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Permit No. 8950 City of C—2no Hills APPLICATIC FOR BUILDING PER IT Community Development 2001 Grand Avenue Chino Hills,CA 91709 Building Address: Proposed Use •—_----'- St No. 2037 Street VISTA DEL SOL RETAINING WALL APN 1032-561-32 THE FOLLOWING WORK IS AUTHORIZED BY THIS PERMIT Lot 95 Block Tract 13906-5 El Struct. 0 Plumb. Applicant MALINS POOLS 0 Mech. 0 Elect. 0 Gradina St No. 5135 Street EDISON #4 Type of Project El New 0 Alter 0 Addition City CHINO Zip 91710 Phone 628-8734 0 Repair 0 Convert. 0 Demo 0 Occupancy Permit Owner;EP RPDROGUEZ Project I Location on I Size St No. 2037 Street VISTA DEL SOL Description Property in Sq. Feet City CHINO HILLS Zip 91709 Phone WALL I 1375 Engr/Arch Lic No. z. I I St No. Street • 3. I I City Zip Phone 4. I I Contractor MALINS POOLS Lic No. 438874 REMARKS/SPECIAL CONDITIONS/PROJECT DESCRIPTION St No. 5135 Street EDISON #4 Sewer I Min.Depth I S/F7100 I Size City CHINO Zip 91710 Phone 628-8734 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 fun force and effect. License Class C-53 License Number 438874 'W Datc 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: L] I,as the owner of the property,or my employees with wages as their whole compensation, will do the work,and the structure is not intended or offered for sale. ri 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 alty of perjury one of the following declarations: Zoning Land Use Da. I ha nd will maintain a certificate of consent to self-insure for workers' compensation as provided Section 3700 of the Labor Code,for the performance of the work for which this permitweiSetbacksZoning ModeVPlan FY I sr b. I have and will maintain worker's compensation, as required by Section 3700 of the I SSY I LaborCode, for the performance of the work for which this permit is issued. My worker's RY compensation insurance carrier and policy number are: P f Z • Group/Division/Type Ins. Co.: deo`/D-S C/ 75 Policy No: `7- j- 47 —7 Exp Date: VALUATION $4,500.00 Ells dection need not be completed if the permit is for one hundred doolars($100)or less). PERMIT FEES c.I certify that in the performance of the work for which this permit is issued. I shall not employ any person' 'r y manner so as to become subject to the Workers'Compensation Laws of California Electrical I Structural $86A0 and ag that if I should become subject to the workers'compensation provisions of Section 3700 oft Labor Code. I shall forthwith comply with those provisions. E-- Dar. ) 7'. Signature ^onc" - Plumbing Grading Warning: Faure to secure wureers•compensation coverage is unlawful,and shall subject an employer .• to criminal penalties and civil fines up to one hundred thousand dollars($100,000),in addition to Mechanical Issuance $29.00 the cost of compensation,damages as provided for In Section 3706 of the Labor Code,interest,and • Idegwrq Bat 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 and state..-laws and hereby authorize representatives of this City Issuance Approved 1 Total Permit Fee to en r u son the above mentioned property for inspection DC $115.40 P" z,. Date Issued Permit Number Signature of Applicant or Agent Date ✓` 7,7) sm� 6/24/97 8950 �� • FINANCE CODE CENSUS CODE Print Applicant's/Agent's Name C4 0/S f TONSTRUCTION LENDING AGENCII. I HEREBY AFFIRM THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED (SEC.3091,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. O 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 WILL3NOT.EMPLCO 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: 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 Temporary Power Shower Pan Test Foundation Reinforcing Steel 1-/-9'j 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 Grourl'd Final Plumbing Mid-Height Bond Beam Final Heating/A.C. 8-Foot Bond Bean Final Construction 9-11 Final Bond Beam 7 - Sj'-' 7 7 Final On Site Improvements Fireplace Bond Beam Final Off Site Improvements Roof Sheathing Final Dedication Framing and Ventilation Final Zoning Roof Covering 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. Y-:j-a-.3-•,•-jar`•-.- -.... • S. Inspector's Signature and Initials �] DATE OF ISSUANCE PERMIT NUMBER