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Permit No. 5365 City of Clti.,no Hills APPLICI- -JN FOR BUILDING PERMIT Community Development 2001 Grand Avenue Chino Hills,CA 91709 . Building Address: f' Proposed Use - St No. 2024 Street VISTA DEL SOL RETAINING WALL APN 1032-561-11 THE FOLLOWING WORK IS AUTHORIZED BY THIS PERMIT Lot 74 Block Tract 13906-5 Ei StRM, 0 Piki b.. Applicant BROCK HOMES ®Mot, 0 lit: 0�I� M St No. 201 Street E SANDPOINTE STE 100 Type of Project N@YIb Atte. AAddition City SANTA ANA Zip 92707 Phone 714-556-4663 1:111.156ir ®C""ft: CI DtmCI® % Nrrillit Owner BROCK HOMES Project Location on Size Description Property I in Sq.Feet St No. 201 Street E SANDPOINTE S I t 1001. RET WALL I 184 City SANTA ANA . Zip 92707 Phone 714-556-4663 Engr/Arch Lic No. 2. I I St No. Street 3. I I City Zip Phone 4. I I Contractor BROCK HOMES Lic No. 54648 REMARKS/SPECIAL CONDITIONS/PROJECT DESCRIPTION Sewer I Min. Depth I S/F/100 I Size St No. 201 Street E SANDPOINTE STE 100 City SANTA ANA Zip 92707 Phone 714-556-4663 Cubic Yards Excavation Fill Over Excavation City Business License License No. 693 Expiration Date 10/31/95 Licensed Contractor's Declaration - - - I hereby affirm that I am licensed under the 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. License Class n License Number 5464a DatP Contractor SAME AS ABOVE Address City and Zip Phone Owner Builder Declaration - � I hereby affirm that I am exempt from the Contractor's License Law for the following reason: I, as the owner of the property, or my employees with wages as their whole / !\�/h�r\/C"C3 compensation, will do the work, and the structure is not intended or offered for sale. I DI, as owner of the property, am exclusively contracting with licensed contractors to �.1 construct the project. ����� ❑ I am exempt under Sec.__,B&PC for this reason Date Initial Workers' Compensation Declaration I hereby confirm that I have a certificate of consent to self insure, or a ZoningI Land Use certificate of Workers Compensation Insurance, or a certified copy thereof, CH/PD Company POLICY NO. Setbacks I Model/Plan ❑ C rtified copy is hereby furnished Date Expires FY I SY I Eler Certified copy is on file with the city City Verified RY I SSY � ] _ �� � � Group/Division/Type Date i' 619 c '• j 4-4v�v,`-�/A a-isi.-(4.._ Certificate of Exemption from Workers' Compensation Insurance VALUATION I certify that in the performance of the work for which this permit is issued, I shall not employ $1,008.00 any person in any manner,so as to become subject to the Workers Compensation Laws of California. PERMIT FEES Date Applicant NOTICE TO APPLICANT: If, after making this Certificate of Exemption,you should become subject Electrical I Structural $32.40 to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. I certify that I have read this application and state that the above Plumbing I Grading information is correct. I agree to comply with all City Ordinances and state laws and hereby authorize representatives of this City Mechanical I Issuance $29.00 to enter upon the above mentioned property for inspection purposes. Geo Review I Plan Check Issuance Approved I Total Permit Fee a..4 '27140 0-6q utB/9 l'- DC $61.40 Signature of Applicant or AgCnt Date I Date Issued Permit Number 11/02/95 5365 Print Applicant's/Agent's Name FINANCE CODECENSUS CODE C4 I 0/S •, ,ONSTRUCTION LENDING AGENC,,_,‘ / 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 NAMELENDER'S ADORES ' DIVISIONOF INDUSTRIAL SAFETY PERMIT CERTIFICATION . , THE CALIFORNIA HEALTH AND SAFETY DOGE REQUIRES A DIVISION OF INDUSTRIAL SAFETY PERMIT AS A PREREQUISITE TO PERMIT ISSUANCE UNLESS THE APPLICANT SIGNS ONE OF THE CERTIFICATES BELOW. 0 I CERTIh'THAT NO EXCAVATIONS FEET OR MORE FEET IN DEPTH,INTO WHICH A PERSON IS REQUIRED TO DESCEND,WILL BE MADE IN CCiNiKECTION WITH WORK AUTHORIZED BY THIS PERMIT,AND THAT NO BUILDING,STRUCTURE,SCAFFOLDING,FALSE WORK.OR DEMOLITION OR DISMANTLING THEREOF.WILL BE MORE THAN 36 FEET HIGH. 0 AS OWNER/BUILDER I WILL NOT EMPLOY ANYONE TO DO WORK WHICH WOULD IFEounsf.'A pEtimi I F noM.THE DIVISION OF INDUSTRIAL SAFETY.AS NOTED ABOVE UNLESS SUCH PERSON RAS A PERM!r FROM THAT DIVISION. .. . DIVISION OF INDUSTRIAL SAFETY PERMIT NUMBER ...._ ..._ . • ' I HAVE READ THE HAZARDOUS MATERIALS QUESTIONNAIRE AND THE WORK APPLIED FOR ON TRIS•PERMIT DIS pis NOT SUBJECT TO THE APPLICABLE REQUIREMENTS OF THE HEALTH AND SAFETY CODE AND FRE LOCAL AIR QUALITY AGENCY. BUILDING INSPECTIONS RECORD DATE INSPECTOR DATE INSPECTOR Setback/Location Rough Plumbing Temporary Power Shower Pan Test _ . Foundation Reinforcing Steel Stucco Mesh or Exterior Siding _ ._. Excavation and Forms Insulation ' Slab Grade -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 BeamFinal Heating/A.G. 8-Foot Bond Beam Final Construction Final Bond Beam Final On Site Improvements Fireplace Bond Beam Final Off Site Improvements Roof Sheathing - , - .. .- „ Final Dedication Framing and Ventilation ''' • —• • • " - - * Final Zoning L . . •::- . ,, Roof Covering • -• : : .: -- .-i--- '',:. --': _,' , Final Electrlcal -- Rough Healing Final Gas Service and Ground . ' Developer Fees Paid .__. . . ... • ---i--:-: ------ -------------- ----- Rough Electrical 0irii6ept. Appio/aVerified — - ... 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 . DATE OF ISSUANCE PERMIT NUMBER 11 ''*' 0 2 95 5*.: 6 5 _