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Permit No. 6280 City of L,41ino Hills , APPLI ,TION FOR BUILDING PER - Community Development r . 2001 Grand Avenue / , Chino Hills,CA 91709 Building Address: Proposed Use - St No2029 StreeYISTA DEL SOL P SOL/SPA/GASLINE FOR BBQ APN THE FOLLOWING WORK IS AUTHORIZED BY THIS PERMIT Lot 94 Block Trace 3906-5 ®Struct. ® Plumb. ApplicantCURCIE POOLS :7 Mech. ® Elect. ❑ Grading St No.1311 StreetN JEFFERSON Type of Projec5 New ❑Alter ❑Addition CitPIAHEIM Zif82807 Phorik14-528-5571 L Repair ❑ Convert. ❑Demo ❑ occupancy Permit Owne.'ANET MOXHAM Project 1 Location on I Size Description Property in Sq.Feet St No2029 StreeVISTA DEL SOL pool I I Cit HiNO HILLS Zii91709 Phone 597-5535 Engr/Arch Lic No. 2. I I St No. Street 3. I I City Zip Phone 4. I I ContractorCURCIE POOLS Lic Na312973 REMARKS/SPECIAL CONDITIONS/PROJECT DESCRIPTION ' Sewer I Min. Depth I S/F/100 I Size 'f\ St No3 311 StreetN JEFFERSON CitANAHEIM Zi192807 Phoe14-528-5571 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 LA effect. License Class C-5B License Number312973 1.1 Date ContractoAMF AS ABOVE C- 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: I-7 I, as the owner of the property, or my employees with wages as their whole 4. 1 compensation, will do the work, and the structure is not intended or offered for sale. UI, as owner of the property, am exclusively contracting with licensed contractors to construct the project. LII am exempt under Sec.____,B&PC for this reason DatP Initial Workers' Compensation Declaration IIhyereby affirm under penalty of perjury one of the following declarations: Zoning I Land Use I1a. I have and will maintain a certificate of consent to self-insure for workers' PD compensation as vfded. by Section 3700 of the Labor Code, for the performance of the work for w ' his permit is issued. Setbacks I Model/Plan . I have and will maintain worker's compensation, as required by Section 3700 of the FY20 I SY 5,5 I LaborCode, for the performance of the work for which this permit is issued. My worker's RY15 I Ii compensation insurance carrier and policy number are: SSY Ins. Co.: OL..-E,t) Group/Division/Type Policy No: AAV/(° .2-9 9 k • Exp Date: —/—9 7 VALUATION (This dection need no)be-completed if the permit is for one hundred doolars($100) or less). $..5,000.00 , Ellc. I ce ' that in the performance of the work for which this permit is issued. I shall PERMIT FEES 2lony person in any manner so as to become subject to the Workers' Compensation alifornia and agree that if I should become,subject to the workers' compensation s of Section• 3700 of the. Labor Code. Ihall forthwith,comply with thosens. �J/ ' Electrical $90.00 Structural $302.40 Date a- /f� _Signature hIJ i - Warning: Failure to secure workers' compensation coverage is unlawful, and shall subject an Plumbing (.o.00 Grading 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 $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 and state.laws and hereby authorize representatives of this City Issuance Approved I Total Permit Fee to e -r upon the above mentioned property for inspection )C $427.40 pu '•ses. I v / L"----'',2" �� Date Issued Permit Number Signature of Applicant or Agent Date 5/2/96 6280 /airv,4- 7---CRR 4-/VO/6- FINANCE CODE CENSUS CODE Print Applicant's/Agent's Name C4 329 / .. �,)NSTRUCTION LENDING AGENCI ,� I HEREBY AFFIRM THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS i.,dUED (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- HE-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 QERMIT• ❑IS•..DIS NOT SUBJECT.,TO THE APPLICABLE REQUIREMENTS OF THE HEALTH AND SAFETY CODE AND THE LOCAL AIR QUALITY AGENCY. BUILDING INSPECTIONS RECORD OJATE INSPECTOR DATE INSPECTOR Setback/Location c//z/4/ `p C- Rough Plumbing Temporary Power ShowerPan Test _ Foundation Reinforcing Steel _�/,-,/z ....27,7--) Stucco'Mesh or Exterior Siding • Excavation and Forms //G,,„ v Insulation Slab Grade Sewer. . Ground Plumbing Soil Interceptor Ground Plumbing Water Septic Tank Underslab Ducts Leach Line or Seep Pit Underslab Conduit Water Service Underslab Gas Lath or Drywall Nailing V------ Fireplace Foundation Gas Line Air Test 11 Ip. di Joists and Girders Final Energy }s,.-----7- 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 Beam Final Off Site Improvements Roof Sheathing Final Dedication Framing and Ventilation Final Zoning / Roof Covering Final Electrical 7,% hr:‘ „d' Rough Heating Final Gas Service and Ground , , Developer Fees Paid / :) Rough Electrical 7/2,3,/' G 1/ Fire Dept. Approval Verified UA 11 ) Bonding 5//V2(.0 / ( Certificate of Occupancy /1 17 'l Over Over Head Electrical ✓ 1 r (I I Height /„}1111 . //—/ Y y� i li I 11 '1(11 ' Gates 2 14 r \ ) I I qII' I// '` � Heater I 1, 1 I ILI” Pool Drainage I I S/ /d/ �C CY—e_. ee//v N.o 4- .0 --/VIE /1/10 ./ / c - c//7/yt 0 ie C-vn/$ c--vZ2 i t L. .-ae_Lx TSG? 77-454, — V�(Ce_tomb 4,fv. / . 1 ' /1 L�%,/ 7:--,,i,47(...._ 1/7 g/9'� 'V. ,l-r�/ - SEPTIC TANK GALS. �/ / / / n SEEP. PIT x (_;/L�l �11�1/�� /�7 / �O I- )oz-i..... /.r LEACH•:LINE WIDE . ; ..�"�17V• �`T�-.�J�1�,//!J� I—� � - �j'`Y,d✓` LONG X DEPTH OF ROCK u N. W. E. S. Inspector's Signature and Initials • DATE OF ISSUANCE PERMIT NUMBER TRIAr) TRIAD GEOTECHNICAL CONSULTANTS INC. Soils Engineering • Engineering Geology • Environmental Engineering 17231 EAST RAILROAD STREET, SUITE 100, CITY OF INDUSTRY, CA 91748 TELEPHONE(818)964-2313 FAX(818)810-0915 NOTICE OF .40--e INSPECTION 4gio- Fitc-ervzsbe JOB LOCATION cZ0c9 //ALC -Y JOB NO.94- 02Y6 DATE OF INSPECTION S--/6 CLIENT/OWNER ArTrel. CLIENT'S ADDRESS f?// DESCRIPTION OF AREA INSPECTED: . , ..� 'cg.c r , wc. , rsr 44;4 L ,Zt-e, A-4,e 4/70--r - "4(45,4 &-e-err-e--4,14-4-e-A)V V JOB SUPERINTENDENT: INSPECTED BY: i P4, Lai SIGNATURE SIGNATUREC66- SO a.