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Permit No. 8071 City of -Ino Hills APPLICATION FOR BUILDING PERMIT Community Development 2001 Grand Avenue Chino Hills,CA 91709 Building Address: Proposed Use - St No. 2072 Street VISTA DEL SOL LATTICE PATIO COVER APN 1032-561-05 THE FOLLOWING WORK IS AUTHORIZED BY THIS PERMIT Lot 68 Block Tract 13906-5 Q str.>ct. l]Plumb. TIMOTHY L SALTER 0 Mech. Q Elect. 0 Grading Applicant 0 New ❑Alter El Addition St No. 15489 Street OAKSPRINGS RD Type of Project City CHINO HILLSZip 91709 Phone 597-9536 []Repair Q Convert. ❑Demo ❑Occupancy Permit ` Owner MARTY GONZALEZ Project I Location on I Size 2072 VISTA DEL SOL Description Property in Sq.Feet St No. Street I I City CHINU HILLS Zip 91709 Phone 606-9751 1. PATIO 288 Engr/Arch Lic No. 2. I I St No. Street 3. I City Zip Phone 4. I I Contractor TIMOTHY L SALTER 669847 REMARKS/SPECIAL CONDITIONS/PROJECT DESCRIPTION Lic No. Sewer I Min. Depth I S/F/100 I Size St No. 15489 Street OAKSPRINGS RD City CHINO HILLS Zip 91709 Phone 597-9536 Cubic Yards Excavation Fill Over Excavation City Business License License No. 1825 Expiration Date 6/30/97 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 B License Number 669847 Date 4/30/97 Contractor SAME AS ABOVE 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: ... mD I, as the owner of the property, or my employees with wages as their whole • 4 ! compensation, will do the work, and the structure is 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: Zoning Land Use ❑a. I have and will maintain a certificate of consent to self-insure for workers' PD 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 ❑ b. I have and will maintain worker's compensation, as required by Section 3700 of the FY I SY 5,10 LaborCode, for the performance of the work for which this permit is issued. My worker's Ry 15 I SSY compensation insurance carrier and policy number are: Ins. Co.: Group/Division/Type Policy No: Exp Date: VALUATION This dection need Y6e completed if the permit is for one hundred doolars($100)or less). $3,456.00 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 Califomi and agree that if I should become subject to the workers' compensation provisio Section 3700 of the Labor Code. I shall fort/y{/piithhh comply with those Electrical I Structural $75.60 pr " ions. n y/J `. J(I t/ " Date Signature �----W --\../ v ' r Warning: Failure to secure workers' compensation coverage is unlawful, and shall subject an Plumbing Grading employer to criminal penalties and civil fines up to one hundred thousand dollars($100,000), in addifinn t•' tt•r - .,-. -'f ^ompensation, damages as provided for in Section 27(l- -° ',-t'..Labor Code, mtei::>.,aru 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 ApprovedTotal Permit Fee to enter n th above mentioned property for inspection Dc I $104.60 puc ems, y . 3/t 1 A-4-- Date Issued I Permit Number Signatu'? 'of"Applic fint or\Agent Date 3/11/97 8071 Print Applicant's/Agent's Name FINANCE CODE C4 CENSUS CODE 0/S • x • ,_ .ONSTRUCTION LENDING AGENCY I HEREBY AFFIRM THAT THERE ISA CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT_'3ISSUED (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. O 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 OIS OIS 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 I INSPECTOR Setback/Location Rough Plumbing I I Temporary Power Shower Pan Test Foundation Reinforcing Steel Stucco Mesh or Exterior Siding Excavation and Forms 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 Fireplace Foundation Gas Line Air Test Joists and Girders Final Energy Electrical Ground Final Plumbing Mid-Height Bond Beam Final Heating/A.C. • I _ 8-Foot Bond Beam Final Construction r�I Ice (�,J� CJJ// Final Bond Beam Final On Site Improvements Fireplace Bond Beam Final Off Site Improvements Iheathing / , ) Final Dedication (Fram{nand Ventilation •. //Yj/') /./t} Final Zoning Wag-Covering r Final Electrical Rough Heating Final Gas Service and Ground Developer Fees Paid Rough Electrical Fire Dept. Approval Verified 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