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Permit No. 5714 City of C►» ono Hills APPLICE _iN FOR BUILDING PERMIT Community Development 2001 Grand Avenue Chino Hills,CA 91709 Building Address: Proposed Use - St No. 1989 Street VISTA DEL SOL RESIDENCE APN 1032-561-28 THE FOLLOWING WORK IS AUTHORIZED BY THIS PERMIT Lot 91 Block Tract 13906-5 IRI Struct. N Plumb. IX]Mech. RI Elect. fel i_rarlinsi Applicant BROCK HOMES •� St No. 201 Street E SANDPOINTE STE #100 Type of Project New Fl Alter fl Addiipn City SANTA ANA Zip 92707 Phone 714-556-4663 ID Repair El Convert ❑Demo ❑Occupancy Permit Owner BROCK HOMES Project I Location onSize Description Property I in Sq.Feet 0.2 St No. 201 Street E SANDPOINTE STE #100 1. LIVABLE I I 2145 City SANTA ANA Zip 92707 Phone 714-556-466? t� Engr/Arch Lic No. 2. GARAGE I I 610 N ' •••••• St No. Street 3. PATIO I I 80 42 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 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 _54648 Date Contractor CAW AC ARM/C Address City and Zip Phone - Owner Builder Declaration ...------- ..-.—"...-.W...-.._.._._.__...-_..---..-.....-..... I hereby affirm that I am exempt from the Contractor's License Law for the following reason: 121 Icamsptehnesaowner oilfl the throe pwrtyk,aonr dmy eemouycteuesre wisithnowa t ignetsenadseoerir owffheorleed for sale. r-1 I, as owner of the property, am exclusively contracting with licensed contractors to 11 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 ❑ a. I have and will maintain a certificate of consent to self-insure for workers' PD,IL1,FR1 compen tion 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). $133,994.00 ❑ c. I certify that in the performance of the work for which this permit is issued. I shall PERMIT FFFS 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/ll I Electrical $235.95 Structural $1,014.62 96 Data I i • ature� 44717 -- Warning: Failure to secure worker compensation coverage is unlawful, and shall subject an Plumbing $244.50 Grading $75.00 employer to criminal penalties and civil fines up to one hundred thous'nd 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 information is correct. I agree to comply with all City Ordinances Geo Review I 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 / 1 A7/46 Date Issued Permit Number • Signature of Applicant or Agent Date 01/17/96 5 714 FINANCE CODE CENSUS CODE Print Applicant's/Agent's Name C4 101 NSTRUCTION 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 THE CALIFORNIA HEALTH AND SAFETY CODE REQUIRESA 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,FALSE WORK,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 ❑IS: IDS 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 INSPECTOR Setback/Location I Rough Plumbing I L///,P14-A" , Temporary Power. I Shower Pan Test I IV'ff Foundation Reinforcing Steel I Stucco Mesh or Exterior Siding Z 1'j \/v Excavation and Forms , i Insulation 01G-1114:2 ((iSlab Grade 3,I I M. V Sewer Ground Plumbing Soil II7A ICi,(0 cI 1/' Interceptor Ground Plumbing Water -1\i2Iol(a . Ti . Septic Tank Underslab Ducts Y Leach Line or Seep Pit - Underslab Conduit Water Service , -/ Underslab Gas Lath or Drywall Nailing 14I NI f'Lh \I v Fireplace Foundation Gas Line Air Test 4..0-rrl.fo .,f 1---/ Joists and Girders Final Energy Electrical Ground Final Plumbing Mid-Height Bond Beam Final Heating/A.C. / 8-Foot Bond Beam Final Construction I V Final Bond Beam Final On Site Improvements 1 ,ftilkkL/ Fireplace Bond Beam , / Final Off Site Improvements /VI t/ ' ./ 1 lI y Roof Sheathing Al/Lr/ Li/j Pic .1f Final Dedication I', 11.) V / I /v/ Framing and VentilationFinal Zoning V)\ / -_ /I. Roof Covering I J ,i / Final Electrical / s / Rough Heating ,//L/Ivt� A V/ Final Gas / Service and Ground 141 ' / Developer Fees Paid �/ / _ Rough Electrical / / Fire Dept. Approval Verified -SMi /2l ��j 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 . . k31 0 to • 5 __ Lo-r-- - g 1 : . . 0 1 o 4 CITY OF CH . ) HILLS . , C 0 IA 1111DNBUILDINGI T YEANDEL OPN IF EE NriT DD ilEvPi As iRoTNM E N T PERMIT # ._.......... ... .... . . . . Galt(909)590-1511 Ext.282 before 3:00 p.m. for next day inspection i 1 POST IN A SAFE, CONSPICUOUS PLACE AT FRONT OF JOB. PROVIDE PERMIT NUMBER WHEN CALLING FOFI INSPECTION. HAVE .PPROVED P NS ON JOB AT TIME OF INSPECTIO . (...46 . iot i 17 / ' • , . OWNER _.,....- J ..- T A Dr) I . ' - . . . . . illr , 1_111 it ! LOCATION . ! : INSPECTION RECORD i • 1INSPECTION I DATE INSPECTOR • ... , . . . „ . Setback/Location ..,. . 1 Temporary Power I Foundalion/Reinlorcing Steel 1 _ ., ..", • ISlab Grade I 71.d 116 I . - Ground Plumbing .• : • 1 /1 451.q4P L44 ------ Underslab Copper 1 7-,-/t4/4Y..... (41'_...:----"-- I • , . • Underslab Conduit/Ducts 1 ,r- . , Fireplace Foundation I 11 . Joists and Girders I 1 . Electrical Ground 1 , DO NOT CONCEAL UNTIL ABOVEWIE..SIGNED AND DATEDFirst Bond SeamJUlt -.. .. i Final Bond Beam/lilt I • Fireplace Bond Beam i Roof Sheathing 4/fe /41... /7-1. . , Shear st i'' ' f F Framing and Ventilation A ttfl Z di" I Rough Heating IA! / . _ 1)/ / 1. . Electrical Service and Ground I ig .f /A )' / !i • ;II Rough Eleclrical 14' / V 0 7 i Rough Plumbing / / I I • . - Shower Pan/Tub Test / Stucco Mesh or Exterior Skiing 1 i Fire Sprinklers 1 DO NOT CONCEAL U-4111;AB9VE ARE SIGNED AND DATED Insulation I a//spne / Sewer 1 Septic Tank 1 * ' Leach Line or Seep P11 1 . Wider Service 11 1 . DO NOT CONCEAL UNTIL ABOVE ARE SIGNED AND DATED l ' interim:Latb or knemall Nalael; I .e..;',;.)f?je,G, I Gas Line Air Test 1 r/ZAPP47 1 46414 ------ Fitual Grading 1 I Final Electrical 1 I Final Plumbing 1 1 Final Heating/AC. 1 1 Final ZonIng/Coridilions of Approval! 1 - Final Fire(Call Local Fire Dept-) i c—A--f I Final Building 1 1 "- Certificate of Occupancy 1 1 1 1 . • .... . NOTICE TO OWNER! Call for FINAL inspection on every job. This permit will expire it 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.