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Permit No. 5713 City of Ch ...io Hills . PPLIC._ iN FOR BUILDING PERMIT Community Development • 2001 Grand Avenue Chino Hills,CA 91709 Building Address: Proposed Use - St No. 1997 Street VISTA DEL SOL RESIDENCE APN 1032-561-29 THE FOLLOWING WORK IS AUTHORIZED BY THIS PERMIT Lot 92 Block Tract 13906-5 z Struct. N Plumb. Applicant BROCK HOMES Ix Mech. p Elect. NGrading St No. 201 Street E SANDPOINTE STE #100 Type of Project L New ❑Alter ❑Addition City SANTA ANA Zip 92707 Phone 714-556-4663 0 Repair 0 Convert. ❑Demo ❑Occupancy Permit Owner BROCK HOMES Project I Location on 1 Size Description Property , in Sq.Feet —.......1St No. 201 Street E SANDPOINTE STE #100 1. LIVABLE I I 2145 City SANTA ANA Zip 92707 Phone 714-556-4663 Engr/Arch Lic No. 2. GARAGE I 1610 St No. Street 3. PATIO I I 80 V''''' City Zip Phone 4. I I /7 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 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 R License Number S4R45 Date Contractor SWAP Ac GRr1VF Address City and Zip Phone W Owner Builder Declaration I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (3 I, as the owner of the property, or my employees with wages as their whole �J compensation, will do the work, and the structure isi 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 Date Initial Workers' Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations: ZoningI Land Use Lia. I have and will maintain a certificate of consent to self-insure for workers' PD,IL1,FR1 compen ion as provided by Section 3700 of the Labor Code, for the performance of the wrkJL�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 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). $133,994.00 ❑ 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 $1,014.62 provisions. /�,,�,� p Electrical $235.95 Structural Dat. !if 7/qA - azure *616-42-1--19---- /r IC-s ff_ Warning: Failure to secure workers' compensation coverage is unlawfu,, and shall subject an Plumbing $244.50 Grading $75.00 employer to criminal penalties and civil fines up to one hundred thousad 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 $88.80 $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 $65.07 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 $1,752.94 purpos s. I �4,( dH -Q !h7/46 Date Issued Permit Number / Signature of Applicant or Agent Date r 01/17/96 5 713 FINANCE CODE CENSUS CODE Print Applicant's/Agent's Name C4 101 (,,, 4STRUCTION LENDING AGENCI , 1---' — 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 • 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 DIS (DS NOT SUBJECT TO THE APPLICABLE REQUIREMENTS OF THE HEALTH AND SAFETY CODE AND THE LOCAL AIR QUALITY AGENCY. BUILDING INSPECTIONS RECORD DATE INSPECTOR I DATE INSPECTOR Setback/Location Rough Plumbing I Ihi Temporary Power Shower Pan Test I �.14 �, Foundation Reinforcing Steel Stucco Mesh or Exterior Siding I L///S(I Cj(„ \J i,...---- Excavation /Excavation and Forms a Insulation , 'GI� \I Slab Grade `,f I AL \flf/ Sewer -ch7- ti/ c//....--,' Ground Plumbing Soil I 17A i g , "41.-- Interceptor -- + Ground Plumbing Water JfjkSS(OL .I V Septic Tank Underslab Ducts Leach Line or Seep Pit - Underslab Conduit Water Service Underslab Gas Lath or Drywall Nailing q 11%I IC /I/- Fireplace Foundation Gas Line Air Test <-1-7rGt,(o \'../i .------- Joists and Girders Final Energy Electrical Ground Final Plumbing Mid-Height Bond Beam Final Heating/A.C. / 1 / 8-Foot Bond Beam Final Construction A Final Bond Beam Final On Site Improvements ,_j / / Fireplace Bond Beam , / Final Off Site Improvements I ITV / 1A / Roof Sheathing - /5A,042t/ ////qt t it/-- ,Final Dedication /Will / EN' iJ / Framing and Ventilation / A Final Zoning 141/ / I U/ Roof Covering /_' . / Final Electrical ` / (I / Rough Heating I,,14./ A /X)/' Final Gas / Service and Ground LI10 1"7 v7 Developer Fees Paid Rough Electrical / / Fire Dept. Approval Verified / / Bonding Certificate of Occupancy / / r Over Head Electrical / Fence Height Y Gates Heater Pool Drainage 6Y? --Scy_aA e-//'o%c -JZ— 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 I 04 CITY OF CI 10 HILLS COMMUNITY DEVELOPMENT DEPARTMENT BUILDING AND SAFETY DIVISION 1PERMIT # .. ;".7i 7 . • • Call(909)590-1511 Ext. 282 before 3:00 p.m.for next day inspection POST IN A SAFE, CONSPICUOUS PLACE AT FRONT OF JOe. I PROVIDE PERMIT NUMBER WHEN CALLING FOA INSPECTION. HAVE APPROVED PLANS ON JOB AT TIME OF INSPECTIOr OWNER i DTE . , LOCATION i s 7 (.1 LcrA 1 w co I I INSPECTION RECORD • 1 ! INSPECTION l DATE 1 INSPECTOR I Setback/Location f I Temporary Power 1 Foundation/Reinforcing Steal I .... f: 1 • Slab Grade ' 4111/7 r,K I Ground Plumbing .1/21.1 94, _ • • 1 Underslab Copper f 7/i Y/PG G ------- I Underslab Conduit/Ducts 1 ` - r IFireplace Foundation 1 _ Joists and Girders 1 Electrical Ground t DO NOT CONCEAL UNTIL ABOVE ARE SIGNED AND DATED ' First Boad'Bearnruit" ' I 1 - - Final Bond Beam/Lift I at . Fireplace Bond Beam I f1 Roof Sheathing 1 1 I • 1 Shear 1 ,r r to �i/.4/. 1 ." . i Framing and Ventilation ' / �"� `� ( ��/ Rough Healing J i�3L/_ I u. . l f I li Electrical Service and Ground f lt& 7 t J j 7 1 Rough Electrical II 1' / 1 /1/ Rough Plum1 Vbing 1 1 V) f Shower Pan/Tub Test 1 I Stucco Mesh er Exterior Skiing g. 1 / Sprinklers. . 1 Fire S.. ... DO NOT CODE. ..,, t:EAt.UNTIL ABOVE ARE SiGME AND DATED In5uiatton Satter r. ? 'C� -‘/4- Septic Tank I ' I . ILeach Line or Seep Pit 1 j Water Service M 1F ' R 1 - DO NOT CONCEAL UNTIL ABOVE ARE SIGNED AND DATED ' Interior Lath or Crry'wolf IV J g 1 4,/./81,140 I -- - Gas Line Air Test 5.-. 7""96.- i �'%1- r I Final Grading 1 -- - I Final Electrical . Final Plumbing f I Final Heating/A.C. . I Fina!Zening9T ondlUons of Approval 1 - Final Fire(Call Local Fire Dept.) 1 ".-(7—g 4a t.--ZJ4 Final Building ) Certificate oh Occupancy r , \ f NOTICE TO OWNER! f;an forelli --7 /vii. IMO permit will • fS St.lgpeniled or abandoned for perces of 180 days. Call for inspection every I,80 days to help keep • Vtilltclt BCetvS. ' NO WORK SHALL BE COVERED WITHOUT INSPECTION. f • FILE THIS CARD WITH YOUR PERMANENT RECORDS WHEN JOB IS COMPLETED. I