Loading...
Permit No. 5484 . City of Ch -io Hills APPLICA',_,N FOR BUILDING PERMIT Community Development 2001 Grand Avenue ' Chino Hills,CA 91709 Building Address: Proposed Use - . St No. 2104 Street VISTA DEL SOL PATIO COVER APN 1032-481-01 THE FOLLOWING WORK IS AUTHORIZED BY THIS PERMIT Lot 64 Block Tract 13906-S IM Struct. p Plumb. Applicant CREATIVE CONS I RUCTION AND DESIGN ❑Mech. f[Elect_ R r_�, tc14 St No. 1586 Street MARSHALL LN Type of Project p New ' 0 Alter ®Addition • City CORONA Zip 91719 Phone 278_382• ❑Repair I7 Convert. Q Demo CI Occupancy Permit Owner S I EVE JOHNSON ProjectLocation on Size Description I Property I in Sq.Feet St No. 2104 Street VISTA DEL SOL City CHINO HILLS Zip 91709 Phone 1. PATIO COVER I I 308 .---- Engr/Arch Lic No. 2. I I _..!- St No. Street 3. I I City Zip Phone 4. I I REMARKS/SPECIAL CONDITIONS/PROJECT DESCRIPTION 0 Contractor CREATIVE CONSTRUCTION AND Lic No. 6846$7 Sewer I Min. Depth I S/F/100 I Size St No. 1586 Street MARSHALL I N City CORONA Zip 91719 Phone 278-3821 Cubic Yards Excavation Fill Over Excavation IJ 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 n License Number Date 11/30/98 Contractor cnnnc AC nan. """— 4".1 P—'. Address City and Zip Phone 7 /.// / I Owner Builder Declaration / ' / I hereby affirm that I am exempt from the Contractor's License Law for the following reason: / f / r—i I, as the owner of the property, or my employees with wages as their whole I I.J compensation, will do the work, and the structure is not intended or offered for sale. \ / D1, 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 Date Initial Workers' Compensation Declaration I hereby,affirm under penalty of perjury one of the following declarations: ZoningI Land Use 1:1a. 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 work for which this permit is issued. Setbacks I Model/Plan ❑ b. I have and will maintain worker's compensation,as required by Section 3700 of the FY 7(1 I SY c c I LaborCode, for the performance of the work for which this permit is issued. My worker'sI -'- compensation insurance carrier and policy number are: RY 1c SSY Ins. Co.: Group/Division/Type Policy No: Exp Date: VALUATION This dect. need not be completed if the permit is for one hundred doolars($100)or less). $3,694.00 c. I certify that in the performance of the work for which this rermit is issued. I shall PERMIT FEES not employ any person in any manner so as to become su ject o the Workers' Compensation Laws of California and agree that if I should become ject th- workers' compensation provisions of Section 3700 of the Labor Code. I shall •h h comply with ••se ( Electrical Structural provisions. I $75.60 Date 1 ( I n, I C Signature �� �-) Plumbing Grading Warning: Failure to secure ure workers' compensation coverage 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 - I information is correct. I agree to comply with all City Ordinances Geo Review Plan Check and state aws and Mreby authorize representatives of this City Issuance Approved I Total Permit Fee to en upon-" he above mentioned .operty for inspection 9 el, ,uA rani pu ?. cl/z' AI C— ��" . x \ Date Issued Permit Number Signature ofl,,App'icant or Agent Date 11/29/95 5484 FINANCE CODE CENSUS CODE Print Applicant's/Agent's Name re. n/- ONSTRUCTION LENDING AGENCI /) I HEREBY AFFIRM THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR TI IF PERFORMANCE 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 INDUSTRIAL SAFETY PERMIT AS A PREREQUISITE TO PERMIT ISSUANCE UNLESS THE APPLICANT SIGNS ONE OF THE CERTIFICATES BELOW. ❑ I CERTIFY THAT NO EXCAVATION 5 FEET OR MORE FEET IN DEPTH,INTO WHICI 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. 0 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 TI IE LOCAL AIR QUALITY AGENCY. • BUILDING INSPECTIONS RECORD pAyE INSP C OR DATE INSPECTOR Setback/Location I //3/fir —Rough Plumbing Temporary Power I Shower Pan Test • Foundation Reinforcing Steel I / Stucco Mesh or Exterior Siding Excavation and Forms Insulation • _ Slab Grade Sewer • Ground Plumbing Soil I 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 Final Bond Beam Final On Site Improvements li Fireplace Bond Beam jFinal 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 /97%e,- , !,c,r#L //25/90 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