar/Copper) Gas Test Hardware/Hold-Downs Piers/Caissons/Tendons FINAL INSPECTIONS Slab Grade—OK to Pour NO OCCUPANCY PERMITTED WITHOUT FINAL DO NOT POUR CONCRETE UNTIL ABOVE IS APPROVED County Environmental Health Dept. (391-7570) Shear Inspection(Wood): Planning Dept.(364-2752) Roof Nailing Public Works (364-2774) Exterior Walls Fire (393-3888) Interior Walls Landscape (364-2766) Hardware/Hold-Downs ALL ABOVE MUST BE APPROVED BEFORE FINAL BLDG.. Final Grade Combo inspection: Final Electric Framing Final Plumbing Rough Electric Final Mechanical Rough Mechanical Final Building/Construction Rough Plumbing/Topout Water Meter Number COVER NO WORK UNTIL ABOVE IS APPROVED CERTIFICATE OF OCCUPANCY Insulation OK TO ISSUE Drywall Inspection: OTHER: Interior Exterior EXT LATH Stucco Scratch Miscellaneous Inspections: Masonry Fireplace Plate Ties,Fire Block Patio/Deck: Footing Frame Access/Light/Switch NOTICE TO OWNER:Call for FINAL INSPECTION on every job. This permit will expire if work is suspended or abandoned for a period of Patio Final 180 days.