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Permit No. 5715 City of Cl.,_,,i0 Hills APPLIC.__JN FOR BUILDING PERMIT Community Development 2001 Grand Avenue Chino Hills,CA 91709 Building Address: Proposed Use - St No. 2000 Street VISTA DEL SOL RESIDENCE APN 1032-561-14 THE FOLLOWING WORK IS AUTHORIZED BY THIS PERMIT Lot 77 Block Tract 13906-5 yg Sti uct. J Plumb. NI l Mech. Vel Elect. l l 13rfa'r;i 11/I Applicant BROCK HOMES Type of Project I l New 11 Alter Addition St No. 201 Street E SANDPOINTE STE #100 City SANTA ANA Zip 92707 Phone 714-556-4663 LI nepai' 0 Convert. n Demo 1✓l Occupancy Permit • Owner BROCK HOMES ProjectLocation on Size Description I Property I in Sq.Feet St No. 201 Street E SANDPOINTE STE #100 Q City SANTA ANA Zip92707 Phone 1. LIVABLE I I 2145 714-556-4663 L� Engr/Arch Lic No. 2. GARAGE I I 610 , St No. Street 3. PATIO I I 80 City Zip Phone 4. I I r0 Contractor BROCK HOMES Lic No. 54648 REMARKS/SPECIAL CONDITIONS/PROJECT DESCRIPTION SewerS/F/100 Size St No. 201 Street E SANDPOINTE STE #100 YES. I Min. Depth I I C% City SANTA ANA Zip 92707 Phone 714-556-4663 Cubic Yards Excavation Fill Over Excavation City Business License g'• 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 Cda[LQ Date Contractor GAME AC ARr1VF •......................................---.._..._..._.......---_.......-............ - --....-... 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: D. I, as the owner of the property, or my employees with wages as their whole 61 compensation, will do the work, and the structure is not intended or offered for sale. -- — I--1 I, as owner of the property, am exclusively contracting with licensed contractors to 6.1 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 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 f 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 Ii 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). $1 33,994.00 ❑ c. I certify that in the performance of the work for which this permit is issued. I shall not employ any person in any manner so as to become subject to the Workers' Compensation PERMIT FEES 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 //���JJJ/// Electrical $235.95 Structural $1,014.62 Data 1/17//& • Si urr 4-1/t( `i/ '� l Warning: 'Failu I to secure workers' 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 thousan� 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 $88.80 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 $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 r �purposes. �j� �j �i1� 11///%9/9 --e-�'' - ��7/" Date Issued Permit Number Signature of Applican or Agent Date 01/17/96 5 715 Print Applicant's/Agent's Name FINANCE CODE CENSUS CODE C4 101 •, -NSTRUCTION LENDING AGENC' •� _ I HEREBY AFFIRM THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THI;3 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,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 DIS NOT SUBJECT TO THE APPLICABLE REQUIREMENTS OF THE HEALTH AND SAFETY.CODE AND THE LOCAL AIR QUALITY AGENCY. BUILDING INSPECTIONS RECORD DATE INSPECTOR DATE INSPECTOR Setback/Location Rough Plumbing i.,i/t1/I41-2/1— 7.517 ) LiVZ ' Temporary Power Shower Pan Test .1:/>,...-- `T Foundation Reinforcing Steel Stucco Mesh or Exterior Siding L.-0 /41 et) kfd-L Excavation and Forms Insulation C%/! / / fj"/) 41 JC. Slab Grade 1 i 1 16 %�D'-/J L, Sewer • '2/3//4/ "G/:/t-- Ground Plumbing Soil I U 2_3 ,-l./L Interceptor ✓' v v Ground Plumbing Water 2 I23lq(e cy." L, Septic Tank Underslab Ducts Leach Line or Seep Pit - Underslab Conduit Water Service / _ Underslab Gas Lath or Drywall Nailing 6/71//e14, 0.4/t/L Fireplace Foundation Gas Line Air Test S--/ 717 � c/v Joists and Girders Final Energy ` • ' r , re f 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 X ^ / Fireplace Bond Beam , , Final Off Site Improvements / / \ / Roof Sheathing /Sher p 141 I Icii.C, /911.) , ,s/b Final Dedication ,VAI„ / 1 /1\) / Framing and Ventilation / Final Zoning \n4 r-/ I / / Roof Covering Vr Final Electrical 1"I / v / Rough Heating I -I,n ," IA ((/ Final Gas -' I / / Service and Ground IA 11 41Z /)U �i Developer Fees Paid / I Rough Electrical " / jfryi, v Fire Dept. Approval Verified // Bonding / LJv 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 61 - I-1 - 960 5115 L__0-( rH i.j I"t 4- CITY OF C1 1O lULLS COMMUNITY DEVEL©PMENT DEPARTMENT BUILDING AND SAI=ETY DIVISION IPERMIT # . - r k.,.„- ins action Ceti(909)590-1511 Ext.282 before 3:00 m.for next day p POST IN A SAFE, CONSPICUOUS PLACE AT FRONT OF JOS. , PROVIDE PERMIT NUMBER WHEN CALLING FOR INSPECTION, OVER PON JOB AT TIME OF INSPECT . HAVE A LAN j 7b4..) j f ��J •A E OWNER' ,. w. ;J ► .I, cc\ I LOCATION 'i _ INSPECTION_. ..... ,. _. �. ,....... . .... ., .: , RECO PATE INSPECTOR INSPECTION ' Selbacidt.ocation Temporary Power i FoundationVReinlorcing Steel `��`�O Slab Grade l t;1 r>' Ground Plumbing /171/ f6' Underslab Copper 2,'z-5 4t 4 Undersiab Conduit/Ducts . - Fire-plate Foundation 1 Joists and Girders Electrical Ground DO NOT CONCEAL UNTIL ABOVE ARE SIGNED AND DATED - First Bond Beam/Lilt • Final Bond BeamiLllt Fireplace Bond Beam _ i Roof Sheathing 1,/ ✓f/.454; } Shear I r/ ° r Framing and Ventilation / • / / , . Rough Heating I i ate/ D f Electrical Service and Ground 1 , I / It�� f Rough Electrkal _ le II ' / t."l} 7 Plough Plumbing t./ �tr /r Shower Pan/Tub Test V l i a Stucco Me Ertergaidire I t/,/�'gf r � , Fire Sprinklers I 4..0- ' --ebb NOT CONCEAL UNTIL ABOVE ARE SIGNED AND DATED 'Insulation 10714}l. Sewer Septic Tank 1 i Leach Line or Seep Pit f • Water Service I DO NOT CONCEAL Bell: UNTIL ABOVE ARE SIGNED Interior talk oiLIZrywail Na .. Gras Line Air et <// 4 Gr j '� Final Grading - j Final Electrical I Final Plumbing i `s Final Healing/A.C. I Final Zoning/Conditions of Approval + _ - Final Fire(Call Local Fire Dept.) ' J Cy'--f 4C RV Final Building ! . - Certificate of Occupancy I . NOTICE TO OWNER! Call for FINAL inspection on every job. This permit will expire it work is suspended or abandoned fora 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..