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Permit No. 5704 C• ity of CLti_gio Hills APPLICA __JN FOR BUILDING PERMIT , Community Development 2001 Grand Avenue Chino Hills,CA 91709 Building Address: Proposed Use - St No. 2008 Street VISTA DEL SOL RESIDENCE APN 1032-561-13 THE FOLLOWING WORK IS AUTHORIZED BY THIS PERMIT Lot 76 Block Tract 13906-5 N Struct. 1 Piumb. Nx Mech. N Elect. l Grading Applicant BROCK HOMES St No. 201 Street E SANDPOINTE Type of Project la New ❑Alter El Addition City SANTA ANA Zip 92707 Phone 714-556-4663 El Repair ❑ Convert. ❑Demo El Occupancy Permit 1 lk Project I Location on I Size Owner BROCK HOMES Description Property in Sq.Feet St No. 201 Street E SANDPOINTE Phone 1• LIVABLE I 11820 �- City SANTA ANA Zip 92707 714-556-4663 r--, Engr/Arch _ Lic No. 2. GARAGE I 1565 , St No. Street 3. PATIO I I 48 City Zip Phone 4. I I Contractor REMARKS/SPECIAL CONDITIONS/PROJECT DESCRIPTION BROCK HOMES Lic No. 54648 Sewer I Min. Depth I S/F/100 I Size St No. 201 Street E SANDPOINTE YES. City SANTA ANA Zip 92707 Phone 714-556-4663 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 c License Number «ane Date Contractor CAI=Ac Aanvc 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: 1--1 I, as the owner of the property,or my employees with wages as their whole PJ compensation, will do the work, and the structure is not intended or offered for sale. ril I, 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 affirm under penalty of perjury one of the following declarations: ZoningI Land Use Ela. I have and will maintain a certificate of consent to self-insure for workers' PD,IL1,FR1 compensation as provided by Section 3700 of the Labor Code, for the performance of the work r 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 I SY I LaborCode, for the performance of the work for which this permit is issued. My worker's Ry I SSY compensation insurance carrier and policy number are: Ins. Co.: Group/Division/Type Policy No: R3/VN Exp Date: VALUATION (This dection need not be completed if the permit is for one hundred doolars($100)or less). $114,741.00 ❑ c. I certify that in the performance of the work for which this permit is issued. I shall PERMIT FEES not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code. I shall forthwith comply with those provisions./ Electrical $200.20 Structural $924.94 Date I/ try'//6 S.,-- ure 4' ` _ Warning: Failure to secure worker- compensation coverage is unla ul, and shall subject an Plumbing $210.00 Grading $75.00 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 $68.82 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 I Plan Check $59.37 and state laws and hereby authorize representatives of this City Issuance Approved I Total Permit Fee to enter upon the above mentioned property for inspection DC $1.567.33 purpo es. �f Y � 54 - f' ' 7/94 Date Issued Permit Number Signature of Applicatt or Agent Date r 01/17/96 5704 FINANCE CODE CENSUS CODE Print Applicant's/Agent's Name C4 101 ( r ,',-,INSTRUCTION LENDING AGENCI- _' 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 ADDRESS DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION r 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 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 EMS ; DIS NOT SUBJECT TO THE APPLICABLE REQUIREMENTS OF THE HEALTH AND SAFETY CODE AND THE LOCAL AIR QUALITY AGENCY. BUILDING INSPECTIONS RECORD DATE INSPECTOR I I DATE I INSPECTOR Setback/Location I Rough Plumbing I i ),ti AI n) . Temporary Power I Shower Pan Test 1 `�v., l� 1 Foundation Reinforcing Steel I Stucco Mesh or Exterior Siding //''7,,/t11)L) Excavation and Forms I f„ Insulation `/11 7i/,`2%G / J Slab Grade - '' III,(;ito q,) t/ Sewer a_2.)1 NO 01 _ Ground Plumbing Soil 1 1?./11W, ., ./11 OL(7 .., L. Interceptor ` Ground Plumbing Water ?'I7.1 PL, ( 11.� Septic Tank Underslab Ducts Leach Line or Seep Pit - Underslab Conduit Water Service / f Underslab Gas Lath or Drywall Nailing `/'/� 5 /(o L/ Fireplace Foundation Gas Line Air Test ��il-7YcJ(, \ 11___ 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 / Fireplace Bond Bean) / / _ , Final Off Site Improvements i.,_ ) A Roof Sheathing •f<//I f,,r a/ I va, ,a., i Final Dedication t A MSI v / ,;\ Framing and Ventilation / / Final Zoning .A/111 / i 1 \ Roof Covering I,-, / � / Final Electrical (,,\L}. / I A)I Rough HeatingFinal Gas 9 �l�'�v� �/U� ✓ \ / V ii Service and Ground k(` •/ 7 Developer Fees Paid / // Rough Electrical / / Fire Dept. Approval Verified /j 1/ Bonding / Certificate of Occupancy ii V Over Head Electrical Fence Height Gates Heater . Pool Drainage SEPTIC TANK t GALS. SEEP. PIT X LEACH LINE WIDE LONG X DEPTH OF ROCK N. • W. E. • Inspector's Signature and Initials .• -j34 '769 . DATE OF ISSUANCE PERMIT NUMBER 01 — -- 9(e 570L/ 1_,_.e.:, -1-- 1L '• . 1-5G1 0 6 - 5 , . 4— CITY OF CI%_ .,0 HILLS coramsz DTINDGEAVNDLOsP:IFEETyNT DDE.ivPisAIR0TNMENT • _ • i 14 PERMIT # Call(909) 690-1511 Ext 282 before 3:00 p.m.for n:10:riTayori.n:1038.0c.inspection . POST IN A SAFE,CONsPICUMS PLACE AT F PHRAOVIApDEpRPEFloyME:zhiUMB4sE:NWJHOTACTA.Ir.ILIIANEGOFFOltillpNESPeTEIC7N. DC,/, _____ _. r\ II ..zr7 I /17/ 6 • OWNER , k -IC Wt . . LOCKnON .9_C)-1-)6 Itj , ..Ps . . INSPECTION RECORD • INSPECTION 1 DATE i INSPECTOR • . . : Sethack/Locahon I I Temporary Power I I /Reinforcin _g Steel 1 I i Foundation Slab Grade I /.1 ii I*4 P C--)/ I.Ground Plumbing ! 011 SS/294 f---.1--- --- • : • Underslab Copper 1 It... /It 1/4-4.--------- . 1 Underalab Conduit/Ducts I t r Fireplace Foundation I . • Joists and Girders • . Electrical Ground I ! -4./e, , 6P e 0 A04-30 I v//07-14 c-1- . DO NOT CONCEAL UNTIL ABOVE ARE SIGNED AND DATED . ; Firet Bend EleaiiiiLitt I . ' - — 1 • - Final Bond Beam/Lift I • : Fireplace Bond Beam I - ' Root Sheathing • - Framing and Ventilation I .1n / , 7` Rough Heating I I i/V - '', r V • . Electrical Service and Ground 1 I 111 v /A L"/ • : Rough Electrical I 14 I / t-- 0," Rough plumbing I / .," • i - . Shower Pan/Tub Test _ I/ / . ,...-IL- Stucco Mesh r‘Extrior 541111 917/*/'141 ---T ---1 . , . . 1 Fire Sprinklers : • DO NOT.CONCEAL UNTIL ABOVE ARE SIGNED AND DATED • ' insulation . i . Sewer I S7ty:// 6 K 4-._ ,• - Septic Tank II , .- Leach Line or Seep PH I . . . . Water Service I , I I DC t4OT CONCEAL UNTIL ABOVE ARE SIGNED AND DATED . ..s - - interior Lath or*Writsvellekt. I 1•"1;1"geWp 1 e....---4----_-- . 1 - Gas Line Air Test I 57 "7 I,Co I .0 ...---"--- - Final GradingI II Final Electrical I . „ FinalII PlumbingI Final HealinpJA.C. I I Final Zoning/Conditions el Approval! I Final Fire(Cal Local Fire Dept.) I 5----/7— e,. / .tetr-Yr ......„...____ , Final Building I ! -- . . * Certificate of Occupancy . , ...._... ,. .__...•..-- ............ 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 COMPLE-rrn