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Permit No. 5483 City of Ch.-,`io Hills APPLICA".— N. FOR BUILDING PERMIT Community Development 2001 Grand Avenue Chino FSIs,CA 91700 Building Address: Proposed Use - St No. 2104 Street VISTA DEL SOL RETAINING WALL APN 1032-481-01 THE FOLLOWING WORK IS AUTHORIZED BY THIS PERMIT Lot 64 Block Tract 13906-5 Il Struct. Li Plumb. CREATIVE CONSTRUCTION AND DESIGN El l�lech: 0 Elect it f�'arariiin l Applicant Type of ProjectXJ St No. 1586 Street MARSHALL LN ypD New D Alter D Additioi City CORONA Zip 91719 Phone 278_382• 0_Repair D.Cony ert. 1=1_Demo EL Occupancy Permitic- Owner STEVE JOHNSON Project I Location on I Size _� Description Property in Sq.Feet St No. 2104 Street VISTA DEL SOL City CHINO HILLS Zip 91709 Phone 1. WALL I I 270 Engr/Arch Lic No. 2. I I St No. Street 3. I I I,IJ City Zip Phone 4. I I G" REMARKS/SPECIAL CONDITIONS/PROJECT DESCRIPTION 'a Cohtractor CREATIVE CONSTRUCTION AND Lic No. 680687 Sewer I Min. Depth I S/F/too I Size St No. 1586 Street MARSHALL LN :_-:_g City CORONA Zip 91719 Phone 278_3$1 Cubic Yards Excavation Fill Over Excavation City Business License License No. Expiration Date 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 eene07 7 Date 11/30/98 Contractor SAMF AS ARn/F \ Address \ 7� / 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--i 1, as the owner of the property, or my employees with wages as their whole EJ compensation, will do the work, and the structure is not intended or offered for sale. ❑ I,as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ I am exempt under Sec.__,B&PC for this reason DatP Initial • Workers' Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations: Zoning Land Use 01a. I have and will maintain a certificate of consent to self-insure for workers' CH/PD compensation as provided by Section 3700 of the Labor Code, for the performance of the I Model/Plan work for which this permit is issued. Setbacks 0 b. I have and will maintain worker's compensation,as required by Section 3700 of the FY 20 I SY S S LaborCode, for the performance of the work for which this permit is issued. My worker'sI compensation insurance carrier and policy number are: RY 15 SSY Ins. Co.: Group/Division/Type Policy No: Exp Date: _, VALUATION (This de 'on need not be completed if the permit is for one hundred doolars($100)or less). $3,240.00 c. I certify that in the performance of the work for wflich this permit is issued. I shall PERMIT FEES not employ any person in any manner so as to become subjett to th-= Work- ' Compensation Laws of California and agree that if I should become Eject to t work rs' compensation provisions of tion 3700 of the Labor Code. I shall for ith 'imply with those _ElectricalI Structural provisio $75.60 C e_ /// �� ___sig nal e_ _ __ ll Plumbing Grading Warning: Failure to secure workers' compensation covers is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the - Labor Code, interest,and attorney's fees. Mechanical Issuance $29.00 I certify that I have read this application and state that the above - information is correct. I agree to comply with all City Ordinances Geo Review Plan Check and state la and ereb authorize representatives of this City Issuance Approved I Total Permit Fee to en r pon the abo a mentioned property for inspection a�nn rn I p/ e i 1125 l',--- Date Issued Permit Number v y signature of Ai.plicantlo 'Agent Date I L=>N Y 1 ).ov(0 L--0(5 11/29/95 5483 FINANCE CODE CENSUS CODE Print Applicant's/Agent's Name C'4 n/c . /✓ ONSTRUCTION LENDING AGENCI, J _ I HEREBY AFFIRM THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR.1 I Ir= PFITI of(MANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED (SEC.3097,CIV.C.). LENDER'S NAME LENDER'S ADDRESS DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION THE CALIFORNIA HEALTH AND SAFETY CODE REQUIRES A DIVISION OF INDUST DIAL SAFET Y PERMIT AS A PREREQUISITE TO PERMIT ISSUANCE UNLESS THE APPLICANT SIGNS ONE OF THE CERTIFICATES BELOW. 0 I CERTIFY THAT NO EXCAVATION 5 FEET OR MORE FEET IN DEPTH,INTO WI-IICI I 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 TI-IAT DIVISION. DIVISION OF INDUSTRIAL SAFETY PERMIT NUMBER I HAVE READ THE HAZARDOUS MATERIALS QUESTIONNAIRE AND THE WORK APPLIED FOR ON THIS PERMIT OIS DIS NOT SUBJECT TO THE APPLICABLE REQUIREMENTS OF THE HEALTH AND SAFETY CODE AND TI IE LOCAL AIR QUALITY AGENCY. BUILDING INSPECTIONS RECORD • DATE INSPECTOR DATE INSPECTOR Setback/Location Rough Plumbing Temporary Power I Shower Pan Test Foundation Reinforcing Steel I /Z/ /95 /O4 • '- Stucco Mesh or Exterior Siding I Excavation and Forms Insulation ' Slab Grade Sewer Ground Plumbing Soil Interceptor I Ground Plumbing Water Septic Tank Underslab Ducts Leach Line or Seep Pit Underslab Conduit Water Service Underslab Gas Lath or Drywall Nailing I Fireplace Foundation I Gas_Line Air Test I 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 BeamIlli //�9f �� Final On Site Improvements Fireplace Bond Beam Final Off Site Improvements Roof Sheathing I Final Dedication Framing and Ventilation Final Zoning Roof Covering I Final Electrical Rough Heating I Final Gas Service and Ground I Developer Fees Paid Rough Electrical I Fire Dept. Approval Verified Bonding I Certificate of Occupancy / Over Head Electrical I / a f/ Il h - w.�.GY r/2 r/ Fence Height . Gates I / Heater Pool Drainage I I (QCT— /2-4./i✓4-GE. bc=fl', 0 -A-- Gale —/r res o` 7-.a-6/E ow 5-1°,4 . ' -- •D'c.ti. , r E fte,0 6c 6z,,.-o Wsf c TG 6C4 PPE"- ,4A /sec.-6/V , 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