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Permit No. 0405 3C APPLICATION FOR A _DING PERMIT AND A CERTIFICATE OF USE & j CY ' CITY OF CHINO HILLS A-pit)s / ./o; .oar BUILDING /3V,3(0 ` /1 f�. 6n917 i/j Drr. CLEARED BY APPLICATION TYPE NO. E ADDRESS v r�(Q V/�/ ((�[f� O LOT 59 BLOCK TRACT 13651-2 6i a OWNER THE FOLLOWING WORK IS AUTHORIZED BY THIS PERMIT: The Fieldstone Company A ADDRESS 145 s. State College Blvd. , #660 ❑STRUCT, 0 PLUMB. C MECH. 0 ELECtm �t to an' Brea ZIP 9 2 6 21 m 990-3006 TYPE OF PROJECT {J NEW G ALTER 0 ADDITION ARCHITECT/ LIG NO. 0 REPAIR 0 CONVERT 0 DEMO 0 OCCUPANCY PMT. ENGINEER Hales-Langston \ ADDRESS 3 111 N. Tustin Ave. , #230 PROJECT LOCATION ON \ DESCR�Y ION PROPERTY lir D.FEET a1Y Orange ZIP 92665 PH. 283-1770 YOI�454 \ �. T�0"Tf1AC1OR Same 'as Owner ucua 402826 '' /'1 'F '( V I I 1 , 493• ' ADDRESS 2 toN° 5TOeV I I 1 ,356 art ZIP PH. 1 (,9F' 1 E I I 555 CITY BUSINESS UCENSE REMARKS i SPECIAL CONDITIONS I PROJECT DESCRIPTIONNZ . UCENSE Nn EXPIRATION DATF UCENSED CONTRACTORS DECLARATION ZOL(N it 4- (_Q .3.4*`5 L r' `A S s I h:" licensed under provisions of Chapter 9(commencing with Section 7000 d „ Division J d the :I'1 '` •v'f,v,'" • s Cow and my Ranee b In lull force and effect. I'l/Y0 411/4° �� Dar • Convector ' v r.. CD CITY AND ZIP PHONE Pt-e2 10.- CONSTRUCTION LENDING AGENCY Ilisofe. I hereby allirm that, era . for the performance d the work lot which o,� • this permit Is Issued(Sea No 1097,Civ.C)Lender's ma 6 i�"� • Lenders Address Si iis OWNER-BUILDER DECLARATION S-(-,. 5 f CILQ . I hereby," r, ,I Irom the Contractor's License Law for the Iollowing reason: - - _ - •_ 0 I,as owner of the properly,o "" - , ,:. with wages as their sale compensation,will do Pre ��j�/ work,and the structure Is not intended or 1' . , e. l/• //A" ^ �' .?i 7,.3 0 I,as owner of the property,am exclusively contracting wit' '- - •niractors to construct the '� r7 '/�AV`"C's pro)ect 0 I am exempt under Sea .BBPC for!hie reason Dale: INITIAl WORKERS'COMPENSATION DECLARATION • I hereby affirm Mel I have a certificale of consent to sell Insure.or a certlll ■ee I Wor re' Compensation Insurance,or a certified copy thereof.POLICY NO. DWP 8 0 5 6 61 7 1 COMPANY Fireman' s Fund DATE EXPIRES: 5/1/93 o Certified copy Is hereby furnished OTY VERIFIcn• Ia.(artlrled copy Is Idled with the city GROUP DIVISION TYPE Dale. APPLICANT • CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATION INSURANCE VALUATION I cart'• 1-, I , •,n once of the work for which this permit Is Issued,I shall no(employ any person In any mann. I. 1t'. K Wed to the Workers'Compensation Laws of California, . Dv': •:414,0 PERMIT FEES NOTICE TO APPLICANT II,eller making this Cantliest,of Exemption; '.I•., . ems subject to the Workers'Compensation provisions of IM Labor Code,you mual lonhwr _ . .Ith such ELECTRICAL: I STRUCTURAL `G t_47 provision or this permit shall be deemed revoked. PLUMBING: GRADING: I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT.I AGREE 10 COMPLY WITH ALL CITY ORDINANCES AND STATE LAWS.AND MECHANICAL I I$SILWCE FEES: HEREBY AUTHORIZE REPRESENTATIVES OF THIS CITY TO ENTER UPON THE ABOVE GEO REVIEW: I PLAN CHECK: MENTIONED PROPERTY FOR INSPECTION PURPOSES. ISSUANCE APPROVED: TOTAL PERMIT FEE: Slgntlure Cl Applicant of Again Date <47 -g- /2, DATE OF ISSUA / PERMIT NUM R ^ / Print Applicant's/Agent's Name //-'Z//(/r//q�� 0 j ..7J CITY OF CHINO :..ILLS _. BUIL DING ADDRESS • •J (p V I cl-a_ e' /LN. Pr. Lo . .r,is.:-'t` BLOCK TRACT 131p51-Z BUILDING INSPECTIONS RECORD OWNER THE FIELDSTONE COMPANY POST IN CONSPICUOUS 145 5.51-A1E wE-8L110. PLACE ON THE JOB ADDRESS SUITE 680 3REArCAU�CVR',X gyp02 4 CITY ZIP PH.�J/ Tl 0 // ggVV -3001 PLUMBING DATE II A%PP"R77OVEDFINSPR'S(y SIGNATURE GROUND SOIL PI I 9/15./7 I V I 4 GROUND WATER P2 !e f(p I 4 4.-.--- REMARKS TOP OUT P3 /c / j Q�_<._ - SEWER P5 1/6/1-1--P- 1� Q �,�/ -�// GAS TEST PG I S/NCO �� P1& \ L)/Lv✓yE�� LI- /V-9-3 Gam/ �-'w I/a/2 I ' ! L FINAL PLUMBING P12 I MECHANICAL DATE APPROVEDIINSPR'S SIGNATURE UNDERGROUNDIFLOOR M1 I / I ROUGH M2 17-/fr'M I Q- AIR COND. 111 I I I FINAL MECHANICAL 1112 I I ELECTRICAL DATE APPROVEDIINSPR'S SIGNATURE TEMP.CONST N.POWER E3 i.-`/7 A��U q f. f J I//�� \--- SIGNATURE J UNDERGROUNDI I ��'l� V Zj PVC-METAL•D.B.C. El ��/////�'[ Ef , ROUGH WIRING I 14/611.2 //`/!'�7 14 1 !! J RECEPT.SPACING• SERVICE-CIRCUIT E2 - I I FINAL ELECTRICAL E12 I I STRUCTURAL DATE APPROVEDIINSPR'S SIGNATURE FOUNDATION:LOCATION SI / / I /J . . REINFORCED 0 UFER ❑ I 7414 _I- L�-,7f SLAB:REINF. ..12"/MEMBRANE ❑ S3 I /6/g/i vi _ ` 40 UNDERPINNING 54 I # I MASONRY 511 I FIREPLACE 511 I ROOF HEAIHG I Z/C/91 I �"e , ROOF SHEATHING S5 FRAMING 56 I /�`,./J 3 SNSULATION OUND/ENERGY 57 1.7,-///r/f/ 7 I AT) ' LATH EXTERIOR SB I 7/7</.4,31 4 (- V LATH INTERIOR/GYPBOARD S5 I Z/23 A 3I 6- 1 I I I I APPROVEDTURF q'S DATE OF ISSUANCE PERMIT NUMBER SIGNATURE BUILDING FINAL 512 1 V,'/y/'9.3 I . .-7.,...___ l 9116Z, 64.0 CITY OF CHINO I LS i ADDRESS / 573(7Y V J 3 f&. V I l/1/L//IC- !� LOT �q , BLOCK TRACT 131v51_2 BUILDING INSPECTIONS RECORD OWNER THE FIELDSTONE COMPANY POST IN CONSPICUOUS 145 5.5TAlt COU.EGEBLVD• PLACE ON THE JOB ADDRESS SUITE 660 nnA—CAU�N � E t CITY ZIP PH.7i ..%'7 U':+L 0. PLUMBING DATE / APPROVEDIINSPR'S i ' . SSIIGNNATTUURE GROUND SOIL P1 I ///fir/i171 ("i T/ GROUND WATER P2 I C if)/6A 2—I 4 , .e_-- l TOP OUT P3 I � I REMARKS ISEWER P5 I/a/'L, (I_ I 4 I GAS TEST P6 I I I I I I FINAL PLUMBING P12 I I I MECHANICAL DATE APPROVEDANSPR'S SIGNATURE UNDERGROUNDIFLOOR MI I I ROUGH M2 I I AIR COND. M1 I I I FINAL MECHANICAL M12 I I ELECTRICAL DATE APPROVEDANSPR'S SIGNATURE TEMP.CONSTN.POWER E3 I I UNDERGROUND PVC•METAL-D.B.C. El I I . • ROUGH WIRING RECEPT.SPACING. SERVICE.CIRCUIT E2 I I . I I FINAL ELECTRICAL E12 I I STRUCTURAL DATE APPROIEDIINSPR'S. /SIGNATURE FOUNDATION:LOCATION SI I / / �< REINFORCED 0 UFER 0 1 �r1 ' SLAB:REINF. 0 MEMBRANE 0 S3 I ,,, 1,/e9-21 . :7e___ UNDERPINNING S/ I I MASONRY Sit I I FIREPLACE S11 I/6/ZZ I Cle--- ROOF FRAMING I I ROOF SHEATHING S5 • FRAMING S6 I I INSULATION I I SOUNDIENERGY Si LATH EXTERIOR SB I I LATH INTERIORIGYPBOARD S9 I I I I 1 I SIGNATUREAPPNSPR'S DATE OF ISSUANCE PERMIT NUMBER BUILDING FINAL S12 I I s •