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Permit No. 5369 City of Cirimo Hills APPLICArON FOR BUILDING PERMIT Community Development 2001 Grand Avenue Chino Mils,CA 91709 `CJ Building Address: f' Proposed Use - St No. 2045 Street VISTA DEL SOL RETAINING WALL APN 1032-561-33 THE FOLLOWING WORK IS AUTHORIZED BY THIS PERMIT Lot 96 Block Tract 13906-5 ®§{FHEt: ®PINfl3: Applicant BROCK HOMES ®M@Ep: ®€i@Et: ®6F§�iRe St No. 201 Street E SANDPOINTE STE 100 Type of Project El New ®Mu ®A$gitieii City SANTA ANA Zip 92707 Phone 714-556-4663 ®Iigfl@IF ®€BRiSgFt: ®®€FRB ®8EEHliiaiiF'i i3gFR3it Owner BROCK HOMES Project I Location on I Size St No. 201 Street E SANDPOINTE STE 100 Description Property in Sq.Feet City SANTA ANA Zip 92707 Phone 714-556-4663 1• RET WALL I 1303 Engr/Arch • Lic No. 2. I I St No. Street 3. I I City Zip Phone 4. I I Contractor BROCK HOMES54648 ' REMARKS/SPECIAL CONDITIONS/PROJECT DESCRIPTION Lic No. Sewer I Min. Depth I S/F/100 I Size St No. 201 Street E SANDPOINTE STE 100 City SANTA ANA Zip 92707 Phone 714-5564663 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 B License Number 54648 Data 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: ri I, as the owner of the property, or my employees with wages as their whole 6.1 compensation, will do the work, and the structure is not intended or offered for sale. [-i I, as owner of the property, am exclusively contracting with licensed contractors to 6.1 construct the project. ElI 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 ID Certified copy is hereby furnished Date Expires FY I SY I Ified copy is on file with the city City Verified RY I SSY Group/Division/Type L Uate 11 ie,/`tT nt 11-4 lifc?-L__ Certificate of Exemption from Workers' Compensation I6surance VALUATION I certify that in the performance of the work for which this permit is issued, I shall not employ $3,636.00 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 $75.60 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 -'-` 1-4:4C___fr.e_ZI /WO o i 0 /ighr DC $104.60 Signatur6 of Applicant or Agent Date I Date Issued Permit Number 11/02/95 5369 Print Applicant's/Agent's Name FINANCE CODEC4 I CENSUS CODE 0/S 0 . • `-,ONSTRUCTION LENDING AGENCI -----) I HEREBY AFFIRM THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT 19 ISSUED (SEC.3007,CIV.C.). LENDER'S NAME LENDER'S ADDRESS • DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION THE CALIFORNIA HEALTH AND SAFETY CODE f%EOUTAES A DIVISION OF INDUSTRIAL SAFETY PERMIT AS A PREREQUISITE TO PERMIT ISSUANCE UNLESS THE APPLICANT SIGNS ONE OF THE CERTIFICATES BELOW. 0 I CERTIFli THAT NO EXCAVATION 5 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 36 FEET HIGH. 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. DIVISION OF INDUSTRIAL SAFETY PERMIT NUMBER ...._. .__ -. ... .__... - _.. . . ._. I HAVE READ THE HAZARDOUS MATERIALS QUESTIONNAIRE AND THE WORK APPLIED FOR'.ON THIS PERMIT ,DIS DIS NOT SUBJECT TO THE APPLICABLE REQUIREMENTS OF THE HEALTH AND SAFETY CODE AND I HE LOCAL AIR QUALITY AGENCY. BUILDING INSPECTIONS RECORD DATE INSPECTOR DATE INSPECTOR Setback/Location Rough Plumbing Temporary Power Shower Pan Test Foundation Reinforcing Steel T11-3619.5-,3Df'9S JL 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 Plt Underslab ConduitWater 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 Final Bond Beam i'"2 `JFinal On Site Improvements ----------- Fireplace Bond Beam Final Off Site Improvements Roof Sheathing Final Dedication , Framing and Ventilation Final Zoning -4 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 DATE OF ISSUANCE PERMIT NUMBER C�s6Z - 95 53 ( 9 I-I- IO? �(p CITY OF CHINO HILLS COMMUNITY DEVELOPMENT DEPARTMENT BUILDING AND SAFETY DIVISION I PERMIT # . -©1 Call (909) 590-1511 Ext. 282 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. q OWNER teoc-4- DATE e--17-cis-- LOCATION /9'd-s IDe-c_ 5424-- INSPECTION ©LINSPECTION RECORD INSPECTION I DATE INSPECTOR Setback/Location I I Temporary Power I I Foundation/Reinforcing Steel ! /en Slab Grade I ////// I <_� Ground Plumbing q 1,4'113"? , - Undersiab Cop i/per 9 /j j Underslab Conduit/Ducts Fireplace Foundation Joists and Girders I Electrical Ground 9A/f- I �f DO NOT CONCEAL UNTIL ABOVE ARE SIGNED AND DATED First Bond Beam/Lilt I Final Bond Beam/Lift 9j?0 Fireplace Bond Beam Roof Sheathing - Shear ' Framing and Ventilation I f+/ Rough Heating ( '1,1/- Electrical i Electrical Service and Ground 1/1 / Rough Electrical I/I! / ( (/ if • Rough Plumbing I r / Shower Pen/Tub Test Y I f Stucco Mesh or Exterior Siding I Fire Sprinklers I I DO NOT CONCEAL UNTIL ABOVE ARE SIGNED AND DATED Insulation I ///-1/1t- Sewer I /Q/o/cr I /l Septic Tank I ' I Leach Line or Seep Pit Water Service I W3-/s' -f�� S I '••� ' I DO NOT CONCEAL UNTIL ABOVE ARE SIG,ED AND DATED Inlerlo tm1Ii-9 Drywall N43/ling I%'/`7/`JS I —� Gas Line Air Test I /j/Z5 /!;S- Final Grading I Final Electrical I lc f/ Final Plumbing I /ISI% I IX Final Healing/A.C. I /?/I/ I v / Final Zoning/Conditions of Approval! `/ I Final Fire(Call Local Fire Dept.) I /2— l�S I i Final Building I e--i-//din" Certificate of Occupancy I I I I NOTICE TO OWNER! Call for FINAL inspection on every job. This permit will expire if work is suspended or abandoned for a period of 180 days. Call for inspection every 180 days to help keep permit active. NO WORK SHALL BE COVERED WITHOUT INSPECTION. FILE THIS CARD WITH YOUR PERMANENT RECORDS WHEN JOB IS COMPLETED.