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Permit No. 5910 City of Ci►•..,no Hills APPLICi. _ON FOR BUILDING PERMIT Community Development 2001 Grand Avenue Chino Hills,CA 91709 Building Address: Proposed Use - St No. 1976 Street VISTA DEL SOL RESIDENCE APN 1032-561-17 THE FOLLOWING WORK IS AUTHORIZED BY THIS PERMIT Lot 80 Block Tract 13906-5 ZI Struct. ®Plumb. l Mech. El Elect. ®Grading Applicant BROCK HOMES Type of Project St No. 201 Street E SANDPOINTE ®New ❑Alter ❑Addition City SANTA ANA Zip 92707 Phone 714-556-4663 0 Repair ❑Convert. ❑Demo ❑Occupancy Permit .--..Project Location on Size Owner BROCK HOMES ___ Description I Property I in Sq.Feet St No. 201 Street E SANDPOINTE -tj City SANTA ANA Zip 92707 Phone 714-556-4663 1. LIVABLE I 11820 Engr/Arch Lic No. Z• GARAGE I 1565 St No. Street 3• PATIO I 148 ...--- City City Zip Phone 4. I I kms* Contractor REMARKS/SPECIAL CONDITIONS/PROJECT DESCRIPTION "\ BROCK-HOMES Lic No. 54648 Sewer I Min. Depth I S/F/too I Size St No. 201 Street E SANDPOINTF 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 -1 7000 of Division 3 of the Business and Professions Code)and my license is in full force and o (� effect. I License Class n ' License Number 54648 _ .� c Date Contractor SAME AS ABOVE Address _ City and Zip Phone Owner Builder DeclarationC. i I hereby affirm that I am exempt from the Contractor's License Law for the following reason: E1 I, as the owner of the property, or my employees with wages as their whole 1 compensation, will do the work, and the structure is not intended or offered for sale. DI, as owner of the property, am exclusively contracting with licensed contractors to �- - �� m- V - construct the project. ------------------------ 0 .. . . . ... ❑ 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: Zoning I Land Use 1:3a. 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 for which this permit is issued. Setbacks I Model/Plan Lib. 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 (ThisTdection need not be completed if the permit is for one hundred doolars($100)or less). $1 14,741.00 �- U 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 provisio Electrical $200.20 Structural $913.44 JL-76 _ Data Signature Warning: Failure to secure workers' compensation overage is unlawful, nd 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 Issuance $68.82 $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 $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 purposes. n DC t, -zc WI - �6 �6 - JDate Issued I 01,-- Permit Number Signatureof4, plicant c61�(g�r t Date ( j rx-) 646 6/9 R-Ll, 03/07/96 5 910 v ,V FINANCE CODE CENSUS CODE__./ \\ Print Applicant's/Agent's Name C4 1(11 :,.JJNSTRUCTION LENDING AGENC' . I HEREBY AFFIRM THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS.ISSUED1 (SEC.3097,CIV.C.). LENDER'S NAME LENDER'S ADDRESQ 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. 0 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. 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;! IIS .❑IS NOT SUBJECT TO THE APPLICABLE REQUIREMENTS OF THE HEALTH AND SAFETY CODE AND THE LOCAL AIR QUALITY AGENCY. BUILDING INSPECTIONS RECORD I DATE I INSPECTOR I I PANE INSPECTOR • Setback/Location I I , /I /,(//I'Rough Plumbing I e.I'-//76 I [Z (-) Temporary Power I 1 I b(/" I , a Shower Pan Test I Foundation Reinforcing Steel I , I I4Y I A 1J.Z I Stucco Mesh or Exterior Siding 14hy-m<co ) Excavation and Forms I H V I p.x Insulation I _A./4/' c, Slab Grade I/ I Sewer_ .� Ground Plumbing Soil 73724/i . _ _AA, 4,77.... Interceptor Ground Plumbing Water 13/z4 I4k, I/r 414 i/ TL Septic Tank Underslab Ducts Leach Line or Seep Pit Underslab Conduit Water Ste^ - /_ J. UnderslabGas Lath Drywall N_______:_-ailing ai g 4/71/771. I C��� Fireplace Foundation I Gas Line AtT-T-est- `7/3/9`p I a'. w Joists and Girders I Final Energy A 1 // .Electrical Ground Final Plumbing P U.U/' I n 117/ Mid-Height Bond Beam Final Heating/A.C. I / I Fr/8-Foot Bond Beam Final Construction AI�/ I7 Final Bond Beam Final On Site Improvements t('7 I / Fireplace Bond Beam / i _-� Final Off Site Improvements I/ V Roof Sheathing 417/14M k7 , jam _ Final Dedication I Framing and Ventilation / 7 Final Zoning _I Roof Covering I ii.i / / I Final Electrical I�V------ I / 11��- Rough Heating vitro/ ) / I Final GasE . !...c..-:--- I Service and Ground -` Ute/ I Developer Fees Paid 7 Rough Electrical / / Fire Dept. Approval Verified I--7//k/4-4a. 1_,A/, /Z.-- Bonding Certificate of Occupancy I Over Head Electrical I I Fence Height I I IGates I Heater I I I I Pool Drainy ge ,_ I I I I ¶/22/1' a`tU %' 572 z/g6 d2,,,o,/ SA - /70 7//,f/f6 - _1� a' ,. a, • -1- . SEPTIC TANK GALS. SEEP. PIT X LEACH LINE. WIDE LONG X DEPTH OF ROCK N. W. E. S. Inspector's Signature and Initials ,, p DATE OF ISSUANCE PERMIT NUMBER 139oto • Lo ,C CITY OF CHINO HILLS I—I I 0 CI3 COMMUNITY DEVELOPMENT DEPARTMENT BUILDING AND SAFETY DIVISION PERMIT # yn Call (909) 590-1511 Ext. 282 before 3:00 p.m. for next day inspection POST IN A SAFE, CONSPICUOUS PLACE AT FRONT OF JOB. PROVIDE PERMIT NUMBER WHEN CALLING FOR INSPECTION. HAVE APPROVED PLAN$ON JOB AT TIME OF INSPECTION..] OWNER ge-fj �� DA 7/ / /g LOCATION i /(l) ' / •��� I( '1 � INSPECTION RECORD INSPECTION I DATE I INSPECTOR Setback/Location 4, / ; Temporary Power ; 10.1 Foundation/Reinforcing Steel `"1 �i i Slab Grade Ground Plumbing Underslab Copper 3tz,et19 , L Underslab Conduit/Ducts Fireplace Foundation Joists and Girders Electrical Ground DO NOT CONCEAL UNTIL ABOVE ARE SIGNED AND DATED First Bond Beam/Lift I Final Bond Beam/Lilt I Fireplace Bond Beam Roof Sheathing I ca41/ 76.) Shear C/7;114110 t� Framing and Ventilation I X Rough Heating „/� Electrical Service and Ground L� G )(7V Rough Electrical I` ' v Rough Plumbing Shower Pan/Tub Test Stucco Mesh or Exterior Siding I �7-7/6 <6�v Fire Sprinklers DO NOT CONCEAL UNTIL ABOyE ARE SIGNF DATED Insulation I Liz./Pic. I /9e Sewer I I Septic Tank I I Leach Line or Seep Pit I I _ Water Service I '//Z'J/ ''� I Lk/— I I V DO NOT CQNcEAL UNTIL AAO),T ARE SIGNED AND DATED • Interior Lath(or Drywall Naiiir!g_.,I 6/7/46, Gas Line AirelTJ I 1/ / Final Grading Final Electrical A Final Plumbing 1414/ Final Heating/A.C. I� Final Zoning/Conditions of ApprovalF Final Fire(Call Local Fire Dept.) 17-./Q-.96 I • Final Building Certificate of Occupancy i Ir— 1 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 COMPLETED.