Loading...
Permit No. 4137 71:40. CITY OF CHINO•IS APPLICATION FOR A BUILDING PERMIT AND rs .. COMMUNITY DEVELOPMENT A CERTIFICATE OF USE & OCCUPANCY *� '1 •- 2001 Grand Avenue cl"t2'<",,,,"",' Chino Hills, CA 91709 BUILDING PROPOSED USE CO ADDRESS a„a (l a Da_ Sot-- F C ` Vv/LU1 APNal--2q likhat' I U�d `�dl _THEJ.9LLOWING WOF K IS AUTHORIZED BY THIS PERMIT D LOT (03 ' BLOCK TRACTI3g0O_e/ PITRUCT 0 PLUMB Q 33 TYPE OF PERMIT IS<W 0 ALTER 0 ADDITION n APPLICANT Re,do FYYRKs nn 0 REPAIR 0 CONVERT 0 DEMO 0 OCCUPANCY PMT ADDRESS 9.319.31w... huU C. _ Dit suit, (3o PROJECT LOCATION ON SIZE AIS �Rt L� �' /�/ DESCRIPTION I PROPERTY I IN SO FEET CITYL0.91Ma IIS CA• ZIP `06n PH s "�"i�"'! 1 I I [J V U � 1 OWNER SW. P.-S li1NV2 2 I I ADDRESS S I I CITY ZIP PH I I Cr 4 ARCHITECT / ENGINEER Kpt m LIC NO REMARKS/SPECIAL CONDITIONS/PROJECT DESCRIPTION ADDRESS 4 100 Can,Ai S NO STORIES NO DWELLING UNITS BEDROOMS CITY IOu1•BIYV -,16 ZIP "" PH1.617r ROOF I FLOOR EXT WALL INT WALL �( CONTRACTOR ,V LIC NO c ADDRESS CEILING HEATING I FIREPLACE METAL MASONRY CITY ZIP PH SEWER MIN DEPTH S/F/100 I SIZE �•• CITY BUSINESS LICENSE LICENSE NO EXPIRATION DATE LICENSED CONTRACTOR'S DECLARATION CUBIC YARDS EXCAVATION FILL OVER EXCAVATION I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000 of Division 3 of the Business and Professions Code,and /m7y�license is in full force and effect License Class As 1 License Number £YGiL 1Z—1&fidel( Gyx I Gate Coniraotor p�/ ADDRESS CITY AND ZIP PHONE OWNER BUILDING DECLARATION I hereby affirm that I am exempt from the Contractors License Law for the following reason ❑ 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 Atta owner of the property am exclusively contracting with licensed contractors to construct ' •prole<t ZONING LAND USE ❑ I am exempt under Sec BBPC for this reason I Date INITIAI SETBACKS I MODEUPLAN WORKERS COMPENSATION DECLARATION FY I SY I I hereby affirm that I have a certificate of consent to self insure,or a certificate of Workers CompensationnInsurance,Inncor a candied copy thereof �j�j�/µ, ,y-, RY SSYI COMPANY Mktg ILS POLICY NO� Lb O'r 1/•1 GROUP DIVISION TYPE ❑ Certified copy is hereby furnished DATE EXPIRES VALUATION ❑ Certified Dopy aided with the city CITY VERIFIED Date i1r4.gC APPLICANT (\IN.-:. Nat Ank n nu n PERMIT FEES CERTIFICATE OF EXEMPTION FROM WORKERS'Ct1MPENSATION INSURANCE I certify that in performance of the work for which this permit is issued,I shall not employ any ELECTRICAL I STRUCTURAL 30 — person in any manner so as to become subject to the Workers Compensation Law of California Date APPLICANT PLUMBING I GRADING NOTICE TO APPLICANT If,after making this Certificate of Exemption,you should become subject to the Workers Compensation provisions of the Labor Code you must forthwith comply yrl-'•'��� with such provisions or this permit shall be deemed revoked MECHANICAL I ISSUANCE FEES V ___ I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMA / TION IS CORRECT I AGREE TO COMPLY WITH ALL CITY ORDINANCES AND STATE LAWS, GEO REVIEW I PLAN CHECK AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS CITY TO ENTER UPON THE ABOVE MENTIONED PROPERTY FOR INSPECTION PURPOSES ` , /�, ISSUANCE APPROVED I TOTAL PERMIT FEE ......-- Signet of Applicant Z Agen J Date ^.)14 , q DATES�II � I rPERM/Tr%MBER� Print AImsal's/Agentl Name ail CI q IST FINANCE CODE 0L-I Operator: VIRGINIA Check #: 000000000 Date: 2/09/95 00 Receipt #: 000034747 WHITE- FILE/GREEN- FINANCE/ YELLOW- OFFICE/PINK• OWNER CHECK GOLD-ASSESSOR/MANILA - INSPECTOR Mount Tendered $59.00 ',CONSTRUCTION LENDING AGEN• I HEREBY AFFIRM THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED (SEC 3097,CIV C) LENDER'S NAME LENDER'S ADDRESe DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION - i ,fes THE CALIFORNIA HEALTH AND SAFETY CODE REQUIRESA DIVISION OF INDUSTRIAL SAFETY PERMIT ASA PREREQUISITE TO PERMIT ISSUANCE UNLESS THE APPLICANT SIGNS ONE OF,THE CERTIFICATES BELOW _'. .r - I CERTIFY THAT NO EXCAVATIONS FEET OR MORE FEET IN DEPTH,INTO WHICH APERSON IS REQUIRED TO DESCEND,WILL BE MADE IN CONNECTION WITH WORK AUTHORIZED BY THIS PERMIT,AND THAT NO BUILDING,STRUCTURE SCAFFOLDING,FALSEWORK,OR DEMOLITION 09 DISMANTLING THEREOF WILL BE MORE THAN 38 FEET HIGH I. ! '— 11 D AS OWNER/BUILDER I WILL NOT EMPLOY ANYONE TO DO WORK WHICH WOULD REQUIRE A PERMIT FROM THE DIVISION OF INDUSTRIAL SAFETY,AS NOTED ABOVE UNLESS SUCH PERSON HAS A PERMIT FROM THAT DIVISION '1 DIVISION OF INDUSTRIAL SAFETY PERMIT NUMBER I ' ^ '& 11 a 1l ` L Z' I HAVE READ'THE HAZARDOUS MATERIALS QUESTIONNAIRE AND THE tWORK APPLIED FOR ON THIS'PERMIT DISC J DIS NOT SUBJECT TO THE APPLICABL`E'REQUIREMENTS OF THE HEALTH AND SAFETY CODE AND THE LOCAL AIR QUALITY AGENCY j I f ,It 1 - Y� + il. llti • �I 1} ' K • API ,14 - . - ', \� _ � I - r' k Allat ^t'P"Y/t1%., '5j ..11"4w..-CarVon-.i.+/c.4 Vs$r% "''I4�rw-+f e.,. ?Mi'tones+PP-..“w`y ,.vv,-aW%r41MMe' ek A'• 44:••”' ''''r.,4`n 7y:e ',f,1'7 'v'?+¢''r- • ..r..: N CITY OF CHINO HILLS APPLICATION FOR A BUILDING PERMIT AND COMMUNITY DEVELOPMENT A CERTIFICATE OF USE & OCCUPANCY ,,-`I I .- 2001 Grand Avenue ,.o.,,,- Chico Hills, CA 91709 BUILDING PROPOSED USE CO ADDRESS h i d r act , 1� 4` C C)11Tr .•,'� ', 11 h ( v APN 1 t 2"1• : . t +4 t a THE FOLLOWING WORK IS AUTHORIZED BY THIS PERMIT y LOT Lc?) BLOCK TRACTS, , t _�+ 0•STRUCT 0 PLUMB ❑ MECH ❑ ELECT ❑ GRADING p Z( 9 TYPE OF PERMIT E'NEW 0 ALTER 0 ADDITION m APPLICANT ', 99 _ n o-t,", r n 0 REPAIR 0 CONVERT 0 DEMO 0 OCCUPANCY PMT ADDRESS 9 i+4_) IT'31, ; , •- ,t( >,„ PROJECT I LOCATION ON I SIZE / DESCRIPTION PROPERTY IN SO FEET CITY L.61 �. , 1'. l r ZIP Y; l:A . PH 1 a S 4. I I fM+CI) t L 1 ^. • OWNER I I 2 ADDRESS I I il}r 3 CITY ZIP PH 4 I I '... ARCHITECT ENGINEER K:,...44 ,,, 1., LIC NO REMARKS/SPECIAL CONDITIONS/PROJECT DESCRIPTION ADDRESS 1V \ it e it NO STORIES NO DWELLING UNITS BEDROOMS CITY , ZIP t'' PHS �'�t" si- l'�x V- I ( ROOF I FLOOR EXT WALL INT WALL CONTRACTOR LIC NO ADDRESS CEILING HEATING I FIREPLACE METAL MASONRY CITY ZIP PH LICENSE NO EXPIRATIONITY BUSINESS DATELICENSE SEWER MIN DEPTH S/F/100 I SIZE v LICENSED CONTRACTOR'S DECLARATION CUBIC YARDS EXCAVATION FILL OVER EXCAVATION I hereby affirm that I am licensed undo provisions of Chapter 9(commencing with Section 7000 of Division 3 of the Business and Professions Code, and ^^y license is in full force and effect License Class I f License Number �`+. .4 /�. (,T,/v I e Date Contractor ' ADDRESS CITY AND ZIP PHONF OWNER BUILDING DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason O I,as owner of the property,or my employee,with wages as their sole compensation,will do the work and the structure is not intended or offered for sale 0` as owner of the property,am exclusively contracting with licensed contractors to construct ,/ the protect ZONING I LAND USE O I am exempt under Sec BBPC for this reasonI Date INITIAL SETBACKS I MODEL/P LAN WORKERS'COMPENSATION DECLARATION FY I SY I hereby affirm that I have a certificate of consent to self insure,ora certificate of Workers Compensation Insurance,or a certdied copy thereof RY I SSVI COMPANY TSf/-r C ' . POLICY NOT- 1if' • ++ I GROUP DIVISION TYPE O Certified copy is hereby furmahed DATE EXPIRES O Certified copy is filed with the city CITY VERIFIED VALUATION / ,'- rr _7 Dale e• f, 11 APPLICANT I.A.+ (.11(... - r PERMIT FEES CERTIFICATE OF EXEMPTION FROM WORKERS COMPENSATION INSURANCE I certify that in performance of the work for which this permit is issued,I shall not employ any ELECTRICAL STRUCTURAL ..."7"...‘ '...... person in any manner so as to become eublect to the Workers Compensation Law of California Date APPLICANT PLUMBING I GRADING NOTICE TO APPLICANT If after making this Certificate of Exemption,you should become •ub1ect to the Workers Compensation provisions of the Labor Code,you must forthwith comply with such provisions or this permit sha11 be deemed revoked MECHANICAL I ISSUANCE FEES ,;f/ .... 1 CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMA TION IS CORRECT I AGREE TO COMPLY WITH ALL CITY ORDINANCES AND STATE LAWS, GEO REVIEW I PLAN CHECK AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS CITY TO ENTER UPON THE ABOVE MENTIONED PROPERTY FOR INSPECTION PURPOSES ISSUANCE APPROVED TOTAL PERMIT FEE -... , . ri ' S ' I 'L_-- Signature of Applicant ar Agent' Date ` i DATE OF ISSUANCE -' PERMIT.NUMBER ) t� . x ry / "'� . j y ! I , t 1 l...y l/ .f Print Applicant a/Agent s Name /" ' , if FINANCE CODE (j L—I /� WHITE- FILE/GREEN- FINANCE/YELLOW- OFFICE/PINK-OWNER GOLD-ASSESSOR/MANILA - INSPECTOR •ONSTRUCTION LENDING AGEN• . I HEREBY AFFIRM THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED (SEC 3097 CIV C) LENDER'S NAME LENDER'S ADDRFce DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION • THE CALIFORNIA HEALTH AND SAFETY CODE REQUIRESA DIVISION OF INDUSTRIAL SAFETY PERMIT AS A PREREQUISITE TO PERMIT ISSUANCE UNLESS THE APPLICANT SIGNS ONE OF THE CERTIFICATES BELOW ;' ❑ I CERTIFY THAT NO EXCAVATIONS FEET OR MORE FEET IN DEPTH,INTO WHICH A PERSON IS REQUIRED TO DESCEND,WILL BE MADE IN CONNECTION WITH WORK AUTHORIZED BY THIS PERMIT,AND THAT NO BUILDING,STRUCTURE,SCAFFOLDING,FALSEWORK,OR DEMOLITION OR DISMANTLING THEREOF,WILL BE MORE THAN 38 FEET HIGH I: AS OWNER/BUILDER I WILL NOT EMPLOY ANYONE TO DO WORK WHICH WOULD REQUIRE A PERMIT FROM THE DIVISION OF INDUSTRIAL SAFETY,AS NOTED ABOVE UNLESS SUCH PERSON HAS A PERMIT FROM THAT DIVISION f1 DIVISION OF INDUSTRIAL SAFETY PERMIT NUMBER I HAVE READ THE HAZARDOUS MATERIALS QUESTIONNAIRE AND THE WORK APPLIED FOR ON THIS PERMIT ❑IS 015 NOT SUBJECT TO THE APPLICABLE REQUIREMENTS OF THE HEALTH AND SAFETY CODE AND THE LOCAL AIR QUALITY AGENCY BUILDING INSPECTIONS RECORD DATE I INSPECTOR I DATE INSPECTOR Setback/Location I I I Rough Plumbing Temporary Power Shower Pan Test Foundation Reinforcing Steel i72// Stucco Mesh or Exterior Siding Excavation and Forms Insulation Slab Grade Sewer Ground Plumbing Soil Interceptor Ground Plumbing Water Septic Tank Underslab Ducts Leach Line or Seep Pit Underslab Conduit Water Service Underslab Gas Lath or Drywall Nailing Fireplace Foundation Gas Line Air Test Joists and Girders Final Energy Electrical Ground Final Plumbing Mid-Height Bond Beam Final Heating/A C 8-Foot Bond Beam - Final Construction /7/11S— Final Bond Beam L ay" _ ' J<- Final On Site Improvements Fireplace Bond Beam - Final Off Site Improvements Roof Sheathing Final Dedication Framing and Ventilation Final Zoning Roof Covering Final Electrical Rough Heating Final Gas Service and Ground Developer Fees Paid Rough Electrical Fire Dept Approval Verified Bonding Certificate of Occupancy Over Head Electrical Fence Height Gates Heater Pool Drainage SEPTIC TANK GALS SEEP PIT X LEACH LINE WIDE LONG X DEPTH OF ROCK N W E S Inspector's Signature and Initials 67 DATE OF ISSUANCE PERMIT NUMBER 1 I 1